OSCE skills

Question 1

What should be given in hypoglycaemia if the patient is unconscious with IV access or without IV access?

Answer 1

With IV = 50ml of 20% glucose

No IV = 1mg IM glucagon (thigh) then IV dextrose

Question 2

How is DKA managed?

Answer 2

Fixed rate intravenous insulin infusion within 1 hr

50units actrapid made up to 50ml with 0.9% saline (at 0.1unit/kg/hr)

Question 3

When measuring weight of a patient what should the patient be wearing?

Answer 3

Ask to take off any heavy outer clothing/jewellery + shoes and empty pockets

Question 4

How many weight readings should be taken?

Answer 4

2

If they are different take a third and use the average

Question 5

At what point should a height measurement be taken?

Answer 5

At the end of a deep inspiration (with no shoes)

Question 6

What should the patient do during a waist circumference measurement?

Answer 6

Stand with feet 25-30cm apart

Breathe in then out gently (measure after exhalation)

Question 7

Where should the measuring tape be for a waist circumference measurement?

Answer 7

Half way between iliac crests and lower ribs

Question 8

What are the thresholds of waist circumference for european or asian males and females?

Answer 8

European
Male: >94
Female: >80

Asian
Male: >90
Female: >80

Question 9

Who should be doing self-monitoring of blood glucose?

Answer 9

Type I diabetics

Type II diabetics treated with sulphonylureas (glicazide) who drive

Question 10

Who needs to contact the DVLA if they are a diabetic?

Answer 10

Anyone who receives insulin treatment (T1/2DM)
T2DM who receive medication
Not if you are controlled by diet and lifestyle

Question 11

What glucose level is the cut off for driving and how long must you wait after you have dealt with this?

Answer 11

<5mmol/L

45 mins after it has risen above 5

Question 12

After how many episodes of hypoglycaemia must a patient notify the DVLA?

Answer 12

> 1 within 12 months