OSCE Flashcards
How can you structure explaining a disease?
Normal anatomy/ physiology What the disease is Cause Problems and complications Management
How can you structure explaining a procedure?
Explain what the procedure is
Why you are doing it
Details of procedure- before, during and after
Risks and benefits
How can you structure explaining a treatment?
Check patients understanding of the condition
How the treatment works
Treatment course- when and how it is taken and for how long
Monitoring
Side effects
Contraindications
What are the contraindications for warfarin?
Pregnancy
Significant risk of major bleeding
Active bleeding
How can you explain how warfarin works to a patient?
Thins the blood to treat or prevent blood clots
It does this by blocking vitamin K which is the vitamin used by the body to make clots
How do you explain the treatment course to patients for warfarin?
Once daily
Dose changes take 2-3 months to take effect
Prescribed lifelong for AF, 3 months for DVT and 6 months for PE
What is the monitoring for warfarin?
Started at 5mg each evening
INR on days 3,4 and 5- warfarin dosing charts to adjust the dose
Regular INR checks by anticoagulation clinic
What are the side effects which a patient should be counselled about for warfarin?
Bleeding- seek medical advise if unusual or significant bleeding (long nose bleed, blood in urine/ stool/ vomiting)
Diarrhoea, rash, hair loss and nausea
Avoid: liver, spinach, leafy greens, cranberry juice, XS alcohol, NSAIDs and aspirin
What are the contraindications for DOACs?
Significant renal impairment
Significant risk of major bleeding
Active bleeding
How can you explain how DOACs work to patients?
Thins blood to treat or prevent clots
Many proteins are involved in making blood clot, this drug blocks one of these proteins from working
How do you explain the course of treatment for DOACs for patients?
Once or twice daily
Take with a full glass of water while sitting upright
Usually prescribed for 3 months for DVT, 6 months for PE and lifelong for AF
What is the monitoring required for DOACs?
None regularly
Check renal function before and annually
What are the side effects of DOACs that a patient should be made aware of?
Bleeding
GI disturbance
Irreversible if serious bleed occurs
What are the contraindications for levothyroxine you should check for when counselling a patient?
Aint none
How can you explain how levothyroxine works to a patient?
It is a man-made version of thryroxine which is a thyroid hormone. You are given it to bring your thyroid hormone levels from low back to normal.
How do you explain the course of treatment for levothyroxine to patients?
Once daily tablet before breakfast
Taken long term
Dose changes take 4-6 weeks to see an effect
What is the monitoring of levothyroxine?
TSH test every 2-3 months
What are the contraindications to statins?
Pregnancy
How can you explain how statins work to patients?
Statins stop the liver from making cholesterol. High cholesterol causes problems with your arteries which increases your risk of heart disease, stroke and kidney disease. It is also important to address other risk factors for CVD
How do you explain the course of treatment for statins to patients?
One tablet daily in the evenings
Taken long term
Decreases the risk over many years
How can you explain the monitoring of statins?
Review in 4 weeks and then every 6-12 months to see how well the blood is responding
LFTs before starting and then 3 and 6 months after starting because statins can cause a change in liver enzymes which needs to be monitored
What are the side effects of statins which patients should be made aware of?
Muscle pains
Headache
Itching
Nausea
Rhabdomyolysis- tell Dr if you are experiencing unexpected strong muscle pain
Some statins interact with grapefruit juice
What are the contraindications to metformin?
Significant renal impairment
Ketoacidosis
Low BMI
How can you explain how metformin works to a patient?
Increases your response to insulin so your cells can take up more glucose from food and reduces the amount of glucose which is made by the liver