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Basic Exam > OSCE > Flashcards

OSCE Flashcards

1
Q

INFORMED CONSENT

A

1-Understanding for the patient situation
2-Indication (for surgery)
3-Process (of anesthesia)
4-Benefits
5-Risk: common/benign (one)
6-Risk: rare/severe (one)
7-Mitigation
8-Alternative
9-Questions
10-Confirm I have your consent

HAVE THE PATIENT GIVE CONSENT IN THEIR OWN WORDS

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2
Q

PERIPROCEDURAL COMPLICATIONS

A

1-Understand
2-Elicit History
3-Physical
4-Potential causes (take responsibility)
5-Plan/Likely outcome
6-Questions
7-Summarize

TAKE RESPONSIBILITY

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3
Q

ETHICS

A

1-Understand the patient situation
2-Identify stakeholders
3-Name core ethical principles (beneficence, non-maleficense)
4-Elicit preferences
5-Clarify options (2 is enough)
6-Plan (may have to negotiate)

Stakeholders: is there anyone else you would like to help you make this big decision

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4
Q

COMMUNICATION WITH OTHER PROFESSIONALS

A

For cancelling a case:
-Understand the situation
-Elicit concerns
-Resolve

For remote crisis management:
-Call for help early
-Closed loop communication

Plan to sit down…and have the angry surgeon sit down

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5
Q

Practicate-Based Learning

A

1-Define problem
2-Measure
3- Stakeholders
4-Educate
5-Implement
6-Measure again

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6
Q

DNR

A

Many patient often suspend their DNR..

Has he mentioned what he would like to have happen if his heart were to stop…chest compression, shocks, medication

We can rescind DNR in part, not at all, or entirely

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7
Q

NEURO EXAM

A

Pupillary reflex
Follow my finger
Facial Sensation
Closs your eyes, smile big, puff out check
Shrug shoulder
Stick out tongue

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8
Q

MONITORS:
Upsloping EtCO2 expiratory phase…ddx

A

-Bronchospasm
-Anaphylaxis

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9
Q

Monitors:
-Elevated inspiratory EtCO2 baseline…ddx

A

1-Exhausted CO2 absorbent
2-Incompetent expiratory valve

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10
Q

MONITORS:
Incompent inspiratory valve…describe

A

Prolonged inspiratory downstroke

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11
Q

Prolonged QTC and torsades…ddx

A

Hypokalemia
Hypocalcemia

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12
Q

1-Mid-esophageal 4 chamber:
(mitral valve leaflets, tricuspid leaflets)
2-Mid-esophageal 2 chamber
(coronary sinus, left atrial appendage)
3-Mid-esophageal Aortic Valve Long Axis
(mitral valve leaflets)
4-Mid-esophageal Aortic valve Short Axis
(Cusps)
5-Mid-esophageal RV inflow-outflow
(Cusps)
6-Mid-esophageal Bi-Caval View
(Intraatrial septum)
7-Transgastric mid-papillary short axis view
(Posteromedial pap, anterolateral pap)
8-Mid-esophageal Ascending Aorta long axis
9-Mid-esophageal Ascending Aorta short axis
10-Descending Aorta long axis view
11-Descending Aorta short axis view

A

4 chamber:
-Posterior leaflet TV, septal leaflet TV
-Anterior leaflet, posterior leaflet

2chamber:
Posterior, anterior leaflet

Aortic valve Long Axis:
Posterior, anterior
-NCC, RCC

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13
Q

TTE
Parasternal short (papillary muscles)

A

R to L:
Posteriormedial…anterolateral

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14
Q

Parasternal short, mid-pap view

A

Tail toward head

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15
Q

PTX M-Mode

A

Barcode sign

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16
Q

Vascular:

1-IJ
2-Cubital Fossa
3-Radial vessels
4- Femoral vessels

A

1-SCM, Anterior scalene
2-Brachial (medial) , vein
3-Flexor carpi radialis (medial)
4-Fascia iliaca, Iliopsoas muscle

Femoral vessels…have them lie down

17
Q

BLOCKS:
1-Supraclav
2-Infraclav
3-Interscalene
4-Axillary
5-Femoral
6-Adductor canal
7-Pop fossa block
8-TAP block

A

1-Supraclav:
Middle scalene muscle, subclavian artery, first rib…2 spots
2- Infraclav:
Pec major, pec minor, axillary artery, axillary vein, brachial plexus cords next to axillary artery
3-Interscalene:
Middle scalene muscle, C5/C6/C7 nerve roots, anterior scalene muscle, IJ, Carotid
4-Axillary
-Biceps, coarachobrachialis, musculocutaneous nerve
-Axillary artery (and MUR nerves)…3 spots
5-Femoral
-Facia iliaca, iliopsoas muscle, femoral artery and vein
6-Adductor canal
Sartorius, femoral artery, femoral vein, vastus medialis, saphenous nerve
7-Pop fossa
Semitendinosus, semimembranosis, tibial, common peroneal, popliteal vein, popliteal artery, biceps femoris…tibial and common personeal become sciatic nerve….1 or 2 spots
8-TAP block
-External oblique, internal oblique, transversus abdominus, peritoneum

18
Q

Block positioning

A

INFRACLAV
AXILLARY
POP FOSSA

19
Q

Blocks

A

Pay attention to laterality, check coags

20
Q

Adductor Canal
Pop Fossa
…what nerves

A

Saphenous
Sciatic

21
Q

OSCE…general

A

WASH HANDS

Basic Exam (5 decks)

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