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Paediatric OSCEs

helpful hints for MBBS4
by

Rachel Folwell

on 21 April 2014

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Transcript of Paediatric OSCEs

History Station
Examination
Station
Paediatric OSCEs
My Hopefully Helpful Hints
Nausea and vomiting
Jaundice
Developmental history
Headache
Marfans Syndrome
Congenital Diaphragmatic Hernia
Syndromic Infant with Murmurs

Neurofibromatosis

Syndromic Infant with Renal Transplant
Communication
Station
Finally...
7 minutes is enought time for anything!

Make a List *share it*

Eat (lots) on the day of your exam!
Important Points
Rule out potential serious pathology

Address parent's concerns

Additional points to cover:
- Perinatal history
- Development history
- Immunisations (part of drug history)
Important Points
ICE ICE ICE!

In conflict, aim to reach a mutually acceptable plan

Saftey-net

Offer written information
Accidental Overdose
CT Head Scan

Type I Diabetes Mellitus
Autism
Asthma & Inhaler Technique
MMR Vaccination
'Borrowing' patient leaflets
www.patient.co.uk
Children's websites

Practicing with non-medics
Important Points
Talk to both child and parent!

Percuss if >10 years old (or ?pneumothorax)

On inspection:
"I would like to plot her height and weight on an age and sex-standardised growth chart."

Don't be afraid to say dysmorphic
Perinatal
Pregnancy & Delivery
Gestation & Weight
SCBU
Feeding & Growth
Development History
"Do you have any concerns about Ema's development?"
"Do you have any concerns about Ema's hearing or sight?"

When did she first...
Smile
(6 weeks)
Sit
(6 months)
Walk
(12 months)
First word
(12 months)
Use words together
(18 months)
Nursery/School
Immunisations
"What immunisations has Ema had?"

BCG in Southwark
Red Book
Helpful to Me...
Question Lists
Differential Cards

100 Cases in Clinical Paediatrics
for scenarios
Infant (birth-1 year) 120-160 bpm
Toddler (1-3 years) 90-150 bpm
Pre-School (3-6 years) 80-140 bpm
School-Aged (6-12 years) 70-120 bpm
Adolescent (>12 years) 60-100 bpm
Heart Rate
Helpful to Me...
'Syndrome Posters
Learning about scars
Respiratory Rate
Infant (birth-1 year) 30-60 brpm
Toddler (1-3 years) 20-30 brpm
Pre-School (3-6 years) 22-34 brpm
School-Aged (6-12 years) 18-30 brpm
Adolescent (>12 years) 12-16 brpm
Apex Beat
Harrison's Sulcus
<4 years - 4th intercostal space
>4 years- 5th intercostal space
Transposition of Great Arteries
Valve Replacement
Heart Transplant
Blalock-Taussig Shunt
(subclavian to pulmonary artery in Tetraology of Fallot)
PDA ligation
Coartation of aorta repair
Blalock-Taussig shunt
PDA ligation
Midline Sternotomy
Right Thoracotomy
Left Thoractomy
SUbcostal
Congenital diaphragmatic hernia repair
Pyloric stenosis with pylomyotomy
Helpful to Me...
Mrs/Mr Samuel is visiting you at the GP practice.

He/she is concerned about their 2-week old daughter who appears yellow. Take a focused history of jaundice and explain your likely diagnosis.
Jamie is a 10 year-old with newly diagnosed type I diabetes mellitus.

He/she is worried about whether this will affect her dancing.
Elicit his/her concerns.
Gel hands at the beginning and end of EVERY station

"Is it okay if I talk out lod to my examiner so they know what it is I'm looking for?"
Comment on signs themselves
Email me: rachel.folwell@kcl.ac.uk
Chronic asthma and rickets
Full transcript