Paediatrics – KFP public report review 2016-2024 topics in exam

Febrile Illness and General Management

1. 2½-Month-Old Aboriginal Infant with Non-Specific Febrile Illness

• Key Areas:
  • Differential diagnoses for febrile illness in infants
  • Appropriate initial investigations
  • Preventative health assessment for Aboriginal and Torres Strait Islander children
  • Addressing greater health disadvantages and common adolescent health issues
• Common Errors:
  • Incorrect diagnoses such as bronchiolitis, otitis media, or acute rheumatic fever
  • Extensive irrelevant family history or unrelated symptom questions for the adolescent sister

2. 7-Year-Old Boy with Abdominal Pain and Constipation

• Key Areas:
  • Additional history to indicate a serious underlying cause of symptoms
  • Non-pharmacological management of constipation
• Common Errors:
  • Providing history features already given in the clinical stem
  • Vague management answers such as ‘educate’ or ‘reassure’
  • Failure to provide specific non-pharmacological strategies for managing constipation

3. 5-Year-Old Girl with Respiratory Symptoms in a Rural Setting

• Key Areas:
  • Identifying history features necessitating face-to-face review
  • Examination findings necessitating transfer to hospital
  • Medico-legal and ethical issues related to providing medical records
• Common Errors:
  • Not taking the patient’s age into account
  • Providing answers appropriate for infants rather than a 5-year-old child
  • Providing similar answers on different lines, missing the opportunity to demonstrate breadth of knowledge
  • Incorrectly refusing to provide medical records to the child’s father

4. Fever and Dry Cough Management in a Child

• Key Topics Discussed:
  • Diagnosis, immediate non-pharmacological, and pharmacological management
• Candidate Performance:
  • Lack of knowledge on managing acute conditions in children
• Improvement Areas:
  • Specific management strategies for pediatric respiratory conditions, including acute and supportive care

Musculoskeletal and Orthopedic Conditions

1. Slipped Upper Femoral Epiphysis

• Insight:
  • The importance of timely diagnosis and management to prevent complications in pediatric orthopedic conditions
• Strengths:
  • Recognizing the need for immediate management and referral
• Improvements:
  • Avoiding non-specific or inappropriate management strategies that could harm the patient

2. Hip Pain in a Child Refusing to Walk

• Key Topics Discussed:
  • Likely diagnosis, further investigations, pharmacological management
• Candidate Performance:
  • Adult-oriented diagnoses, lack of pediatric focus
• Improvement Areas:
  • Pediatric-focused diagnostic and management strategies for hip pain

Respiratory and Infectious Diseases

1. Simple Upper Respiratory Tract Infection and a Significant Cause in an 18-Month-Old Child

• Key Areas:
  • Determining significant underlying causes for respiratory symptoms in a pediatric patient
  • Recognizing signs and symptoms that warrant further investigation
  • Managing patient and family inquiries about unrelated medical concerns during a consultation
• Common Errors:
  • Providing non-specific or irrelevant answers to the history-taking question
  • Failing to focus on serious underlying causes of respiratory symptoms
  • Not adequately addressing the shift in consultation focus when asked about the husband’s test results

2. Fever and Cough Management in an Aboriginal Infant

• Key Topics Discussed:
  • Differential diagnoses, risk factor identification, management actions
• Candidate Performance:
  • Failure to recognize high-risk presentations and relevant risk factors
• Improvement Areas:
  • Apply knowledge of high-risk factors and evidence-based guidelines to manage serious conditions in Aboriginal health context

3. Acute Respiratory Distress in an Infant

• Key Topics Discussed:
  • Identification of physical examination features warranting hospital admission, post-discharge management, and handling unexplained bruising
• Candidate Performance:
  • Lack of specificity in physical examination details
• Improvement Areas:
  • Focus on specific, relevant physical examination findings indicative of respiratory distress and appropriate management of potential child abuse signs

4. Acute Respiratory Symptoms in a Child

• Key Topics Discussed:
  • Immediate management for coughing and shortness of breath, identification of signs requiring hospital admission, and management during transfer
• Candidate Performance:
  • Lack of immediate action knowledge for an acutely unwell child
• Improvement Areas:
  • Emergency management skills for acute respiratory distress and criteria for hospital admission

Developmental and Behavioral Issues

1. Pediatric Bedwetting in the Context of Parental Separation

• Key Topics Discussed:
  • History relevant to underlying diagnosis, non-pharmacological management, handling medical record requests by a non-present parent
• Candidate Performance:
  • Repetitive history taking, lack of knowledge on medical record legislation
• Improvement Areas:
  • Focus on holistic, non-pharmacological management strategies for bedwetting, and understand medicolegal aspects of patient care, including confidentiality and record release

2. Fever and Jerking in an Infant

• Key Topics Discussed:
  • Underlying cause identification, advice on symptom recurrence, immunization advice
• Candidate Performance:
  • Gaps in knowledge on immunization program
• Improvement Areas:
  • Updated knowledge on immunization schedules and management of acute pediatric conditions

Dermatological and Gastrointestinal Conditions

1. Vaginal Itch and Rash in a Child

• Key Topics Discussed:
  • Differential diagnoses, pharmacological and non-pharmacological management
• Candidate Performance:
  • Lack of specificity in diagnoses and inappropriate management strategies
• Improvement Areas:
  • Specific diagnostic approaches and relevant management strategies for pediatric dermatological conditions

2. Persistent Cough and Fevers in a Child

• Key Topics Discussed:
  • Identification of causative pathogens, public health management actions, and management of persistent symptoms
• Candidate Performance:
  • Lack of knowledge regarding common pathogens and failed to focus on public health issues in their management plans
• Improvement Areas:
  • Enhance understanding of pathogens common in pediatric cases and emphasize public health approaches in management strategies

Developmental Delays and Immunization

1. Developmental Delays in Infants

• Key Topics Discussed:
  • Identifying signs of developmental delay, considering differential diagnoses, recommending further investigations, and providing immunization advice according to the National Immunization Program Schedule
• Candidate Performance:
  • Often lacked specificity in their answers, failed to read the case stem fully, and missed considering all key features
• Improvement Areas:
  • Enhance attention to detail, specifically tailoring answers to the provided case information, and ensure a comprehensive approach to differential diagnoses and investigation plans

2. Routine Childhood Immunizations and Vaccine Opposition

• Key Topics Discussed:
  • Identifying contraindications to vaccination, handling vaccine opposition, and managing a facial rash
• Candidate Performance:
  • Lack of knowledge on contraindications and legal aspects of vaccination
• Improvement Areas:
  • Enhance understanding of vaccination contraindications and legal frameworks regarding parental opposition

Infectious Diseases and Orthopedics

1. Recurrent Fevers in an Aboriginal Child

• Key Topics Discussed:
  • Differential diagnosis for recurrent fevers, consent issues
• Candidate Performance:
  • Inappropriate diagnostic focus, misunderstanding of consent process
• Improvement Areas:
  • Tailored diagnostics for recurrent fever, appropriate consent procedures

2. Hip Pain in a Child

• Key Topics Discussed:
  • Differential diagnoses and management of pediatric hip pain
• Candidate Performance:
  • Generalized diagnoses and misunderstanding specific causes
• Improvement Areas:
  • Develop specific diagnoses and tailored management strategies for pediatric orthopedic issues