Congenital High Airway Obstruction Syndrome (CHAOS): A perinatal autopsy case report.

INTRODUCTION: Congenital High Airway Obstruction Syndrome (CHAOS) is a rare anomaly where a partial or complete obstruction of upper airway is seen. As a consequence, the foetus develops enlarged lungs, inverted or flattened diaphragm and ascites. The pathological findings in a case of CHAOS is presented. CASE REPORT: A 28-year-old primigravida presented with a history of 5 months of amenorrhoea. Ultrasonography revealed enlarged echogenic lungs, cardiac mid-position, inverted diaphragm, foetal ascites and talipes of left foot. The parents opted for termination of pregnancy. Foetal autopsy revealed a male foetus with ascites and talipes of left foot. Lungs were massively enlarged, diaphragm was flattened. A dome-shaped cricoid cartilage at the subglottic level was seen as the cause of obstruction. CONCLUSION: CHAOS is a rare anomaly. A foetal autopsy can be helpful in establishing the level and nature of the obstruction and in documenting other associated foetal anomalies.

Blueprinting in assessment: A tool to increase the validity of undergraduate written examinations in pathology.

CONTEXT/BACKGROUND: Written examinations are the most commonly employed method for assessment of cognitive skills in medical education. The few disadvantages of essay questions are less number of questions, limited sampling, unfair distribution of questions over topics, vague questions etc., Blueprinting overcomes these issues, increasing the validity of examinations. OBJECTIVES: To describe the process of developing a blueprint for undergraduate written examinations in pathology; and to evaluate its effect as a tool to increase the content validity of assessment. METHODOLOGY: A workshop was conducted in the Department of Pathology to sensitize the faculty about the importance of blueprinting. A blueprint was prepared for written examinations in pathology, question papers were set accordingly and administered in preliminary examinations. Feedback was collected from the students and faculty to know their perceptions about the question papers with reference to blueprinting. RESULTS: The students and faculty felt that there was appropriate distribution of questions across topics (77% and 89%, respectively), appropriate weightage given to topics of public health importance (65% and 100%), examinations were fair (86% and 89%). All the faculty felt that blueprints aligns assessment with objectives and helps as a guide and to paper construction. CONCLUSIONS: Students were satisfied as blueprinting helped them to attempt examination better. The faculty who validated the blueprint felt that it helps in distribution of appropriate weightage and questions across the topics and blueprinting should be an integral part of assessment.