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Summary of Paediatric OSCE guide Part 2
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a summary of common paediatric OSCE scenario for 4th year and final year medical student
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Paediatric OSCE guide part 221. Faltering growth
HOPI-
How long?
any symptoms bothering him at all?
Urination? bowel movement? Weight loss?
Feeding? Swallowing? Any vomiting or reflux?
Irritability? Has he been active? Does he behave like his usual self?
Developmental delay?
ICE
Pregnancy problem? Do u smoke or taken any medication when you were pregnant? Before during
after the delivery?
Mode of delivery?
Full term?
Birth weight?
Past medical history? Recent illness? Any problem when he was young? hospital admission
Immunisation? Baby check everything alright?
Family?
Social? Smoker in the house? Recent travel? Enough support? How does he behave at home? Coping
well? Siblings?
Constitutionally small child-which means that the child has temporary growth delay compared to his
peers, but this is completely normal, usually will catch up during their teenage year, and nothing to
be worried about
There is no need for further investigation or intervention for now, what we will do is that we will
have regular follow up to check on the growth charts, if this persists for a long time, further
investigation might be needed to find out the underlying
Other differentials:
psycho-social deprivation
, inadequate feeding
coeliac or cystic fibrosis
cow milk protein intolerance
management: blood test to check the nutrient levels, antibodies, sweat test, avoid some food,
regular follow up to see how he is getting on
22. Henoch-Schonlein purpura
What- an immune condition where the antibody targets the blood vessel and inflammation occurs
around the blood vessel causes some blood leak
Causes- exact causes still unknown, a recent viral infection could be the trigger for it
Problem- usually its harmless, however some people will develop some kidney problem, joint
problem, abdomen pain. Blood pressure, Urine test and blood test (U&E, CRP, FBC,BC) might be
needed to detect the signs of kidney involvement, if there is kidney involvement, follow up to
monitor changes in kidney function
Management- usually it will go away in a few weeks’ time. However, we would offer you some
paracetamol to control the pain and temperature, in some serious cases, steroid might be needed.
Follow up to check urine and bp
23. Inhaler and spacer explanation
ICE-ideas, concerns, expectation
What-is a medication called salbutamol, its action is to dilate the airway to allow the air to flow
freely inside the airway so that the child can breathe better, this is a spacer, the purpose of it is to
allow the child to breath in the medication efficiently to allow the medication to settle down in the
lung for it to be effective as the breathing technique might not be as good as adult
Why- it’s a medication for asthma as asthma is a airway narrowing disease caused by overactive
immune system and its trigger like pollen dust exercise animal fur and cold air.so, it’s really
important to identify what the trigger is
How-give it a good shake to make sure the medication is well mixed
Remove the cap and make sure there is no object obstructing the opening
Connect it to the spacer
Give one puff to make sure the device is working
Sit upright and head tilt upward to allow them to breath efficiently
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