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In this scenario, the community pharmacist counsels a patient who has come in complaining of an itchy bottom. The student must take a history, make a diagnosis, and suggest an appropriate over-the-counter medication.
Please ensure that this scenario and mark scheme aligns with the most up-to-date guidelines from the UK NICE and the BNF when using it for your OSCE assessment.
You will need a student pharmacist and an actor for this OSCE station.
Threadworms
You are a pharmacist working in a community pharmacy. The patient is a 5-year-old child complaining of an itchy bottom. You have been asked to take a history, make an appropriate diagnosis and advise the patient's father on the best over-the-counter medication for this condition.
To do:
Conduct a thorough medical history assessment.
Based on the information gathered, formulate a treatment plan or, if necessary, recommend a referral to a healthcare provider or emergency services for further evaluation and management.
You have 10 minutes.
You have access to the BNF.
You are Tom Hanks (Tom, Hanks).
Opening statement:“I've noticed that my daughter has been itching her bottom a lot recently and I’m really worried”
Patient information:
Provide this information when prompted.
Name: Scarlet Hanks
Age: 5
Past medical history:
“None.”
Medication History:
“None.”
Allergies:
“None.”
Symptoms:
“She has an Itchy bottom she won’t stop itching the area.”
“It has been going on for a week.”
“She has trouble sleeping because of the itch.”
“Her bottom is red and inflamed because of the scratching. There is no pus and no open wounds.”
“I spotted something white in her stool but I wasn’t sure if my eyes were playing tricks on me (You swear it was white speckles).”
“This is the first time she has had these symptoms.”
“We have not tried anything to make it better yet.”
“We're a family of three. Me, her mum, and Scarlet.
“We all have no medical conditions, no allergies and do not take any medications.”
“Her mother is not pregnant.”
“We have not been abroad in 5 years.”
At this point, the student should inform you that they think that the child has threadworms/ pinworms.
The student should offer you mebendazole, an over-the-counter medication that comes in 2 forms: a chewable tablet or a liquid.
The student should also offer you advice on what you should do at home to stop it from spreading or recurring. If they do not, prompt them by asking:
“Are there any other precautions I need to take at home?”
“Can my child go to school with this going on?”
Any criteria marked in red must be met to pass this station. Â
Red Flags missed: 1
Failed missed: 2
Achieving at least 50% OR missing specific required marks.