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1. What is the abnormality in this karyotyping?
2. Diagnosis
2. Two associated anomalies

Write the age that meets the following developmental milestones:
. Plays simple ball game...
.Unbottons clothing, build a tower of 9 to 10 cubes ...
.Hops on feet ...
.Draw a circle ....

Give diagnosis:
A.
HBsAg +ve
Anti-HBc IgM +ve
Anti-HBs -ve
Anti-HBc IgG -ve
B.
- HBsAg +ve
- AntiHBc +ve
- Anti Hbc IgM -ve
- AntiHBs -ve

Sex: Male
Age: 8 years
Wight: 53kg
Height: 125 cm
LS: 62 cm
1. Put on growth chart and make interpretation?
2. Calculate BMI and put it on growth chart?
3. Give two blood investigation for the case?
4. how to differentiate between overweight and this condition in growth chart?

اختبار اليوم #OSCE 👆

Pathology: linear skull fracture
N.B
1. Do CT scan if the patinet had symptoms ( loss of consciousness, projactile vomiting , CSF leakage from nose or ear )
2. Don't do CT scan if the patient had no symptoms ( put him underobservation for 24 hours)

P: depressed skull fracture of frontal bone.
N.B
Do CT scan even if the patient had no symptoms.

P: wide diploic space
D: chronic hemolytic anemia ( most probably thalassemia)
N.B sickle cell anemia is also chronic but doesn't cause widening of diploic space

P:
1. Widening of diploic space
2. Hair on end appearance
D. Chronic hemolytic anemia ( most probably thalassemia)

P:
1. Silver beaten appearance
2. No any fontanelles
3. No appearance of sutures
D.
Most probably craniosynostosis

P. Single osteolytic lesion
D. Most probably histocytosis ( localized type )

P: multiple osteolytic lesion
D: most probably histocytosis ( generalized type )

P: ventriculoperitoneal shunt

P: multiple white dots ( scattered calcification)
D: most probably toxoplasmosis

P: multiple white/ black dots ( salt paper appearance)
D: hyperparathyroidism

Skull x-ray 👆

P.
- Gastric air bubbles on the right side.
- The left border of the heart is formed by the right atrium while the right border is formed by the pulmonary artery, left atrium and left ventricle.
D.
Dextrocardia ( situs inversus totalis)