Paediatric OSCE guide Part 1
1. Paediatric history taking structure
Presenting complaint
HOPI
Past medical history: any problem in the past
Birth and neonatal history: full term? How was he delivered? Any problems after the delivery? Was
he admitted to special care unit?
Medication: ask about immunisation
Family history:
Social history: what does the parent work as? Smoker in the family? Diet?
Development: any problems with his development milestone?
2. Childhood absence epilepsy explanation
What- a type of seizure where they blank out for few seconds
Causes- unknown, but It has been linked with genetic components
Problem: usually harmless, but it can be dangerous if it happens when the child is in the middle of
danger
Management: sometimes EEG is needed to confirm the diagnosis
antileptic drugs - ethosuximide, refer to a paediatric neurologist
3. Apgar score interpretation
Apgar score 0 1 2
Appearance all blue blue extremities pink
Pulse 0 <100 >100
Grimace no response feeble cry when stimulated sneeze or cough
Activity absent limb flexion active
Respiration nil slow irregular strong cry
1 and 5 minutes after birth
, Reassess later if score is low
3 and below bad
4-6 fair
7-10 normal
if Apgar score remains below 3, reassess at later times such as 10, 15, or 30 minutes, risk of longer-
term neurological damage
4. Asthma explanation
What- an airway conditions where there is narrowing of the airpipe, which is triggered external
triggers like pollen, dust, animal furs and so on
Causes- the cause of this is that there is overactive immune system which will trigger it by the
external trigger that we mentioned just now, causes inflammation of the air pipe which causes the
narrowing of the pipe, sometimes it runs in the family, people with eczema and hay fever have
higher risk of getting it as well
Problem- usually its manageable, most of them will get rid of it when they are older although some
persist into their adulthood
Management- there is a few things we can do to manage this problem, here are two ways of
managing it, 1st one is preventive, try to identify what is the trigger and avoid contact with the
trigger
2nd is medical, red inhaler-steroid lower the chance of getting asthma attack
Blue inhaler, use it when the symptoms come, can use it up to 10 times, 10 mins apart, if not getting
better, go to the nearest a and e to seek for further treatment
In the meantime, if breathing effort is severe, turn blue, could not finish sentence and unconscious,
go to the nearest A&E to seek for help
Leaflet to patients
5. New-born assessment
Brief birth history + feeding, bowel, and urination
ICE
General inspection
Colour, tone, movement, no medical gadget, no respiratory distress