Course Content
🔬 Station 1 — Identification of Normal Blood Cells on Peripheral Smear
Learning Outcomes Identify normal RBCs, WBCs and platelets on a provided peripheral blood smear/image. Differentiate the major blood-cell lineages using their morphological features.
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Identification of Normal Blood Cells on Peripheral Smear
🔴 Station 2 — Abnormal RBC Morphology & Identification of Anemia
Learning Outcomes Differentiate normal from abnormal red blood cells on a peripheral smear. Identify common abnormal RBC shapes. Suggest the likely type of anemia from the provided RBC morphology.
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Abnormal RBC Morphology & Identification of Anemia
💊 Station 3 — Prescription Writing for Iron-Deficiency Anemia
Learning Outcomes Write an appropriate prescription for a patient at risk of developing iron-deficiency anemia. Select an appropriate iron preparation and provide clear instructions for its use.
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Prescription Writing for Iron-Deficiency Anemia
🩸 Station 4 — Safe Blood Transfusion & Recognition of Transfusion Reactions
Learning Outcomes Demonstrate the essential safety checks required before blood transfusion. Identify common transfusion reactions from a supplied clinical scenario. Describe the appropriate immediate response when a transfusion reaction is suspected.
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Safe Blood Transfusion & Recognition of Transfusion Reactions
⚪ Station 5 — Identification of White Blood Cells on Peripheral Smear
Learning Outcomes Identify the major types of white blood cells on a provided peripheral smear. Differentiate neutrophils, eosinophils, basophils, lymphocytes and monocytes using morphology. Recognize a smear demonstrating leukocytosis.
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Identification of White Blood Cells on Peripheral Smear
🔬 Station 6 — Microscopic Examination of Human and Animal Blood
Learning Outcomes Perform/interpret microscopic examination of provided human and animal blood specimens or images. Differentiate human from animal blood using the supplied microscopic features.
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Microscopic Examination of Human and Animal Blood
🔦 Station 7 — Examination of Blood Stains Under Ultraviolet Light
Learning Outcomes Demonstrate the correct approach to examination of a suspected blood stain using ultraviolet light. Recognize findings suggestive of a blood stain on the supplied material.
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Examination of Blood Stains Under Ultraviolet Light
🩸 Station 8 — Identification of Blood-Stain Patterns
Learning Outcomes Identify different blood-stain patterns from supplied specimens/images. Differentiate the presented patterns on the basis of their gross appearance.
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Identification of Blood-Stain Patterns
💉 Station 9 — EPI Vaccination, Route & Cold-Chain Assessment
Learning Outcomes Identify vaccines included in the Pakistan EPI schedule from provided material. Identify the appropriate route of administration of selected vaccines. Demonstrate/describe correct vaccine storage and maintenance of the cold chain. Recognize important contraindications to vaccination.
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EPI Vaccination, Route & Cold-Chain Assessment
🧪 Station 10 — Interpretation of Coagulation Tests
Learning Outcomes Interpret PT and APTT from provided laboratory results. Interpret bleeding time and clotting time. Use the pattern of abnormalities to identify the likely defect in hemostasis.
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Interpretation of Coagulation Tests
🩸🔬 AIM OSPE/OSCE Lab — Blood & Immunology-II Module | 3rd Year MBBS
AIM OSCE / OSPE • MBBS

💉 Station 9 — EPI Vaccination, Route & Cold-Chain Assessment

Rapid Revision • Vaccine Recognition • Administration Route • Cold Chain

🎯 Task

CANDIDATE TASK

You are provided with selected EPI vaccine vials/cards and a vaccine storage or carrier setup. Identify the selected vaccines, state their appropriate route/site of administration, assess maintenance of the cold chain, and mention important contraindications relevant to vaccination.

⚡ Model Station Answer

  • Pakistan routine childhood EPI visits: birth, 6 weeks, 10 weeks, 14 weeks, 9 months and 15 months.
  • Routes: BCG is intradermal; OPV and rotavirus are oral; hepatitis B, pentavalent, PCV, IPV and TCV are intramuscular; MR is subcutaneous.
  • Cold chain: vaccines at the service-delivery level are generally maintained at +2°C to +8°C; I would check the temperature record, expiry date, VVM and evidence of inappropriate freezing or heat exposure.
  • Contraindications: a severe allergic reaction to a previous dose or vaccine component is an important general contraindication; severe immunodeficiency is particularly relevant to live vaccines.

🔎 Stepwise Procedure / Approach

  1. Inspect the material systematically. Note the child’s stated age, EPI card and the vaccine vial or label presented.
  2. Identify the vaccine. Read the antigen name and check vial integrity, expiry date and Vaccine Vial Monitor where present.
  3. Match it to the EPI visit. Birth: BCG, OPV-0, hepatitis B; 6 weeks: OPV-I, rotavirus-I, PCV-I, pentavalent-I; 10 weeks: second doses; 14 weeks: OPV-III, IPV-I, PCV-III and pentavalent-III; 9 months: MR-I, TCV and IPV-II; 15 months: MR-II.
  4. State the correct route. BCG — intradermal; OPV/rotavirus — oral; hepatitis B/pentavalent/PCV/IPV/TCV — intramuscular; MR — subcutaneous.
  5. Assess storage temperature. Confirm an appropriate cold-chain temperature, generally +2°C to +8°C at the vaccination facility, using the temperature-monitoring device or record.
  6. Assess vaccine handling. Check VVM status, avoid direct contact of freeze-sensitive vaccines with frozen ice packs, and look for evidence of heat or freeze damage.
  7. Screen for contraindications. Ask about previous severe allergic reaction and relevant vaccine-specific contraindications, particularly severe immunodeficiency for live vaccines.
  8. Conclude clearly. State whether the vaccine is appropriate and safe to use; quarantine and do not administer a vaccine when cold-chain integrity or vial suitability is doubtful.
Exam point: A mild respiratory illness, low-grade fever or antibiotic use alone is not usually a contraindication to routine vaccination.

🖼️ Visual Learning

VISUAL 1

Pakistan EPI Schedule & Administration Routes

🎥 Practical Video

🎥 Practical Demonstration — What Is the Vaccine Cold Chain?
Source: Immunization Academy • WHO-guidance-based training

A short practical demonstration explaining how correct temperature control protects vaccine potency throughout storage and transport.


▶ Watch Practical Video

📝 Important Viva Questions

Q1. What are the routine childhood EPI visit ages in Pakistan?

Birth, 6 weeks, 10 weeks, 14 weeks, 9 months and 15 months.
Q2. Which EPI vaccine is administered intradermally?

BCG is administered intradermally, classically in the right upper arm.
Q3. Which routine childhood vaccines are given orally?

OPV and rotavirus vaccine are given by the oral route.
Q4. What is the usual cold-chain temperature range for vaccines at a vaccination facility?

Most routine vaccines should be maintained at +2°C to +8°C according to approved storage requirements.
Q5. What does a Vaccine Vial Monitor indicate?

A VVM indicates cumulative heat exposure of the vaccine and helps determine whether it remains usable. It does not detect freezing damage.
Q6. What is an important general contraindication to a further dose of a vaccine?

A severe allergic reaction, such as anaphylaxis, following a previous dose or to a vaccine component is an important contraindication.
Q7. Is a mild upper respiratory infection or low-grade fever a contraindication to vaccination?

No. A minor illness or mild fever alone is generally not a reason to postpone routine vaccination.
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