OSCE IN PAEDIATRICS

A 15 month old boy brought to Oni

Memorial by his mother. He
weighed 6.3kg but no other
symptoms. Physical examination
showed him to have edema of the
legs, hyper- and hypo-pigmented
skin and thin friable reddish hair.
a. What is he suffering from?
b. Which age group is most commonly
affected?
c. Name 2 causes for hepatomegaly in
this child
d. Skin and hair changes are constant
features of the disease. T/F
e. Hypothermia is a complication of
this condition. T/F
f. Muscle wasting is a prominent
feature of this condition. T/F
 Answer
a. Kwashiorkor
b. 1 – 3 years(2-3yr)
c. Fatty infiltration(steatosis), oedema
d. F (They are common not constant)
e. T
f. T
The infant felt floppy when handled by the nurse.
a. Name 5 causes of such floppiness.
b. What characteristic sign is seen.
 ANSWER
a. Cerebral lesion:bilirubin
encephalopathy,B.A,[Link],[Link]
itis,[Link]:hypercalcemia,hyper
magn,hypocalcm,[Link]:
DMD,MD,cong muscular D. Peripheral
nerve: GBS,DM,hypothyroidism,Vit B12 def,
drug [Link],INH. NM jxn:
MG,botulism. Spinal cord lesion:polio
b. Head lag
a. Name 3 clinical
abnormalities visible in
this 9 month old child
b. What is the likely cause of
this abnormalities?
c. What is the treatment of
choice?
d. List 3 investigations
e. List 4 complications of this
condition
 ANSWER
a. Abdominal distension, dilated abdominal
veins, jaundice
b. Biliary atresia
c. Hepatico-enterostomy
d. Serum bilirubin, Duodenal intubation,
Rose-Bengal test, Liver biopsy, USS
e. Portal HTN, Cholangitis, Cirrhosis, GI
bleeding
 Biliary Atresia
a. Is an acquired condition
b. It is the commonest cause of liver related
deaths in childhood
c. Results in pale stools and dark urine
d. It is associated with situs inversus
e. Kasai procedure is required within the
first 60 days of life
 ANSWER
a. T
b. T
c. T
d. T (The congenital type)
e. T
This child presented with 3 months
history of progressive malaise,
weight loss and nocturnal cough.
The swelling was first noticed
one month after the onset of
symptoms. Examination
revealed an unwell child with an
enlarged inflamed right tonsil
but no other abnormality.
a. What is the most likely diagnosis
b. Name 2 investigations that may
be useful.
c. List 4 differential diagnosis.
d. Mention 4 drugs used in the
management and 2 side effects
of each
 ANSWER
a. TB Adenitis
b. Mantoux test, Chest X-ray, Excision Biopsy
c. Pyogenic adenitis, Fungal infection, Hogkins
Lymphoma,
d. Rifampicin – hepatotoxicity, discolouration of
all body secretions
Ethambutol – Optic neuritis, hepatotoxicity
Isoniazid – peripheral neuritis, Hepatotoxicity
Streptomycin – ototoxicity, nephrotoxicity
a. What abnormal physical
sign is demonstrated?
b. What is the treatment
of choice?
c. Name 5 associated
findings on
examination?
 ANSWER
a. Enlarged head, setting sun sign
b. Extracranial shunt(Ventriculo-peritoneal shunt/
Ventriculo-atrial shunt)
 OFC (large for age), hypotonia, craniofacial
disproportn(broad forehead dwarfing the face),
Sutural diastasis (widely separated sutures)
 “Cracked pot” note on percussion of the skull
(Macewen sign). The anterior fontanelle is
wide open and bulging.
 The scalp veins are dilated and prominent.
 A 5yr old child presented with high
grade fever and convulsion
CSF analysis result shows: a. Result is suggestive of viral
CSF glucose – 20mg/dl meningitis
RBG – 80mg/dl b. Result is suggestive of
WBC count -10,000/mm3 pyogenic meningitis
Neutrophil – 60% c. The CSF blood sugar is
Lymphocyte – 40%
normal
d. Partially treated
meningitis is suggested
e. Dexamethasone is
indicated
 ANSWER
a. F
b. T
c. F
d. F
e. F
This baby has nephroblastoma
a. The peak age incidence is 18
months.
b. Hypertension is a rare finding
c. List 4 differential diagnosis of
this condition
d. List 5 associated congenital
anomalies.
e. Chemotherapy is mainstay of
treatment in this environment.
 ANSWER
a. F (3-4years)
b. F
c. Neuroblastoma, rhabdomyosarcoma,
Poycystic kidney disease, hepatoblastoma
d. Hypospadias, cryptorchidism, aniridia,
beckwith-wieldeman syndrome, cystic kidneys,
urecteric abnormalities, Hemihypertophy,
deletion of chromosome 11
e. F (Sugery – nephrectomy is mainstay)
 Concerning diarrhea

a. If greater than 5 days is persistent diarrhea.

b. Enteroinvasive E. coli causes secretory
diarrhea.
c. G. lambia is associated with acute watery
diarrhea.
d. Commonest bacteria cause is shigella.
e. Dextrose is an appropriate solution for
rehydration in cases of severe dehydration.
 ANSWER
a. F
b. F (EIEC causes dysentery)
c. T
d. F
e. F
 Ambigous genitalia is a feature of
a. Fragile X syndrome T/F
b. Turner’s syndrome T/F
c. CAH, 21 hydroxylase deficiency T/F
d. Edward’s syndrome T/F
e. Pseudohermaphroditism T/F
 ANSWER
a. F
b. F
c. T
d. F
e. T
Examine this X-ray film;
And make a diagnosis.
a. There are cavitatory lesions
T/F
b. List 2 extrapulmonary signs.
c. List 5 clinical features the
patient can present with.
d. List 6 complications of the
condition
 ANSWER
Diagnosis:- Lobar pneumonia

a. F
b. Conjuctivitis, otitis media
c. Cough, breathlessness, fever, chills, dyspnoea,
chest pain, pustules, absesses in the body
d. Heart failure, empyema, atelectasis,
pneumothorax, pyopneumothorax, pleural
effusion, pneumatocele, Acute respiratory
failure, septicaemia, subcutaneous
emphysema
a. What symdrome is
demonstrated
b. The mode of
inheritance is
autosomal dominant.
T/F
c. It is commoner in
females
d. List the components of
the syndrome.
 ANSWER
a. Prune Belly Syndrome
b. F
c. F
d. Deficient/Absent ant. Abdominal wall,
undescended testis, hydronephrosis.
 Extrahepatic biliary atresia:

a. is less common in premature or small-for

gestational age infants than in full term infants
b. causes yellow colouration of the urine from birth
c. is a disorder unique to infancy
d. hepatic portoenterostomy reduces mortality if
performed by 14 weeks of age
e. portal hypertension is present in almost all
cases at the time of initial surgery
 ANSWER
a. T
b. F
c. T
d. F
e. F
Radiograph of a 10 yr old boy who
presented with shortness of
breath which had become
progressively worse over 48hrs.
a. What abnormality is
demonstrated
b. Name 3 possible causes
c. Answer T/F
- the child’s chest is hyperresonant
on percussion
- Lung aspiration is required to
make a diagnosis.
- Pneumothorax is a complication
- Percussion note on the affected
side is hyperresonant.
- Tactile fremitus on the affected
side is increased.
 ANSWER
a. Left Lower lobe opacity (Lt Pleural effusion)
b. Tb, Neoplasm, lymphaticobstruction,
pneumonia, Heart failure,nephrotic syndrome,
Liver cirrhosis
c. i. F
ii. F
iii. F
iv. F
v. F
a. The mode of inheritance is
autosomal dominant.
b. Bone pain crisis is a
common complication of
the condition.
c. The condition is protective
against all forms of
malaria infection
d. They have impaired xylose
absorption test.
e. The patients require folic
acid and ferrous sulphate
supplement for life.
 ANSWER
a. F
b. T
c. F
d. T
e. F
Study this paediatric lab request of a 3 day old male on admission
in SCBU on account of LBW, prematurity

Time of collection: 8.30am Concerning this child

a. An urgent EBT is required
PCV – 30%
b. ABO incompatibility is a
G6PD assay – normal likely diagnosis
Bilirubin – c. Blood culture is indicated
total – 15mg% d. Prompt phototherapy will
congugated – 0.1mg% prevent the need for EBT
e. Peroxide haemolysis test is
indicated
 ANSWER
a. T (bcos of the anaemia)
b. T
c. T
d. F
e. F (Indicated only in conjugated
hyperbiliubinaemia)
The baby in the photograph is 2
days old.
a. Name the condition being
treated?
b. What treatment is he
receiving?
c. Describe 2 clinical features of
kernicterus other than
jaundice
d. Name 2 potential long term
sequelae of kernicterus.
e. List 4 complications of the
procedure.
f. Two contraindications to the
procedure.
 ANSWER
a. Neonatal jaundice
b. Phototherapy
c. Opisthotonus, hypotonia, Chronic encephalopathy: CP,
sensori-neural deafness
d. Mental retardation, CP, sensori-neural deafness
e. insensible water loss -Dehydration, Diarrhea,
Conjuctivitis, increased, bronze baby syn, overheating
or chilling, hyperpigmented skin, optic or retina nerve
damage. Hypocalcemia.
f. Conjugated hyperbilirubineamia-to prevent d risk of
bronze baby syn, infant with copious eye discharge
whose eyes cannot be covered, infant wt porphyria.
 Viral hepatitis:

a. type B is caused by a RNA virus

b. the host immunological response may be
ineffective, in type A, leading to chronic infection
c. hepatitis D virus occurs in conjunction with
hepatitis A, B and C
d. viral hepatitis type E may be transmitted by
blood transfusion
e. appearance of anti-HBe indicates recovery and
protection from re-infection
 ANSWER
a. F
b. F
c. F
d. F(hepatitis A & E: faeco-oral)
e. F (marker of acute HBV)
Identify the instrument
shown
a. List 3 uses of the
instrument.
b. 5 complications of its
use
c. How many drops using
this instrument makes
1ml
 ANSWER
a. IVF, TPN, Drugs
b. Fluid overload, Thrombophlebitis, Air
embolism,
c. 60 drops
 Petit mal epilepsy
a. More commonly present in adolescents
b. Has a characteristic EEG appearance
c. Seizures usually persist to adulthood
d. Can be precipitated by hyperventilation
e. It is associated with loss of tone and falls
f. are more prevalent in girls
g. are not associated with post-ictal states
h. are the most common generalized seizure type
below 5 years of age
i. are typified by a 3 per second spike and wave
discharge pattern on an EEG
 ANSWER
a. F
b. T
c. F
d. T
e. F
f. F
g. T
h. F
i. T
 Hyaline membrane disease is:
a. more common in girls than boys
b. less likely in infants of a diabetic mother
c. less severe in babies whose mothers are
given steroids immediately before birth
d. characterised by respiratory acidosis and
hypoxia only
e. is treated with supportive therapy only
 ANSWER
a. F
b. F
c. F
d. F
e. F
A 3 yr old boy presented with high
grade fever and sore throat
a. Neuritis is a delayed non-
suppurative complication
b. It t is caused by Group B β-
haemolytic streptococcus
c. Mastoiditis is a suppurative
complication of this condition
d. IV penicillin V is the drug of
choice in management
e. List 3 investigations that will aid
in making a diagnosis
 ANSWER
a. F
b. F (Group A β haemolytic streptococcus)
c. F
d. F (Penicillin V is ONLY given orally)
e. Throat swab, Blood culture, FBC
Congenital cardiovascular disease
a. Incidence is 1/1000
b. Patients require antibiotics 3 days before
dental treatment.
c. Is increased in maternal thyrotoxicosis
d. Is associated with karyotype XO
e. VSDs account for about 20% of
congenital cardiac defects.
 ANSWER
a. F
b. F
c. F
d. T
e. F
Identify the instrument
shown
a. In which procedure is
the instrument used.
b. List 5 indications for
the procedure
 ANSWER
A 4-way tap
• EBT
• Neonatal jaundice (unconjugated),
severe anaemia, toxic poisoning, SCD
esp in CVD, Septicaemia, DIC,
hyperbilirubinemia, hemolytic dx of the
newborn.
 Retinoblastoma
a. Is the second most common eye tumour of
childhood
b. All bilateral cases are inherited in autosomal
dominant trait
c. Unilateral cases are never inherited as
autosomal dominant
d. The gene for the trait is a tumour suppressor
gene
e. Chemotherapy is associated with secondary
bone tumours.
 ANSWER
a. F: most common pry ocular malignancy
of childhood.
b. F: hereditary form & sporadic
c. F: AD-mostly bilateral
d. T: mutation on the long arm of
chromosome 13
e. F: involving the bone marrow
This is the blood film of a 3yr old
who presented with high
grade fever, convulsion and
Loss of consciousness
a. Hyperglycemia is a common
complication of treatment
b. Splenomegaly may be
present
c. Chloroquine is the first line
drug
d. CSF analysis is not necessary
in diagnosis
e. Persistent neurologic deficit
in >15% of cases
 ANSWER
a. F
b. T
c. F
d. F
e. F
 Congenital nephrotic syndrome:

a. is most common in Finland

b. is inherited in an X linked recessive
fashion
c. is associated with a small placenta
d. is associated with raised alpha-feto
protein in amniotic fluid
 ANSWER
a. T
b. F (Mode of inheritance is AR)
c. F (Large placenta)
d. F
A normal 6 month old infant can

a. Hold its head steady

b. Always has a Moro reflex
c. No longer have a plantar grasp reflex
d. Can pick up an object between thumb
and finger
e. Show hand preference
 ANSWER
a. T
b. F
c. F
d. F (7 months)
e. F
 Study this lab request report of a
3yr old child.
• Na+ - 122mEq/l a. There is hyponatremia
• K+ - 2.2mEq/l b. Patient may have paralytic
• Cl- - 86mEq/l ileus
• HCO3- - 14mEq/l c. IV dextrose and insulin is
beneficial
d. Serum HCO3- is normal
e. Report is in keeping with
gastroenteritis in a
malnourished child
 ANSWER
a. T
b. T
c. F
d. F
e. T
A 3 yr old boy presented at
OTECHEW
a. What is the most likely
cause of the swelling
b. What are the associations
of the swelling?
c. TB is a differential T/F
d. List the components of
tumour lysis syndrome
e. Jaw X-ray is diagnostic. T/F
 ANSWER
a. Burkitt’s Lymphoma
b. Translocation 8:2, 8:14, 8:22; EBV
infection; chronic malaria infection
c. T(abdominal TB)
d. Hypocalcemia, hyperphosphatemia,
hyperkalemia, hyperuricaemia, Metabolic
acidosis, hypoglycemia.
e. F(histology_hallmark of diagnosis)
 The following are contraindications to
immunization

a. Prematurity
b. Previous history of pertussis infection
c. Family history of adverse reactions
following immunization
d. Child’s mother is pregnant
e. Child of HIV +ve mother
 ANSWER
a. F
b. F
c. A
d. F
e. F
 Children with acute laryngotracheo
bronchitis (croup):

a. have a barking cough

b. should be allowed home with stridor at
rest
c. may benefit from oral dexamethasone
d. can be reassured that it will not re-occur
e. should inhale steam at home
 ANSWER
a. T
b. F
c. T
d. F
e. T
This 10yr old girl presented with a
swelling in the neck.
a. She may develop features of
heart failure
b. Digital clubbing may be found
on examination.
c. An emergency thyroidectomy is
indicated
d. She has bilateral proptosis
e. Anti-thyroid drugs may effect a
cure.
 ANSWER
a. T
b. T
c. F
d. F
e. F
Acute severe asthma is associated
with:
a. an inability to talk
b. pulsus alternans
c. a PEFR that is 70% of predicted (or the
child's best)
d. Presence of cyanosis
e. an absence of wheeze on auscultation
 ANSWER
a. T
b. F
c. F
d. F
e. F
a. Which structure in the neonatal
skull is being examined?
b. Which pair of bones form the
boundaries to this structure?
c. If the skin over this structure is
sunken, what would you suspect?
d. If the skin over this structure is
tense, what would you suspect?
e. At what age does the structure
usually close?
f. What is the term given to a
subperiosteal haematoma of the
neonatal skull
g. What clinical feature is
pathognomonic of this?
h. List 2 complication of the above
condition (question f)
 ANSWER
a. Anterior fontanelle
b. Frontal and Parietal
c. Dehydration
d. Raised ICP
e. 18 months
f. Cephalhematoma
 Urinary tract infection:

a. is more common in males in the neonatal period

b. in childhood is more likely to be due to
ascending infection.
c. gram negative Escherichia coli is the most
common organism in Ibadan.
d. scarring is more likely to occur if there has been
a delay in treatment
e. an ultrasound is the best way of detecting renal
scarring
 ANSWER
a. T
b. T
c. F
d. T
e. T
a. Pseudocholinesterase drug
might be of help in
management
b. Neostigmine is both
diagnostic and therapeutic
c. Severe cases can be life
threatening
d. Infants of affected mothers
can develop a transient
disease
e. There is in adequate
acetylcholine molecules at
the Neuromuscular jxn.
 ANSWER
a. F
b. F
c. T
d. T
e. F
 HIV positive children:
a. may receive live measles vaccination
b. may receive live oral polio vaccine
c. should not receive BCG immunization
d. may receive meningococcal A & C
vaccines
e. may receive yellow fever vaccine
 ANSWER
a. T
b. F
c. T
d. T
e. F
A 2 yr old boy with 2 wks
history of catarrh,
sneezing preceding this
cough.
a. What is the diagnosis
b. 4 differential diagnosis
c. On lateral radiograph of
the neck, what sign can be
seen.
d. What is the mainstay of
treatment.
 ANSWER
a. Laryngotracheobronchitis
b. Acute epiglotitis, Laryngeal diphteria,
foreign body in airway, Retropharyngeal
abscess
c. Subglottic narrowing
d. Humidified Oxygen therapy
 The following are true of a metabolic
alkalosis in children:

a. it may be caused by potassium deficiency

b. may occur in pyloric stenosis
c. often requires treatment with up to 1 mmol
of potassium per kg over 24 hours
d. is best treated by giving 10 per cent
dextrose and added potassium chloride
e. is associated with an altered conscious
state
 ANSWER
a. T
b. T
c. F
d. F
e. F
a. What abnormality is seen in this
picture.
b. what are the X-ray findings.
c. List 4 differentials of this condition.
d. What is the normal recommended
daily allowance for Vitamin D.
e. Surgery (Wedge osteotomy) is
done in the first year. T/F
f. Measurement of the
intermalleollar distance is
required. T/F
 ANSWER
a. Rickets, genu varum
b. Cupping, lipping, widening, fraying, irregular
end of bone- champagne/wine glass
appearance
c. Blount’s disease(tibia vara) -Retardation of
growth plate or trauma on medial side of
proximal tibia bone, physiological variation,
idiopathic, familiar
d. 400 – 800 IU/day
e. F
f. T
 Congenital adrenal hyperplasia:

a. neonates with 21-hydroxylase or 11-beta-

hydroxylation have abnormally high testosterone
levels
b. 21-hydroxylase and 11-beta-hydroxylase are
cytochrome P450 enzymes
c. cortisol is produced in the zona glomerulosa and
aldosterone in the zona fasciculata
d. in 21-hydroxylase deficiency, salt-wasting is
related to the severity of the genetic mutation
e.
 ANSWER
a. F
b. T
c. F
d. F
 Hepatitis A:

a. humans are the only host

b. there is no specific treatment
c. splenomegaly occurs in the majority of
patients
d. is an uncommon cause of childhood
jaundice
e. fulminating hepatitis occurs in 15%
 ANSWER
a. T
b. T
c. A
d. F
e. F
Identify the condition
shown.
a. It is a sex linked
disorder.
b. It is an acquired
condition.
 ANSWER
Ambiguous External genitalia
a. F
b. F
c.
a. Has autosomal recessive
inheritance
b. There is speech defect if
mother starts to talk to
child early
c. If not treated early,
malnutrition could be a
complication
d. It predisposes to chest
infections
 ANSWER
a. T
b. F
c. T
d. T
 DEPARTEMNT OF
PAEDIATRICS OOU
TH
ON LINE ZOOM APP BASED OSPE MAY 2020.
[Link] the ECG tracin
g shown
A. Causes include serum po
tassium of 3.8mmol/L
B. Causes include serum po
tassium of 2.2mmol/L
C. Causes include serum po
tassium of 7.2mmol/L
D. Digoxin therapy is indica
te
E. Iv Calcium is essential in
management.
ECG shows ST Depression
a. F
b. T
c. F
d. F
e. F
2. Concerning this radio
graph
A. Hb electrophoresis is essential
in management.
B. May cause limp and leg-length
discrepancy
C. The Mandible may be affecte
d.
D. Regular blood transfusion ther
apy has been demonstrated be ef
fective in treatment
E. Chronic osteomyelitis of the hi
p joint is a differential.
[Link] the tes
t kit
A. It’s a rapid diagnostic set
B. The result shown always indic
ate an active infection when P
fHRP-2 test kit is used
C. If It contains monoclonal anti
bodies against parasite lactate
dehydrogenase then its specifi
c for p. falciparum
D. PfHRP-2 test kit has ability to
differentiate live from dead o
rganisms
E. Sensitivity of PfHRP-2 test kit i
s 96.9% for parasite densities
>100 parasites/µL
a. T
b. F
c. F (pfHRP-2 is specific for p. falciparum
d. F
e. F
4. Concerning the 10 yea
r old lower limbs shown

A. The incidence is 1 in 3,600 liv

e born infant boys
B. Walking is often accomplished
at the normal age of approximat
ely 12 month
C. Common presentations in tod
dlers does not include delayed w
alking, toe walking & developme
ntal delay.
D. 20–30% have an IQ > 70.
E. The usual serum of creatinine
Kinase concentration is 15,000-3
5,000 IU/L
[Link] Picture shown is that of
a 4 weeks old infant with ten
der right breast mass and fever
A. Definitive diagnosis is that of
congenital gynecomastia
B. Breast abscess should be enter
tained
C. Majority caused by S. aureus
and anaerobic bacilli (bacteroi
des)
D. Causes include hot fomentati
on
E. Non accidental injury should
be entertained.

A. T
B. T
C. T
D.
E.
[Link] following are fals
e concerning the appar
atus shown
A. Its an Incentive respirom
eter
B. It assesses the functions o
f the lungs
C. Prevents lung pathologie
s like Pneumonia
D. Does not help in lung ex
pansion but increases fun
ctional residual capacity.
E. Prevents Atelectasis

a. T
b. T
c. T
d. F
e. T
 7. Centrifuged C
SF of a neonate
who had HIE
A. Infant likely died from Neo
natal Meningitis
B. Xanthochromic CSF indicat
es IVH
C. Maternal Tetanus vaccinatio
n is important
D. TFUSS is the best form of i
maging
E. Could be complication of C
orticosteroid therapy.

a. F
b. T (Xanthochromia is used to describe pink, orange or yellow
CSF supernatant
c. F
d. F (MRI should be the best ?)
e. T?
8. About this neonate pi
cture.
A. Its painful
B. Can persists for two mon
ths
C. Common treatment is w
ith sliver nitrate
D. Excision and application
of absorbable hemostatic
material is an option
E. Results from exuberant g
ranulation.
Umbilical granuloma: occurs when the raw
surface of umbilical cord persists more than 2
weeks
a. F (painless and harmless)
b. T
c. T (or copper nitrate)
d. T
e. T
9. About the picture sh
own
[Link] syndrome is
a differential
[Link] than 90% will
have complete recov
ery
[Link] result from ins
trumental delivery
[Link] anesthesia is
a risk factor
E. It may be congenital
a. T
b. T
c. T
d. T (Epidural slows down birth process,
causing prolonged labour that
predisposes to birth trauma
e. T
 10. Concerning the instr
ument shown
A. Sizes from left to right ar
e : 24G, 22G and 20G
B. Can be used in emergenc
y management of pneu
mothorax
C. Smallest size not shown i
s 28G
D. Parts include bushing an
d wings
E. Useful in management of
gross ascites
a. Yellow 24, blue 22, pink 20
b. T
c. F (26G Violet is the smallest size)
d. T
e. F
 OSPE
OOUTH DEPT. OF PA
EDIATRICS OOUTH
1. Concerning this radi
ograph?
A. Macrosomic babies are at
risk
B. Features on the radiogra
ph suggest infant is >one
week old.
C. Second commonest of bi
rth injury
D. Infant will need surgery t
o correct malunion
E. Likely secondary to non-
accidental injury
[Link] the
radiograph display
ed
A. History of recurrent b
lood transfusion is ess
ential
B. History of trauma to
the left hip is essential
C. Osteomyelitis is a stro
ng consideration
D. Limb length discrepan
cy will not be appare
nt
E. Tuberculous arthropat
hy is a strong differen
tial.
[Link] this photogra
ph
A. Avitaminosis is a strong diff
erential
B. Cyclosporine use should be
excluded
C. Caused by stimulatory actio
n on gingival fibroblasts, resulti
ng in accelerated synthesis of c
ollagen
D. occurs in 90% of patients tr
eated with phenytoin.
E. Surgical treatment is the mai
nstay.
[Link] this rash
?

A. Random blood sugar de

termination is essential
B. Neuralgia is unusual in.
C. Leukopenia is typical du
ring the first 72 hr. after on
set of rash
D. Anti viral therapy does
not prevent post herpetic n
euralgia
E. Use of corticosteroids in
the treatment of herpes zos
ter in children is
recommended
 [Link] of a one
week neonate
A. Leukocytosis is found in a
bout 90%
B. Regional Adenopathy is se
en in 50% of cases
C. Septic arthritis is a possible
complication
D. Acute post streptococcal g
lomerulonephritis is a com
plication in older children
E. Topical treatment is accept
able for localized disease
[Link] this neon
ate, the following are fal
se?

A. Immediate Karyotyping is
mandatory
B. Congenital virilizing adrena
l hypoplasia should be ente
rtained
C. Mothers exposure to exoge
nous or endogenous andro
gens during pregnancy shou
ld be sought
D. 21-hydroxylase deficiency is
a strong differential
E. Potassium sparing diuretics i
n pregnancy are implicated
[Link] this midlin
e mass that moves with t
ongue protrusion?

A. Declining school perfor

mance is important part
of history.
B. Its congenital
C. TSH is increased
D. Free T3 is reduced
E. Excision of mass is thera
peutic
[Link] following are t
rue concerning the co
ndition shown
A. Secondary to growth plate softening
B. Child could present with Dilated Cardi
omyopathy
C. Stridor is a form of presentation
D. Normal PTH when due to Vitamin D d
eficiency
E. Prevention possible with administrati
on of 400IU of Vitamin D to infants
[Link] the pi
cture shown
A. Flang sign is positive.
B. Hypokalemia is an unusua
l finding.
C. Excess iron is converted to
ferritin.
D. Brain parenchyma affectati
on is irreversible
E. Refeeding is associated wit
h severe Hyperphosphate
mia.
[Link] following are n
ot true concerning the
ECG tracing

A. Abnormality could be nor

mal in children
B. Hyperkalemia is a commo
n cause
C. Digitalis toxicity could be
a cause
D. Seen in hypothyroidism
E. Not seen in pericarditis
OSPE PRACTICE
APRIL 2021
FOCUS
Concerning the portra
yed clinical photograp 1
h
a. The condition is pri
marily cause by epid
ermophyton
b. The child will have p
ermanent alopecia
c. Is predominantly se
en in both pre-and
post-pubertal childr
en
d. Fluconazole is a dru
g of choice
e. Wood lamp examin
ation of lesion will r
eveal yellow fluores
cence
The clinical photo
graph is that of a s 2
ix months old infa
nt

a. It is not a recognized
sequelae of perinatal
asphyxia
b. Spasticity is unusual
c. Disorders of amino a
cid is a recognized pr
edisposing factors
d. There is evidence of
visual axis disorder
e. Patient may present
with sustained ankle
clonus
 3
Concerning the condi
a. A pale colour of sclera i
tion sign
s a possible evident
b. Early infection enter th
e hepatocytes
c. May be prevented by m
ebendazole
d. Is a rare condition in ou
r country
e. Primary attack is charac
terize by Periodical par
oxysms of chill and foll
owed by fever
The red blood cell indices
of a five-year-old are proje
cted
4
• PCV 27g
%
a. The MCV is nromal
b. The MCH is abnor
mally low • MCV 72fl
c. The MCHC is norm
al
d. The blood film may • MCH 25pg
show target cells
e. Thalassaemia is a p
ossible differential
diagnosis
• MCHC 27%
 The following are true
about the vaccine bein 5
g administered

a. It is live attenuated
b. It is contraindicated in HI
V exposed infants
c. A common side effect is d
iarrhoea
d. It should be stored in the
fridge at 4-8oC
e. A dose is 2 drops
 Concerning the activi 6
ty shown
a. Latching on is appropr
iate
b. Should commence 6h
rs after birth
c. Becomes coordinated
at 28weeks gestation
al age
d. Contraindicated in ba
bies delivered by Caes
arean section
e. Can transmit CMV
 Concerning the 7
display clinical p
hotograph
a. The most obvious clini
cal abnormality is grad
e 3/6 digital clubbing
b. There may be no assoc
iated pathology
c. Chronic hypoxia is a lik
ely causative factors
d. May be associated wit
h sickle cell anaemia
e. Can be assessed by ha
ving patient place the
ring fingers together w
ith other fingers exten
ded
 8
Concerning the projec
ted radiograph

a. It is a renal angiogra
m
b. The condition eviden
t is not compatible w
ith life
c. Surgery is a treatmen
t options
d. Ectopic kidney is a dif
ferential diagnosis
e. It is unusual an incid
ental finding
The clinical photograph is t
hat of eight years girl 9
a. The condition evident does
not confer life-long immunit
y
b. The condition evident is cau
sed by an RNA virus
c. Is of no significant morbidit
y and mortality in immunoc
ompromised children
d. Airborne is not a recognized
mode of transmission
e. Intense pruritus is an unusu
al presentation
 10
Concerning the instrume
a. nt method
Is a direct projectedof me
asuring body compositio
n
b. Unlike BMI is a relatively
accurate means of deter
mine body fat
c. It measures subcutaneou
s tissue to determine per
centage of body fat
d. It is the least accurate m
ethod for estimating body
composition
e. It measures fat levels at
specific sites around the
body
Q1: Concerning the portrayed clinical p
hotograph 11
a. The condition is reliably
diagnosed antenatally
b. The child will have prob
lem with deglutination
c. The aetiology may be m
ultifactorial
d. The defect is repair is a
multistage approach
e. it’s seen in Treacher Co
llins syndrome
Q2: concerning the clinical photograph
shown 12
a. The child will drink nor
mally
b. The Glasgow coma scal
e will be 9 and above
c. The fluid deficit should
be corrected within 4 –
6 hours
d. Nutritional assessment
is not relevant in the m
anagement
e. Not seen in children wit
h renal tubular acidosis
 Q3: Concerning the activity shown
a. Attachment is appro 13
priate
b. Positioning is approp
riate
c. Can be associated wi
th poor weight gain
d. Occurrence of racked
nipples and mastitis i
s less likely
e. Activity also enjoy by
the mother
Q4: The projected urine report is that of a three year o
ld girl, at discharge the girl should be thought

• Sugar: nil 14
a. Fluid and salt re
striction • Protein: ++
b. Daily height mo • Leucocytes: 3-4/m3
nitoring
c. Self blood press • Bacteria: nil
ure monitoring
d. Antibiotic dosag
• Nitrites: nil
e and regimen • Red blood cell casts:++
e. Uraemic sympto
ms • Culture: No growth after 4
8hours
 15
Q5: Chest radiograph of a 3 year old shown

a. Shortness of breath
is usually absent
b. Cardiac anomaly is
not an identifiable
cause
c. Further history may
reveal contacts wit
h adult with chroni
c cough
d. Surgical manageme
nt is not an option
e. There is no urgency
in its management
Q6: The upper limb of 6 weeks old infa
16
nt
a. The abnormality is in th
e right upper limb
b. Clavicular fracture is a p
ossible aetiological fact
or
c. The affected limb is ext
ernally rotated
d. Prognosis is usually poo
r
e. Malpresentation at deli
very is not a recognized
risk factor
Q7: The back of 10 year old boy 17
a. Haemoglobin genotype
is of no relevance in ide
ntifying the possible aet
iology of the condition
b. Paraplegia is an usual p
resentation
c. The child will present w
ith lateralizing signs
d. Babinski sign is extenso
r
e. Fungal infection is not a
possible aetiology
Q8: The neck of a six months old infant
18
a. The evident condition ma
inly affects children
b. The condition is a deep in
fection of the epidermis
c. Beta haemolytic streptoc
occus is not a common ca
usative organism
d. The condition is not conta
gious
e. Topical antibiotics are mo
re effective than systemic
antibiotics
Q9: The perineal region of a newborn baby
a. The external genitalia is
19
clearly that of a male
b. Abdominal ultrasound i
s not indicated in its ma
nagement
c. Enzymopathy is not a li
kely aetiology
d. Progressive masculiniza
tion will be absent
e. Treatment is not for life
 20
Q10: concerning the shown instrument
a. Its useful in patient with i
ntact gag reflex
b. It may induce vomiting in
patient
c. It impair effective deliver
y of positive pressure ven
tilation during bag-mask
d. Very useful in patient wit
h foreign body airway obs
truction
e. Appropriate size not dete
rmined on individual basi
s
OSPE PRACTICE
JULY 2021
 [Link] th
e unit shown
A. Use is limited in developing c
ountries
B. Thyroid screen for infant plac
ed under
C. Works as light emitting diode
s
D. Irradiance of 30-40 uW/cm2/n
m more effective
E. Narrow light spectrum harmf
ul
 2. Concerning t
he Hair of the c
hild shown
[Link] may be auto
somal dominant
B. Its of Parasitological imp
ortance
C. Could lead to medicoleg
al issues
[Link] hamper emergenc
y intervention.
E. Nutritional deficiency m
ay be present .
 3. Concerning t
he picture sho
wn
A. History of Seizures is essenti
al
B. History of fall on outstretche
d hand is important
C. Serum Calcium but not Phosp
horus is essential to diagnosis
D. Child may have tender expan
sion of costochondral joints
E. Child will be in Pain
 4. Regarding th
e picture Show
n
A. The woman must be the m
other of the Baby
B. Dangerous to do this at ho
me
C. It cannot substitute Incubat
or care
D. Cannot be done for babies
weighing >1800gm
E. May promote infection
5. Concerning t
he displayed ra
diograph?
A. Kveim test is mandatory
B. Serial ESR useful for monito
ring response to treatment
C. Ophthalmologic assessmen
t useful prior to treatment
D. RVS status determination is
essential
E. History of FB aspiration is i
mportant
PAED OSCE “19
 CLERKING STATION
Take a relevant history from this
child who presented with cough,
breathlessness and easy
fatigability, all of 3month duration.
(Age of Child 3years)
Diagnosis:- TOF
 CLERKING STATION
Take a relevant history from the
mother of this 6 day old child who
presented with
• Refusal of feeds
• Vomitting
Of 2 days duration
Diagnosis:- Neonatal sepsis
 CLERKING STATION
The patient is a 5 years old boy who
presented with a history of fever,
cough and catarrh all of 5 days.
Take a relevant history from his mother
Diagnosis:- Pneumonia
 CLERKING STATION
Child presented with
• yellowness of eyes &
• body weakness
of 5 days duration (Age 4years old)

Diagnosis:- Sickle cell anaemia