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5th (Final year) > OSCE knowledge > Flashcards

OSCE knowledge Flashcards

1
Q

What are the three reasons you do a DNACPR?

A

Resus unlikely to be successful

The pt does not want it

It may be successful but would result in a QOL that is not to the pts benefit

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2
Q

What percentage of hospital CPR is successful roughly?

A

20% - lower if significant co-morbidities

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3
Q

Causes of blood on urinalysis?

A

ONNIT

Obstruction
Neoplasm
Nephritic syndrome 
Infection
Trauma
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4
Q

What three things are required for consent to a procedure to be valid?

A
  1. Consent must be informed
  2. Consent must be voluntary
  3. Patient must have capacity
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5
Q

What is involved in explaining a procedure for consent?

A 
Explain what it is
Explain why we are doing it 
Explain Before, during and after
Explain the risks and benefits
Explain any alternatives

Assess capacity

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6
Q

What are the fraser guidelines for contraceptive consent in children?

A

The child understands the advice
They cannot be persuaded to tell their parents
Likely to continue having sex
Physical/mental health may suffer without contraception
It is in their best interests

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7
Q

Warfarin counselling structure?

A

Check for contraindications

  • Active bleeding, or risk of
  • Pregnant

How treatment works
- Blocks vitamin K, which helps to stop your blood forming clots, thins the blood.

Treatment course and how taken

  • Once daily (usually in the eve)
  • 3 months DVT, 6 Months PE, lifelong for AF

S/Es

  • Bleeding - safetynet for any significant blood loss
  • Diarrhoea rash, hair loss, nausea
  • Avoid alcohol binges, liver, spinach NSAIDS and aspirin.

Monitoring

  • INR days 3, 4 and 5
  • Regular checks in warfarin clinic
  • Warfarin booklet
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8
Q

Methotrexate counselling structure and content?

A

Check for contraindications

  • Pregnancy
  • Immunodeficiency
  • Breast-feeding
  • Active infection
  • Hepatic impairment

How the medication works

  • Suppresses inflammation and the immune system
  • Stops folic acid synthesis

Treatment course and how taken

  • Once a week tablet
  • Take folic acid on another day
  • Dose is built up slowly
  • Long term if effective
  • Takes 3-12 weeks to work

S/Es

  • Hair loss
  • Headaches
  • GI disturbances
  • Myelosupporession - if infections, unexpected bruising seek medical help
  • Liver and lung toxicity

Monitoring

  • FBC, LFTs U&Es
  • Before starting then every 2 weeks until established, then every 2 months
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9
Q

Insulin counselling structure and content?

A

Check for contraindications
- None

How it works

  • Allows cells in your body to take up glucose and use it for energy
  • Insulin reduces the sugar in the blood

Treatment course and how you take it

  • depends on their regime
  • 90 degree angle in suncut tissue
  • Vary sites, abdomen, buttocks and thigh

S/Es

  • Weight gain
  • Sharps injuries
  • Hypoglycaemia - management
  • Lipodystrophy

Monitoring

  • Cap glucose before each meal and before bed
  • High or low sugar symptoms
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10
Q

Bisphosphonate counselling structure and content?

A

Contraindications

  • Pregnancy
  • Dysphagia
  • Peptic ulcer
  • Renal impairment
  • Sit upright for 30 mins?

How it works

  • Stops the bone bening broken down and strengthens new bone
  • Lifestyle can also help

Treatment course and how it’s taken

  • Either once a day or once a week
  • Swallow with a full glass of water
  • 30 mins before food (in the morning)
  • Upright for 30 mins after taking it
  • Long term course

S/Es

  • Heartburn and indigestion
  • Headaches
  • Bowel habit
  • Urgent advice for: UGIB, Dysphagia, Osteonecrosis of jaw

Monitoring
- Dental check ups

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11
Q

Two places you swab for MRSA?

A

Nasal and groin

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12
Q

General structure to a explaining disease station?

A
  1. Normal anatomy
  2. What the disease is and what causes it
  3. Risks/complications
    4 .Management
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13
Q

Immunisation schedule?

A

2, 3 4 months, 1 year, 3 years 4 months, girls 12-13, teens.

2 months

  • 6 in one
  • rotavirus
  • pneumococcal
  • meningitis B

3 months:

  • 6 in 1
  • rotavirus

4 months

  • 6 in one
  • pneumococcal
  • Meningitis B

1 year

  • MMR
  • Pneumococcal
  • Men B
  • Hib B
  • Men c

Preschool (3 y, 4 m)

  • MMR
  • 4 in one

Girls 12-13
- HPV

Teens

  • 3 in 1
  • Men ACWY

6 in 1

  • Diptheria
  • Polio
  • Tetanus
  • Pertussis
  • Hib
  • Hep B

4 in 1

  • Diptheria
  • Polio
  • Tetanus
  • Pertussis

3 in 1

  • Diptheria
  • Polio
  • Tetanus
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14
Q

quick developmental review?

A

3 weeks
- Smiling

3 months
- Turn to sound

6 months
- Sitting up

18 months
- Walking

18 months
- first words

3 years
- Short sentences

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15
Q

Bronchoscopy counselling structure and content?

A

What it is

Why needed

Before, during after
- Before: 6 hours no food, 2 hours no fluid, stop anticoags, and do clotting

  • During: Midazolam and lidocaine spray for all
  • After: No eating or drinking for 2 hours, No driving, alcohol, or signing legal documents for 24 hours. Keep someone with you for 24 hours.

Risks

  • Lung damage
  • Infection
  • Bleeding

Alternatives
- Imaging?

ICE

Capacity

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16
Q

Gastroscopy counselling structure and content?

A

What it is

Why needed

Before, during after
- Before: 6 hours no food, 2 hours no fluid, stop antiacid meds 2 weeks before

  • During: Midazolam or lidocaine spray
  • After: No eating or drinking for 2 hours (if throat spray), No driving, alcohol, or signing legal documents for 24 hours. Keep someone with you for 24 hours - if midaz.

Risks

  • perforation
  • Infection
  • Bleeding

Alternatives
- Imaging?

ICE

Capacity

17
Q

Colonoscopy counselling structure and content?

A

What it is

Why needed

Before, during after
- Before: 1 day before only clear fluid, bowel prep afternoon before and morning of.

  • During: Midazolam
  • After: No driving, alcohol, or signing legal documents for 24 hours. Keep someone with you for 24 hours.

Risks

  • perforation
  • Infection
  • Bleeding

Alternatives
- Imaging?

ICE

Capacity

18
Q

Structure and content for a counselling station about surgery?

A

WIPE

Confirm op
What they know so far, any questions they want to ask

What is, why needed

Before

  • Pre operative assessment, mobility and independence assessment, history and examination
  • Pre op investigations, including imaging, ECG, blood tests
  • Consent taken by a surgeon
  • (risks and benefits)
  • fasting - 2/6

During

  • Anaesthetic room with nurse
  • Meet anaesthetist, insert cannula and give anaesthetic, fall asleep

After

  • Wake up in recovery area
  • May have tubes from the operation
  • Pain control
  • VTE prophylaxis
  • Physio/OT

Risks

  • Most are rare and we minimise the risk as much as possible.
  • Anaesthetic reaction
  • Bleeding
  • Damage to nearby structures
  • Infections of the wound or systemic
  • VTE
  • Pain
  • Fluid collections

Alternatives

Ask for any questions, ICE

5th (Final year) (34 decks)

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