OSCE Pediatrics Observed Stations

1. OBSERVED STATIONS
28TH APRIL; 2013

2. • The OSCE Questions & Answers are prepared by
the faculty for the benefit of Post graduate
students and some are contributed from faculty
• These Questions and answers are made for the
students to understand the pattern of OSCE and
not meant to completely cover the subject of
Pediatrics.
• Answer are checked from standard textbook in
case of doubt plz email
ashwinborade@yahoo.com

3. • Counsel a parent whose child has been
diagnosed with dyslexia
• Dr. Nivedita / Dr.Pote

4. Marks 10
• Introduction ½
• Explains the meaning Dyslexia 1
• Explains the causes of Dyslexia 1
• Explains age wise approach – Remediation to Accomodation 1
• Approach to include 5 parts of speech i.e. phonemic
awareness, phonics, fluency, vocabulary, and comprehension
strategies 2
• Accommodation techniques – Extra time for exam, laptops with
spell checkers, recorded books, lecture notes 1
• Non use routine performance test for assessment ½
• Help groups ½
• Role of medicines 1
• Gives positive encouragement 1
• Thanks ½

5. • A 2 yr old child presents to emergency
department with severe pallor. Take the
history of the child from mother.
• Dr. Parimal

6. Marks 10
• Introduces himself and tries to make the mother comfortable 0.5 marks
• Asks onset sudden or gradual 1 mark
• history of bleeding or bluish spots 1 mark
• History of associated symptoms : fever, failure to thrive 1 mark
• Recurrent blood transfusions 1 mark
• History of associated jaundice 1 mark
• History of worm infestation 0.5 mark
• Birth history 0.5 mark
• Community and religion and history of consanguinity 1 mark
• Dietary history 0.5 mark
• Family history 0.5 mark
• Drug history 1 mark
• Thanks 0.5 mark

7. • EXAMINATION OF B.P IN A 10 YEAR OLD
• Dr. Meghna / Dr. Nadkarni

8. Marks 10
• Rapport with patient and Bystander 1
• Choice of cuff size 1
• Positioning of the patient 1
• Site of tubing in relation to artery is correct 1
• Initial palpation, then auscultation method 2
• Rate of deflation is correct 1
• Reconfirm reading/ ask for BP chart 1
• To say if reading is normal or otherwise 1
• Thanking patient and bystander 1

9. • Administer MMR Vaccine to this 17 month old
child who is otherwise normal.
• Dr. Ashwin Borade

10. Introduces. ½
Explain to parents about vaccine / cost / side effect 1
Asks regarding any allergy in child ½
Wash Hands ½
Take 2 ml syringe and needle to withdraw diluent and Mix it with the
lyophilised Powder
½
Changes the needle ½
Identify the site. Anterolat Thigh middle 1/3 1
Clean the site without spirit ½
Correct direction ( at 45 degree angle) .. ½
Withdraw and press at the Inj Site ½
Post procedure advise to mother ½
Instructions to wait 30 min and inform on case of problem ½
When to come for the next dose, Proper Documentation 1
BIOWASTE DISPOSAL 1
Thanks the Mother ½
TOTAL 10

11. History taking
• 18 month old boy presented with fever with
rash 8days
• Take the appropriate history
• Dr. Rushikesh

12. • Introduction and rapport with parents 1
• Onset –sudden/ insidious 0.5
• Timing and pattern of fever ,pattern and distribution of
rash 2
• h/o associated symptoms-joint pain swelling, conjunctivitis
1
• h/o of travel, mosquito bite, animal exposure, season of the
year 2
• h/o medications, lab testing1
• Family history1
• Immunization-measles, MMR 1
• thanking parents 0.5

13. Clinical examination
• Do the musculoskeletal examination of this 8
year old boy
• Dr. Niraj

14. • Introduction rapport, permission for examination[1]
• INSPECTION-observe child sit, stand, walk looks and
reports obvious abnormalities in gait, muscle [2]
• PALPATION-swelling tenderness deformities ,abn
curvatures in spine [2]
• RANGE OF MOVTS-IN major joints of UL AND LL [1]
• SPINE- INSP,PALP of spine, forward bending(touching
toes without bending knees)assess flexion extension
,lateral flexion,rotation [2]
• Reporting impression to examiner[1]
• Thanking child and parents[1]

15. Counseling
• 29weeks male 1.1kg delivered just
now, developed grunting
• Counsel about the immediate treatment plan
hospital stay and future prognosis
• Dr. Mayuri D

16. • Introduces, asks language, establishes rapport with parents[1]
• Importance of early CPAP, and surfactant replacement
therapy, need for mechanical ventilation [2]
• Frequent blood gases ,xrays and relevant blood testing and cultures
[1]
• Monitor for expected complications-air leaks pulmonary
haemorrhage,apnea,septicemia [1]
• Need for long hospital stay till child accepts orally
tolerates, euthermic, weighs at least 1.5kg,discharge check with
screen for cong anomalies, rop, hearing [2]
• Prognosis-prolonged oxygen
requirement(BPD),ROP, neurodevelopmental impairment [2]
• Thanks, asks for doubts [1]

17. Newborn examination
• Check weight length/height head
circumference of the new born
• Discuss cord and eye care with the mother
• Dr. Ashish D.

18. • Introduction and rapport [1]
• Take permission for examination, washes hands [1]
• Weight-removes cloths adjusts 0,removes parallax,reports wt to
examiner[ 2]
• Length-head at 0 movable end at feet, reports L to examiner[1]
• HC-uses nonstretchable tape, covers areas of max protuberance of
occiput and point just above glabella, reports to examiner [2]
• Cord care-clean stump with soap and water, allow to dry [1]
• Eye care-wipe eyes with sterile moist cotton, no routine topical
antibiotics [1]
• Thanking mother [1]

19. Procedure
• Demonstrate liver biopsy procedure with
given material
• Dr. Preeta Mathur

20. • Takes consent [1]
• Asks for pre procedure work up-CBC, coagulation profile,
LFTS [1]
• Position ,painting and draping the area [1]
• Administer local anesthesia [1]
• Checks liver biopsy needle, uses correct technique, checks
movement of needle with respiration after entering in liver
[2]
• Sends piece of biopsy in formalin bulb [1]
• Applies benzoin, monitors abdominal girth post procedure
[2]
• Dispose in BMW [1]

21. Developmental assessment
• Assess the developmental age of the child
• Dr Sandeep K / Dr Dhongade

22. • Introduction and rapport with child [1]
• DOLL-asks to tell the parts [1]
• Paper-good enough draw a man test, shows
number of body parts drawn by the child[ 2]
• Crayons, pencils- scribbles, copies circle,
rectangle, triangle, hexagon [2]
• Cubes-makes tower of 6,9,12,makes bridge[ 2]
• Tells developmental age to examiner and says
thanks to child/parent [2]

23. http://oscepediatrics.blogspot.in/