OSCE Flashcards
ICE format for Iron supplementation
Ideas
“Have you heard of iron supplements before?”
“Do you know why iron is important for health?”
“Have you ever been told that you have low iron before?”
Concerns
“Is there anything that worries you about taking iron?”
“Have you any concerns about your physical health at the moment?”
Expectations
“Do you understand the benefits of taking iron supplements?”
“What are you hoping iron supplements will do for you?”
What is the role of iron in the body?
- Transport of oxygen in red blood cells
- Providing oxygen to muscles, especially skeletal and cardiac muscle
- Acting as a co-factor for important enzymes
- Playing a role in immune response
When should you take iron supplements?
Iron is absorbed best if taken an hour before a meal.
Side effects of oral iron?
- Nausea
- Constipation
- Diarrhoea
- Dark-coloured stools
- Metallic taste
What foods are rich in iron?
- Red meat
- Leafy vegetables
- Dried fruit and nuts
What is the other vitamin important to consider when taking Iron supplements?
Vitamin C combines with iron to form an iron chelate complex which makes iron more soluble and results in increased uptake of iron in the small intestine
What are the benefits of blood transfusion?
- Can relieve symptoms caused by anaemia
- Can prevent damage caused to organs associated with anaemia
- Can allow earlier mobilisation and quicker recovery after an operation, acute illness or injury
What is the risk of a serious problem occuring with blood transfusion?
1 in 10,000
What are some of the possible risks of blood transfusion?
- Identification error (never event)
- Reactions
- Build-up of fluid
- Infection
- Formation of antibodies
- Iron overload
CAGE questions for alcohol dependency
- Ever felt you should cut down
- Been annoyed by people telling you to cut down
- Do you feel guilty about how much you drink
- Eye opener: ever had a drink first thing in the morning.
What special tests can you do in a hip examination and what are they looking for?
- Thomas’s test - used to assess for a fixed flexion deformity DO NOT PERFORM IN PATIENTS WITH HIP REPLACEMENT
- Trendelenburg’s test - used to screen for hip abductor weakness
What special tests can you do in a spinal examination and what are they looking for?
- Schober’s test - can be used to identify restricted flexion of the lumbar spine which may occur in Ankylosing Spondylitis
- Sciatic stretch test (a.k.a straight leg raise) - used to identify sciatic nerve irritation
- Femoral nerve stretch test - used to identify femoral nerve irritation
What are the cautions you should consider when prescribing steroids?
- Hepatic impairment
- Unhealed wounds
- Stomach ulcers
- Pre existing medical conditions
- MH problems
How to take steroids?
- Should be taken same time each day, usually in the morning
- Oral steroids should be taken with or soon after a meal
What should you do for a missed dose of steroids?
Should take it as soon as they remember but if it is the next day, they should not take two doses to compensate for the forgotten dose
