SCA practice case · Video consultation
Child health: SCA practice case
A three-year-old’s blood test result
Video consultation
Child patient
Someone else speaking
Hard
Children & young peopleEthnicity, culture & diversityHealth disadvantage & vulnerabilities
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Denis Lakatos (mother: Marika Lakatos) · 3-year-old boy
Setting
Video consultation with the mother of a three-year-old to discuss a recent blood test.
Past history
- No significant past history recorded
- Born in Slovakia at term; no red book or vaccination record
- Weight 14 kg (50th centile), height 25th centile at health visitor review
Medication
- No regular medication
Allergies
No known drug allergies
Recent notes
Health visitor review three weeks ago: pale, otherwise well and developing normally. Bloods last week: Hb 88 g/L, MCV 62 fL, ferritin 4 micrograms/L, CRP 2, coeliac screen negative. No immunisations recorded; three invitations to the immunisation clinic by letter, each ’was not brought’. Registered five months ago; third address in two years. Reception note: mother asked for the appointment text to be read out to her.
Reason for contact
Video consultation with his mother to discuss the blood test result. The practice telephoned her to book it.
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
Iron deficiency anaemia in a toddler drinking large volumes of cow’s milk is common and very treatable, but this station is won or lost on trust. The mother’s avoidance of clinics is explained by illiteracy, past discrimination and a relative’s children being removed, not by neglect. The skills are a quantified diet history, a plain explanation, a treatment plan built around what the family eats, communication needs recorded under the Accessible Information Standard, and a catch-up immunisation offer made without coercion. Missed immunisations and anaemia in a mobile family are a reason to support and involve the health visitor; they are not on their own a reason for a child protection referral.
The guidance behind it
Similar SCA cases
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