Now I'm going to continue from my previous post-Short OSCE
4. Patient came in with shoulder pain.Examine the shoulder
-Basically i think the examiner just want to see how do you perform the examination,put more attention on the special test. Exp: Frozen shoulder you will have global reduce range of movement,For rotator cuff injury,you will need to perform Lift off Test,Napoleon test,etc.For Impingement you need to perform Neer test,Hawkin Test and painful arch.For instability you need to do appehension and drawer test.Not to forget the Winging of Scapula!
-Management for frozen shoulder
5.Patient had a haematemesis and banding was done on him.Perform a general examination on this patient and do a ruuning commentary.Examiner will ask you a few questions after that,
-We are expected to look for stigmata of chronic liver disease,such as palmar erthema,dupunture contracture,pallor,perpura,echymosis,icterus on sclera,hepatic flap,fetor hepaticus,gynaecomastia,spider naevi,parotid gland enlargement,absent of axillary hair,so on and so forth.
-Basically it is a quite a easy station.I personally regretted for not remember all the findings,if not you will score in this station.But for my patient,he didnt really has jaundice but lecturer insisted that there was jaundice seen.
-Examiner will ask what is the diagnosis-oesophageal varices secondary to liver cirrhosis evidenced by (the findings that you have found)
6.Patient came in with hearing loss for the past 6 months.Take a focused history and examined the patient.
-Diagnosis-Chronic suppurative otitis media,tubo-tympanic type.
-We are expected to ask on any recent trauma,infections and risk factors that are causing chronic otitis media.
-We need to examine using the otoscope.Well,you need to start with inspection,palpation(tragus tenderness),and use the otoscope to comment the external auditory canal and tympanic membrane.
-Management of tubo-tympanic type of CSOM-it is a safe type,so just manage it conservatively.
7.Elderly patient who is a known case of hypertension,under hydrochlorothiazide, came in with a results.It showed hypokalaemia and low chloride with hyperuricaemia.Explain to the patient regarding the renal profile and cousel and take history if needed.
-Basically you need to change the medication from diuretics to CALCIUM CHANNEL BLOCKER-nifedipine.This is because patient does not has any other co-morbids except hypertension.
-Counsel the patient to come back for follow up and any complication that might arise from calcium channel blocker and diuretics.Ask for any signs and symptoms of gout.
-Patient ask does he needs to get allopurinol.The answer is NO,you just need to change the medication and follow up the patient first.
More to come...
4. Patient came in with shoulder pain.Examine the shoulder
-Basically i think the examiner just want to see how do you perform the examination,put more attention on the special test. Exp: Frozen shoulder you will have global reduce range of movement,For rotator cuff injury,you will need to perform Lift off Test,Napoleon test,etc.For Impingement you need to perform Neer test,Hawkin Test and painful arch.For instability you need to do appehension and drawer test.Not to forget the Winging of Scapula!
-Management for frozen shoulder
5.Patient had a haematemesis and banding was done on him.Perform a general examination on this patient and do a ruuning commentary.Examiner will ask you a few questions after that,
-We are expected to look for stigmata of chronic liver disease,such as palmar erthema,dupunture contracture,pallor,perpura,echymosis,icterus on sclera,hepatic flap,fetor hepaticus,gynaecomastia,spider naevi,parotid gland enlargement,absent of axillary hair,so on and so forth.
-Basically it is a quite a easy station.I personally regretted for not remember all the findings,if not you will score in this station.But for my patient,he didnt really has jaundice but lecturer insisted that there was jaundice seen.
-Examiner will ask what is the diagnosis-oesophageal varices secondary to liver cirrhosis evidenced by (the findings that you have found)
6.Patient came in with hearing loss for the past 6 months.Take a focused history and examined the patient.
-Diagnosis-Chronic suppurative otitis media,tubo-tympanic type.
-We are expected to ask on any recent trauma,infections and risk factors that are causing chronic otitis media.
-We need to examine using the otoscope.Well,you need to start with inspection,palpation(tragus tenderness),and use the otoscope to comment the external auditory canal and tympanic membrane.
-Management of tubo-tympanic type of CSOM-it is a safe type,so just manage it conservatively.
7.Elderly patient who is a known case of hypertension,under hydrochlorothiazide, came in with a results.It showed hypokalaemia and low chloride with hyperuricaemia.Explain to the patient regarding the renal profile and cousel and take history if needed.
-Basically you need to change the medication from diuretics to CALCIUM CHANNEL BLOCKER-nifedipine.This is because patient does not has any other co-morbids except hypertension.
-Counsel the patient to come back for follow up and any complication that might arise from calcium channel blocker and diuretics.Ask for any signs and symptoms of gout.
-Patient ask does he needs to get allopurinol.The answer is NO,you just need to change the medication and follow up the patient first.
More to come...
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