Zbg

ABG1
• pH 7.28
• PaCO254mmHg
• PaO2 45mmHg
• HCO3 29mEq/L
• Base excess +7
dnbpaediatrics.blogspot.in

What are the-
• Abnormalities? 1
• Diagnosis? 1
• Likely causes? 1

ABG 2
• pH 7.57
• PaCO2 22mmHg
• PaO2 156mmHg
• HCO3 18mEq/L
• Base excess -8

What are the-
Abnormalities? 1
Diagnosis? 1
Likely cause? 1

ABG 3
 pH 7.32
 PaCO2 30mmHg
 PaO2 70mmHg
 HCO3 12mEq/L
 Base excess -8

QUESTIONS
 ABNORMALITIES 1
 DIAGNOSIS 1
 LIKELY CAUSES 1

ABG 4
 pH 7.60
 PaCO2 21mmHg
 PaO2 65mmHg
 HCO3 24mEq/L
 Base excess +2

ABG 5
 pH 7.36
 PaCO2 70mmHg
 PaO2 75mmHg
 HCO3 35mEq/L
 Base excess +14

ABG 6
 pH 7.52
 PaCO2 47mmHg
 PaO2 80mmHg
 HCO3 30mEq/L
 Base excess +3

ABG 7
 pH 7.14
 PaCO2 54mmHg
 PaO2 55mmHg
 HCO3 14 mEq/L
 Base excess -7

ANSWERS

–Low pH, high PaCO2, low PaO2, high HCO3
–Uncompensated respiratory acidosis with
hypoxemia
–RESPIRATORY FAILURE (pneumonia, RDS)

• High pH, low PaCO2, high PaO2, low HCO3
• UNCOMPENSATED RESPIRATORY
ALKALOSIS WITH HYPEROXIA
• Hyperventilation with high FiO2

• Low pH, low PaCO2, normal PaO2, low
HCO3
• UNCOMPENSATED METABOLIC ACIDOSIS
• SHOCK, RENAL FAILURE

• High pH, low PaCO2, normal PaO2,
normal HCO3
• UNCOMPENSATED RESPIRATORY
ALKALOSIS
• HYPERVENTILATION (BRONCHIAL
ASTHMA)

• Low pH, high PaCO2, normal PaO2, high
HCO3
• COMPENSATED RESPIRATORY
ACIDOSIS
• VENTILATED INFANT WITH TUBE
BLOCK

• High pH, high PaCO2, normal PaO2, high
HCO3
• UNCOMPENSATED METABOLIC
ALKALOSIS
• VOMITING, PYLORIC STENOSIS

 Low pH, high PaCO2, normal PaO2, low
HCO3
 UNCOMPENSATED RESPIRATORY AND
METABOLIC ACIDOSIS
 INFANT ON VENTILATOR WITH TUBE
BLOCK & SHOCK

Observed Station 1
DRUG COUNSELLING
• 4 yr old boy weighing 15 Kg , diagnosed
as Nephrotic Syndrome to be started on
steroids.

1. Introduces self/ puts the child
and attendant at ease. 0.5
2. Explains the disease in simple words 0.5
3. Explains the medication
– Dose 0.5
– Frequency 0.5
– Relationship with meals 0.5
4. Explains side effects
– GIT 0.5
– Steroid effect 0.5
5. Explains monitoring of response
– Urinary output 0.5
– Body weight 0.5
6. Asks for queries if any. 0.5
7. Advises to report back if any problems. 0.5
8. Advises about pain abdomen 0.5
(Total marks 6.0)

Observed Station 2
DRUG COUNSELING
• A 8yr old boy, weighing 30 kg, diagnosed
as DM Type I requires 30 units insulin/day,
in two divided doses ,combining short and
intermediate acting insulins.
Counsel regarding administration.

1. Introduces self & puts child and 0.5
attendant at ease.
2. Explains the problem in brief. 0.5
3. Familiarizes the attendant with the injectables 0.5
and the syringes.
4. Explains dose, time of injection and relationship 2.0
with meals, sites, route and rotation of sites
5. Explains the calculation of dose in ml. 1.0
6. Explains the sequence of loading (regular first). 0.5
7. Briefs about hypoglycemia incl mgt. 0.5
8. Inquires about any doubts and advises to report 0.5
back in case of any problems.
(Dose – 2/3rd before breakfast,1/3rd before dinner)
(Ratio intermediate /regular 2:1/3:1)
(Total marks 6.0)

Observed Station 3
COUNSELING
• 24 yr old lady diagnosed as HIV + at 36 weeks
of gestation. Counsel regarding perinatal
transmission and follow up.

1. Ensures the presence of husband 0.5
2. Introduces self/ puts the couple at ease. 0.5
3. Explains the disease in simple words 0.5
4. Explains the incidence and modes of perinatal
transmission
20-30% 0.5
Prenatal 0.5
Intranatal 0.5
Breast feeding 0.5
5. Explains modalities of reducing rate of transmission
ART to mother and child 1.0
LSCS Vs Vaginal delivery 1.0
Breast feeding Vs top feeding 1.0
6. Explains effect of measures – reduction by 50% 1.0
7. Explains screening of the infant 0.5
8. Explains safety of cuddling, petting and kissing 1.0
9. Asks for queries if any. 0.5
10. Advises to report back if any problems. 0.5
(Total marks 10.0)dnbpaediatrics.blogspot.in

• 4 yr old child (15Kg) ,a case of gen tonic-
clonic seizures has been advised syr
carbamezapine (100 mg/5ml).Counsel the
mother regarding administration.
Observed Station 4
Drug Counseling

attendant at ease.
3. Familiarizes the attendant with the drug 0.5
and dispenser
4. Explains dose(75 mg-3.5 ml), in 3 divided 0.5
doses
5. Advises not to miss the dose 0.5
6. Increase to (150 mg – 7.5 ml) 0.5
7. Explains side effects 1.0
8. Calls for blood counts weekly 0.5
9. Calls for serum levels of the drug 1.0
10. Advises to report in case of doubt 0.5
(Total marks 6.0)

Observed Station 5
DRUG COUNSELING
• 2 yr old child weighing 10 Kg is being
discharged after admission for febrile seizure.
Counsel the mother regarding domiciliary
management of seizure with rectal diazepam.

attendant at ease.
3. Familiarizes the attendant with the drug, 0.5
the syringe and the catheter.
4. Explains dose(3mg), and loading of the syringe 0.5
5. Explains the position of the child (lateral) 0.5
6. Explains introduction of the catheter (lubrication, 1.0
and length of introduction)
7. Explains pushing the drug 0.5
8. Advises pinching of the buttocks together after 1.0
9. Withdrawing the catheter)
10. Advises one repetition after 15 mts 0.5
11. Explains side effects 0.5
(Total marks 6.0)

THE END

Zbg

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