OSCE (BBH, 2011)

1. BANGALORE BAPTIST HOSPITAL
DEPARTMENT OF PEDIATRICS
PEDIATRICS OSCE WORKSHOP 3/9/11
ANSWERS TO OSCEs

2. OSCE STATION - VACCINE
In a primary health centre monthly requirement of DPT is 280 doses. Lead time (time
between ordering of new stock and its receipt) is 1 week.
a. Calculate what should be the buffer stock 1
b. What should be the minimum stock level (reorder level)? 2
c. What is the maximum stock level? 2
Buffer stock serves as cushion or buffer against emergencies, major fluctuations in vaccine
demands or unexpected transport delays. (25% of monthly requirment for vaccines and 10%
of monthly requirement for syringes). DPT buffer stock should be 25% of 280 = 70
Minimum stock level (reorder level) is the the least amount you should have in stock, usually
expressed as weeks/ months of supply. It is the amount of stock you will have between placing
and receiving an order plus the buffer stock. Since lead time is 1 week, the minimum stock
should be 1 week requirement i,e 280 devided by 4 = 70. Buffer stock is 70. So, minimum stock
level is 70+ 70 = 140.
Maximum stock level is largest amount of stock you should have, usually expressed as weeks/
months supply. It is minimum stock plus amount of stock used between orders. 140 + 3 weeks
stock of 210 doses. (1 week stock is 280 divided by 4 = 70. So 3 weeks stock is 70 multiplied by
3 = 210.).
Maximum stock = 210 + 140 = 350 doses.

3. OSCE STATION – X RAYS
1.
a. What is the diagnosis? 1
b. What is this sign called? 1
c. What are the structures that cause this appearance in this condition? 0.5
a. Total anomalous pulmonary venous drainage- supracardiac type
b. Snow man appearance, figure of 8 appearance
c. Cardiomegaly with increased vascular markings
Dilatation of both the left and right innominate veins and right SVC producing the
classical snow man or figure of 8 appearance
Superior mediastinum is enlarged secondary to right venacava, innominate artery and
ascending vertical vein.

4. 2.
a. Describe the findings on the spine 1
b. Name the disease where this is seen 1
c Name 2 other skeletal complications of this condition. 0.5
a. Infarction affecting the central part of the vertebrae (fed by a spinal artery branch) results
in the characteristic h vertebrae of sickle cell disease. The outer portions of the plates are
spared because of the numerous apophyseal arteries. The lateral cxr shows multiple vertebral
end-plate irregularities and depressions. The peripheral portions of the end-plates are spared.
The appearance is due to bone infarction and subsequent collapse. This is an early example of
the classical h-shaped vertebrae seen in sickle-cell anaemia.
b. Sickle cell anemia (also seen in Gauchers disease)
c. Dactylitis, avascular necrosis of femoral head and humerus, osteomyelitis

5. OSCE STATION - KARYOTYPE
1.
a. Identify the karyotype. 1
b. What is the basic genetic defect? 0.5
c. List four clinical features of the same. 1
a. Fragile X syndrome
b. 200-2000 repeats of CGG/CCG on fragile site of distal long arm of chromosome X
c. Mental retardation, macro-orchidism, long face, prominent jaw, stereotyped speech and
behaviour.

6. 2.
a. Identify the karyotype 1
b. What is the basic genetic defect? 0.5
c. List four clinical features. 1
a. Cri-du-chat syndrome
b. 5p deletion
c. Characteristic cry, hypotonia, microcephaly with prominent metopic suture,
hypertelorism, bilateral epicanthic folds, high arched palate, flat nasal bridge, short
stature and mental retardation.

7. OSCE STATION- AUDIOGRAM
1.
a What is the study?
b. Interpret the same.
c. Give two conditions for the same.
a. Audiogram 1
b. Bilateral conductive deafness 1
c. Ear wax, otitis media 0.5

8. 2.
a. Interpret the study.
b. Give two conditions for the same
a. Bilateral sensorineural deafness 1.5
b. CMV, congenital rubella syndrome, ototoxic drugs 1

9. OSCE STATION- INTRAOSSEOUS NEEDLE INSERTION
Demonstrate the procedure and verbalize the same
Pretends to wash hands and follows universal precautions- 0.5
Paints and drapes the leg and places it in slight external rotation 0.5
Identifies the tibial tuberosity and locates the site one finger breadth below and medial to it
0.5
Stabilizes the leg at the knee joint and does not place the hand below the leg 0.5
Holds the needle like a knife and inserts the needle perpendicular to the tibia in a twisting
manner 0.5
Continues to insert the needle till there is a give way feeling once in the marrow space 0.5
Needle is steady once in the marrow space 0.5
Aspirates the marrow and flushes with a small volume of saline and makes sure there is no
swelling of soft tissues 0.5
Fixes the needle and connects IV fluid 0.5
Verbalizes the whole procedure 0.5

10. OSCE STATION- CLINICAL EXAMINATION
Examine the motor system of the child excluding reflexes
Findings will be documented in the next station
Measures bulk in all the areas 1
Examines tone 2
Examines power in all four limbs 2
Examines gait 1

11. OSCE STATION- DOCUMENTATION OF CLINICAL FINDINGS
Document the findings of motor system excluding reflexes
Posture 1
Bulk 1
Tone 1
Power 2
Gait 1

12. OSCE STATION- SLIDES
a. Identify the slide 1.5
b. Mention the clinical condition concerned with the same 0.5
c. Mention the drugs used to treat the same. 0.5
a. Bone marrow smear showing Leishmania donovani
b. Kala Azar/ Leishmaniasis
c. Sodium stilbogluconate, pentamidine

13. 2.
a. Identify the slide 1.5
b. Mention the clinical condition concerned 0.5
c. Mention two complications of the same 0.5
a. Corynebacterium diphtheriae
b. Diphtheria
c. Toxic myocarditis, toxic neuritis, air way obstruction

14. OSCE STATION- CASE SCENARIO
A father brings his 5 year old son Raju to OPD concerned that he is hyperactive. Past history
shows that he was treated for iron deficiency anaemia with 5mg/kg/day elemental iron for 3
months an year back. He has also been treated at home for stomach pains and constipation
with a laxative. His sister has been diagnosed with ADHD and is repeating Std 1. Father has
an automobile repair shop and mother is a housewife and is 3 months pregnant. On
examination, Raju is in the 10th percentile for height and weight. His attention span is very
short and he has difficulty following simple instructions. Except for the slightly delayed
language and social skills, Raju has reached most important developmental milestones.
a) What is the diagnosis? 1
Lead poisoning
b) What test would you order to confirm or rule out your diagnosis? 0.5
Venous blood lead levels
c) Which family member is at greatest risk? 0.5
The unborn baby
d) Name two drugs used for treatment 0.5
Calcium disodium EDTA
BAL(dimercaprol)
D-penicillamine
Succimer(DMSA)

15. OSCE STATION- CASE SCENARIO
Soumya is 4 months pregnant with her first child. Her 15 year old brother Jai began to have
difficulty in climbing stairs at 4 years of age. He is now confined to a wheelchair. All other
family members including Sowmya are normal. She is worried that her child may be affected.
a. What is the most likely clinical diagnosis?
Duchennes muscular dystrophy 1
b. What is the inheritance pattern? 0.5
X linked recessive
c. What are the chances that Sowmya could be affected with the same diasease?
0 %. She will be a carrier. 0.5
d. What would you recommend for antenatal diagnosis? 0.5
Chorionic villi sampling by 12 weeks of gestation for DNA analysis

16. OSCE STATION- CLINICAL PHOTOGRAPH
1.
1.
a. Identify the rash 1
b. Name the clinical condition in which it is seen. 1
a. Erythema marginatum
b. Rheumatic fever

17. OSCE STATION- CLINICAL PHOTOGRAPH
2.
a. Identify the clinical condition. 1.5
Beckwith Wiedemann syndrome.
b. What are the physical findings? 1
Hemihypertrophy, macroglossia, omphalocoele, macrosomia, visceromegaly
c. What is the metabolic abnormality? 0.5
Hyperinsulinemic hypoglycemia.

18. OSCE STATION- PEDIGREE
1.
a. Identify the inheritance pattern 1.5
Autosomal dominant inheritance
b. Mention four clinical conditions with the same inheritance 1
Neurofibromatosis type-1,
Von Willebrands disease,
Autosomal dominant polycystic kidney,
Hereditay spherocytosis

19. 2.
a. Identify the inheritance 1.5
Mitochondrial inheritance
b. Mention two clinical conditions with the same inheritance 1
Lebers hereditary optic atrophy
Kerans Sayers disease

20. OSCE STATION - ECG
1.
a. Identify the ECG rhythm 1
Sinus tachycardia
b. Write the points in favour of your diagnosis. 0.5
HR 170 beats/min
Presence of P waves preceding ORS
narrow QRS<0.8 sec

21. OSCE STATION
2.
a. Identify the ECG rhythm
1
b. Write the points in favour of your diagnosis.
0.5
a. Supra ventricular tachycardia
b. HR 300 beats/min
Absence of P waves
Narrow QRS<0.8

22. 3.
a. What is the diagnosis? 1
Hyperkalemia
b. Mention the drugs used to treat this condition. 1
Inj.Calcium glucaonate 10/%
Inj Sodium bicarbonate
Salbutamol nebulization
Glucose insulin drip

23. OSCE STATION-ULTRASOUND
1.
a. What is the clinical diagnosis? 1.5
Intaventricular hemorrhage
b. Mention four causes for the same
Prematurity- germinal matrix bleed
Haemorrhagiic disease of the newborn
Neonatal ITP
Trauma/ Child abuse 1

24. 2.
a. What is the diagnosis? 1.5
Congenital hypertrophic pyloric stenosis
b. What is the electrolyte imbalance seen? 1
Hypochloremic metabolic alkalosis

25. OSCE STATION- ASTHMA COUNSELING
9 year old Arun has been diagnosed with bronchial asthma. His mother has been explained
about the chronic nature of the illness and treatment options. She is anxious about the
measures she can take at home to prevent recurrent attacks. In the next 5 minutes talk to
Arun’s mother about “PREVENTION and ELIMINATION OF TRIGGERS AT HOME”
You are being observed by the examiner for health education and communication skills.
Mother
What precautions should I take at home to prevent my child from getting recurrent attacks?
EXAMINER CHECKLIST (maximum 3 marks for 6 and above)
SKILL
1. Bed room to be kept clean and dust free
2. Wet mopping preferable to dry mopping
3. Light plain curtains, bed sheets easily washable ones in child’s bedroom (to be washed in
hot water)
4. Regular dusting of calendars and paintings and books when child not at home
5. Keeping animal pets like dogs and cats away from the child’s bed room
6. Smoking to be avoided at home
7. Strong and pungent odours like wet paint, disinfectants minimized
8. Windows to be kept open when strong smells of cooking or smoke at home
9. Windows to be closed when outside air is very much polluted or full of pollen from
flowers and trees
10. Avoid very cold foods
ATTITUDE (0.5 mark each)
1. INTRODUCTION TO THE MOTHER
2. MANNER OF THE STUDENT IS GENTLE WITH THE MOTHER
3. EXPLANATION TO THE M0THER IS CLEAR AND ORGANISED
4. TAKES FEEDBACK FROM THE MOTEHR TO BE SURE IF SHE HAS UNDERSTOOD

26. OSCE STATION- ORDER SHEET
Mehul, one year old child weighing 10 kg is admitted with loose stools and vomiting with no
obvious signs of dehydration. His serum sodium is 160 meq/l and serum potassium is
3.5 meq/l.Urine output is adequate.
a. Calculate the free water deficit 2
FWD = 0.6 x wt x (1 - 145/current sodium)
= 560 ml
b. Write the fluid orders for this child. 3
Hypernatremia should be corrected over 48 hours
Serum sodium should be monitored serially
Fluid order for each day= maintenance fluid +half of FWD + ongoing losses
Adequate urine out implies 2ml/kg/hr= 480ml/day
Maintenance fluid= 1000ml +
Half of FWD = 280 ml +
Ongoing losses = 480ml
Total fluid requirement per day = 1760 ml
D50.45NS 440 ml IV Q 6 hourly with 5meq Inj KCl in each 500 ml of IV fluid to be given
each day for two days

27. OSCE STATION
1.
a. Identify the clinical condition 2
Pyothorax
b. What is the sign seen in the imaging study? 1
Split pleura sign
c. How will you treat the condition?
IV antibiotics
Intercostal drainage
VATS

28. OSCE STATION
2.
What is the diagnosis? 1
Extradural hematoma

29. 3.
What is the diagnosis? 1
Subdural hematoma

30. OSCE STATION
1
a. Identify the slide 1.5
Macrocytic anemia
b. Mention two causes for the same 1
B12 deficiency
Folate deficiency

31. 2.
a. Identify the slide 1.5
AML
b. Mention two points of identification 1
Large immature cells
Two or more nucleoli
Auer rods- distinctive rod like red staining structures

32. OSCE STATION: BLS
c. 14 year old male child has collapsed suddenly.
Provide one rescuer CPR for the child
Please clean the mouth of the mannequin with spirit cotton before stating
CPR
Checks for response- 0.5
Activates emergency response 0.5
Opens airway using head tilt and chin lift 0.5
Checks for breathing 0.5
Gives two rescue breaths 0.5
Checks for carotid pulse 0.5
Locate CPR hand position 0.5
Delivers first 30 cycles of chest compressions at the correct rate 1
Gives two rescue breaths 0.5

33. OSCE STATION- PFT
1. Identify the study
2. Identify the clinical patterns in a, b and c
a.
b.

34. c.
1. Spirometry- flow volume curves
2.
a. normal curve
b. restrictive lung diseasse
c. obstructive lung disease

35. OSCE STATION – NALS
Resuscitate a newborn with the provided equipments.
Please ask questions regarding status of infant –wherever necessary.
1) Check the following equipments before proceeding further
Ø Bag mask valve
Ø Laryngoscope
2) Get information about the infant from the observer before proceeding to resuscitate
and at each step whenever necessary
Answer Key
Check list for observer.
Bag mask valve…does the candidate 1
- attach reservoir?
- check pop off valve?
Laryngoscope – Checks bulb & handle
Does candidate ask the following 3 questions? 1
Ø Crying well – breathing well or not?
Ø Pink or blue colour?
Ø Good muscle tone?
The Observer Should Say Baby Is Not Breathing
Does he clear airway/provide warmth/ position dry infant/stimulate? 1
and then ask status of baby
Observer Says: Baby Still Not Breathing well
Does he give PPV for 30 seconds? 1
Correct position
EC clamp technique

36. Chest expansion
and then ask status of baby
Observer Says Hr- 50/Min, Blue
Does he start chest compressions? 1
Correct technique?
Recent changes in Neonatal resusciatation (2010 guidelines)

37. OSCE STATION- ANTHROPOMETRY
PHYSICAL EXAMINATION STATION (TIME 5 MINUTES)
Measure the following in this child and document.
1. Standing height
2. Head circumference
3. Chest circumference
4. Upper segment to lower segment ratio
You are being observed for skills in anthropometry.

38. EXAMINER CHECK LIST
HEAD CIRCUMFERENCE 1
1. Occipital protruberance to supraorbital ridges
2. Crossed tape method (firm pressure on hair to compress)
STANDING HEIGHT 1
1. Heels buttocks and back brought in contact with vertical surface- wall
2. Frankfurt plane—horizontal
3. Head piece firmly over vertex to compress hair
CHEST CIRCUMFERENCE 1
Measures the chest circumference at the level of nipples
LOWER SEGMENT
Measures from pubic symphysis to sole
UPPER SEGMENT
Standing height – lower segment
UPPER SEGMENT TO LOWER SEGMENT RATIO 1
ATTITUDE 1
1. EXPLAINED TO THE CHILD WHAT HE IS GOING TO DO
2. WAS GENTLE WITH THE CHILD
3. WAS COURTEOUS

39. OSCE STATION- DRUG
PROSTAGLANDIN E1
1. What are the indications for administration? 2
2. Mention four adverse effects of this drug? 2
3. How do you monitor the newborn when the drug is given? 1
1. INDICATIONS
1. Transposition of the great vessels.
2. Lesions with ductal dependent pulmonary blood flow- TOF, PS, pulmonary atresia,
tricuspid atresia, Ebsteins anomaly
3. Lesions with ductal dependent systemic blood flow- AS, COA, hypoplastic left heart
syndrome, interrupted aortic arch
2. ADVERSE EFFECTS
1. Apnoea.
2. Hypotension.
3. Hyperthermia (transient).
4. Hypoglycaemia
5. Tachycardia.
6. Bradycardia.
7. Seizures.
8. Diarrhoea.
9. Skin flush secondary to vasodilation- occurs more frequently with intraarterial
administration.
10. Sepsis, cardiac arrest, disseminated intravascular coagulation, hypokalaemia, oedema,
cortical proliferation of the long bones.
3. MONITORING
o Observe respiratory effort closely
o Monitor arterial pressure closely.
o Watch for apnea
o Watch for bleeding diathesis-

40. OSCE STATION- SENSITIVITY/ SPECIFICITY
1000 babies were born in a maternity home in 2010. 185 babies had cord TSH more than
25µIU/ml. 95 of these turned out to be congenital hypothyroidism. 5 babies had cord TSH less
than 25 µIU/ml who later on had proven congenital hypothyroidism.
Calculate the following for newborn thyroid screening test-
a. True positive and true negative 1
b. Sensitivity 1
c. Specificity 1
d. Positive predictive value 1
e. Negative predictive value 1
Total population = 1000
Positive test = 185 Negative test = 815
True positive = 95 False positive = 90
Flase negative = 5 True negative = 810
Sensitivity = TP/ TP + FN x 100 = 95%
Specificity = TN/ TN + FP x 100 = 90%
Positive predictive value= TP/ TP + FP x 100 = 51.4%
Negative predictive value= TN/ TN + FN x100= 99.4%

41. OSCE STATION – NATIONAL HEALTH PROGRAMME
1. 28 year old Meera who has delivered 1 hour ago in your hospital. Baby weighs 2.8 kg
and has no apparent problem. She was tested HIV positive during early preganency.
Her CD4 count was 500. She has been on Anti retroviral drugs (tripple drug regimen)
since 14 weeks of gestation.
a. What is advice regarding breast feeding and weaning? 1.5
Exclusive breast feeding upto six months
Start complementary feeds at six months
Continue breast feeds with complementary feeds upto one year of age
b. What is the advice regarding ART for the baby? 1
Syrup nevirapine 15 mg OD for 6 weeks only
2. 25 years old, Mrs Nazeema has delivered a female baby weighing 3 kgs one hour back.
She was unbooked and was detected to be HIV positive during delivery. She was given
nevirapine during delivery.
a. What is the advice regarding breast feeding? 1.5
Exclusive breast feeding upto six months
Start complementary feeds at six months
Continue breast feeds with complementary feeds upto one year of age
b. What is the advice regarding ART for the baby? 1
Syrup nevirapine 15 mg OD for 6 weeks
Syrup nevirapine 20 mg OD for 6 weeks -6 months
Syrup nevirapine 15 mg OD for 6 -9 months
Syrup nevirapine 15 mg OD for 9 months to 1 year
Syrup nevirapine to be continued for one week after all the breast feeding is stopped.

42. OSCE STATION
1. 3 year old child with loose stools-
Na- 134 meq/l, K – 2.9 meq/l, Cl – 113 meq/l, HCO3- 16 2
ABG- ph- 7.31, PCO2- 34, HCO3- 16
a. Calculate anion gap
( Na +K) – (Cl+HCO3)= 7.9
b. What is the acid base imbalance?
Compensated Metabolic acidosis
Expected PCO2 = (1.5x HCO3) + 8 +/- 2 = 32+/- 2
2. 10 year old child with salycilate poisoning. 1.5
Anion gap= 30
ABG- ph- 7.3, pCO2 = 32, HCO3= 10
What is the acid base imbalance?
Expected PCO2= 23 +/-2
Actual PCO2= 32, so there is respiratory acidosis also
In all cases of high anion gap metabolic acidosis,
corrected HCO3 = Actual HCO3 + [anion gap-12] , should be calculated.
Corrected HCO3 = 28
Corrected HCO3 > 24 is associated with coexisting metabolic alkalosis
This child has -
metabolic acidosis with respiratory acidosis with co-existing metabolic alkalosis
3. 5 year old child with severe respiratory distress 1.5
PaO2=56, PaCO2= 50
Calculate d(A-a)
PAO2= 150-1.25(PaCO2)=87.5
d(A-a)= PAO2-PaO2 = 31.5

43. OSCE STATION- DEVELOPMENTAL ASSESSMENT
I. Child ‘A’ walks up and down stairs with alternating legs.
a) What would be your assessment of the age of this child?
b) Name 2 adaptive milestones specific for this age.
II. Child B - copies cross and square
- Imitates construction of “gate” of 5 cubes
a) What would be the child’s probable age?
b) Mention 2 specific motor milestones for this age.
III. Match the following
a) Palmar grasp gone - 8 months
b) Transfers object from hand-to-hand - 4 months
c) Turn pages of book - 5.5 months
d) Thumb finger grasp - 12 months

44. I.
a) 30 months
b)
• Makes tower of 9 cubes
• makes vertical and horizontal strokes, but generally will not join them to make
cross;
• imitates circular stroke, forming closed figure
II.
a) 48 months
b) – Hops on one foot
- throws ball overhand
- Uses scissors to cut out pictures
- Climbs well
III.
a) 4 months
b) 5.5 months
c) 12 months
d) 8 months

45. OSCE STATION- MORTALITY RATES
Total births in 2006 – 1,00000
Died between 28 weeks to term - 500
Died during first week – 300
Died after one week but before one month – 100
Total deaths under 1 year – 100
Calculate
a. Perinatal mortality rate
b. Neonatal mortality rate
c. Infant mortality rate
PMR =
Total perinatal deaths/Total no. of live births X 1000
800/1.00000 X 1000 = 8 per 1000 births
NMR =
Total neonatal deaths/Total live births X 1000
400/1.00000 X 1000 = 4.0/ 1000 live births
IMR =
No. of deaths < one year/Total live births X 1000
1000/100000 X 1000 = 10/ 1000 live births

46. OSCE STATION- HISTORY TAKING
Two year old female child is brought with global developmental delay
Elicit – Birth history from the mother.
EXAMINER CHECK LIST
Introduces to the mother 0.5
Attitude- polite, courteous, good posture, maintains eye to eye contact
Asks leading questions
ANTENATAL (at least six points)
1. What was the age at conception? 1.5
2. What was the pre-pregnancy weight?
3. Any pre-existing illness?
4. Was it a spontaneous/assissted conception?
5. Was the pregnancy booked, supervised with regular follow ups?
6. What was the weight gain during pregnancy?
7. Did you take iron and calcium tablets from third month to end of pregnancy?
8. Did you have any fever with rash and lymphadenopathy during first three months?u
9. Did you have any exposure to drugs/radiation?
10.Any H/O PIH,GDM,UTI, bleeding PV?
NATAL (at least six points) 1.5
1. Was it a hospital/home delivery?
2. Who conducted the delivery?
3. Were sterile precautions taken if it was a home delivery?
4. What was the duration of labour?
5. What was the duration of leaking PV?
6. Did y fevou have any fever before or during delivery?
7. Did you have any foul discharge PV?
8. Was the delivery- NVD/ Cs/instrumental?
9. Was it a twin delivery?
POST NATAL (at least six points) 1.5
1. Did baby cry at birth?
2. If not any treatment done?
3. What was the birth weight?
4. Did baby suck well on the breast?
5. Did baby have any fast breathing?
6. Any abnormal movements was noticed in the baby?
7. Any yellowish discolouration of skin?
8. Any fever, rash or poor feeding was noticed in the baby?
9. Any floppiness, paucity of movements, abnormal fisting, prolonged sleeping was noticed in
the baby?

47. OSCE STATION – HISTORY TAKING
One year old child Raghav is brought to your OPD with concerns of shortness of hearing.
Elicit relevant history.
EXAMINER CHECK LIST
Introduces to mother, polite, courteous, and asks leading questions. 0.5
Response to noises of varied loudness and progression of the disease 1.5
H/O trauma to the ear, ear infection, ear discharge
H/O fever with seizures and prolonged illness
Did baby receive any ototoxic drugs?
ANTENATAL- H/O fever with rash and lymphadenopathy 0.5
NATAL Was the baby term or preterm? 0.5
POST NATAL- Did baby cry at birth? 1
What was the birth weight?
Did the baby have jaundice?
Do you know how high the bilirubin value was?
Was the baby ventilated for any reason?
Did the baby have any fever, rash and convulsions?
DEVELOPMENT-
When did baby start recognising your voice, 0.5
turning towards loud noises?
FAMILY HISTORY OF DEAFNESS 0.5

48. OSCE STATION – INSTRUMENTS
1.
a. Identify the device 1
Peripherally inserted central catheter /epicath
b. What is it used for? 0.5
To provide medium and long term IV access/ TPN in neonates

49. 2.
a. Identify the device
1
Amplatzer septal occluder
b. What is it used for?
1
For device closure of ASD

50. 3.
a. Identify the device 1.5
PDA coil

51. OSCE STATION : IMMUNIZATION
Aryan is a 1 year old healthy child. He has been fully immunized.
His mother is concerned that he does not have a BCG scar. She is worried that he
may catch TB. She is also concerned about the BCG vaccine which she feels may
need to be repeated.
How do you address these two concerns?
You are being observed by the examiner for health education and communication
skills.
Marking:
Health Education
• 1 ½ marks each for :
1. Repeat BCG vaccination is required.
2. Mentioning the natural history after a BCG vaccine such as development of
a nodule after 4-6 weeks with possibility of formation of abscess and ulcer.
• -1 mark for mentioning a Mantoux test.
Communication skills:
½ mark each for the following:
• Introduction to the mother
• Non-verbal communication skills such as eye contact/hand gestures/body lan-
guage
• Verbal communication skills such as ability to explain in clear English with non-
medical terminology in a clear and organized manner
• Concluding with a brief summary + asking the mother if she has any questions.

52. http://groups.yahoo.com/group/PediatricsDNB/
Theory: http://dnbpediatricstheory.blogspot.in/
OSCE: http://oscepediatrics.blogspot.in/
Clinical: http://clinicalpediatrics.blogspot.in/
Practicals: http://practicalpediatrics.blogspot.in/
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