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Paeds Casesclinical-assessment-and-reasoning

Paeds Cases · clinical-assessment-and-reasoning

Weight loss in children and adolescents — OSCE

OSCE counselling and clinical reasoning station for adolescent weight loss.

osce communication and clinical reasoning station1 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCE
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Study tools

Target exams

MRCPCH ClinicalRACP DCE
Prompt
You have 8 minutes with a parent and a 14-year-old whose weight has fallen from 58 kg to 51 kg in four months. BMI is on the 30th percentile. Counsel, outline assessment and agree a plan.

Station brief (candidate)

  • Quantify percentage loss and explain why BMI band alone is not reassurance.
  • Screen for medical red flags (including polyuria/polydipsia) and restriction behaviours.
  • Outline examination priorities (vitals, orthostatics) and first-line tests.
  • Agree a plan: safety, nutrition restart principles, team involvement, follow-up and safety-net.
  • Use respectful language with adolescent and caregiver; teach-back. [1] [2]
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References5ShowHide
  1. [1]Hornberger LL Identification and Management of Eating Disorders in Children and Adolescents. Pediatrics, 2021.PMID 33386343
  2. [2]Society for Adolescent Health and Medicine Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults. The Journal of adolescent health, 2022.PMID 36058805
  3. [3]da Silva JSV ASPEN Consensus Recommendations for Refeeding Syndrome. Nutrition in clinical practice, 2020.PMID 32115791
  4. [4]Veauthier B Diabetic Ketoacidosis: Evaluation and Treatment. American family physician, 2024.PMID 39556629
  5. [5]Harrington BC Initial evaluation, diagnosis, and treatment of anorexia nervosa and bulimia nervosa. American family physician, 2015.PMID 25591200
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