NAC OSCE Paediatric Assessment

Question 1

What is the 'Paediatric Assessment Triangle' (PAT) and what does it assess?

Accepted Answer

A rapid visual and auditory assessment tool that evaluates Appearance (consciousness, tone, interactivity), Work of Breathing (respiratory effort), and Circulation to Skin (colour, perfusion) within the first 30 seconds

Answer

A tool for measuring a child's height, weight, and head circumference

Answer

A method for calculating paediatric drug doses

Answer

A screening tool for developmental delays

Question 2

A 6-month-old infant presents with fever of 39°C. Which of the following findings would be MOST concerning?

Accepted Answer

The infant has a bulging fontanelle, is inconsolable, and has a non-blanching rash

Answer

The infant is feeding well and playing normally

Answer

The infant has a runny nose and mild cough

Answer

The infant has a single episode of loose stool

Question 3

How do you calculate the weight of a child for emergency drug dosing when the actual weight is unknown?

Accepted Answer

Use an age-based formula: Weight (kg) = (Age in years + 4) × 2 for ages 1-10, or use a Broselow tape for length-based estimation

Answer

Use the parent's estimated weight

Answer

All children receive adult doses divided by 2

Answer

Use a standard weight of 20 kg for all children

Question 4

What are the signs of dehydration in a 2-year-old child and how is severity assessed?

Accepted Answer

Mild: slightly dry mucous membranes, normal skin turgor. Moderate: sunken eyes, decreased skin turgor, decreased urine output, tachycardia. Severe: lethargic, very sunken eyes, very poor skin turgor, absent urine, hypotension

Answer

Dehydration is only assessed by measuring urine output

Answer

All dehydrated children need IV fluids immediately

Answer

Dehydration is diagnosed only by blood tests

Question 5

A parent brings in a 4-year-old with a limp. The child is afebrile. What is the MOST important diagnosis to exclude?

Accepted Answer

Septic arthritis — which requires urgent joint aspiration and IV antibiotics, though less likely when afebrile; also consider Legg-Calve-Perthes disease, transient synovitis, and occult fracture

Answer

Growing pains

Answer

A muscle strain from playing

Answer

Flat feet causing discomfort

Question 6

What are the key developmental milestones expected at 12 months of age?

Accepted Answer

Pulls to stand, cruises along furniture, says 1-3 words (e.g., 'mama,' 'dada'), uses pincer grasp, waves bye-bye, and shows stranger anxiety

Answer

Running, speaking in full sentences, and toilet training

Answer

Sitting unsupported, babbling, and rolling over

Answer

Walking independently, counting to 10, and drawing circles