OSCA Flashcards
VERY IMPORTANT
What is the 3C1H refering to
Consent (Obtain from patient)
Chaperone (Ask prof to be)
Curtain
What is BMI
Body Mass Index. Weight (In Kilogram) divided by Height (in m) squared
What are the ranges for BMI in WHO standard
Underweight: <18.50
Normal: 18.50-25
overweight: 25-30
Obesity: >30
What are the ranges for BMI in CHP (FOr Asians)
Underweight: <18.5
Normal: 18.5-23
Overweight: 23-25
Obesity: >25
What are the causes for obesity
Lack of physical activity, excessive calorie intake
What are the complications for Obesity
T2DM, hypertension, fatty liver disease
How do we treat obesity
Healthy diet, exercise, medicine(statins)
What are the causes of underweight
High metabolic rate, poor diet, anorexia, cancer
What can underweight cause?
Osteoporosis, decreased immunity, anemia
How do we treat underweight
Adding snacks, increasing number of meals per day, addressing underlying cause
What shld we do
After 3C1H
Before making him onto the balance?
Ask for Pain or discomfort
Make him remove all heavy objects on his body
Tare
For palse palpitation, what are the 7 pulses
Radial
Carotid
Brachial
Popliteal
Posterior tibial
Dorsalis Pedis
Femoral
What is the anatomical landmark for Carotid pulse
Lateral to the thyroid cartilage
What is the anatomical landmark for Radial PULSE
At the base of the thumb at the lower forearm
What is the anatomical landmark for Brachial Pulse
Medial to the biceps tendon in the antecubital fossa
What is the anatomical landmark for femoral Pulse
midway between the pubic bone and the anterior superior iliac spine
What is the anatomical landmark for Popliteal pulse
The popliteal pulse is located in the popliteal fossa, directly under the knee.
What is the anatomical landmark for Posterior Tibial pulse
area behind the medial malleolus
What is the anatomical landmark for Dorsalis pedis pulse
At the dorsum of the foot in the first intermetatarsal space just lateral to the extensor of the extensor hallucis longus tendon
(What do we look for in Ankle edema)
Press the thumb into the skin above the medial malleolus on both sides, press down considerably hard for a few seconds, and then release
Formation of dimples indicates edema
What is the definiton of brady and tachy
Brady: <60bpm
Tachy: >100bpm
What are Difference between carotid pulse and jugular venous pressure
Carotid
-Palpable
Will not change with inspiration and expiration
1 peak per cardiac cycle
Will not change with the position of the patient
No way to accentuate
Lateral to laryngeal prominence and medial to SCM ( sternocleidomastoid muscle)
JVP
- Not palpable but pulsatile
-Will change with inspiration and expiration
-2 peaks per cardiac cycle
-Will change with the position of the patient
-Can accentuate with hepatojugular reflux maneuver
-Lateral to the SCM
Why can’t I palpate carotid pulse bilaterally
Compromise cerebral perfusion. May cause stroke
How to calculate Ankle-brachial index
ankle systolic pressure
/ brachial systolic pressure
Normal: 0.9-1 low may be due to peripheral arterial occlusion.
Why will u overestimate the BP
Cuff bladder too narrow/applied loosely/not centered over the brachial artery
Arm held below heart level
Talking during measurement
Arm not properly supported, causing isometric contraction of limb muscle
White coat hypertension
Why will u underestimate the BP
Cuff bladder is too wide or too tight
Leakage in the tubing
Heavy pressure on the stethoscope over the artery underestimates diastolic pressure
Arm held above heart level
Rest
Standing - a slight decrease in systolic blood pressure, and even more for the elderly and people on alpha-blockers
What are the 2 types of Hypertension
Primary: Unknown cause
Secondary: Has an underlying cause like medication
What can cause Hypertension
Pheochromocytoma, stress, caffeine consumption, exercise, white coat hypertension
What can cause hypotension
Hypovolemia(blood loss/dehydration), medication, heart failure with reduced ejection fraction
Name 2 class of drugs for Hypertension
Calcium channel blockers(amlodipine), Beta-blockers(propranolol)
Complications of hypertension
Atherosclerosis, hemorrhagic stroke, aneurysms, metabolic disorders
