Paeds Cases · nephrology-urology-fluids-and-electrolytes
Paediatric kidney assessment OSCE — febrile infant, bag culture and residual-risk counselling
Observed structured encounter testing urine collection method choice, dipstick and microscopy interpretation, reliable-sample confirmation, and family counselling after an equivocal culture in a febrile infant.
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Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
A 14-month-old febrile infant has a bag-urine culture growing mixed growth. The candidate must decide collection method, interpret the dipstick and microscopy, and explain the plan to the family under uncertainty.
Candidate brief
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Decide whether the bag-urine result can confirm infection, and state the preferred next step. [3]
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Interpret the dipstick and microscopy provided, and integrate them with the clinical picture. [2]
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Explain the plan to the family in plain language, including safety-netting. [3]
References6ShowHide
- [1]Schwartz GJ, et al New equations to estimate GFR in children with CKD J Am Soc Nephrol, 2009.PMID 19158356
- [2]Simerville JA, et al Urinalysis: a comprehensive review Am Fam Physician, 2005.PMID 15791892
- [3]Whiting P, et al Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review BMC Pediatr, 2005.PMID 15811182
- [4]Stevens PE, et al Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline Ann Intern Med, 2013.PMID 23732715
- [5]Bogie AL, et al Is There a Difference in the Contamination Rates of Urine Samples Obtained by Bladder Catheterization and Clean-Catch Collection in Preschool Children? Pediatr Emerg Care, 2021.PMID 34772880
- [6]Shaikh N, et al Prevalence of Asymptomatic Bacteriuria in Children: A Meta-Analysis J Pediatr, 2020.PMID 31787323