OSCE Pediatrics Observed Stations (Mock Exam Apr 2013)


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OSCE Pediatrics Observed Stations

OSCE Pediatrics Observed Stations (Mock Exam Apr 2013)

  2. 2. • The OSCE Questions & Answers are prepared bythe faculty for the benefit of Post graduatestudents and some are contributed from faculty• These Questions and answers are made for thestudents to understand the pattern of OSCE andnot meant to completely cover the subject ofPediatrics.• Answer are checked from standard textbook incase of doubt plz emailashwinborade@yahoo.com
  3. 3. • Counsel a parent whose child has beendiagnosed with dyslexia• Dr. Nivedita / Dr.Pote
  4. 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. phonemicawareness, phonics, fluency, vocabulary, and comprehensionstrategies 2• Accommodation techniques – Extra time for exam, laptops withspell 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. 5. • A 2 yr old child presents to emergencydepartment with severe pallor. Take thehistory of the child from mother.• Dr. Parimal
  6. 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. 7. • EXAMINATION OF B.P IN A 10 YEAR OLD• Dr. Meghna / Dr. Nadkarni
  8. 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. 9. • Administer MMR Vaccine to this 17 month oldchild who is otherwise normal.• Dr. Ashwin Borade
  10. 10. Introduces. ½Explain to parents about vaccine / cost / side effect 1Asks regarding any allergy in child ½Wash Hands ½Take 2 ml syringe and needle to withdraw diluent and Mix it with thelyophilised Powder½Changes the needle ½Identify the site. Anterolat Thigh middle 1/3 1Clean the site without spirit ½Correct direction ( at 45 degree angle) .. ½Withdraw and press at the Inj Site ½Post procedure advise to mother ½Instructions to wait 30 min and inform on case of problem ½When to come for the next dose, Proper Documentation 1BIOWASTE DISPOSAL 1Thanks the Mother ½TOTAL 10
  11. 11. History taking• 18 month old boy presented with fever withrash 8days• Take the appropriate history• Dr. Rushikesh
  12. 12. • Introduction and rapport with parents 1• Onset –sudden/ insidious 0.5• Timing and pattern of fever ,pattern and distribution ofrash 2• h/o associated symptoms-joint pain swelling, conjunctivitis1• h/o of travel, mosquito bite, animal exposure, season of theyear 2• h/o medications, lab testing1• Family history1• Immunization-measles, MMR 1• thanking parents 0.5
  13. 13. Clinical examination• Do the musculoskeletal examination of this 8year old boy• Dr. Niraj
  14. 14. • Introduction rapport, permission for examination[1]• INSPECTION-observe child sit, stand, walk looks andreports obvious abnormalities in gait, muscle [2]• PALPATION-swelling tenderness deformities ,abncurvatures in spine [2]• RANGE OF MOVTS-IN major joints of UL AND LL [1]• SPINE- INSP,PALP of spine, forward bending(touchingtoes without bending knees)assess flexion extension,lateral flexion,rotation [2]• Reporting impression to examiner[1]• Thanking child and parents[1]
  15. 15. Counseling• 29weeks male 1.1kg delivered justnow, developed grunting• Counsel about the immediate treatment planhospital stay and future prognosis• Dr. Mayuri D
  16. 16. • Introduces, asks language, establishes rapport with parents[1]• Importance of early CPAP, and surfactant replacementtherapy, need for mechanical ventilation [2]• Frequent blood gases ,xrays and relevant blood testing and cultures[1]• Monitor for expected complications-air leaks pulmonaryhaemorrhage,apnea,septicemia [1]• Need for long hospital stay till child accepts orallytolerates, euthermic, weighs at least 1.5kg,discharge check withscreen for cong anomalies, rop, hearing [2]• Prognosis-prolonged oxygenrequirement(BPD),ROP, neurodevelopmental impairment [2]• Thanks, asks for doubts [1]
  17. 17. Newborn examination• Check weight length/height headcircumference of the new born• Discuss cord and eye care with the mother• Dr. Ashish D.
  18. 18. • Introduction and rapport [1]• Take permission for examination, washes hands [1]• Weight-removes cloths adjusts 0,removes parallax,reports wt toexaminer[ 2]• Length-head at 0 movable end at feet, reports L to examiner[1]• HC-uses nonstretchable tape, covers areas of max protuberance ofocciput 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 topicalantibiotics [1]• Thanking mother [1]
  19. 19. Procedure• Demonstrate liver biopsy procedure withgiven material• Dr. Preeta Mathur
  20. 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, checksmovement 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. 21. Developmental assessment• Assess the developmental age of the child• Dr Sandeep K / Dr Dhongade
  22. 22. • Introduction and rapport with child [1]• DOLL-asks to tell the parts [1]• Paper-good enough draw a man test, showsnumber 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 saysthanks to child/parent [2]
  23. 23. http://oscepediatrics.blogspot.in/