OSCEs for Medical Students, Volume 3 Second Edition

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Paediatrics Answers 125STATION 1.4GrowthThis station can be run with a child of any age, but will work best over 4 years. For ababy, a manikin will be used. For a manikin, the first item is not used.Assessment Good Adequate Poor/not doneAnswers1 Appropriate introduction (full name androle)2 Candidate washes their hands using thealcohol handwash provided (no marks ifcandidate only expresses the need towash if handwash is provided)3 Explains what about to do4 Measures head circumference (threeattempts)5 Selects appropriate length/heightdevice6 Uses correct technique for length/height7 Weighs correctly, ensuring properlyundressed8 Obtains all measurements with smallerror9 Plots three measurements accurately10 Describes current and past measurements11 Provides differential diagnosis12 Does examination in professional manner
126 OSCEs for Medical Students, Volume 3AnswersCommentGrowth assessment in children should be very easy, but may be difficult to doaccurately. The head circumference is the largest repeatable circumference betweenthe occiput and forehead. Three attempts should be used. Height is used over 2years old and supine length under 2 years old. The eyes and ears should behorizontal (or vertical if supine), the heels together and gentle traction should be puton the mastoid process (and feet if supine). Weight should be done with onlyunderclothes and no nappy.Plotting on the centile chart is done with weeks under 1 and months thereafter. Ifthere is information that the child was born early, it is worthwhile for the first year toallow for this when plotting the measurements.In a growth station you are most likely to get a normal child or a manikin. A childwith a syndrome is a possibility (small, light, small head), or one with microcephalyalone, or perhaps a hormonal problem (short and fat). Another possibility is a childfailing to thrive with a systemic disease (relatively light, but height and headcircumference maintained). The growth chart here shows a small child with normalgrowth.
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OSCEs for Medical Students, Volume 3 Second Edition

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