7. 1. What is the diagnosis?
2. What is the mutation that results in this
disease?
3. What are the three main categories of crises in
patients with sickle cell disease?
dnbpaediatrics.blogspot.in
8. Questions
1. Describe the cells
seen.
2. Name one condition
each from following
category in which these
cells are seen
a. Neurological
b. Metabolic
c. Hepatic
d. Endocrinal
dnbpaediatrics.blogspot.in
9. • What is this modality of investigation?
• Name three common indications .dnbpaediatrics.blogspot.in
10. • What is this modality of investigation?
• Name one common indication . dnbpaediatrics.blogspot.in
11. • What is the diagnosis ?
• What are the cardiac conditions associated ?
• What are the endocrinal conditions associated
? dnbpaediatrics.blogspot.in
12. Questions
1. What is the
diagnosis?
2. Give two sexual
characters in this
condition
3. Give one cardiac
condition that
may be
associated with
this condition
4. What would be
the plasma levels
of
a. FSH
b. LH
c. Testosteronednbpaediatrics.blogspot.in
14. Questions
• a. Diagnosis
• b. Commonest differential how do you
distinguish between two?
• c. Give 3 Steps of management
dnbpaediatrics.blogspot.in
22. Answers: Lab – 2 (Blood)
• All three cell lines are depressed
• Bone marrow depression
Diagnosis- Aplastic anemia
Causes
–CMV
–Hepatitis B
–HIV
Total 2 marksdnbpaediatrics.blogspot.in
23. Lab – 3 (Urine)
• Age – 9yrs
• Appearance - Turbid
• Sp Gr – 1019
• Proteins – 4 +
• RBCs – 6 to 10 per HPF, occasional RBC
casts seen
Questions
– Diagnosis?
– Causes?
dnbpaediatrics.blogspot.in
24. Answers: Lab – 3 (Urine)
• Sp Gr – normal
• Nephrotic range proteinuria
• Microscopic hematuria with RBC casts –
glomerular pathology
• Nephrotic syndrome with hematuria –
Nephritic onset Nephrotic syndrome
• Common causes – Idiopathic, SLE,
Malaria, HSP, Hepatitis B
Total 3 marksdnbpaediatrics.blogspot.in
25. Lab – 4 (CSF)
• Age – 3 days term neonate
• CSF –
– Appearance – clear
– Proteins – 10 mg/dl
– Glucose – 45 mg/dl ( Blood sugar – 80 mg/dl)
– Cells – WBC – 6/cmm pred neutros
• Questions
–What is your interpretation
dnbpaediatrics.blogspot.in
26. Answers: Lab – 4 (CSF)
• Normal CSF in a neonate
WBC 11+/-10 (90th centile-22)
• polys 2.2+/-3.8 % (90th centile- 6)
• Protein 84+/-45 mg/dl
• Glucose 46+/-10 mg/dl
Interpretation – normal CSF report Total 3 marks
dnbpaediatrics.blogspot.in
28. Answer : Lab - 5 Peritoneal fluid
• Normal value
Transudate Exudate
Sp Gr <1.016 >1.106
Protein <3gm/dl >3gm/dl
WBCs <1000/cmm >1000/cmm
RBCs <10,000/cmm Variable
Glucose = serum <serum
pH 7.4 to 7.5 <7.4
• Diagnosis
Tuberculosis
• Treatment-
ATT as per IAP consensus
Total 2 marks
dnbpaediatrics.blogspot.in
29. 1. What is the diagnosis?
2. What is the mutation that results in this
disease?
3. What are the three main categories of crises in
patients with sickle cell disease?
dnbpaediatrics.blogspot.in
30. Answers
1. Sickle cell disease
2. On the beta chain, valine is substituted
for glutamic acid at position 6
3. Aplastic crisis
Vaso-occlusive crisis
Acute splenic sequestration
1
1
1
1
1
Nathan and Oski's Hematology of Infancy and Childhood,
6th ed. 2003, pp 802-811 dnbpaediatrics.blogspot.in
31. Questions
1. Describe the cells
seen.
2. Name one condition
each from following
category in which these
cells are seen
a. Neurological
b. Metabolic
c. Hepatic
d. Endocrinal
dnbpaediatrics.blogspot.in
32. Answers
1. Acanthocytosis
2. Conditions
a. Neurological Neuroacantocytosis
b. Metabolic Abetalipoproteinemia
c. Hepatic Severe liver dysfunction
d. Endocrinal Hypothyroidism
1
1
1
1
1
dnbpaediatrics.blogspot.in
33. • What is this modality of investigation?
• Name three common indications .dnbpaediatrics.blogspot.in
34. Answer: Spots: 1
• Radionuclide bone scan
• Indication
–Metastasis
–Osteomyelitis
–Stress fracture
Total 2 marksdnbpaediatrics.blogspot.in
35. • What is this modality of investigation?
• Name one common indication . dnbpaediatrics.blogspot.in
37. • What is the diagnosis ?
• What are the cardiac conditions associated ?
• What are the endocrinal conditions associated
? dnbpaediatrics.blogspot.in
39. Questions
1. What is the
diagnosis?
2. Give two sexual
characters in this
condition
3. Give one cardiac
condition that
may be
associated with
this condition
4. What would be
the plasma levels
of
a. FSH
b. LHdnbpaediatrics.blogspot.in
40. Answers
1. Klinefelter Syndrome (47 XXY)
2. Any two
Lack secondary sexual characteristics
Infertility, azoospermia
Gynecomastia
Testicular dysgenesis
3. Any one
Mitral valve prolapse (55%)
Varicose veins (20-40%)
4. Plasma levels of
a. FSH Increased
b. LH Increased
c. Testosterone Decreased
1
2
0.5
0.5
0.5
0.5
dnbpaediatrics.blogspot.in
42. Questions
• a. Diagnosis
• b. Commonest differential how do you
distinguish between two?
• c. Give 3 Steps of management
dnbpaediatrics.blogspot.in
43. Answers
• PSVT
• Sinus tachycardia - there is beat to beat
variability.
• Vagal manoeuvres:
– Carotid Massage
– Ice packs over face
– Valsalva manouver
• Adenosine drug of choice. 4 marks
4 marks
dnbpaediatrics.blogspot.in