Mock Oral Examination Set 1: Case 2

Question 1

Delilah is going to the gold coast in a couple of days and going on a boating day trip they are taking whilst on holiday.

Delilah asks: “Can I get medicine that I can take with me on a boat trip please”

A) Who is it for

B) What are the means of travel and duration of travel/symptoms?

C) Previous history of motion sickness

D) Action taken

E) Medical conditions

F) Medications being taken

G) Allergies

H) Pregnant/BF

Answer 1

A) myself

B) When I go on boats or sometimes long plane or car trips I experience significant nausea and sometimes I will vomit. I will be on a boat for approximately 4-6 hours.

C) I have experienced this when traveling on boats since I was a child.

D) I have tried the armbands and ginger in the past however they didn’t seem to work well

E) History of seizure many years ago

F) I take 500 mg valproate twice a day for my seizures

G) None known

H) No

Question 2

Appropriate extended questions

1. Will you be driving afterward/will it matter if you are drowsy at all?
2. Do you have a preference for a particular product or medicine
3. Have you tried any motion sickness tablets or medicines in the past? If yes, did it work?

Answer 2

1. I don’t mind being drowsy as my husband will be there to help with the kids. I won’t be driving
2. No preference really, but I would rather a tablet that I can take
3. Just ginger tablets. I have not tried any other medicines or tablets, but I am willing to give it a go.

Question 3

What is the diagnosis? Explain reasoning to patient.

Answer 3

We are going to manage your motion sickness. Motion sickness tends to occur when conflicting information is received from the brain. Motion is experienced but not expected. These messages are managed by sections of the brain and the ears. Motion sickness is best prevented, and the treatment works better when you take it a short while before you travel, rather than later when you experience symptoms.

Question 4

What product would you recommend for this patient? Provide IDARL.

Answer 4

Hyoscine hydrobromide 0.2mg, dimenhydrinate 50mg, caffeine 20mg

• Indication: Main ingredient in this product, hyoscine hydrobromide, is a medication used in motion sickness to try and prevent symptoms. These medicines are thought to worm by acting on the system in-ears to prevent symptoms of motion sickness
• Dosage and directions: Take 1-2 tablets 30 minutes before travel. Maximum 4 tablets per day. repeat dose after 4 hours if required.
• Adverse effects: Generally well tolerated. May cause drowsiness so avoid driving and avoid alcohol. It can also cause dry mouth and constipation but less likely as you are using this medication in a short term.
• Duration of treatment, time to recovery, when to refer: medications are used before boarding the vehicle and then repeat doses if required whilst still on board (to max dose). I will refer you to a doctor if you have delirium, confusion, dehydration due to severe vomiting or if significant symptoms of sickness requiring medical care. Also significant anticholinergic effects such as tachycardia, delirium, confusion, hallucinations, urinary retentions.
• Lifestyle/self-care: focus on still objects, lie on back, avoid reading, keep head still, close eyes, limit food/drinks especially alcohol

I will give you a self-care card for motion sickness and a consumer medication information leaflet. Do you have any questions for me?