S1

1st unprovoked generalised seizure in a 2 yr

old child

Essential investigation

Optional investigation

Treatment of choice

S2
3 months baby has intractable epilepsy
since birth and delayed development

Name 2 vitamins you can try

Does not respond to them what
investigation next

S3
Name 3 newer AEDs

Name a carbonic anhydrase inhibitor used

as AED

S4
Lamotrigine

Indication, Dose
Synergistic with?
What dosage modification done?
Life threatening side effect?

S5
Carbamazepine

Commonest side effects

Not used in
Higher derivative with advantage
Syrup strength

S6
Topiramate

2 indications
2 side effects
Contraindicated in
Tablet strength? Syrup? Any other
preparation known?

S7
SODIUM VALPROATE

Each 5ml of syrup contains

Commonest 3 side effects
Contraindicated in
Synergistic activity with
Dosage range
With Lamotrigine what precautions Are needed?

S8
A 7 year old boy presented with intermittent
abdominal pain and difficulty walking due to
painful knees. He had been previously well
except for a mild upper respiratory tract
infection approximately one week ago. On
examination he seems well but a nonblanching rash was seen on the buttocks and
the legs . The rest of the body was spared.
Q1. What is the diagnosis?
Q2. What renal complication can occur?

S8

S9
A 5 month old boy is seen because of failure to thrive. As part of
the investiagtion the following blood tests are done:
Hb 4.2 g/dl
WBC 12.3 x 109/l
Plt 211 x 109/l
Haemaglobin electrophoresis:
HbA - 0%
HbA2 - 9%
HbF - 91%
Q1. What is the diagnosis?
Q2. What are the main treatment options?

S10
A 16 month old girl is brought to a general
practice clinic due to constipation. During
the examination this raised skin lesion was
seen above the left buttock.
Q1. What is the diagnosis?
Q2. What treatment should be offered?

S10

S11
A 24 hour old baby that was born at term
presents with bile stained vomiting. The
baby has been bottle fed but it is not
feeding well. On examination the baby was
noted to have a distended abdomen. An
abdominal x-ray was performed:
Q1. What is the diagnosis

S11

S12
A previously well 10 year old boy presented to the
emergency department following a 6 hour period
of vomiting. His parents say that he has been
feeling generally unwell for the last week and has
lost some weight. On examination he is found to
have "sighing" hyperventialtion and to have a
reduced level of consciousness - only responding
to a sternal pressure by moaning. Urgent blood
tests show the following:
Q1. What is the diagnosis?
Q2. Why is he hyperventilating?

S12
Blood test results
Haematology

Biochemistry

Venous Blood Gas

Hb 17.5 g/dl

Na 136

pH 7.06

WBC 23.4 x 109/l

K 6.4

Bicarb 9.2

Plt 429

Ur 12.5

Base Excess -14.8

Cr 112
Glucose 33.5 mmol/l

S13
A junior doctor examines the first child of a
28 year old woman as part of a routine
"baby-check" prior to discharge from
hospital. The baby is 20 hours old. The
doctor notices that the baby is hypotonic
and also finds a systolic murmur on
auscultation of the heart. After further
examination by a senior paediatrician the
baby's chromosomes are analysed.
Q1. What is the diagnosis?
Q2. What is the most likely cardiac defect?

S13

S14
A 12 week old boy is admitted with a fever and
being generally unwell. He is found to have a
urinary tract infection. He is treated with antibiotics
and several weeks after the infection resolves he
has a number of investigations performed:
Q1. What kind of investiagtion is radiological
investigation 1 and what does is show?

Q2. What kind of investiagtion is radiological

investigation 2 and what does is show?

S14

S15

1. What is the
diagnosis??
2. What is the
disease

S16

What is this?
For what?

S17

Diagnosis?
Which stage??

S18

Diagnosis?
Management?

S19

Diagnosis?
Treatment?

S20
Diagnosis?
most common organism??

S20