Obstructive sleep apnoea in children — structured clinical encounter

Station brief (candidate)

You are the paediatric registrar in a general clinic. A 4-year-old boy is referred because he snores loudly every night, with his parents describing pauses in his breathing followed by gasping, and he sleeps restlessly with his neck extended. He is a mouth breather with large tonsils, his weight has drifted from the 50th to the 9th centile over the past year, and preschool report new hyperactivity and inattention. The team asks you to establish the diagnosis, order and interpret the investigations, plan treatment, and address the peri-operative and follow-up considerations. You have 12 minutes with the team and 5 minutes for examiner discussion. ^{[1] [9]}