OSCE PEDIATRICS

Respiratory

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Station 1
Appropriate active device for a passive user
i.e., a child below three years with asthma:

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Answer Station 1
Spacer with mask

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Station 2
What is the grade of asthma severity in a
child having:
Symptoms of airflow obstruction > once a
day.
Night time symptoms > once a week.
PEF 60-80% of personal best with >30%
of diurnal variation.

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Answer Station 2
Moderate persistent.

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Station 3
What would be the pulmonary score/
severity of asthma exacerbation in a 7 year
old child with a respiratory rate of 35,
terminal expiratory wheeze and mild
increase in work of breathing:

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Answer Station 3
3 (mild)

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Station 4
Name the device:

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Answer Station 4
Peak flow meter.

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Station 5
What would be the approximate normal
value of PEFR of a subject standing 120
cms. tall?

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Answer Station 5
200 Litres/min.
Formula for approximate normal PEFR for
a given height:
PEFR ( L/min) = [ ht. ( in cms ) 80] x 5

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Station 6
Spirometer is used to measure:

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Answer Station 6
Vital capacity and its subdivisions and
expiratory (or inspiratory) flow rate.

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Station 7
3 findings in this
CXR:

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Answer Station 7
Multiple fractured ribs on the right side.
B/L pneumothorax.
Air in the soft tissue of neck.
Scoliosis

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Station 8
Resistance to penicillin in streptococcal
pneumonia is mediated by:

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Answer Station 8
Penicillin binding proteins with altered
affinity for penicillin.

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Station 9
The most important indirect marker of PCP
(P. carinii) pneumonia:

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Answer Station 9
Hypoxemia (i.e., a PaO2 < 80 mm of Hg in
room air).

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Station 10
Chest radiograph findings typical of PCP
pneumonia:

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Answer Station 10
Interstitial infiltrates beginning in the
perihilar region and spreading to the
periphery. Apices spared until later in the
disease.

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Station 11
Predominant pathogenetic feature,
responsible for a broad variable presenting
manifestations and complications in Cystic
Fibrosis:

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Answer Station 11
Dysfunction of epithelial surfaces.

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Station 12
Unilateral hyperlucent lung syndrome is:
(a) also known as
(b) associated with

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Answer Station 12
(a) Swyer James syndrome.
(b) Adenovirus infecton

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Station 13
Silo Fillers disease is caused by:

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Answer Station 13
Inhalation of the oxides of nitrogen.

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Station 14
Diagnosis of Silo Fillers disease requires:

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Answer Station 14
History of entering a silo within 4 weeks (usually
within 24-100 hrs) of its being filled.
And 2 or more of following symptoms:
- dyspnoea
- wheezing
- cough
- nausea
- choking or fatigue.
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Station 15
Most common cause of lung abscess in
children:

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Answer Station 15
Aspiration of infected material

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Station 16
Pleural effusion is said to be purulent when
leukocytes are --------.

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Answer Station 16
>5000/mm3

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Station 17
Criteria for exudative pleural fluid:

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Answer Station 17
At least one of the following:
Pleural fluid/serum LDH > 0.6
Pleural fluid/serum protein > 0.5
Pleural fluid LDH > 2/3 upper limit of normal
serum values
Pleural fluid cholesterol > 55 mg/dl.
Or
pH < 7.2
Pleural fluid protein > 3 gs/litre
Pleural fluid LDH > > 200 IU/L
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Station 18
Indications for drainage in a case of
pneumothorax:

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Answer Station 18
>5% collapse
Recurrent pneumothorax
Pneumothorax under tension

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Station 19
Qualifiers of Asthma require------ episodes
of airway obstruction.

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Answer Station 19
>3

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Station 20
Assessment of lung volume is done by
counting down the anterior rib ends till:

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Answer Station 20
Middle of the diaphragm.

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Station 21
This film is:
inspiratory/expiratory
normal/overinflated

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Answer Station 21
Inspiratory with mild overinflation.
Explanation - A good inspiratory film
should have the anterior end of the fifth or
sixth rib meting the middle of the
diaphragm.

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