Trial SAQ exam: 'Trial' by Mat Oliver

You are taking part in a trial exam created by Mat Oliver. There are 9 SAQs in this exam (54 minutes).
 

This SAQ is worth 21 marks

A 2 year old girl is referred by the GP with a high temperature. On examination she is pale and has increased work of breathing. She has a fine non blanching petechial rash on both her arms, legs and torso. Her lungs are clear. She has hepatosplenomegaly.

Her vital signs are:
HR 170 beats/min
BP 90/66 mmHg
RR 60 /min
Temperature 39 °C
O2 Saturation 96 % on room air
Cap return 2 sec

Question 1.
List three (3) differential diagnostic categories and two (2) examples of each for this scenario. (9 marks)

 

     Diagnostic Categories Examples               

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Question 1.
List six (6) immediate investigations and provide one (1) justification for each of them. (12 marks)

     Investigation Justification
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This SAQ is worth 21 marks

A 2 year old girl is referred by the GP with a high temperature. On examination she is pale and has increased work of breathing. She has a fine non blanching petechial rash on both her arms, legs and torso. Her lungs are clear. She has hepatosplenomegaly.

Her vital signs are:
HR 170 beats/min
BP 90/66 mmHg
RR 60 /min
Temperature 39 °C
O2 Saturation 96 % on room air
Cap return 2 sec

Question 1.
List three (3) differential diagnostic categories and two (2) examples of each for this scenario. (9 marks)

Some candidates were unable to give 2 examples of a diagnostic category
Bacterial and viral sepsis should not be viewed as 2 different diagnostic categories

Question 1.
List six (6) immediate investigations and provide one (1) justification for each of them. (12 marks)

Upper abdominal ultrasound and CT head scan would not be considered to be immediate investigations in this scenario

Some candidates did not mention meningococcal sepsis as a justification to performing one of the immediate investigations

Performing a CXR to ‘assess the work of breathing’, ‘looking for pulmonary haemorrhage’ were not deemed to be adequate answers in this scenario

Please answer the question asked. Justifications for performing a ‘blood culture’ provided by candidates included ‘would give broad spectrum antibiotics unless strong alternative diagnostic cultures prior’ and ‘would provide ongoing care’