1. OSCE 1 NEURO(PAEDS)

2. A 10 year old boy came with history of fever,chills and rigors,headache,vomiting and one episode of seizure.On physical examination,the patient was drowsy and has neck stiffness.Lumbar puncture was done.and the result of CSF analysis is as shown below. CSF analysis Appearance :cloudy/turbid Mononuclear cells :30/mm3 Polymorph cells :200/mm3 Protein :1.5g/L Glucose :<1/2 blood glucose

3. What is the most likely diagnosis BACTERIAL MENINGITIS Typical history of meningitis in children Symptoms precipitated by history of infection and complicated with neck stiffness Other PE: Kernig’s sign, Brudzinki sign What is the most common organism causing this type of pathology Virus:enterovirus-coxsackieviruses Fungi:cryptococcus Bacteria:depends on the age < 3/12 : GBS,e.coli, 1/12-6 years:streppneumoniae,H.influenza,Neisseriameningitidis >6 years: Neisseriameningitidis,H.influenza

4. How to differentiate it from other types

6. Stict I/O chart

7. Complication of SIADH

8. Fit chart

9. Fluid maintenance  if a/w SIADH,2/3 maintenance/24 hours only

11. Ampicillin + ceftriaxone/cefotaxime

12. Steroid –dexamethasone

13. Prevent hearing deafness

14. Antiviral-aciclovir

17. What is the developmental age 10 months Name another group of motor skills of that age Gross motor activity Sit without support Stand with support Name 2 conditions with defect in that skill (c ) Cerebral palsy Congenital myopathy- Duschen Spinal cord lesion