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Osce 2

The document presents multiple clinical case scenarios involving pediatric and adult patients with various medical conditions, including nutritional deficiencies, metabolic disorders, and respiratory distress syndrome. Each case includes questions regarding diagnosis, treatment, and laboratory findings related to the conditions. The document emphasizes the importance of identifying deficiencies, understanding enzyme functions, and recognizing symptoms for effective management.

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JAGADISH PANDA
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20 views18 pages

Osce 2

The document presents multiple clinical case scenarios involving pediatric and adult patients with various medical conditions, including nutritional deficiencies, metabolic disorders, and respiratory distress syndrome. Each case includes questions regarding diagnosis, treatment, and laboratory findings related to the conditions. The document emphasizes the importance of identifying deficiencies, understanding enzyme functions, and recognizing symptoms for effective management.

Uploaded by

JAGADISH PANDA
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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• 3 year old girl bought to OPD

having anorexia a.He is


lethargic and apathetic. Sparse
,soft and thin hair is
seen.Generalised edema is
present.Laboratory test results
were as follows Hb-6gm
%,total Protein 4gm% and
Albumin 1.5gm%

a. What is your diagnosis?


b. What is deficient here?
c.What is its treatment?
d.How this can be prevented?
e.What is seen in the skin of
these patients?
• A 24 year female who is strict
vegeterian presents with
tiredness ,weakness and numbness in
extremities.Her laboratoery
investigation show Hb -7.5gm% and
peripheral smear shows
megaloblastic cells with
hypersegmentaed nuclei

• Which vitamin is defficienct here?


• Name one enzyme which needs this
vitamin as Cofactor.
• What is the active form of the
vitamin?
• What is the RDA of the viatmin?
• What is its storage form
•A 2 year old intellectually disabled child is having blue eyes, blonde hair and
fair skin. He also have a mousy body odour.
•What is the diagnosis?
•Which enzyme is deficient here?
.Which test is done to confirm the diagnosis?
•What is synthesized by the deficient enzyme?
•What is its treatment?
A 2 year old boy presented with
fasting hypoglycemia which is not
correc,ted after epinephrine injection,
hepatomegaly doll like facies and thin
extremities.
•1.What is the diagnosis?
•2.why hypoglycemia is seen?
•3. Which enzyme is deficient here?
•4.what is the rate limiting enzyme for
glycogenolysis?
•5. why hyperuricemia is seen here?
• A 7 year old boy with
compulsive self
mutilation ,intellectual
disability. He is always
strapped to bed. Serum
uric acid is elevated/
• What is the diagnosis?
• What is the enzyme
deficient here?
• What is the reaction
catalyzed by the enzyme?
• What is the normal level of
uric acid ?
• Why uric acid is increased
here?
Q-1 CASE HISTORY
A 55yrs old man with long standing type2 DM presented with
fever, delirium & low urine output. His blood urea level
was 135mg% and urea clearance was 35ml/min.
1) What is the most likely diagnosis?
2) Define urea clearance?
3) What is the normal volume of urine/ day?
4) What is the test for reducing sugar in urine?
5) What other test you will do to assess renal function test?
CASE HISTORY 1
• A 24 months old girl has failure to thrive and unusual
gait. On examination, she has frontal bossing, bowing
of legs and swelling of costochondral junctions. Lab
results were:
• serum calcium-8.2 mg/dl,
• serum phosphorus-2.8mg/dl
• serum alkaline phosphatase is 720 U/L.
• Q1.What is the likely diagnosis ?
• Q2.What is the function of the vitamin causing
the disease ?
• Q3.What is the the most active form of this
vitamin?
• Q4.what is the most common dietary source of
this vitamin?
• Q5.What is the corresponding condition called
in adults?
Case 1:

• A 50 year old woman was admitted to the


hospital because of very rapid heart rate,
severe weakness, weight loss and
exophthalmos. She was extremely irritable
and couldn’t tolerate heat.
1. Which laboratory tests will be done for the
diagnosis?
2. Write a condition leading to this disease?
3. What changes are seen in the values of blood
sugar and cholesterol in this disease?
4. Write an autoimmune condition leading to this
disease.
5. Which amino acid is required for the production
of hormones related to this diseaese?
Case 2:
1. Write the type of PEM shown
in picture.
2. Write two preventions for
PEM.
3. In which type of malnutrition
Wt/Age < 60%?
4. Features of both wasting and
edema seen in which type of
PEM?
5. Flaky paint dermatitis seen in
which type of PEM?
Case Senario
• Preterm neonate born to unbooked mother
shows increased respiratory rate,chest wall
retractions,cyanosis,pallor .His condition was
progressively worsening and was put on
oxygen. baby is grunting .X ray chest was
showing ground glass appearance
Questions related to case
• 1.What is the cause of RDS in premature
babies
• 2.What is the major component of lung
surfactant
• 3.How to acess lung maturity antenatally
• 4.What precaution to be taken antenatally to
prevent RDS

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