Manned OSCE

MOCK OSCE 2012PUNE

Station 23

• Counselling of a 15 year old boy with BMI of 36 (12 marks)

• Dr. Mayuri Dhongade

Roll no - Marks obtained

• Introduction ,ask for language(1)• Explains the meaning of increased BMI( 1)• Explains the co morbidities of obesity (1)• Explains change in diet (traffic light diet plan) (2)• Explains importance of activity / exercise (2)• Importance of avoiding high risk behaviour ex

smoking (1)• Role of medicines and surgery SOS(1)• Gives positive encouragement (1)• Ask for doubts and clarify (1)• Thanks (1)

Station 24

• History taking of a mother with child having short stature (14 marks)

• Dr.Rushikesh Damle

Roll No.• Introduction ½ • Ante-natal History– Substance abuse, Medication, Infections (IUGR) 1• Birth History -- Birth weight /Gestation age ( IUGR) , H/O birth asphyxia ( Hypopituitrism),

Breech delivery, Neonatal hypoglycemia (GHD) Prolonged neonatal hyperbilirubinemia (Hypothyroidism) 2

• Developmental milestones . (Hypothyroidism ,chromosomal/genetic cause) 1• Shortness of breath, cyanosis, cough, fever, (Heart disease, asthma,TB) 1/2 • Diarrhoea, Steatorrhoea, Abdominal pain (Malabsorption) 1/2 • Head ache , vomiting, visual problems ( Pituitary – hypothalamic mass) 1• Constipation, lethargy, feeding difficulty (.Hypothyroidism) 1• Polyuria ,(.RTA, Chronic renal failure ) 1• H/O Hepatitis, distension abdomen, malena (Chronic liver disease ) 1• Recurrent blood transfusions ( Thalassemia and other chronic anemias) 1 • Dietary history .. to elicit weaning practice, calorie and protein intake 1• Drug history .. prolonged use of corticosteroids, amphetamine derivatives. 1 • Family history of SS in first /second degree relatives (FSS), Delayed puberty in one or both

parent (CDGP) 1• Social history .. child abuse, family discord, emotional deprivation (Psychosocial dwarfism) 1/2•

Station 25

• Show motor examination of right arm of this child (12 marks)

• Dr. Sandeep K.

Roll No. Marks

• Introduction 1• Asks Permission and gives assurance 1 • Inspection and Posture Assessment 1• Clinical acumen and patient rapport 1• Assessment of tone 2 • Assessment of power in all joints Ex Shoulder, Elbow,

Wrist 2• Assessment and grading of Deep tendon reflexes 2• Inform results to examiner1 • Thanks 1

Station 26

• You are attending a labour call. A full term baby is born with clear liquor, no spontaneous respiration.

• Continue with the resuscitation• (14 marks)• Dr Ashish Dhongade

Roll No marks obtained

• Warm, clear airway, dry stimulate 1• Checks Heart rate /ask for vitals 1• Starts PPV, SpO2 monitoring 2• Checks Heart rate /ask for vitals 1• Ventilation correction steps 2• Checks Heart Rate ask vitals1• Consider intubation/chest compression 2• Checks Heart Rate ask vitals1• Medications 2• Post resuscitation care 1

Station 27

• Counselling of a mother of 1 year old boy with Breath holding spells (12 marks)

• Dr.Ram dhongade

• Introduction ,establish rapport 1 • Ask language in which mother comfortable 1 • Explains benign nature of disease 1• Explains need to avoid reinforcement 1• Explains anticipation and intreceding before actual episode 1• Explains no need for investigations 1• Explains role of Medical management 1• Explain time for further evaluation or investigations 1 1/2• Explain precaution in next episode 1 1/2• Ask for doubts and clerify 1• Thanks 1

Station 28

• Take the following measurements for this child• Head circumference• Mid upper arm circumference• Length of this child is:• Calculate his BMI, Kanawati index• (12 marks)

• Dr. Ashwin Borade

Roll No. Marks obtained

• Introduction ,estabilish rapport 1• Counsels child and parent 1• Correct positioning of tape on head 1• Correct positioning of non dominant hand 1• Correct site of mid upper arm by measuring exact mid point

between acromion and olecranon 2• Correct formula and calculation of BMI • BMI = Weight (kg) / [Height (m) x Height (m)].2• Correct formula and calculation of Kanawati Index • MUAC divided by occipitofrontal head circumference2• Proper documentation 1• Thanks child and parent 1

Station 29

• Counsel the mother of a 6 month old baby about complementary feeding

• Marks 12• Dr. Preeta Mathur

Roll No. Marks obtained

• Introduces and establishes rapport 1• Advises continuation of breast feed upto 2 yrs. 1• Advises introduction of complementary foods 2• Advises cereals first, vegetables, fruits next. 2• Stresses on home prepared complementary foods. 1• Stresses on spacing of new foods by at least 3 to 4 days 1• Stresses on hygiene of feeds (handwashing)1 • Discourage use of feeds such as pudding and dessert which contain

only calories and not nutrient. 1• Avoid animal milk upto 1 yr. 1• Ask for doubt and clarify, thanks 1

Station 30 • You are called to attend a term delivery where baby was

antenatally diagnosed to have some congenital lung anomaly details not available. The baby was born cried immediately after birth but soon developed cyanosis, tachypnoea and chest recessions You have done the initial steps of resuscitation and intubated , transferred to NICU. Baby was ventilated and Xray was done which showed.

• Manage the case .• What procedure is done on laptop• 12 marks)• Dr Priti ladd

Roll no. MARKS OBTAINED

• Initial care in NICU /basic management 2• surgery be undertaken soon after the birth 1• Ventilatory strategies that you follow 2• The complications that may develop and management 1• The importance of blood pressure and pH on blood gas in such a case 1• The management and newer modalities of treatment? 2• Parental counselling and financial constrain 1• EXIT procedure 2

EXIT Procedure