MBCHB IV GROUP B

OSCE 30 March 2012

WARD BI CVS EXAMINATION

Sharmaine Kanjuta 3y 8m/ F

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium - without lymph nodes and
pulses)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, dysmophic features, pallor ………… 5 5
Inspection: 2
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
Heart sounds………………………………………………………………. 1
Murmurs in all zones (eliciting the murmur)……………………………… 2 -
Murmur description ……………………… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /22
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /14

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

(Diagnosis: Congenital Rubella syndrome)

Grand Total………………………………………………………………………..../40

1
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CNS EXAMINATION - HEAD

Bethany M Tsvarai - 4mo/F Wt 6.3kg

Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients head

Test Technique
Appropriate greeting (caregiver+/-child) 1
Inspection – comment on large head, posture – flaccid paraparesis………………
2 1
Measurement of head circumference (….cm) 1 1
Interpretation 1
Palpation 2
Fontanelles 1
Suture lines 1
Shunt 1
Percussion
Crack pot sign (hydrocephalus) 1 1`
Suggest other examination
Back (Myelomeningocele repair) 1
Cranial nerves 1

TOTAL SIGNS …………………………/11

TOTAL TECHNIQUE………………………………………………………..…5
……
Interpretation/differential diagnosis…………………………/4
(Hydrocephalus with repaired myelomeningocele and flaccid paraparesis)

Grand total………………………………………../20

2
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CNS EXAMINATION - MOTOR SYSTEM

Justice Mazvovemwe
Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients lower limbs(motor system)

Test Technique
Appropriate greeting caregiver+/-child 1
Inspection
Gait (if appropriate) 1

Muscle wasting 1
Posture 1
Fasciculations 1
Trophic changes 1
Palpation
Tone-Hip joint, knee joint, ankle ) 3 2
Muscle tenderness 1 1
Power grading
Hip joints( all muscle groups) 2 2
Knee joints(all muscle groups) 1 1
Ankle(all muscle groups) 1 1
(Infant gross assessment, observe movement- total for power- 2 1)
Reflexes
Knee jerk 2 2
Ankle 2 2
Clonus (anke/patellar ) 1 1
Babinski 1 1
Inspection of the back 1 1

TOTAL SIGNS…………………………………/21(Infant…………../19)
TOTAL TECHNIQUE ………………………………19 (Infant …………../11)
Interpretation/differential diagnosis………………………………../3

Grand total…………………………………../38 or …………………………./33(infant)

3
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CVS EXAMINATION

Shamiso Maradze 1y/F

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium - without lymph nodes and
pulses )

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, dysmophic features, pallor ………… 5 5
Inspection: 2
Comments on microcephaly 1
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
st nd
Comments on 1 and 2 hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (pansystolic murmur in left parasternal region, VSD)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /22
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /14

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

4
MBCHB IV GROUP B
OSCE 30 March 2012

Thomas Zenda 8mo/M

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium without lymph nodes and
pulses.)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, pallor ……………………..………… 4 4
Inspection: 2
Comments on dysmorphic features (Down’s syndrome)…………………………..2
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
Comments on 1st and 2nd hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (pansystolic murmur in left parasternal region, VSD)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /25
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /11

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

(Down’s syndrome with VSD)

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

5
MBCHB IV GROUP B
OSCE 30 March 2012

Rmbidzai Makombe 1y/F wt-6.3kg

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium - without lymph nodes and
pulses )

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for jaundice, pallor, clubbing, cyanosis, oedema, ,…………..………… 5 5
Inspection: 2
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes- normal apex)…………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
st nd
Comments on 1 and 2 hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (systolic murmur in left midsternal edge grade III/IV)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /23
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /12

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

(Haemolytic anaemia with pallor and systolic murmur grade 3/4)

Grand Total………………………………………………………………………..../39

WARD BI CVS EXAMINATION

Simphwe Dhewa 2yrs

6
MBCHB IV GROUP B
OSCE 30 March 2012
Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general without lymph nodes and pulses but
precordium)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, pallor ……………………..………… 4 4
Inspection: 2
Comments on dysmorphic features (Down’s syndrome)…………………………..2
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
st nd
Comments on 1 and 2 hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (pansystolic murmur in left parasternal region, VSD)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /25
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /11

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

Taonaishe Muranda 2yrs

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

7
MBCHB IV GROUP B
OSCE 30 March 2012
Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general without lymph nodes and pulses but
precordium)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, pallor ……………………..………… 4 4
Inspection: 2
Comments on dysmorphic features (Down’s syndrome)…………………………..2
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
st nd
Comments on 1 and 2 hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (pansystolic murmur in left parasternal region, AVSD)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /25
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /11

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

Tadiwanashe Karimanzira 7mo

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

8
MBCHB IV GROUP B
OSCE 30 March 2012
Examine the CVS system (quick general and precordium - without lymph nodes and
pulses)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, dysmophic features, pallor ………… 5 5
Inspection: 2
Comments on microcephaly 1
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
Comments on 1st and 2nd hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (pansystolic murmur in left parasternal region, VSD)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /22
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /14

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

(Congenital rubella Syndrome)

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

Tadiwanashe Karimanzira 7mo

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium - without lymph nodes and
pulses)

9
MBCHB IV GROUP B
OSCE 30 March 2012
Sensitivity and attitude Sign T
Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, dysmophic features, pallor ………… 5 5
Inspection: 2
Comments on microcephaly 1
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
st nd
Comments on 1 and 2 hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description (pansystolic murmur in left parasternal region, VSD)…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /22
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /14

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

(Congenital rubella Syndrome)

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

Godknows Manase 11yrs

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium - without lymph nodes and
pulses)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -

10
MBCHB IV GROUP B
OSCE 30 March 2012
Comments on nutrition …………………………………… 2
Checks for clubbing, cyanosis, oedema, pallor …………………….………… 4 4
Inspection: 2
Comments on microcephaly and dysmorphic features …………………………...2
Checks for chest deformity ………………………………………….. 1 -
Checks for respiratory distress ………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1

Auscultation :…………………………………………………………… - 4
Comments on 1st and 2nd hearts sounds…………………….………. 1
Listens in all listening posts ……………… ……………………………… 2 -
Murmur description ………………………………………………….…… 3 -
TOTAL SIGNS --------------------------------------------------------------------------- /25
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /11

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

(Congenital rubella Syndrome)

Grand Total………………………………………………………………………..../40

WARD BI CVS EXAMINATION

Faith Kupfinya 2yrs/F Wt - 5.6kg

Patient’s Name /Age---------------------------------------------------------------------

Name of Consultant ---------------------------------------------------------------------

Name of Student -------------------------------------------------------------------------

Examine the CVS system (quick general and precordium - without lymph nodes and
pulses)

Sensitivity and attitude Sign T

Greets child and parent appropriately. …………………………………….. 1 -
Comments on nutrition (severe wasting, dermatosis, hair changes)………………2
Checks for oedema, pallor, clubbing, cyanosis……………………….…………...4 4
Inspection: 2

11
MBCHB IV GROUP B
OSCE 30 March 2012
Checks for respiratory distress.……………………….…………………………...2
Checks for chest deformity ………………………………………….. 1 -
Comments on precordium……………………………………………….. 2
Palpation:
Apex beat (locates and characterizes)…………………………………….. 2 1
Examines for thrills (palpate all valvular areas), 2 1
Checks for parasternal heave………………………………………………. 1 1
Palpates for liver …………………………………………………………………..1 1
Auscultation :…………………………………………………………… -
Comments on 1st and 2nd hearts sounds…………………….………. 1 1
Listens in all listening posts ……………… ……………………………… 2 -1
Tachycardia and gallop ………………………………………………….…… 3 -1
Listens to chest – coarse crackles front/back………………………………………2 1
TOTAL SIGNS --------------------------------------------------------------------------- /28
TOTAL TECHNIQUE ----------------------------------------------------------------------------- /12

Interpretation of physical finding(can be differential diagnosis)……………....... ……./4.

((Cardiac failure, corpulmonale, severe acute malnutrition)

Grand Total………………………………………………………………………..../44

WARD BI CNS EXAMINATION - MOTOR SYSTEM

Justice Mazvovemwe 4 yrs

Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients lower limbs(motor system)

Test Technique
Appropriate greeting caregiver+/-child 1
Inspection
Gait (if appropriate) 1

Muscle wasting 1
Posture 1
Fasciculations 1
Trophic changes 1
Palpation
Tone-Hip joint, knee joint, ankle ) 3 2
(Picks spasticity)
Muscle tenderness 1 1
Power grading

12
MBCHB IV GROUP B
OSCE 30 March 2012
Gross assessment, observe movement- total for power- 2 1
Reflexes
Knee jerk 2 2
Ankle 2 2
Clonus (anke/patellar ) 1 1
Babinski 1 1
Inspection of the back 1 1

TOTAL SIGNS…………………………………/19
TOTAL TECHNIQUE ………………………………11
Interpretation/differential diagnosis………………………………../3

Grand total………………………………….. …………………………/33

13
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CNS EXAMINATION - MOTOR SYSTEM

Munashe Kambanje 3 yrs

Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients lower limbs(motor system)

Test Technique
Appropriate greeting caregiver+/-child 1
Inspection
Gait (if appropriate) 1

Muscle wasting 1
Posture 1
Fasciculations 1
Trophic changes 1
Palpation
Tone-Hip joint, knee joint, ankle ) 3 2
Picks hypertonia
Muscle tenderness 1 1
Power grading
Gross assessment, observe movement- total for power- 2 1
Reflexes
Knee jerk 2 2
Ankle 2 2
Clonus (anke/patellar ) 2 2
Babinski 1 1
Inspection of the back 1 1

TOTAL SIGNS……………………………………………../20)
TOTAL TECHNIQUE …………………………… …………../12)
Interpretation/differential diagnosis………………………………../3

Grand total…………………………………..…………………………/35

14
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CNS EXAMINATION - MOTOR SYSTEM

Tashelle Mazivire 5yrs

Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients lower limbs(motor system)

Test Technique
Appropriate greeting caregiver+/-child 1
Inspection
Gait (if appropriate) 1

Muscle wasting 1
Posture 1
Fasciculations 1
Trophic changes 1
Palpation
Tone-Hip joint, knee joint, ankle ) 3 2
Muscle tenderness 1 1
Power grading
Gross assessment, observe movement- total for power- 2 1
Reflexes
Knee jerk 2 2
Ankle 2 2
Clonus (anke/patellar ) 1 1
Babinski 1 1
Inspection of the back 1 1

TOTAL SIGNS……………………………………………../19)
TOTAL TECHNIQUE ……………………………… …………../11)
Interpretation/differential diagnosis………………………………../3

Grand total…………………………………..…………………………./33

15
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CNS EXAMINATION - MOTOR SYSTEM

Ashley Gombiro 6 yrs

Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients lower limbs(motor system)

Test Technique
Appropriate greeting caregiver+/-child 1
Inspection
Gait (if appropriate) 1

Muscle wasting 1
Posture 1
Fasciculations 1
Trophic changes 1
Palpation
Tone-Hip joint, knee joint, ankle ) 3 2
Muscle tenderness 1 1
Power grading
Hip joints( all muscle groups) 2 2
Knee joints(all muscle groups) 1 1
Ankle(all muscle groups) 1 1
Reflexes
Knee jerk 2 2
Ankle 2 2
Clonus (anke/patellar ) 1 1
Babinski 1 1

TOTAL SIGNS…………………………………/20
TOTAL TECHNIQUE ………………………………18
Interpretation/differential diagnosis………………………………../3

Grand total…………………………………../41

16
MBCHB IV GROUP B
OSCE 30 March 2012

WARD BI CNS EXAMINATION - MOTOR SYSTEM

Tadiwanashe Chapungu 8 yrs

Patient’s Name/Age : ------------------------------------------------------------------------

Name of Consultant --------------------------------------------------------------------------

Name of Student ------------------------------------------------------------------------------

Examine this patients lower limbs(motor system)

Test Technique
Appropriate greeting caregiver+/-child 1
Inspection
Gait (if appropriate) 1

Muscle wasting 1
Posture 1
Fasciculations 1
Trophic changes 1
Palpation
Tone-Hip joint, knee joint, ankle ) 3 2
Muscle tenderness 1 1
Power grading
Gross assessment, observe movement- total for power- 2 1
Reflexes
Knee jerk 2 2
Ankle 2 2
Clonus (anke/patellar ) 1 1
Babinski 1 1
Acute severe malnutrition 1 1
TOTAL SIGNS……………………………………………../20)
TOTAL TECHNIQUE ……………………………… …………../12)
Interpretation/differential diagnosis………………………………../3

Grand total…………………………………..…………………………./35

17
MBCHB IV GROUP B
OSCE 30 March 2012

18