Children Down, Vaginas To Go.

I didn't think 'one down, one to go' was quite right for this post.

My paediatrics OSCE is done, to be honest I'm disappointed in myself, I know I should have done better, it was a relatively fair exam, I just didn't fulfil my true potential. Its worse when that happens. I could just about cope if it was a horrible exam or if I didn't know anything but when you know the stuff but it all just goes a bit tits up, its fucking annoying.

I hope the uni won't get mad at me for explaining the stations (they shouldn't because everyone has done the exam by now)

PAEDIATRICS: (excuse the dodgy numbering, its the order I did them in)

Station 3 - Scenario: Young boy admitted previous night with exacerbation of asthma, comment on his vitals and examine him.

So, I looked at his vitals, but I wasn't exactly sure what comment on them meant so I just remarked that they had improved and took a few guesses at normal ranges of peak flow for children. Then disaster struck, I flunked the respiratory exam, Fuck knows why, I've done it a million tomes, maybe it was nerves, maybe I'm just stupid but I completely fucked it up, I did stuff in completely the wrong order, I forgot to even bother to do most of the stuff and the stuff I did do was rushed and messed up. What a waste, a fair and easy station but I flunked it.

Rest Station - Great, 5 minutes to reflect on my disastrous first station, just what I needed, I took a drink and a jammy dodger before carrying on.

Station 4 - Scenario: Mother attends GP because she is worried about her 7year old daughter who is putting on weight. Take a history.

Probably my best station, my history was good, I almost froze at a couple of points but I bought myself some time with open questions and managed to cover as much as I possibly could in 5 minutes, which again is ridiculously little time to take a decent history. (even GPs have longer than that) I addressed the mothers concern, I even summarised, and started to make a plan before the buzzer went.

Station 5 - Scenario: Mother has just a baby which has been diagnosed with Downs syndrome. She would like some more information on the condition. Discuss it with her.

A strange and somewhat unexpected station although it was fair I suppose. I could have talked about the signs and symptoms of Downs, even discussed the genetics in depth but I was much less sure of this station. I managed to waffle a lot and managed to elicit and address most of the mother's concerns but I'm not sure I did what was expected of me. Goodness knows how I did in this station, hopefully my blagging was enough.

Station 6 - Scenario: 2 brothers have impetigo, calculate their doses of antibiotics using BNF

Another fair, if rather unexpected station, I don't think I did too badly here either but I couldn't for the life of me think of some contra-indications for penicillin, obviously I got allergy but apparently they were after renal impairment. I got half way there by waffling about metabolism. I also tried to give one of the children, a baby the wrong dose until I used my eyes to bother to actually read the BNF.

Station 7 -Scenario: 14yr old boy in a+e after mother became increasingly worried about symptoms of paranoia. Viva station.

Ah yes, the obligatory child psych station, I don't if I shafted this station big time or if I just misread the examiner. I mean, its a waffle-y topic at the best of times and I answered her questions but I was ridiculously vague and waffled like never before. I still don't know what I was actually supposed to say but hopefully I did ok, psych isn't my strong point but I had a vague idea about schizophrenia and I tried to satisfy the examiner.

Station 1 - Scenario: Young girl in clinic complaining of facial weakness, examine her cranial nerves.

My heart sank at this station, for 2 reasons, a) I hadn't really expected this to come up as it came up in neuro last term, I hadn't revised it but I had vague idea., and b) All 12 cranial nerves in 5 minutes? In fact, more like 4 minutes with traveling between stations and a bit of admin work. Are they having a fucking laugh? Oh well, I launched in saying "I'd also do this, and that and t'other" Whilst trying to be quick but rushing made me forget things, I got into a muddle and ended up having no idea what nerve I was up to. 5 Minutes is just too short, if it had been a 10 minute station I could have gone thorough it all slowly, systematically and properly. I was also bamboozled at the presence of orange quarters on this station, I didn't know whether to eat them or to use them to test taste and smell. In the end I chose the latter, although I could have done with refreshments at that time. I fucked up my diagnosis at the end too but he said I did ok so we'll see.

Station 2 - Scenario: mother accompanies child to a+e, child has a mark/rash on his bottom. Take a history

Now I thought this was a bit of a silly station, I mean it would have been ok as a viva or discussion but as a history it didn't make much sense. It was ok, I managed to deal with the mothers worry about the possibility of meningitis and asked her about the possibility of non-accidental injury (NAI) It turned out that the child had recently stayed with its father who had a new girlfriend. But just as I was discussing the NAI aspect of the case the buzzer went and that station ended. 5 minutes just isn't enough.


And that was the end of that, time flies when you're having......fun? (hmmm, not too sure about that). In summary, my histories were good but 5 minutes is way too short to get anywhere, my examinations were crap and overall I should have done a lot better. Bring on obs and gynae tomorrow, hopefully I'll make up for today's semi-disaster.