BOOKLET CODE: 012 SUBJECT CODE : 02 OPD with a complaint of rapid, shock-like and non-rhythmic convulsion of four episodes with two days duration. What is the most likely diagnosis of this child? (C) Grandmal seizure (A) Clonic seizure (D) Myocionic seizure 10 (B) Petitmal seizure 39. A child weighting 5kg was admitted to pediatric ward with a complaint of unable to feed. On examination, the baby had moderate respiratory distress and his hematocrit level was 25% (HCT packed RBC to be given was 70% What is the amount of packed RBC to be transfused for this patient? (A) 160 ml (C) 198 ml (B) 182 ml (D) 204 ml 40. An adolescent girl came to pediatric clinic and diagnosed with uncomplicated nephrotic syndrome. What is the most appropriate nursing intervention for this patient? (A) Administration of prednisone (B) Administration of cyclosporine (C) Administration of 'cephalosporins (D) Administration of cyclophosphamide 41. A two-year-old female child was brought to a health center with difficulty of feeding and fever of three days duration.On examination, she has rash around the face and neck and the clinician suspected measles. What could be the pathognomonic sign to substantiate this diagnosis? (A) Red eyes (C) Runny nose (B) Rose spots (D) Koplik spots 42. An infant with confirmed hemophilia B developed hematuria and admitted to the hospital. The nurse provided the appropriate amount of maintenance fluid with bed rest but hematuria continued for consecutive days. What is the most appropriate next step in the management of this infant? (A) Giving 20IU/kg factor IX (C) Giving 401U/kg factor VIII (B) Giving 40IU/kg factor IX (D) Giving 20IU/kg factor VIII

38. The correct answer is (C) Grandmal seizure. Grandmal seizures, also known as tonic-clonic seizures, are characterized by a sudden loss of consciousness, muscle stiffening, and convulsions. They are the most common type of generalized seizure and can last for several minutes. The symptoms described in the question, such as rapid, shock-like, and non-rhythmic convulsions, are consistent with grandmal seizures.<br /><br />39. The correct answer is (C) 198 ml. To calculate the amount of packed RBC to be transfused, we need to determine the volume of RBCs needed to increase the hematocrit level from 25% to 70%. The formula to calculate the volume of RBCs needed is:<br /><br />Volume of RBCs needed = (Desired hematocrit - Current hematocrit) x Total blood volume<br /><br />Given that the child's weight is 5 kg, the total blood volume can be estimated as 70 ml/kg, which is 350 ml. Plugging in the values, we get:<br /><br />Volume of RBCs needed = (70 - 25) x 350<br />Volume of RBCs needed = 45 x 350<br />Volume of RBCs needed = 15750 ml<br /><br />Since the child's hematocrit level is 25%, the volume of RBCs in the blood is 25% of 350 ml, which is 87.5 ml. Therefore, the amount of packed RBCs to be transfused is 15750 - 87.5 = 198 ml.<br /><br />40. The correct answer is (A) Administration of prednisone. Prednisone is a corticosteroid commonly used to treat nephrotic syndrome. Nephrotic syndrome is a kidney disorder characterized by high levels of protein in the urine, low levels of protein in the blood, and edema. Prednisone helps to reduce inflammation and suppress the immune system, which can help to control the symptoms of nephrotic syndrome.<br /><br />41. The correct answer is (D) Koplik spots. Koplik spots are small, white spots that appear on the inside of the cheeks, usually opposite the molars. They are considered a pathognomonic sign of measles, which is a highly contagious viral infection. Measles is characterized by a distinctive red rash, fever, and respiratory symptoms. Koplik spots typically appear one to two days before the onset of the rash.<br /><br />42. The correct answer is (B) Giving 40 IU/kg factor IX. Hemophilia B is a bleeding disorder caused by a deficiency of factor IX, a protein that helps blood to clot. In the case of hematuria (blood in the urine) in an infant with hemophilia B, the appropriate next step in management would be to administer factor IX to help promote clotting and stop the bleeding. The recommended dosage is 40 IU/kg of factor IX.