OSCE 2 Flashcards
Myocardial infarction signs and symptoms
Signs:
Pale
Sweaty/ cool skin (diaphoretic)
Hyper or hypotension
Symptoms:
Acute chest pain
Chest pressure
Left shoulder/ lower jaw pain
Shortness of breath (dyspnea)
Other:
Activity makes pain worse
Radiates to one or both arms
Radiates to lower jaw, neck, throat
Myocardial infarction treatment
Send to ER
If in ER- EKG & Cardiac Monitoring
Meds:
Oxygen
Aspirin 325mg chewed up
Nitroglycerin 0.4mcg every 5 min for pain- up to 3 pills
Chest x-ray
Refer to cardiologist
Pneumonia signs/ symptoms
Signs:
Tachypnea (rapid shallow breathing)
Increases work to breath
Hypoxia (O2 saturation < 95%)
Symptoms:
Cough- with or without sputum
Shortness of breath (dyspnea)
Pleuritic chest pain (pain worse w breathing in, coughing…)
Fever/chills
Fatigue
Pneumonia plan
- Amoxicillin 1 gram three times a day X 10 days or Z pak 250mg 2 tabs per day 1 then 1 tab per days 2-5
- (Supportive care idk)
- Chest x-ray
- Sputum culture & possible flu/covid testing
- Follow up in 10 weeks w/ repeated x-ray (if not improving day 7- call office)
Pneumonia treatment
Amoxicillin 1 gram three tabs per day X 10 days
Or
Z pak 250mg 2 tab day 1, 1 tab day 2-5
If O2 < 92%= hospitalized
Chest X-ray
Sputum culture/ possible flu or covid test
Plan aspects
- Wyd ab problem
-medication
-supportive care
-diagnostic tests
-labs
-referral to specialist - Counseling (alc or depression)
- F/U visit
- Patient verbalized understanding & questions answered
Pulmonary- embolism signs/symptoms
Symptoms
Shortness of breath (dyspnea)
Pain w breathing in coughing.. (pleuritic chest pain)
Coughing- non productive
Hemoptysis- BLOOD COUGH
Signs
Tachycardia
Hypoxemia- low O2
Hypotension- low bp
Pulmonary embolism treatment
Meds
- oxygen- 2L supplemental
- anticoagulation meds
Lab tests:
-CBC
-D-Dimer
Diagnostic tests
-CT pulmonary angiography
May need to transfer to ER
F/U couple days after discharge
Patient comes in w/ chest pain and looks pale with sweaty/cool skin.
Patient most likely has?
What meds, labs, diagnostic…
Myocardial infarction
Med
- aspirin 325mg chewable
- oxygen
- nitroglycerin .4 mg every 5 min for pain
Lab
-ekg
-cardiac monitoring
Diagnostic
-chest X-ray
Patient comes in with cough and tachypnea and shows positive egophony
Patient has pneumonia
Meds-
amoxicillin 1 mg three times a day for 10 days
Or
Z pak 250mg 2 1st day, 1 day 2-5
Labs-
Sputum culture
Posible flu/ Covid test
Of O2 < 92%= hospitalized
F/u in 10 weeks- call office if not better in 7 days
Deep vein thrombosis signs/symptoms
unilateral leg swell
leg/calf pain, especially with walking
warm & red skin area of pain
pain over course of major vein affected
special test DVT
perform MSK tests @ joints near suspected DVT in order to eliminate possible msk injury
treatment DVT
immediate labs/ultrasound
CBC
D-dimer
coagulation study (if genetic in history)
compression venous doppler of affected leg
follow up
if above knee be concern with PE (anticoag meds, may need transfer EMS)
below knee 5 days
patient present with calf pain after long flight what is it and how treat?
deep vein thrombosis
immediate labs/ultrasound
CBC
D-dimer
coagulation study (if genetic in history)
compression venous doppler of affected leg
follow up
if above knee be concern with PE (anticoag meds, may need transfer EMS)
below knee 5 days
Rotator cuff treatment
Rest
Nsaids (ibuprofen 800mg TID)
OMT- if partial tear
Suggest Physical Therapy
Xray: if trauma
Possible joint injection
MRI of joint if 8 weeks of OMT or PT does not help
Orthopedic referral greater than 6-12 month
