Paeds Cases · preventive-and-community-paediatrics
Critical bloodspot result before rural discharge — structured clinical encounter
Structured encounter testing incomplete card recognition, critical TSH action in a well neonate, galactosaemia feed safety if introduced, and rural safety-netting.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
Noah, 5 days old, term, well, family requesting same-day return to a town 2 hours away. First bloodspot was unsatisfactory. Laboratory now reports a critical elevated TSH. Parents ask if this can wait because he is feeding perfectly.
Station brief (candidate)
You are the paediatric registrar. Noah is 5 days old and looks well. The first dried bloodspot was unsatisfactory. The laboratory has now reported a critical elevated TSH. The family wants to leave for a town 2 hours away within the hour. You have 12 minutes with the family and 5 minutes for examiner discussion. [3] [17]
References4ShowHide
- [3]van Trotsenburg, P Congenital Hypothyroidism consensus guidelines update. Thyroid, 2021.PMID 33272083
- [10]Berry, GT Galactosemia: when is it a newborn screening emergency? Molecular genetics and metabolism, 2012.PMID 22483615
- [14]Dietzen, DJ Follow-up testing for metabolic disease identified by expanded newborn screening. Clinical chemistry, 2009.PMID 19574465
- [17]O'Leary, P Newborn bloodspot screening policy framework for Australia. Australasian medical journal, 2015.PMID 26464586