Trial SAQ exam: 'micksfirst trial' by Michael Devlin

You are taking part in a trial exam created by Michael Devlin. There are 9 SAQs in this exam (54 minutes).

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This SAQ is worth 26 marks

A 6 year old girl is brought to the emergency department by her mother. She has had a cold for one week, and for the last 24 hours her right eyelids have become very red and swollen. She is not able to open her eye. Her relevant vitals are:

Temperature 39.4 C
Weight 20 kg

Question 1.
Using the table provided, list four (4) physical examination differences between pre-septal and orbital cellulitis. (12 marks)

   Physical sign Pre-septal cellulitis Orbital cellulitis
1      
2      
3      
4      



Question 2.
The patient has a CT. List four (4) findings that will confirm your diagnosis of orbital cellulitis or its complications. (4 marks)


1. ___________________________________________________________________________

2. ___________________________________________________________________________

3. ___________________________________________________________________________

4. ___________________________________________________________________________



Question 3.
List two (2) bacteria that can cause this presentation, and choose two (2) appropriate antibiotics (include route and dose) for each of those bacteria. (6 marks)

   Bacteria Antibiotic 1
(route and dose)
Antibiotic 2
(route and dose)
1      
2      



Question 4.
List four (4) specialist services that should be consulted during the management of this patient. (4 marks)


1. ___________________________________________________________________________

2. ___________________________________________________________________________

3. ___________________________________________________________________________

4. ___________________________________________________________________________



 

This SAQ is worth 26 marks

A 6 year old girl is brought to the emergency department by her mother. She has had a cold for one week, and for the last 24 hours her right eyelids have become very red and swollen. She is not able to open her eye. Her relevant vitals are:

Temperature 39.4 C
Weight 20 kg

Question 1.
Using the table provided, list four (4) physical examination differences between pre-septal and orbital cellulitis. (12 marks)

Examiner Comments: Candidates who answered this question well noted the clinical points of differentiation between orbital and preseptal cellulitis, and were able to identify the features clinically and on CT that would characterise orbital cellulitis. Many had good knowledge of the important causative microorganisms and relevant antibiotic with doses in the paediatric age group.

Poor responses did not know the points of differentiation or provided non-specific points.


Question 2.
The patient has a CT. List four (4) findings that will confirm your diagnosis of orbital cellulitis or its complications. (4 marks)



Question 3.
List two (2) bacteria that can cause this presentation, and choose two (2) appropriate antibiotics (include route and dose) for each of those bacteria. (6 marks)



Question 4.
List four (4) specialist services that should be consulted during the management of this patient. (4 marks)