1- Dr. hanan/2wks with feeding problems ask about focused feeding history.
(nipple cracks)
o Ask if first child, who feeds the child
o Ask about time stays at breast and bottle
o How many times he breast/bottle feeds in a day
o Ask why she stops breastfeeding and switches to bottle
o If bottle feeds ask about formula and preparation
o Ask about number of diapers
o Ask about stool and urine and color or urine
o Infection suspicion
o Ask if the child is irritable, or crying, yellowish discoloratoin a lot or has
fever.
o Ask about diarrhea and vomiting.
o Ask about birth weight and recent weight.
o Enumerate 3 breast feeding benefits for mom/child.
2-Dr. Abdullah/18 months old with pallor and poor weight gain(iron deficiency anemia)
o Is this 1st child, any children with same issue.
o Ask about feeding
o
o What is the baby eating? (exclusive breast feeding, no solid food)
o How many time he is fed
o Is there any diarrhea or vomiting?(diarrhea with parasitic infections hookworm
causing anemia)
o Color of stool (dark stools if internal bleed)
o What is the weight of the child at birth and recent.
o Know ddx of pallor (iron def, internal bleed, ulcers d/t GERD, hookworm, leukemia
causing anemia….)
o How to treat iron deficiency.
3- Dr. Mostafa/4 years with cough, nasal discharge, fever and respiratory distress since 4
days.(bacterial pneumonia)
o Ask about time of onset of cough, nasal discharge and fever and resp. distress.
o Is the cough productive? Colour of sputum?
o Fever is continuous? Used antipyretics?
o Is this the 1st time or there is recurrence?
o How is the feeding and activity level(differentiate between bacterial or viral)
o Investigations( chest exam, take vitlas, CBC, CRP, nasopharyngeal swab/sputum culture
and CXR)CRP >100 and neutrophils are 70%→ bacterial
o When to use antibiotics? If bacterial, if severe symptoms.
4-Dr. Hakam/ neonatal jaundice in 20 days old(hypothyroidism)
o Think about prolonged jaundice causes(don’t rely on our notes only!)
o Sepsis
Ask about fever, irritability, vomiting, diarrhea and fontanelle.
o Breastfeeding jaundice/dehydration
What and how many times is the baby fed?
Birth weight and current weight
Number or diapers
o Breast milk jaundice
o Biliary atresia
o Inborn error of metabolism
o Hypothyroidism
Swollen face
Feeding
Diapers
Posterior fonatanalle
Umbilical hernia
Excessive sleeping
o Investigations (TSH and T4)
o Treatment (thyroxine)
5-Dr. Rabah/ sickle cell anemia presents with headache(stroke)
Ask history of headaches
o FAST(facial drooping, slurred speech, sided weakness)
o Photophobia
o Vison issues
o Aura
o Site
o Family hx of migraines
o Sick contact and travel hx
o Vaccinations and medications(folic acid, hydroxyurea, and penicillins)
o Diagnose it with neuroimaging (CT and MRI)
o Treat it with IV, fluids and EXCHANGE TRANSFUSION.
6-Dr. Sarrah/ (counsel parent about febrile convulsions)
What do you know febrile convulsions?
Advise about what to do during febrile convulsions and that it shouldn’t exceed the time
limit and how to spot the complex febrile seizures signs.
She asked about the possibility of recurrence.
7- unmanned station/ Rickets Xray
Describe features
Mention two etiologies
Mention 3 Clinical features (S/S)
Blood test for ( serum calcium and vitamin D or phosphate)
Treatment (sun exposure for 20 mins minimum and vit D supplement)
8-unmanned/nephrotic syndrome
Mention 3 hallmarks of nephrotic syndrome(eodeme, hypoalbuminemia and
proteinuria)
Investigations (serum albumin and urine protein quantification/urineanalysis)
Treatment (corticosteroids)
9-unnmanned/ acidosis
Interpret the values (metabolic acidosis)
Diagnosis : DKA (DM1)
Most feared complication : cerebral edema
Two biochemical changes after the initial management?
o Hyperkalemia →hypokalemia
o ?
how will you treat? Insulin, hydration
10-unnmanned/ Xray (no one knows TOF, TGA or pneumothorax)
describe xray
2 other findings out of the chest
what is the diagnosis?
Initial management?
And permanent management?
11- unmanned/ Henoch schonlein purpura(picture of red rash on buttocks)
What is the diagnosis?
What is the ddx? (HUS, Kawasaki, ITP, leukemia and DIC)
3 Other systemic presentations? (arthiritis, abdominal pain(GI bleed) and
hematuria(nephritis))
Immune mediated IgA small vessel vasculitis
mx (steroid and NSAIDs)
12-unnmanned/ down syndrome (picture) of newborn and xray of duodenal atresia
What genetic abnormalities (trisomy, translocation and mosaicism)
Clinical fearures: sandal toe, hypotonia, low set ears, up slanting eyes, Simian crease and
clinodactyly)
Complications/co-morbidities: neurosensory deafness, short stature, mental
retardation, leukemia, hypothyroidism and duodenal atresia and cardiac defects.
Diagnose the xray.
