Common Videos of previous exams

RESPIRATORY AND ENT VIDEOS

1. (RS) neonate with RD , desaturated , on O2 by nasal canula ( video show micrognathai ,

cleft palate – "pierin robin syndrome" )
- what is next intervention ?
 nasophargeal airway.
 Intubation and ventilation.
2. (RS)2 year old with 1 day history of URTI followed by stidor which is not associated with
distress and baby was crying , on his back there was capillary haemangimoa otherwise
nothing important.
- What is the most diagnosis ?
 croup
 subglottic haemangioma
3. (RS) 3 years boy with 12 hours history of cough and difficult breathing (Video show barking
cough and stridor with no RD)
- what is organism?
 Para influenza
Comment : Parainfluenza (Croup is parainfluenza virus not toxic present usually in
theearly dawn with some coryaza symptoms.)
Epiglottitis with toxic look high grade fever, there will be drooling of saliva as well
haemophlus influenza bacteria
4. (RS)Child 1 yr with runny nose and temp 37.7 c , in video barking cough
- What is the diagnosis.?
 Croup " laryngeotracheo bronchitis".
- What investigation ?
 no investigation needed
5. (RS)8 months old with noisy breathing
- What is the most likely diagnosis ?
 laryngiomalacia
 choanal atrasia...
 croup .
6. (RS) mild stridor very happy.
- what is the management?
 no need medications
7. (RS)Child with mild to moderate stridor. …..Follow up
8. (RS)poor weight gain with stridor 1 month baby,
- what is investigation ?
 flexible bronchoscopy.
Comment : indication for investigation in laryngeomylacia are : weight loss

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9. (RS)2yr h/o of TEF repair present with cough , barking cough , stridor , prolong expiration
- what investigation ?
 do nothing.
10. (RS)asthmatic patient received 3 nebs of salbutamol and atrovent and oral steroids still
wheezy saturation is around 93
- what to do next ?
 Offer oxygen
 I.v salbutamol?
 Back to back salbutamol
 mgso4-dexamesthasone-hydrocortisone-methylpredisolone
 nothing.
11. (RS) asthmatic pt. just came to ER on neb. tachypnic conscious PR 130 – SPO2 93 on
monitor
- what to do next
 nothing
 ABG
12. (RS)preterm baby distress admitted for poor feeding brother having URTI no hepatomgaly ,
systolic murmer ?
- what is diagnosis ?
 chronic lung disease.
 Bronchiolitis.
13. (RS) Acute bronchiolitis with moderate distress , with hypoxia and hypercapnia
- What to do next ?
 Ipratropium.
 NCPAP.
14. (RS)Baby with distress, NG tube insitu, Oxygen Nasal canula and coughing.......
- What is the diagnosis ?
 Bronchiolitis
15. (RS)8 months stable child with bronchiolitis.
- What next step ?
 per nasal swab .
 none of above.
16. (RS)8 year old girl/boy with cough , fever Reduced chest expansion on left side. On
auscultation diminished air entery and Bronchial breathing and dull percussion note on left
scapula area. History of 10 days fever in spite of oral antibiotics.
- What is diagnosis ?
 Left pleural effusion.
 Left lobar pneumonia
17. (RS)Chest x ray in a child boy with cystic fibrosis and with wheezes , sudden deterionation
not respond to IV antibiotics with esinophelia ...

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 - What is diagnosis ?
 allergic bronchopulmnor aspergollosis ..
- what is the ttt ?
 steriod
18. (RS)Whooping cough ..
- What is best investigation ?
 pre nasal swap
- What is ttt ?
 Azithromycine or erythromycin

19. (RS)Girl with cough with sputum persistently received erythromycin for 10 days , without
improvement
- What is next step?
 no treatment will her .
 clarithromycin high dose for 10 days.
20. (RS)Down with resp distress ... bronchilitis or heart failure ... according to history
21. (RS) Small child coughing at night
- what to do next ?
 CPAP .
 Anti reflux .
 nothing
22. (ENT) pus from external auditory meatus , in child with OM 3 days back now temp 37.4c
- what to do next ?
 iv antibiotic
 oral antibiotic.
 Urgent CT.
 Nothing
 ENT referral after 3 weeks.
 swab and Culture
comment : CT scan in perforated tympanic membrane in AOM only indicated if
there is major complication like cavernous sinus or facial nerve palsy.
23. (ENT)18 months old previously well,you have been called in ED,child sitting in mum's lap
with dummy in mouth, inspiratory stridor, and recessions, no indication of fever or drooling,
- What is the diagnosis ?
 Foreign body.
 Epiglottis,
 tracheolaryngitis,
 croup etc
24. (ENT) A case with sudden onset of stridor and cyanosis 2 years old and chest x Ray showing
coin shadow at the level of C4 ,

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 - what to do next?
 rigid bronchoscopy
 Flexible bronchoscpy
25. (ENT)child with retching and coin in CXR in last 10 sec of videos
- what to do next
 calling ENT
 calling general anesth.

HAEMATOLOGY VIDEOS

26. (haematology) Child with purpura and hx of URTI ………

- What is diagnosis ?
 ITP.
27. (haematology)Little girl with purpuric rash lTP.
28. (haematology) Child with extensive rash of ITP.
- What is Management ?
 Weekly follow up.
29. (haematology) Pancytopenia with febrile neutropenia in ill child with HGB 5
- what ur first choice ?
 IV antibiotic
 IV blood transfusion
30. (haematology )Neonate with petechae rash just after delivery baby generally well
- what action to do.?
31. (haematology)Baby with low platelet and mother was normal platelet his platelet was 2000
- What is best action?
 HPA negative platelet.
32. (haemtology )a boy 5 year old known to be haemophilea A (didn't specifiy how sever) had
history of falling and minor head trauma with picture of contusions and superficial
lacerations , but no active bleeding , baby was active smiling and calm with no history of
neither vomiting ,DCL nor haemodynamic stability.
- what to do next ?
 admission for neurological observation.
 give factor 7
 give factor 8
 factor 9
 give tranexmic acid
 just bandage.
 give cryoprecpitate
 FFP .

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 Comment : tranexmic acid is only used in Gum bleeding or idopathic ipistaxis in
haemipohilic patient but any trauma to head for haemophilc A patient it's
mandiatoryto give him factor 8 please take care because there is a voice lecture
uploaded here for one of colleagues insisting on selection of doing nothing

33. (haemtology )4 yr girl drinking milk since birth , Hb 4 gm/dl , no signs of distress , with
feature of iron def anemia ,
- what treatment?
 Oral iron
34. (haematology ) 6 weeks Child presented with general fatigue and tiredness (in video recived
bottle feeding) , Hb: 4.1 , mch 58 , normal wbcs and platelets
- What investigation ?
 Feritin level.
35. (haematology)11 years girl brought to ER by her stepfather with history of multiple bruises.
normal CBC and Coagulation profile (Video show well girl with multiple bruises in arms
and legs)
- what next action?
 Skeletal survey.
 Bone marrow .
 none of the above
 platelet function .(VWF Disease)
36. (haematology)Pt. with tracheostomy , although good care but still have difficulty with
breathing. Face of pt. with infected big haemingioma like sturge weber.
- What will do to help him ?
 steroids inhaler
 antiviral
 antibiotics ?
 salbutamol
 CPAP.

Comment : Infected cavernous hemangioma needs antibiotics for infection and

plastic surgeon input .

37. (haematology)newborn preterm multiple progressive lesions increase in size " capillary
haemgioma" in scalp , upper eyelid abdomen ?
- what is treatment ?
 oral propanolol
38. (haematology)A child with ITP and low platelet count but active ...
- What is treatment ?
 wait & observe.
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 CARDIOLOGY VIDEOS

39. (CVS)CXR of dextrocardia …….

- What is the next step ?
 Echocardiography
40. (CVS) preterm neonate with stethoscope and you could hear continuous murmur
- what is the diagnosis?
 PDA.
41. (CVS) 14 years old boy. video is record of auscultation with systolic murmur radiated to the
neck .
- What is the diagnosis ?
 aortic stenosis
- what expected complications ?
 angina .
 sudden death
42. ( CVS) young boy tall fingers and elongated face ( look like marfan) with AS murmur and
thrill over neck …
- what complications may occur ?
 Sudden death
 aortic aneurythm.
43. (CVS)Pt. with TGA sp O2 84-82% , with yesterday septostomy .
- what to do next ?
 reassure parents.
44. (CVS) Down syndrome big boy clubbed cyanosed pansystolic murmur in LLSE
- what is diagnosis ?
 Essmenger syndrome
 TOF.
 AVSD.
 Pulmonary HTN.
45. (CVS) 3 /6 months old baby on ventilator , central sternotomy scar and continuous murmur
on rt. Infra clavicular side . saturation is 86%.
- What diagnosis ?
 BT shunt.
 Fontan shunt at 3-4 yrs.
Comment : BT shunt can be through sternotomy scar , or lateral thoracotomy
scar., sat in BT shunt b/w 80-90%.
If the murmur is systolic ejection...it is not a BT shunt. Can be TOF correction
with residual murmur. But saturation should be 95% and above...Because total
correction. So the saturation is a must know.

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 ENDOCRINE VIDEOS

46. (endocrine)2 years old child sitting on a chair, trying to look around ( blind) , short
, patient came with hypoglycaemia "Case was septo optic dysplasia "
- what treatment you do ?
 increase glucocorticoid and mineralocorticoid
47. (endocrine) Obese child e striae ( cushing syndrome)
- What is Diagnostic test ?
 Dexamethazone suppression test.
48. ( ENDOCRINE) girl with chorea and thyroid eyes and very minimal bulging in the neck
- What investigations?
 TFT.
- what treatment ?
 carbimazole.
49. (endocrine) 8 years old girl with significant acidotic breathing "kaussmal breathing( DKA)"
and history of polyuria and weight loss , with abdominal pain and altered consciouseness .
- What is Initial management ?
 normal saline bolus.
- What direct cause of death ?
 cerebral oedema.
 Dehydration
 Shock.
- what to do next ?
 RBS.
 ABG
 CBC
 CXray.

Comment : blood sugar (If you did gas you will confirm acidotic breathing but still cause
is not clear ,while if u did RBS u know at least 2 out of 3 diagnostic criteria for DKA, and
by theway not all machines having glucose in it and also not availabe in lot of facilities.).

Nephrology videos

50. ( renal) Nephrotic girl anasarca ascitis effusion lower limbs edema CRT 4 high blood
pressure tahchy cardic
- what is first treatment ?
 bolus NS 10 ml/kg

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51. (renal) Girl with URTI and took amoxil for 5 days with no effect, came with B/L periorbital
swelling and Abd distension on video (nephrotic syndrome).
- What immediate investigation ?
 Urine anylasis.
 s/albumin.
 S/cholestrerol.
 USS
52. (renal) Yong girl with buffy face and LL oedema and proteinuria , Vital signs stable ...
capillary refill < 2 sec. Video show +ve shifting dullness.
- What is the ttt ?
 60 mg / m2 prednisolone daily.
53. (renal) 6 year old boy with history of atopy and asthma, and family hx. Of hay fever
developed URTI 2 days back , receive antibiotic . present with puffiness of eyes started one
day and LL edema (pitting one)
- What is the diagnosis ?
 nephrotic syndrome
 C1 estrase inhibitor .
MSS VIDEOS

54. ( MSS)2 year old stable child pain on walking .look like irritable hip.
- What is Management ?
 Discharge without follow up.
 discharge with follow up
55. ( MSS) girl with left knee swelling for one week , she is non toxic , h/o of fever , run normal
after examination
- what is diagnosis ?
 Reactive arthritis
56. ( MSS) Video show girl playing , hand showing proximal interpharngeal joints swelling and
redness , high ESR , WBCs count " JIA"
- what treatment?
 NSAID
57. (MSS)URTI in a child with joint pain & normal lab
- What is diagnosis ?
 Transient Synovitis
58. (MSS)3 yrs old with antalgic gait mom concerned about limping gait for the last 2 months
only
- What is diagnosis ?
 Perthes disease
 DDH ( appear from the start).
 Other DD of limbing gait.

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59. (MSS)Afagani/ pakastani boy about 3 yrs in age with his father ricket manifestation " bow
leg and swelling wrist "
- what is diagnosis ?
 nutritional .
 x-linked hypophsophataemic rickets.
- What investigation?
 Wrist x-ray.

60. (MSS)baby with loss pectoralis major.

- What is Diagnosis ?
 poland syndrome
61. (MSS)Pre teen boy in ED with swollen knee after a fall from tree, noted to have bruises and
healed paper this scaring of skin on video .
- What is the diagnosis?
 Ehlor Danlos syndrome.
62. (MSS)A child with joints hypermobility ,,, 2scenario
- What diagnosis ?
 Ehlerdanol syndrome (if without glasses)
 Marfan syndrome (if with glasses).
- What is mode of inheritance ?
 AD.
63. (MSS) a 3 years old child with unilateral neck swelling
- What is diagnosis ?
 Lymph Node.
64. (MSS) redness and swelling behind the ear in small child ,
- what investigation ?
 CT scan.
65. (MSS)Child had URTI then after few days abnormal swelling in sub mandibular and another
one was in midline of neck with a blue tounge and abnormal voice .
- What is the diagnosis ?
 branchial cyst
 heamangioma
 caffe syndrome.
66. (MSS)neonate with neck swelling lateral aspect of the neck
- What is diagnosis ?
 cystic hygroma
- What is complication ?
 airway obstruction
67. (MSS)Child with neck mass mainly…… torticollis.
68. (MSS)Neck swelling …. Mumps?
69. (MSS)Obese neonate with swelling in the neck ,
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 - what investigations you will do?
70. (MSS)large red swelling in rt side of neck in well child
- What is diagnosis
 Parotitis
 lymphedenitis
71. (MSS)Pt. with swelling in shaft of tibia , baby is febrile , he can stand and crawling ,not pain
full , skin is erythametous
- What is the cause of swelling?
 Fracture.
 cellulitis .
 osteosarcoma.
 ewing sarcoma.?
 oesteomylitis.
 Reassurance.
72. (MSS)a kid 2-4yrs with limping gait and swollen 1 lower limb when the swelling is pressed
the kid did not mind .
- What is diagnosis ?
 osteomyelitis Vs cellulitis?

Dermatology videos

73. (derma)Baby received MMR vaccine before 1 month came with extensive blanching
erythema (in video) . vitally stable , feeding well
- What is next step in management?
 reassurance
74. (derma) 2 weeks old baby referred by health visitor with skin lesion ( Video show just Rt
hand with bustules (boil) and erythema ).
- What is it ?
 Epidermolysa Bulosa.
 Pustules.
 Boils .
 herpes .
 staph infection
75. (derma ) Small child with peanut allergy. Clinically stable. But hives and itching.
- What is Management ?
 oral antihistamine
76. (derma )2 year old baby who developed allergic wheels after ingestion of antibiotic with no
other signs of distress nor haemodynamic instability
- what to do ?
 dexamethasone.
 hydrocortisone.
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  methylpredesolone.
 oral chlorophenramine-
 oral predisolone.
 send home.
77. (derma )Infected eczema …..
- What is the treatment ?
 penzile pencilline + flucoxthaline .
78. (derma)Infant with rash around mouth anus and foot "acrodermitis enteropathica"
- What treatment ?
 zinc .
79. (derma)10 y old child with a blister/vesicle skin lesion "shingle" on one side "one
dermatomal supply" hypotonia and hyporeflexia
- What is diagnosis ?
 herpes zoster
 herpes simplex virus .
80. (derma )ataxia with rashes investigation distressed infant with O2 sat 93 %
- What is initial management ?
81. (derma )Child with shingle ,
- what is treatment?
 Oral acyclovir .
 iv acyclovir .
 antibiotics.
 steroid
82. (derma)A well looking boy with couple weeks history of multiple reddish, scared, lesions
suggestive of Bulous impetigo around lips and on rest of feet including feet, child was smiling
and picking up skin in videos.
- What choice of antibiotics ?
 IV acyclovir
 Oral Flucloxacillin.
 IV flucloxacillin.
 Co amoxiclav .
Comment : Oral Flucloxacillin as child look well to me though lesions
were extensive.

83. (derma)Infant with scalded skin but well no fever ,,,,management.

84. (derma)There was a strange video of atoddler miserable walking around the room in nappy I
think to see the gait then ten sec to the end same baby of the itchy rash in arms and back
85. (derma)Scarlet fever .
86. (derma)slapped cheek disease.
87. (derma)Steven jhonson
88. (derma)Child with rash after drug therapy……..ssss
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89. (derma)Infant with generalized skin rash
90. (derma)skin rash after urti …….erythema multiform
91. (derma) Neonate with rash is of concern of nurse and parents , vitally stable ,well feeding.
- What is next action ?
 Reaasurance (looks like erythema toxicum)
92. (derma)10 year old girl with rash on body ? Like scratch marks .
- What is diagnosis ?
 eczema .
 NAI .
93. (derma )Black Child presented with status epilepticus and hypopigmentation.
- What is the diagnosis ?
 Hypomelanosis of ito.
94. (derma)Generalized Rash for 2 weeks in a young infant girl with Ataxia while sitting ,finger
nose and past pointing was there plus i could see healed chicken pox rash------
- What is the diagnosis ?
 Varicella cerebellitis.
95. ( derma) Young boy post chicken pox , 3weeks later present with unsteady gait and signs of
cerebellar ataxia .
- what investigations ?
 viral serology
 CSF isolation of the organism
 no need for investigation .??
 varicella titre.

INFECTIOUS VIDEOS

96. 3 years girl with fever for 3 weeks not responding to one week course of amoxacillin ...
Hb=11.2 WBC=16 PLT=635 with high ESR and CRP
97. (infectious)Infant with lymphadenopathy , hepatosplenomegaly
- What is diagnosis ?
 disseminated BCG
98. (infectious)baby who is doing very well with history of low grade fever and diarrhea , flue
symtoms , on video having non blanching rash and active , non-toxic
- what to do next ?
 iv acyclovir.
 antibiotic
 antihistamine
 antipyretics and discharge
 admission and work up

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comment : petechial rash management plan, we often see children with balanchable rashes but
clinically well as GP usually feel undecisive about such rashes, in that case it all depends on clinical
presentation if child looks unwell with high grade temperature and tachycardia we usually do blood
investigations and decide about antibiotics after certain period of observation or blood results.

99. (infectious)Cervical LN ... cat scratch disease

100. (infectious)Scabies
101. (infectious) treated as meningitis and next day child very ill.
- what investigation?
 plasma osmolarity ( SIADH)
102. (infectious) HSP …..
- what important investigation ?
 urine full examination and microscopic examination
103. (infectious)6 month child e fever for 5 days , T. 39C , no spleenomegally , no LN. , in video
showing the rash .
- What is the diagnosis ?
 Measles
 kawaski
104. (infectious )a child with fissure lip , fever for 10 days non purulent conjunctivitis .peeling
of skin .
- what is diagnosis ?
 kawsaki disease.
- what specific treatment?
 IVIG .
 aspirin
- what expected on bloods ?
 low platelets .
 high platelets.(on 3rd week).
 high ESR,
 High CRP,
 High WBC
105. (infectious) EBV infection with palatal haemorrhage
- What is management ?
 reassurance
106. infectious) Big boy with exudate in his tonsils and hard and soft palate peticial
hemorrhage…..
- What is diagnosis ?
 glandular fever (infectious mononucleosis) .
107. (infectious )Hand foot mouth syndrome ...
- What is cause ? Coxackie virus
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108. (infectious) pt. with chorea after 4 weeks URTI
- what investigation ?
 antistreptolysin .
 nothing

NEUROLOGY VIDEOS

109. (CNS)Infant 9 month become unable to sit unsupported (regression) , in video

- What is the diagnosis ?
 Infantile spasm .
 landu-kliffer syndrome.
110. (CNS)Infant with infantile spasm……
- What investigation ?
 EEG
- What treatment ?
 vigabatrin or prednisolone.
111. (CNS) Pt. with status epilpticus given lorazepam , and prepared for intubation/intubated –
in video abdomen distended …..
- what next step ?
 insert NGT.
112. (CNS)A child with a limb then there is MRI of Spine ...
- What is the diagnosis ?
 Tethering of the cord
113. (CNS)Boy new onset abnormal gait looked like unilateral high stepping gait for 2 month
- What is best investigation ?
 MRI spine .
 nerve conduction study .
114. (CNS)10 years old boy returned from Pakistan 2 days ago, not able to walk, on video dr
and mum were holding and he was not bearing weight, on examination ( hypotonia and
hyporeflexia and reduce power of both LL , child was conscious " GBS "
- What investigation to monitor progression ?
 Spirometry
115. (CNS)young female lying in bed and on examination showing hyporeflexia , hypotonia
(other scenario patient with foot drop gait).
- What is diagnosis ?
 guillane baree syndrome.

116. (CNS)child with scoliosis and huff of hair at the cervical region. ex show UMNS
- what investigation ?
 MRI spine
117. (CNS) child crying and withhold breath with jerking movement ,
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 - what is the diagnosis ?
 breath holding attack
118. (CNS)Neonate present with floppieness and refuse of feeding ..management.
119. (CNS) hypocalemia with carpopedal spasm ..
- What is treatment ?
 IV calcium
 Name the sign …… Govestick sign on stimulate the face
 Trousse sign ….. on inflating the BP cuff on the arm
120. (CNS)newborn birth truma… erbs palsy.
121. (CNS)4th cranial nerve infection
122. (CNS) Child couldn't follow finger outside
- What is diagnosis?
 RT. Abducent nerve palsy
- What is investigation ?
 MRI brain
123. (CNS )Facial nerve palsy e skin rash " ramsy hunt"
- What is management ?
 acyclovir
 steroid
124. (CNS)boy 9 year old with facial palsy on the right side with maculopaplular rash on the
face " erythema migrans".
- what to do ?
 CT scan.
 Lyme serology.
 start steroids.
125. (CNS )a fair boy 13 yrs old with sudden development of LMN FACIAL PALSY. i noticed a
reddish cheeks n face generally .
- what initial investigations?
 CT brain scan.
 MRI for acoustic auditory canal.
 Screening for HSV.
- What is most important to protect the eye ?
 artificial tear

OPTHALMOLOGY VIDEOS

126. (ophthalmology )Conjunctivitis not responding to fluxaciilin with vesicles around eye
- What is diagnosis ?
 HSV .
 varicella .
127. (ophthalmology)Neonate 9 days present with eye discharge ,
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 - what is causative organism ?
 Chlamydia tracheomitis
 n.gonnorhea.
- what is treatment ?
 erythromycin

128. (ophthalmology)Eye discharge not respond to floxacillicin…….

- What is diagnosis ?
 herpes simplex.
129. (ophthalmology)Eye swelling with low grade fever or + CRp (periorbital cellulitis )
- What is treatment ?
 IV antibiotics
130. (opthalmology) Girl with swollen rt. Eye lid and fever , hx of urti
- What is the diagnosis ?
 periorbital cellulitis .
 sinusitis.
 orbital cellulitis.
131. (ophthalmology ) orbital cellulitis
- what to do next ?
 CT scan

Gastroenterology and others videos

132. (GIT)2yrs old child with FTT and wasted buttocks and distended abdomen
- What is diagnosis ?
 celiac disease.
133. (GIT) 3 week old baby with scar in Rt subcostal area with a tinge of jaundice ( look like
kasai)
- What is diagnosis ?
 biliary atresia.
- what complication?
 liver abscess .
 ascending cholangitis.
 Peritonitis.
 wound infection

134. (OTHERS)Increased nuchal thickness in a sonar ;

- What is diagnosis ? Down syndrome
135. (OTHERS)Neonate with features of down ,…
- What investigation ? Karyotyping
136. (OTHERS)syndromic baby…….
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 - What is the diagnosis ? mostly turner or pradder willi?
137. (OTHERS)shocked child
- What to do ? ABC(airway+iv line fluid)
138. (OTHERS) 2 year old baby, mother came to OPD complaining that today morning he was
not active is the morning and lazy when she wake him up then video showing developmental
motor and neurological examination of the baby , the question is
- what do do ?
 admit the baby.
 discharge and give him follow up visit.
 discharge without follow up.
 start work up .
139. (OTHERS)Neonate in NICU with dehydration…….

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Prepared by Dr.Mohammed Abdalla Khidir