Prompt

A 9-year-old is stable after blunt abdominal trauma. CT has answered the trauma question and reports a small simple renal cyst. Parents are distressed and ask for 'full cancer bloods and another scan tonight.' You must classify the finding, counsel, plan and hand over.

Candidate brief

You have 10 minutes. The examiner plays a parent. A nurse may give observations showing a stable child. Your tasks: [1]

Confirm the trauma status and the meaning of the incidental cyst. [4]
Classify the finding (act / plan / observe / stop) with reasoning. [3] [5]
Counsel about cascade risk if every incidental is chased tonight. [3] [6] [10]
Agree a safety net and follow-up owner. [1] [5]
Deliver a one-minute handover that includes residual risk. [3] [7]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References10Show ledger

[1]Coon ER Overdiagnosis: how our compulsion for diagnosis may be harming children. Pediatrics, 2014.PMID 25287462
[2]Brodersen J Overdiagnosis: what it is and what it isn't. BMJ evidence-based medicine, 2018.PMID 29367314
[3]Ganguli I Cascades of Care After Incidental Findings in a US National Survey of Physicians. JAMA network open, 2019.PMID 31617925
[4]Ugalde IT Incidental Findings on Computed Tomography in Children With Blunt Abdominal Trauma. Annals of emergency medicine, 2025.PMID 39846906
[5]Størdal K Overtesting and overtreatment-statement from the European Academy of Paediatrics (EAP). European journal of pediatrics, 2019.PMID 31506723
[6]Deyo RA Cascade effects of medical technology. Annual review of public health, 2002.PMID 11910053
[7]Newman-Toker DE A unified conceptual model for diagnostic errors: underdiagnosis, overdiagnosis, and misdiagnosis. Diagnosis (Berlin, Germany), 2014.PMID 28367397
[8]Money NM 2021 Update on Pediatric Overuse. Pediatrics, 2022.PMID 35059726
[9]Quinonez RA When technology creates uncertainty: pulse oximetry and overdiagnosis of hypoxaemia in bronchiolitis. BMJ (Clinical research ed.), 2017.PMID 28814557
[10]Gram EG Less is more for patients, practitioners, public and planet: a taxonomy for the harms of too much medicine. BMJ evidence-based medicine, 2025.PMID 41047163

Candidate brief

You have 10 minutes. The examiner plays a parent. A nurse may give observations showing a stable child. Your tasks: [1]

Confirm the trauma status and the meaning of the incidental cyst. [4]

Classify the finding (act / plan / observe / stop) with reasoning. [3] [5]

Counsel about cascade risk if every incidental is chased tonight. [3] [6] [10]

Agree a safety net and follow-up owner. [1] [5]

Deliver a one-minute handover that includes residual risk. [3] [7]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References10Show ledger

[1]Coon ER Overdiagnosis: how our compulsion for diagnosis may be harming children. Pediatrics, 2014.PMID 25287462
[2]Brodersen J Overdiagnosis: what it is and what it isn't. BMJ evidence-based medicine, 2018.PMID 29367314
[3]Ganguli I Cascades of Care After Incidental Findings in a US National Survey of Physicians. JAMA network open, 2019.PMID 31617925
[4]Ugalde IT Incidental Findings on Computed Tomography in Children With Blunt Abdominal Trauma. Annals of emergency medicine, 2025.PMID 39846906
[5]Størdal K Overtesting and overtreatment-statement from the European Academy of Paediatrics (EAP). European journal of pediatrics, 2019.PMID 31506723
[6]Deyo RA Cascade effects of medical technology. Annual review of public health, 2002.PMID 11910053
[7]Newman-Toker DE A unified conceptual model for diagnostic errors: underdiagnosis, overdiagnosis, and misdiagnosis. Diagnosis (Berlin, Germany), 2014.PMID 28367397
[8]Money NM 2021 Update on Pediatric Overuse. Pediatrics, 2022.PMID 35059726
[9]Quinonez RA When technology creates uncertainty: pulse oximetry and overdiagnosis of hypoxaemia in bronchiolitis. BMJ (Clinical research ed.), 2017.PMID 28814557
[10]Gram EG Less is more for patients, practitioners, public and planet: a taxonomy for the harms of too much medicine. BMJ evidence-based medicine, 2025.PMID 41047163

Incidental findings OSCE — trauma CT cyst counselling and cascade control

Candidate brief

Incidental findings OSCE — trauma CT cyst counselling and cascade control

Candidate brief