The Aga Khan University Hospital

Pediatric SCU Course

FINAL EXAM TEST PAPER

Name: ___________________ Unit: _________

Date: ______________________

Total time: 60minutes

Total marks: 55

Obtained: ______

Mark True [T] or False [F] for the following (15 marks):
1. Difficulty in breathing when lying down is known as Orthopnea.
2. The apical pulse is heard at the 2nd intercostal space.
3. In diabetic ketoacidosis [DKA], the body shifts from its normal fed metabolism
(using carbohydrates for fuel) to a fasting state (using fat for fuel).
4. Extracellular fluid consists of Intravascular fluid, Interstitial fluid and
Transcellular fluid.
5. Ringer lactate, Normal saline, and 3% NaCl are all isotonic solutions.
6. CVAD are contraindicated in patients with sepsis or coagulopathy problems.
7. Hyperalimentation is given to patients via naso/oro gastric tube feeding.
8. When collecting a sample from an indwelling catheter ensure you touch the
syringe to the Urine Culture Specimen bottle to avoid spillage of urine.
9. Identifying the pediatric early warning signs does not help in decreasing
mortality.
10. In shockable V.Fibrillation or V. Tachycardia the initial manual shock is
delivered at 2J/kg.
11. An airway threat, hypoxemia, resp.distress, tachycardia and hypotension needs
activation of emergency team.
12. Postural drainage during chest physiotherapy prevents drainage of broncho-
tracheal secretions.
13. A large spleen can lower the white blood cells and platelets counts.
14. The classical sign of Croup is Stridor, in which Epinephrine nebulization and
Dexamathosone is indicated.
15. In VF the heart quiver and does not pump blood to the body.

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Choose the best answer(s) (10marks):

1. A reflex seen in newborn babies, who automatically turn their face toward the
stimulus and make sucking motions with the mouth when the cheek or lip is
touched, is called:

a) Palmar grasp
b) Tonic Neck
c) Rooting reflex
d) Moro reflex

2. A continuous sound that originates in the small air passages may be inspiratory
and expiratory but usually predominate in expiration. They are high pitched,
whistle like and are called:

a) Crackles
b) Wheeze
c) Crepts
d) Friction rub

3. Physical examination of the abdomen is done in following order:

a) Palpation, percussion, inspection, auscultation

b) Inspection, auscultation, palpation, percussion
c) Auscultation, inspection, percussion, palpation
d) palpation, percussion, auscultation, inspection

4 An EEG is a painless, non-invasive test which monitors electrical activity in the:

a) Heart
b) Limbs
c) Brain and Heart
d) Brain

6. CSF is drained through a flexible silicon tube, called a shunt, to another part of
the body where the re-absorption of this fluid can safely take place:

a) Usually the abdominal cavity

b) Usually the femur
c) Usually the Rt Ventricle
d) Usually the Archnoid layer.

7. What will be the distance for insertion of the nasogastric

tube:

a) 18cm

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 b) 11cm
c) 07cm
d) 09cm

8. In shock management we must not let the B.P fall. Which statement is correct.

a) Lower limit for diastolic BP=70+ (age x 2)

b) Higher limit for systolic BP=70 +( age x 2)
c) Lower limit for systolic BP = 70 +( age x 2)
d) Higher limit for diastolic BP=70+ (age x 2)

9. In management of shock there are (5) vital points that can save a patient’s life:

a) ABC, supplement 02 always.IV or IO access and fluid resuscitation upto

60 mL/Kg.Early dopamine infusion @10µg/Kg/min.Empirical antibiotic
& Frequent monitoring.
b) Oxygen, Antibiotics, Rest, Food, & Fluids
c) ABC, In tropes, Fluids, Rest, & Antibiotics
d) ABC, supplement 02 always.IV or IO access and fluid resuscitation upto
60 mL/Kg.Early epinephrine infusion @10µg/Kg/min.Empirical
antibiotic & Rest.

10.

a) Monomorphic Ventricular Fibrillation.

b) SVT
c) Atrial Fibrillation
d) Torsades de Pointes

Match the columns (10marks):

1. Amphoteracin B Avoid Hypertonic fluids

2. Before checking reflo clean the finger Red Man Syndrome
with spirit swab
3. Radivac Drain on Lower Wall 15 minutes vitals for 1 hour, then ½ hour for 1
Suction hour, then hourly till transfusion completed
4. Nasogastric Tube on Gravity Change after 48 hours
5. Blood Transfusion Active Drain
6. Porta cath Anti-fungal
7. Vancomycin Passive Drain
8. Continuous feeding bag Needs a needle to be inserted every time for
usage

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 9. Morphine To minimize infection
10. Diabetes Ketoacidosis 15mg/ml

INFUSION CALCULATIONS:

1. Doctor ordered to give Dopamine 12 mcg/kg/min. The wt of the child is 25kg.

a) Calculate the concentration. b) ml/hr the child is to receive. (2marks)

2. Doctor ordered to give Milirinone at 0.05mcg/kg/min. The wt of the child is 15 kg.

a) Calculate the concentration. b) Calculate ml/hr the child is to receive. (2marks)

3. Doctor order to give Somatostatin at 0.01mcg/kg. The wt of the child is 10kg.

a) Calculate the concentration. b) calculate ml/hr the child is to receive. (2marks)

4. A patient with RADS is admitted. You are to start Inj Aminophylline at 12

mg/hr. How many ml/hr will you infuse the drug at? (1 mark)

5. A patient is to receive an infusion of Epinephrine at 0.01mcg/kg/hr.

a) Calculate the concentration. b) Calculate ml/hr the child is to receive. (2marks)

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6. Doctor orders you to start an infusion of Heparin. You are to give the patient
6u/hr. How many ml/hr will the patient receive? (1mark)

7. A baby with PDA is to be give Prostaglandin infusion. At 0.05mcg/kg/min. Wt of

the child is 4kg. a) Calculate the concentration. b) Calculate ml/hr the child is to
receive. (2marks)

You are called to the bedside to evaluate a 4month old infant admitted in SCU,
having increased respiratory distress. Secondary assessment reveals the child began
having difficulty eating 2 days ago; he was a healthy term baby. He has no allergy or
medical history. He has had 2oz formula 4hours ago. And now is irritable, with
rapid breathing. Highlight what SAMPLE stands for put the data as appropriate.
(5marks)

1. S:________________________________________________________________
2. A:_______________________________________________________________
3. M:_______________________________________________________________
4. P:________________________________________________________________
5. L:________________________________________________________________
6. E:______________________________________________________________

Explain the difference between Respiratory Distress and Respiratory Failure?

(3marks)

Prepared By: Veronica Braganza Approved By: Naureen Lalani

CNI Peads B Manager, MCH
Fazal Amin, CNI Paeds A