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OSCE PAEDS:

2001
1.

Physical examination Gait and LL Neuro

2.

Developmental history
i.

15 mth old boy with multiple medical history since birth. Premature, intubation for 10 days,
seizure. On Carbamazepine.

ii.

What do you think? Tests/investigations you would like? What will you find on neuro exam?

3.

Surgical 1
i.

14 yo boy with 4 hour history of scrotal pain. How do you assess? If red painful scrotum,
what is your differential diagnoses, what will you tell parents, and what is your management?

ii.

22 month boy swallowed 20c coin. What will you do, investigations, what will you tell dad
(coin is in abdomen on Xray)

4.

Girl presented with polyuria and polydipsia. Currently unwell vomiting


and decrease consciousness. BSL is 23. What physical findings? Comment on investigations
(ketoacidosis ABG)

5.

Demonstrate technique of spacer puffer to 7 yo boy. How many puffs to


take? What to do during acute attack?

6.

Surgical 2
i.

Exompholos

ii.

5 yo girl with abdominal pain. Blood in poo. Diagnoses, investigations

2001.2
1. Physical examination Gastrointestinal system
2.

Advice giving Anxious mom has just been told her 2 yr old child has had her first febrile
convulsion: she wants to know what it is, complications, what causes it, prevention, what to do
next time; etc.

3.

Surgical station 1 7 yr old falls of wire fence and presents to ED: immediate and further
management of lacerated forearm, possible dangers/complications

4.

Hypospadia: baby history and examination, long term complications, management, when will
you operate?

5.

Pen and paper school age child presents with sore throat: fill out a script for amoxicillin,
choose appropriate formulation, advice to mom regarding script. Child later presents with
morbilliform rash (photo provided). Subsequent change in management?

6.

Clinical scenario 2 yr old presents with lethargy, pallor, eats few solids, drinks copious
amounts of cow milk: interpret FBE, iron studies, management of Fe def, advice to mother.

7.

Surgical station 2 Appendicitis, 9 yr old, post op complications, advice to parents on


discharge, child represents with abdominal pain 2 days later why?

8.

Acute appearance of lateral neck lump 7 yr old history and examination, diff diagnoses, most
likely cause.

2001.3
1. Respi exam in normal child
2.

Hx from mom regarding childs immunisation.

3.

Explain asthma management plan to 10yo, triggers.

4.

Urine dipstick results (UTI)

5.

Acute scrotum, Strawberry naevi (photos)

6.

Umbilical hernia, Pyloric stenosis (management etc)

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2001.4
1. Lowerlimb ex
2.

Hx on unretractile foreskin

3.

Umbilical granuloma photo

4.

Fracture of supracondylar humerus (photo)

5.

Fluid replacement for diarrhea advice station

6.

Post natal depression and irritable infant Hx and Mx

2002
1.
2.

CVS examination of school aged child


Mom concern developmental delay. Child has seizures, on carbamazepine. Take Hx to
determine if there is developmental delay.

3.

FBE results Fe deficiency. List DDX

4.

Surgical midline neck lump (thyroglossal cyst)


- umbilical hernia

5.

Explain use of Ventolin and spacer to 10 yo boy. Asthma management plan.

6.

Vomiting, diarrhea, RIF pain. (appendicitis) DDX, assessment, advice on complications of


surgery.

7.

Picture lump in groin (hydrocele). DDX, management.

2003
2004
OSCE (4 Child & Adolescent Health)
1. Orthopaedics: Perform a hip examination looking for developmental dysplasia of the hip
2. Immunisation: Address a mothers concerns about vaccinating her child
3. Surgery: Discuss the management of two clinical cases (red lateral neck swelling, bowel obstruction
in a neonate)
4. Growth: Plot a head circumference on a growth chart, and explain some causes of a big head in an
infant, plus additional questions on anaemia
SLIDE QUIZ (6 Child & Adolescent Health)
1. International child health: Discuss measles, and some of the barriers to effective prevention of this
disease in third world settings
2. Renal medicine: Ponder the issues surrounding the collection of urine specimens, and use of ward
urinalysis
3. Surgery: Explain a red swollen penis
4. Respiratory medicine: Comment on bronchiolitis, pneumonia, cough, and asthma
5. Trauma: Describe the management of a child with a fracture near the elbow (supracondylar)
6. Development: Reflect on a young girl who is somewhat delayed in her speech development
Paeds :
-Surgery : neck lump and acute scrotum (2 photos - talk about Dx and Mx)
-Mother with PND and baby with colic - take Hx and advise on Mx
-Child with recurrent infections - take Hx and discuss Mx
-Vaccination - discuss vaccination with and adolescent and do it on a model then.
(can't remember if there was a 5th station)...
2005
1)

Mrs Smith has brought in Jason because he is small for his age. Take a history. Discuss
differential diagnoses. List investigations youd like to order and interpret a CXR.
This station was just an examiner.

2)

2. Two case scenarios with just an examiner


a.

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A four year old child with RLQ abdominal pain and fever. What has he got. What is

your management. Any tests.


b.

This baby was born in a country hospital and youre the intern on duty what do you do.
A photo of a baby with exomthalos. What syndrome does might baby have? The
babys blood glucose is 1.6. What do you do.

3)

You have been asked to see this adolescent and give advice. Thats all that was on the door.
The station was that you had to ask him about his asthma and answer his questions.
a.

Will the steroid inhaler make me fat?

b.

help his with strategies to remember his medication

c.

there were more but I cant remember. The examiner also started writing when I went
through confidentiality.

d.
4)

This one had the examiner and a teenage actor.

You have been asked to see Jenny Jones about her son Luke who is two and still not walking.
The door had an extensive birth history, which basically indicated hypoxic ischaemic
encephalopathy. You had to then take a developmental history and describe what examination
and findings youd expect.

MORE:
child with middle ear infection
-

supracondylar fracture

oesophageal defet

counsel a mother after a child has had febrile convulsions

1)

Jake is an 8 year old aboriginal boy who has been experiencing cough and shortness of
breath, particularly at night for the last four months.
His teacher has also said that he is very disruptive in class and doesnt do his work. He has
been getting into fights in the school yard. She is concerned that he has learning difficulties.
Jake lives with his mum, siblings and extended family in Fitzroy.
Jakes Mum is depressed and was in foster care as a child.
Discuss the organic and social causes. Discuss the organic and social management.

2)

2. A mother calls you from home and says that her two year old has just poured a cup of boiling
noodles over herself. You can hear the child screaming in the backfround.

3)

4)

a.

what is the at home management of a scald

b.

describe the assessment once the child arrives in hospital

c.

what is the hospital management

d.

what are the criteria for management of a burn

An 18 month old child presents with abdominal pain and bloody diarrhoea
a.

what is the differential

b.

what is the management

c.

what are the surgical treatments of this condition

What is the management of eczema. What are some of the different issues about managing
eczema in an adolescent.

5)

x-ray showing the double bubble and asking what is this and what is it associated with.

6)

videos showing fits and asking us to describe what sort of ft it was

7)

Sally is a five year old child who fell out of a tree. She was initially ok but then vomited and
became drowsy. Discuss assessment and management.

8)

Andrew is a 6 month old infant whose mother brought him in following a fit. He now has a

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temperature of 39 and he appears floppy and lethargic. Discuss possible causes, history,
examination and management.
9)

Jessie is a nine month old girl brought to your surgery because of concerns raised by the
maternal child health nurse. While Jessies head circumference and length remain on the 75th
percentile, her weight has fallen from the 75th to the 10th.
a.

discuss possible causes

b.

discuss important history

c.

what examination findings will help you determine if the cause is organic or nonorganic?

d.

1)

what will you tell the mother?

Adol has worsening asthma. Poor compliance Take a Hx & he will ask you some questions.
(action plan, SE of steroid :make u fat? Smoking makes u thinner?, do I need a preventer?,
adherence, smoking)
- take a Hx on why compliance is poor and give advice

2)

Take a Hx from a mo of a 23 mo baby with early medical problems (seizures) and determine if
child has developmental delay, if so what, and ?what would you seek on examination to confirm

3)

23mth Developmental delay Hx. 1st mum (Global delay- cant walk, cant wite, cant
build blocks,cant say words, just make noise, not intereact with other child in day
care.) what this child has ?what can u find in phy exam? (neuro signs)
3yo w Recurrent OM & chest infection. Hx, ddx, Ix. See CXR. What advice would u give to
mother who fears immunocompromise

4)

Surg (2 parts:

4 yo with signs of dehydration, cyclical abdo pain, guarding, RIF pain initial assessment and
management, diagnosis, management post diagnosis

neonate with exomphalos born in country hospital, first aid and intitial mx, mx of blood sugars,
considerations for surgical correction

CAH
Smoking and asthma in a teenager
A pale child
Counsel parent about febrile convulsion
Emergency presentation of baby (dont know what that means)

Slide Show
1) Video on Breath holding Spell. A) Whats that? B) Any investigations? What? & why? C) Mx
2) Infant-A)Eczema (pic), red itchy, principle of Mx
B) superimpose of bacterial infection? Mx
C)14 yo later, extra factors to consider for his mx of eczema (treat him not as an infant)
3) Seizure video, describe, what sort (general), what kind (tonic clonic), physical
signs
4) surg-non tender red L scrotum, hydrocele? How to confirm?
5) X-ray (double bubble) Duodenal Atresia. Asso with? Down Syndrome
6) Differentiate pneumonia and bronchiolitis. If acute bronchiolitis, Mx- including time course the
following week.. Mum asked his RF for asthma.
OSCE
5) Adol has worsening asthma. Take a Hx & he will ask you some questions. (action plan, SE of
steroid :make u fat? Smoking makes u thinner?, do I need a preventer?, adherence, smoking)
6) 23mth Developmental delay Hx. 1st mum (Global delay- cant walk, cant wite, cant build
blocks,cant say words, just make noise, not intereact with other child in day care.) what this
child has ?what can u find in phy exam? (neuro signs)
7) Recurrent OM & chest infection. Hx, ddx, Ix. See CXR

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8)

Surg- A)abdomen pain- appendicitis- Hx, exam, Ix, Mx. B) exomphalos, Mx, & mx on
hypoglycemia.

2006
2006.2
1) DDH/ what would you see on history (risk factors), on examination
2)

surgical quiz: 2 clinical cases, what are the pictures, what is the treatment, what would you tell
mum (torsion of testicular appendage/ sternomastoid tumor in baby and adolescent)

3)

on the door, it said: mum complains of 2year old child having seizures and worried about
epilepsy so they wanted one to ask questions, rule out abnormal neurology, then look at a
video which suggested breath holding spells, and have some discussion about it.

4)

perform an ear examination on an 8m child who seems to have a painful ear and fever. (i totally
forgot to interact with the child). Then a picture of the tympanic membrane was shown (red,
effusion, bulging, loss of translucency, etc, etc). How do you manage this?

osce stations paeds 2006 sem 10


1) DDH/ what would you see on history (risk factors), on examination
2) surgical quiz: 2 clinical cases, what are the pictures, what is the treatment, what would you tell
mum (torsion of testicular appendage/ sternomastoid tumor in baby and adolescent)
3) on the door, it said: mum complains of 2year old child having seizures and worried about
epilepsy so they wanted one to ask questions, rule out abnormal neurology, then look at a
video which suggested breath holding spells, and have some discussion about it.
4) perform an ear examination on an 8m child who seems to have a painful ear and fever. (i totally
forgot to interact with the child). Then a picture of the tympanic membrane was shown (red,
effusion, bulging, loss of translucency, etc, etc). How do you manage this?
slide quiz station paeds 2006 sem 10
1) kid w swollen L eyelids (? ddx: orbital/ periorbital cellulitis, how do you differentiate between
them/ management)
2) unequal corneal reflections showing true strabismus (what other examination would you do?/
investigations)
3) petechiae rash over the lower limbs of a child (if child has joint pains, what is the ddx?/ what
are the complications associated with this condition?/ if child is unwell and hypotensive, what is
the ddx?/ what is the immediate management in that context)
4) fever and facial rash in a child with mild/ moderate atopic dermatitis (ddx: looked like vzv to
me.../ how would you tell the dx/ what should you do if the brother is undergoing treatment for
leukaemia)
5) happy baby in one picture, eye in another picture showing pale conjunctivae (dx?/ what are the
causes of this?/ what tests would you order?)
6) videos of 3.5 year old girl does she have speech delay? (videos from the CD ROM of 2 year
old girl speech) (history that you would like to ask parent/ describe speech/ is she delayed?)
7) XR of elbow (Dx: supracondylar fracture/ what structures are you worried about in this fracture/
mx)
8) swollen left hemiscrotum the information given sounded like a hydrocele (dx? is urgent
treatment required? embryological basis of this?)
9) picture of black infarcted bowel at laparotomy + picture of a volvulus (dx? classical
presentation?/ ix to dx this) short question
10) Fever in the 1year old, otherwise well. Bag culture urine shows: Picture of dipstick results (what
is the result?/ what would you do next?/ what future investigations should you do?)

CAH
Breath holding spells: hx, then watch a video of one and talk about breath holding spells
Sx station: two photos- acute scrotum (DDx and Mx), lateral neck swelling (Dx and Mx; I think it was that
SCM lump)
Otitis media: examine a childs ear plus Mx of OM
Examination of babys hip, then talk about causes of hip dysplasia and Mx
2007

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2007.2
1) Discuss the dx and mx of the surgical scenarios presented. (2 scenarios - abdo pain and
abdominal wall defects.)
2)

Mx of recurrent chest and ear infections (incl CXR)

3)

Take developmental hx from worried mother*

4)

Talk to adolescent re. medical problem* (examiner specified inside that a full HEADSS screen
was not required. Teenager had asthma, so take hx regarding recent exacerbation and
possible contributors)

2007.2
1) Examine this childs respiratory system. Explain to the mother using an Asthma Action Plan the
current Mx of this acute episode, prevention of future episodes and use of preventer.
a.
2)

dont forget abdo and ENT

A child with recurrent ear & chest infections mum is worried child make have underlying
immune problem
b.

What do u want to know from Hx?

c.

Say the infx have not been serious, what is ur likely Dx? How would you Mx? Would u
give Atb?

3)

d.

Say the child had serious recurrent chest infx, what are ur Ddx? Ix?

e.

Describe CXR

Developmental Hx of a 2yo child parents worried. Complicated postnatal course with poor
Apgar scores & intubation & PVH haem, suffers from recurrent GOR and seizures
f.

Take developmental Hx

g.

What clinical condition does this child have? At what age is his dev stage?

h.

What signs would u look for in P/E with respect to his past medical Hx? hypertonia,
hyperreflexia

4)

6/52 old baby with a groin lump


i.

Examine baby marks for rapport with mother and baby

j.

Clinical findings? Both testes palpable & no groin lump felt

k.

Ddx? Inguinal hernia, encysted hydrocoele of the cord

l.

Explain to mum what inguinal hernia means and the Mx

m. What should mum look out for while waiting for Sx? Strangulation (persistent lump,
redness, pain, irritability, vomiting)
1)

Dad presents worried re 2y/o with global developmental delay, Hx of hypoxic ischaemic
encephalopathy at birth. Take a Hx then answer questions re level of development and what
you'd look for on examination (hypertonia, hyperreflexia). Dx: cerebral palsy.

2)

No patient, examiner only. Scenario: mom presents worried re child having frequent URTIs
and ear infx (I think), what would you ask on Hx, likely Dx (?CF), DDx, plot growth
charts (failure to thrive), interpret CXR, discuss FTT.

3)

Surg: neonate plus mom p/w lump in baby's inguinal region, please examine, present your
findings as you go, explain to mom likely Dx (inguinal hernia) and planned Mx incl when
surgery will take place.

4)

Resp exam of patient who had been admitted for asthma attack (10y/o boy), dont forget abdo
and ENT, present findings at the end, explain asthma Mx plan to boy and parent (examiner).

1)

Physical exam respiratory. And explain the asthma action plan.

2)

Dev. delay. Interview. You must know the appropriate ages for different milestones and able to

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estimate the child's age.


Cystic fibrosis - given an X-ray and asked to interpret. Also plot values in the growth chart (Be careful!
50% of ppl plotted it wrong). Familiarise yourself with the growth chart.

2007 (.1?)
1. Mum brought daughter, 15 month old (a doll) for an eye check. She is concern about her
daughters right eye which has been moving inward (esotropia).
-

Do a cover test (Communicate with mum and daughter as you go along)

What other tests would you do? (Visual acuity- 100s and 1000s, test for ophthalmoplegia,
fundoscopy)

Watch a video of a cover test: Girl has exotropia (diagnosis and Mx)

Shown a photo of a unilateral white reflex ( Diagnosis, Mx, Complication)

2.

15 year old adolescent came in for DTP vaccination. Take a history and administer the
vaccine.

Hx: Answer her questions regarding why does she need to take this vaccine? What are the
possible side effects? Would it affect her for the next few days as she has drama practice?
Assure her that though it is painful, itll be a quite procedure and shell be monitored for 15 mins
for any anaphylactic episodes.

Administer vaccine

3.

Mum with a 6 week old child (doll). Mum is concern about her frequent crying episodes
(> 4 hrs a day)

Take a history and answer questions regarding differential diagnosis, examinations, and
investigations.

Most likely diagnosis of child Colic

Mum has been upset and angry Post partum blues/ PND

4.

Surgical station (2 scenarios)

a)

A 6 y/o child cut his hand while trying to saw some wood with a rusty saw. Now presenting in
ED.

What would you like to know from the history?(injury, immunizations)

How would you manage him? (examination, general management)

Shown a photo of the cut (deep cuts on boys fingers, he has tingling sensation, pain and
wouldnt let you examine his fingers)

What would you do? (Refer to plastic surgeon)

If the Plastic surgeon is running 4 hours late, what would you do in the mean time?

b)

6 month old girl presenting with intussusception

Explain to parents regarding her condition

What investigations would you do and Mx

2007.?
1) immunization: adolescent comes in with because of a missed DTPa booster. tell him why
immunization needs to be done, address his concerns, and give him an injection
2)

do a cover test on an 18m old child (doll), interacting with mum. watch a video and give your dx
(?esotropia). Causes of squint.

3)

take a hx from mum who has PND, explain infant colic (irritable, inconsolable crying), what
are ur strategies to cope w this. tell the examiner what a newborn checkup involves. what

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investigations would you do?


4)

surgical station:1) scenario of boy cut by old rusty saw, given picture of a hand with laceration
over 2nd and 3rd finger. how would you examine the hand? asked more questions about the
hand. 2) intussusception scenario, talk to mum and tell her about the natural hx of this, and
explain it in laymans terms

osce stations paeds 2007 sem 11


5) immunization: adolescent comes in with because of a missed DTPa booster. tell him why
immunization needs to be done, address his concerns, and give him an injection
6) do a cover test on an 18m old child (doll), interacting with mum. watch a video and give your dx
(?esotropia)
7) take a hx from mum who has PND, explain infant colic, what are ur strategies to cope w this.
tell the examiner what a newborn checkup involves. what investigations would you do?
8) surgical station:1) scenario of boy cut by old rusty saw, given picture of a hand with laceration
over 2nd and 3rd finger. how would you examine the hand? asked more questions about the
hand. 2) intussusception scenario, talk to mum and tell her about the natural hx of this.
slide quiz station paeds 2007 sem 11
1) DDH: given XR of hip, asked what is the anomaly, 2 tests to differentiate this, risk factors
predisposing to this, what are associated abnormalities
2) video of breath-holding spell: what is the abnormality? what would u tell mum?
3) developmental video of boy copying a figure of a circle and a cross: what are the
developmental skills that are required to complete this task?
4) video of respiratory distress: what are the signs that you can see and what is it showing?
5) plot on growth charts, given picture of boy with proximal muscle wasting: 2 likely ddx, what ix
would you do?
6) picture of haemangioma: what is the natural hx of this?
7) picture of hypospadias: name 3 associated features
8) picture of eczema superinfection: what is it? what is your mx?
9) video of 2 year old girl: what communication skills is she demonstrating?
10) picture of intraoperative and diagram of volvulus: how do they present?
2008

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2008.1
1) 6 month old child presenting with fever and vomiting. Half the time was for
taking a history from Mum (no examination). Then they asked what
differential diagnosis would be (4 were asked for) and what tests would you
order as well as other management. We were then given vitals for the child
(had fever, capillary refill of 4 seconds and tachycardia) as well as results for
urine dipstick, LP and MSU MCS and asked to interpret.
2) DDH Station- 4/52 w. mum for 6 week checkup. You had to talk to Mum
about doing the exam, what it involved. Examination was performed on a
dummy and observed by the examiner. They then asked what were the risk
factors. What on physical examination would lead you think the child had
DDH? Short station, finished with time to spare
3) Febrile convulsions- 2.5 year old kid who has had his second febrile
convulsion in the last year. He's been previously well with no past
developmental or medical history. The child's conveniently asleep so you need
to talk to Mum and answer her questions about febrile convulsions. She asks
questions more than once on occasion but it went quite well (if you knew your
facts, a lot of people didn't revise this and struggled immensely). It was a good
station though, Mum actor was quite genuine and the interaction was an
interesting one.
4) 28 week premature baby presents at 3 months: measure head circumference,
plot on charts, examine eyes, examine motor development, what on physical
exam suggests cerebral palsy, if cerebral palsy, will the baby have a big/small
head? (small)
Developmental station- growth chart featured in this. Mum came in with Bubs
who was an ex-28 weeker and was now 3 months old. Bubs is a doll in this
case. They gave you a rather complicated history but none of it was actually
relevant to the task. So you had to begin by demonstrating how you measure
head circumference and then plot it on the chart. You had to correct for age of
course. They also gave current weight, birth weight and current length and
asked you to comment. He was doing fine. They then asked how would you
assess vision in a child. She stopped me once I pulled out my toy and did fix
and follow as well as examination using a pen torch (mentioned reflexes here
as well). She then asked me to demonstrate how I would assess gross motor
function. The trick was to put him on the bed apparently (some people
examined the doll in Mum's lap). I was then asked what gross motor signs
would you expect at 6, 12, 18, and 24 months. They asked about reflexes (to
name 4- grasp, rooting, Moro and suck). And that was pretty much it.
2008.2
1. With consultant - spot diagnosis - gastroschesis or exomphalos. What is your
immediate management? (There was another bit to this that I've forgotten)
2. This man has brough in his sick kid (not present) to ED. Take a history (some
already provided) - pooing a lot. What would you like to examine (hydration, etc.).
Now, you've assessed the child and he's ok to go home: viral gastro. Counsel the
father (there's a good speil on this on the RCH website) - e.g. keep fluids up
(gastrolyte or pedilyte), will be off food - that's ok, notify creche / child-care. Bring
back if worried, persistant, gets worse.
3. Eye examination. Do it. Watch video and do spot diagnosis. What's the possible
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complicaton (amblyopia)
4. Counsel girl for immunisation and do it. Remember the anaphylaxis bit - check for
adrenaline nearby and keep pt for 15 mins after.
CAH
1) Strabismus examination of an actual child
Perform a cover test Eye exam of 10 yo child (Must bring your own toy)
Questions:
Look at a video of a girl with strabismus (the video that was shown in Lectures) and explain
what type of strabismus she has
What other eye examinations would you do on a child? E.g visual fields, visual acuity,
ophthalmoscope
What would you look for with an ophthalmoscope e.g. retinoblastoma
List the important features of a Paediatric History with particular reference to a child with
Strabismus
2) Surg Mx of exomphalos and acute abdo pain just the examiner and you

Recognise a picture of Exomphalos

Run through the immediate (first aid) Mx, include informing the parents

List the DDx of acute abdo pain in male child

List the elements of Hx and Ex that you would look for to help your Dx
3) Counselling of a Mother of an 18 month child with gastro with a female actor

Advice about what to feed the child, what fluids are appropriate

What to look out for and when she should come to hospital

Advice about dairy products


4) Immunisation counselling of a teenage girl with a female actor and fake arm for injections

Girl requires catch up immunisation but she is apprehensive

Counsel her as to why immunisation is a good idea (eg prevent you getting
sick, herd immunity, good thing to do for your community to protect those
who cant be immunised or those who immunisations dont work etc)

Take a pre immunisation Hx (e.g any allergies, do you have a fever today)

Give her the injection (on the fake arm next to her), (syringe was already
drawn up, needed to swab, inject into deltoid, hold pressure on the site etc)
talk through the procedure with the actor.

Mention that she should hang around for about half an hour in case of
anaphylaxis
2009
OSCEs
1. Jo (real-life child) has been referred because of a murmur. Asked to do a cardiovascular
exam. At end, was asked what simple investigation you would do (CXR) and asked to interpret
it (normal CXR). Asked most likely diagnosis (innocent murmur) and what would you explain to
mum. [Station comprised of just examiner and child.]
2.

Mother worried her 2 year old son might have seizures. Asked to take a history. At end, asked
what the most likely diagnosis (breath-holding spells) is and what features on history suggest
that.

3.

Ear exam on a 10 month old child (doll). Examiner asks what else you would do in exam
(pneumatic otoscopy). Given a photo of ear drum and asked what you see (Acute otitis media).
Asked what your management is for first 48 hours, and subsequently if no improvement. Really
short station. [Had a bit of difficulty with this one, as the dolls ears dont actually have a canal,
so cant exactly insert the speculum properly.]

4.

Trauma station, talked through with examiner. Boy fell from bike, complaining of abdominal
pain. First asked what youll like to ask on history. Immediate management (primary survey,
ABCD, analgesia, etc.).Secondary survey shown a picture with bruise on left side of chest.
Asked what possible injuries (ruptured spleen, tension pneumothorax, etc.). Whats most
appropriate investigation (CT)? Then shown a CT abdo scan and asked what you see. Setting
in rural hospital, so what else would you do? Call trauma team at paediatrics hospital, arrange
for PETS to transfer him, communicate to parents whats happening.

Slide Quiz

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1.

Development. Shown a video of the 2 year old (from CD-ROM) copying circle. Asked what
developmental skill shown, when 90% of normally developing children can do skill. Asked what
neurodevelopmental skills required to complete skill. Asked what 2 things indicative of a
preverbal childs cognitive ability (receptive language, play).

2.

Burns. Asked what your management priorities. What you would specifically do for the burn?

3.

Video of child in respiratory distress (taken from the acute respiratory problems video you get
in the library; its the chubby child with croup). List the signs you can observe. List three
differentials. What would you do if child deteriorated?

4.

Video of girl in respiratory distress. [Asthma] List three signs you observe (wheeze isnt one of
them). Management if she deteriorated. As the story goes, she was admitted and recovered,
then asked what your discharge plan would be (2 marks for this part).
3 month old child with non-tender transilluminable scrotal lump that you can get above.
Diagnosis? (hydrocele) Does it require urgent operation? (no) Embryological origin? (patent
processus vaginalis)

5.

6.

Pelvic x-ray (taken from Medical Imaging CD-ROM). [DDH] Describe what you see. Describe 2
clinical screening tests done earlier that would have detected the problem (5 marks). At what
age should these tests be done? Risk factors for condition (4 marks).

7.

Photo of hypospadias. Identify condition. List three cardinal features. Name one associated
anomaly.

8.

Infected midline neck lump. Thyroglossal cyst or submental


lymph node?? (These are the only 2 midline neck lumps that get
infected.) Asked to identify problem. Give 2 reasons to support your
diagnosis.

9.

6 year old boy present with sore throat and high fever. Photo
shown of his throat.
List 4 differentials. What makes it more likely on history and exam
that it is of a bacterial cause (4 marks)? Name 3 complications if it
was a bacterial infection. What would your management be?

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