Pediatric OSCE

6th year (Group D), August 2008

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Stations:
Station 1: History taking for a case of abd. Pain?
it was a functional abd. Pain
Station 2: History taking for a case of skin rash?
I think it was HSP (there was hematuria)
Station 3: Examination of a child with infective endocarditis?
General look, Vital signs
Eyes: Roths spot, subconjuctival hemorrhage
Oral cavity: Dental caries, mucous membrane bleeding
Hands: clubbing, splinter hemorrhage, oslers nodule
Chest: Inspection: .
Palpation: tenderness, apex beat, tracheal deviation & TVF
Percussion (pulm. Edema)
Auscultation: S1 & S2 , murmurs. air entry, breathing type, addes
sounds, basal crackles.
Abdominal for hepatosplenomegaly
Lower limbs for petichial hemorrhage & pulses (emboli)
Neurological exams (cerebral emboli)
Station 4:
A) ECG of SVT:
Q1: what is the HR?
It was 300b/min (there was only 1 large square between each RR)
Q2: Give two modalities of treatment?
1- carotid massage
2- medical with adenosine
B) A history with recurrent vomiting & give u an ABG with electrolytes results
Q1) what is the ABG finding?
Partially compensated metabolic alkalosis
Q2) what is the electrolyte abnormality? & explain it?
Hypokalemic hypochloremic; ..

Slide show:
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Syndactyly & if it happen in normal variants (answer yes).

Prader willi syndrome
Pedigree for an X-Linked dominant
Kwashiorker
Duodenal atresia (double bubble sign)
CXR: Rt Pleural effusion or teratology of fallot (boat shaped heart). I dont know
Turner syndrome (coarctation of aorta)
Anal atresia, single investigation is pelvic X-ray to show level of obstruction.
Vaccination (remember that Pertussis is contraindicated >3years)
Age of a child standing on a Baby Trolley? 10 months.

Special thanks for our colleague who wrote this exam; Ghanem
Albasha