Ethics and Communication – Set 4

What this deck covers

Ethics and Communication – Set 4 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A sofa fall and what raises concern
2. Tired colleague asleep on nights
3. Who settles resuscitation status
4. Blood on a young girl’s underwear
5. Nurse declines a child with HIV
6. Opening the first palliative meeting
7. Thin, hungry, unwashed schoolboy
8. Intern given the discharge paperwork
9. A warm chest and a beating heart
10. Loop-shaped bruises and a fracture
11. Colleague admits using tablets
12. A father who will not sign
13. Mother asks who does such harm
14. Head nurse gives an instruction
15. Mother at the arrest
16. Name-calling at home
17. Technician’s offer on the round
18. Examiners for the brainstem tests
19. Background features that add risk
20. Loyalty against duty
21. New chest signs under the order
22. Forms of incest, counted two ways
23. Mother describes unwelcome remarks
24. What stays when support is withdrawn
25. Who to involve next
26. Care given in the ambulance
27. Timing the donation conversation
28. Medically well the morning after
29. Antibiotics not started that night
30. Do earlier stated wishes still count
31. Discharge blamed on a shared towel
32. Ward manager’s aim for the team
33. Relatives a week’s travel away
34. Mother’s tearful plea
35. Mother objects on the teaching round
36. A plea for a final injection
37. Recording the skin findings
38. Refuses help and writes scripts
39. Donor card, parents decline
40. Lifeless in the morning at 3 months
41. Consultant asks about your tasks
42. Father begs them to keep going
43. Mother wants him home today
44. So many faces, who is in charge
45. Night-time arrest under an order
46. Father asks for a delay
47. Yardstick for a review of care
48. Family asks about the paperwork
49. A week of spotting, swabs clear
50. Question about the earlier visit

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: That nobody saw the fall from the sofa happen, Her quiet, watchful manner in the department, Neglect, Her injuries show physical abuse, A stranger the child has never met before, Physical abuse, Being older than one year, A dietitian alone, for a high-energy diet, A skeletal survey of every other child in the home, Report only if the father agrees, to keep his trust.

Clinical pearls from this deck

• Ask two questions of every injury: does the story fit it, and was help sought when it should have been?
• First conversation: private and kind. Next step, if needed: senior and formal.
• Three signatures, one of them the consultant’s.
• In a prepubertal girl, genital injury with no fitting story is abuse until proved otherwise.
• Refusing to nurse a child with HIV is discrimination, not caution.
• First ask; then plan.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all ethics and communication case decks · pediatric reference values.