Memorise For OSCE Flashcards
Diabetes and pre diabetes HbA1c?
Diabetes: > 48 mmol/L
Prediabetes: 42-47 mmol/L
What is QRISK2?
Risk if developing MI/stroke in next 10 years
Factors for QRISK2?
14 things
Age, males, ethnicity, smoking, diabetes, angina/MI in 1st degree relative <60, CKD 4 or 5, AF, BP treatment, RA, cholesterol/HDL, BP, BMI, UK postcode
When would someone be offered a statin who has not had CHD or a stroke?
If QRISK more than 10%
What lifestyle factors are important for heart health?
- healthy diet
- physical activity
- stopping smoking
What is the flow rate and percentage oxygen of nasal cannulae?
0.5-4L
24-36% O2
Considerations for nasal cannulae?
- Positive: speak, eat, drink, good claustrophobic/agitated/confused
- Negative: drying nasal mucosa/bleeding especially at higher flow rate, avoid oil creams
What is the flow rate & % oxygen for a Hudson mask/simple face mask?
30-40%
5-10L
What are considerations for simple face masks?
- Consider humidification for long term therapy
- latex allergies for all masks!
- Avoid over tightening of straps
- Do not allow tight control of FiO2
- Risk of aspiration if patient vomits
Straps under ears!
What % and flow rate of oxygen for non rebreathe mask?
70% and 10-15L
When and how is a non-rebreathe mask used?
Emergency therapy
Occlude valve to inflate reservoir bag before fitting on patient
What % and flow rate do the Venturi masks range?
2-15L/min
24-60%
What are the benefits and negatives of Venturi masks?
- Can change flow rate without altering %
- More accurate for long-standing lung disease
- Can be noisy
What does the tracheostomy mask and elephant tubing need?
Must be humidified and can be noisy
Chest X-ray steps?
- This is an erect chest X-ray!
- Patient ID, date, time, previous imaging
- RIPE: rotation, inspiration (5-6 ribs), projection, exposure (left hemidiaphragm visible to spine and vertebrae behind heart)
- Airway: trachea deviation, can see carina & bronchi?, hilar size and symmetry?, mediastinal shift
- Breathing: compare 3 zones - shadows and lung markings
- Cardiac: size and heart borders
- Diaphragm: air, costophrenic angles
- E: mediastinal contours (aortic knuckle & aortopulmonary window), bones, soft tissue, tubes, valves, pacemaker
- Review: lung apices, retro cardiac, behind diaphragm, peripheral lung, hilar