OSCE finals Flashcards
What must you remember to ask in respiratory chest pain
- Signs & Sx of DVT - erythema, leg pain, swelling
- Exclude PE - haemoptysis, cough, SOB
- RF of VTE: malignancy, surgery, immbolity, smoking, thrombophilia
- Systemic sx - weight loss, fever, night sweats
How do you proceed if you need to consnet a non-capacitous disabled adult brought in with carer
- introduce/talk to patient
- ask if carer if there is a way of communicating/what disability they have
- is there an LPA in place - if so, consent the LPA
What must you remember with self-harm history
- thoroughly explore intent
- ask about drugs and alcohol
- previous support/mental health input
How do you take an Obstetric history
- HPC
-
Systems review
- systemic: fever, rigors, sweats, weight loss, fatigue, rash, bruising
- PV bleed: IMB, PCB, PMB
- PV discharge
- Pain: cyclical or dyspareunia
- Pregnancy
- chance of pregnancy
-
Current preg
- Foetal movements
- contraction
- PV loss
- pre-eclapmsia sx
- 1st dayof LMP
- Scans
- Ix
- Problems
-
Previous obstetric
- GP
- Children
- Miscarriages or terminations
How do you take a paeds historuy
- HPC
-
Systems review
- general: fever, behaviour, activitiy, rashes, development, last feed, last motion
- CVS: noisy breathing…
- GI
- GU: wet nappies, dysuria
-
BIND
- Birth
- Immunisations
- Nutrition
- Development
- Social
- family unit - who’s at home
- social sevcies involvement
What are some long term consequences of coeliac
- increased riks of B12, folate and iron deficiency
- rash
- T cell lymphoma
- Osteoporosis
- Oesophageal cancer
What can you do for coeliac patients
- prescirbe gluten free food
- give hope, especially in young patients
- emphasise that coeliac doesn’t mean you can’t lead a normal life
What safety netting advice can you give to stable angina patients
GTN
- take one puff - wait 5
- if persistent, take another - wait 5
- if not aborted, call (((
Continue to exercise even if it causes chest pain
What are some important points to assess asthma control
- Symptoms
- nightime sx
- no. of times per day reliever is used
- asthma sx during day - has it affected daytime activities
- admissions
- Adherence
- are you taking inhalers correctly
- review asthma sx
How do you explain chronic kidney disease? assess RF for progression? Risks
- Chronic kidney disease (CKD) is a long-term condition where the kidneys don’t work as well as they should.
- risk factors afffecting progression
- smoking
- NSAIDs
- DM
- HTN
- Maintain healthy diet
- reduce salt
- exercise
- complications
- increased risk of AKI
- Bone
- Blood
- Dialysis
How do you systems review rheum
- weight loss
- rash
- ulcers
- hair changes
- nodules
- diarrhoea
- fever
What are key sx to review with
a) every patient
b) ladies
a
- bowels and bladder
- similar episodes
b
- MOSC
- Menstrual periods, menstrual/gynae sx
- obstetric hx
- sexual hx and smears/mammograms
- contraception
- smears and mammograms
- bleeding disorders/PMH or DH of blood thinning
How do you consent for a procedure
- why are you here
- what have you been told
- brief HPC and red flags
- What the procedure is
- What you’re going to do
- Risks
- Follow up
- How will they receive results
- Questions
How do you cousel on mirena
- explore patient perceptions
- explain how it works
- explain the pros
- reversible
- localised hormones, reduced cancer risk
- explain cons
- irregular bleeding for the first few months
- initial period like pain
- SE:
- headaches
- acne
- breast tenderness
- no STI protection
- Explain risks
- infection
- expulsion
- perforation
- Explain procedure
- have you had a smear before?
- -ve pregnancy test and bimanual before
- post procedure
- light bleeding
- can check position themselves
- explains removal after five years
What are the endocrine systems review questions
- heat intolerance
- sweating
- fatigue
- termore
- neck swelling
- weight gain or loss
- omsotic symptoms
What must you remember in spine exam
gait
chest expansion
What are the concluding bits for resp
- cervical nodes
- oedema
- sputum pot
- peak flow
what are some bits often forgotten in cardio
ausculatate left axilla for mitral incompetence
lung bases
palpate carotids
state - femoral pulses
Bits
- BP both arms
- lying and standing BP
- 12 lead ecg
- opthalmoscopy
How do you accentuate various murmurs
Held inspiration increases R sided murmurs
Held expiration increases L sided murmurs
Bell - apex - roll - mitral stenosis
Diaphragm - lean forward - aortic regurg
How can you open a consultation
I’m going to explain this to you in a second, but i would just like to double-check what you’ve been told.
