OSCE Pediatric Assessment 5 — Questions and Answers
Question 1: A 2-year-old is brought in with a 3 cm burn on his palm from touching a hot oven tray. The wound is blistered but blanches with pressure. What burn depth does this represent?
- Superficial (epidermal)
- Superficial partial-thickness (dermal) (Correct answer)
- Deep partial-thickness
- Full-thickness
Correct answer: Superficial partial-thickness (dermal)
Superficial partial-thickness burns are blistered, pink, moist, painful, and blanch with pressure as the papillary dermis is involved.
Question 2: During an OSCE child protection station, you notice a toddler has multiple bruises in different stages of healing over the shins and forehead, with one bruise over the lumbar spine. What is most concerning?
- Shin bruises — normal in a walking toddler
- Forehead bruise — consistent with falling forward
- Lumbar spine bruise — in a non-mobile area, raising abuse concern (Correct answer)
- Multiple bruises in a toddler are always normal
Correct answer: Lumbar spine bruise — in a non-mobile area, raising abuse concern
Bruises over non-bony prominences such as the lumbar spine are not consistent with typical childhood falls and should raise concern for non-accidental injury.
Question 3: A 7-month-old is noted to have no babbling and does not respond to her name. She also fails to track faces. What is the most appropriate next step?
- Reassure parents — all infants develop at different rates
- Refer urgently for hearing assessment and developmental evaluation (Correct answer)
- Advise reducing screen time and review in 3 months
- Request a skull X-ray
Correct answer: Refer urgently for hearing assessment and developmental evaluation
Absent babbling, failure to respond to name, and not tracking faces by 7 months are red flags for both hearing loss and autism spectrum disorder requiring urgent assessment.
Question 4: In a pediatric OSCE anaphylaxis station, a 6-year-old (weight ~20 kg) has urticaria, wheeze, and hypotension after eating peanuts. What is the correct IM epinephrine (adrenaline) dose?
- 0.05 mL of 1:1,000 (0.05 mg)
- 0.15 mL of 1:1,000 (0.15 mg)
- 0.3 mL of 1:1,000 (0.3 mg) (Correct answer)
- 0.5 mL of 1:1,000 (0.5 mg)
Correct answer: 0.3 mL of 1:1,000 (0.3 mg)
Children weighing 15–30 kg receive 0.3 mg (0.3 mL of 1:1,000) epinephrine IM into the anterolateral thigh for anaphylaxis.
Question 5: You are examining a 3-year-old and want to assess for meningism. Which clinical sign involves passive hip flexion causing involuntary knee flexion?
- Kernig's sign
- Brudzinski's sign (Correct answer)
- Babinski's sign
- Oppenheim's sign
Correct answer: Brudzinski's sign
Brudzinski's sign is elicited by flexing the neck; involuntary hip and knee flexion indicates meningeal irritation.
Question 6: A 5-year-old has been prescribed amoxicillin for otitis media. His parent asks why they should complete the course even though he feels better after 2 days. What is the most important reason?
- To prevent tooth staining
- To ensure eradication of bacteria and reduce resistance risk (Correct answer)
- Because stopping early causes allergy
- Amoxicillin only works after 5 days of dosing
Correct answer: To ensure eradication of bacteria and reduce resistance risk
Completing antibiotic courses prevents rebound infection, reduces the risk of resistance emerging, and ensures full bacterial eradication.
Question 7: During a pediatric cardiac examination, you note a fixed, widely split S2 that does not vary with respiration. Which congenital defect does this suggest?
- Ventricular septal defect
- Patent ductus arteriosus
- Atrial septal defect (Correct answer)
- Tetralogy of Fallot
Correct answer: Atrial septal defect
A fixed, widely split S2 unaffected by respiration is the hallmark auscultatory finding of an atrial septal defect.
OSCE Pediatric Assessment 5
A 2-year-old is brought in with a 3 cm burn on his palm from touching a hot oven tray.
The wound is blistered but blanches with pressure.
What burn depth does this represent?