Download OSCEs for Medical Finals by Hamed Khan, Iqbal Khan, Akhil Gupta, Nazmul Hussain, Sathiji PDF

By Hamed Khan, Iqbal Khan, Akhil Gupta, Nazmul Hussain, Sathiji Nageshwaran

OSCEs for clinical Finals has been written by way of medical professionals from quite a few specialties with wide adventure of clinical schooling and of establishing and studying OSCEs.

The publication and site package deal involves the commonest OSCE situations encountered in scientific finals, including checklists, just like OSCE mark schemes, that disguise the entire key studying issues scholars have to prevail. each one subject list includes accomplished exam-focussed recommendation on the way to maximise functionality including various ‘insider's assistance' on OSCE approach and customary OSCE pitfalls.

Designed to supply sufficient insurance for these scholars who are looking to achieve as many marks as attainable of their OSCEs, and never only a publication so as to be sure scholars ‘scrape a pass', the booklet is absolutely supported via a significant other web site at www.wiley.com/go/khan/osces, containing:

  • OSCE checklists from the book
  • A survey of medical professionals and scholars of which OSCEs have a excessive probability of showing in finals in every one united kingdom clinical school

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Additional info for OSCEs for Medical Finals

Example text

Be clear and systematic when describing your findings You will probably have to examine a model in which various retinal slides have been placed. Be sure to look carefully into both eyes as different pathologies might be presented. To maximise your marks, give your description in the following order: 1. Optic disc: If you cannot see this straight away, follow the blood vessels medially to the disc. Then comment on the ‘3 Cs’ – colour, contour and cupping. 2. Retinal vessels: Examine these by quadrant.

State that you would like to test visual acuity (may be reduced). • Test for Kernig’s sign – flexing the patient’s knee to 90 degrees and then extending it causes pain. • Test for Brudzinski’s sign: ask patient to flex their neck – this causes flexion at the hips. • Note that Kernig’s and Brudzinski’s signs are signs of meningism. • Other signs of a raised ICP that may feature include Cushing’s reflex – hypertension and bradycardia. This is a late sign. • How would you investigate the likely diagnosis?

Q. Where is the lesion in this patient? A. The answers can all be found in the text above. g. ) • Volume • Coherence • Quality Assess articulation for dysarthria (patient repeats words with increasing difficulty; if wrong, student asks once more): • Lips: ‘Ma ma ma’ • Reading • Writing (assessing dysgraphia, hand dominance, other neurological signs such as tremor) • Swallow • Abbreviated Mental Test Score • CNS – ‘Nerves in head and neck’ Thanks patient • Brown Washes hands • Butter Presents findings • Artillery Offers appropriate differential diagnosis • British constitution Suggests appropriate further investigations and management • Baby hippopotamus Assess language for dysphasia (expression, comprehension and repetition): 44 OVERALL IMPRESSION: P MP F Examinations: 8 Speech 45 Summary of common conditions seen in OSCEs Dysphasia: language problem Conditions Specific signs Lesion Broca’s expressive dysphasia (BED) Non-fluent speech Can understand Cannot answer appropriately and is aware of this (naming objects) – may become frustrated Word-finding difficulty Reading and writing affected Inferolateral dominant frontal lobe Wernicke’s receptive dysphasia Fluent speech Confident in responses Paraphasias (incorrect words) Neologisms (made-up words) Does not understand questions Reading and writing affected Posterior superior dominant temporal lobe Global aphasia Unable to speak or understand Dominant lobe infarction Conduction aphasia Repetition affected Connecting fibres (arcuate fasciculus) between Wernicke’s and Broca’s areas Nominal dysphasia Only naming objects is affected Posterior dominant temporoparietal lesion Dysarthria: articulation (difficulty coordinating muscles of speech) Conditions Specific signs Cause Cerebellar disease Slow and deliberate speech Slurring Scanning/‘staccato’ speech Multiple sclerosis Stroke Pseudobulbar palsy (UMN) ‘Donald Duck’ speech Slow Indistinct Jaw jerk increased Tongue cannot protrude, is ‘stuck’ at base of mouth Tongue is ‘spastic’ Disease of corticobulbar tracts Motor neurone disease (UMN and LMN signs) Multiple sclerosis Stroke Bulbar palsy (LMN) Nasal quality Quiet Slurred Jaw jerk decreased/normal Tongue hangs out Motor neurone disease Guillain–Barré syndrome Myasthenia gravis Brainstem tumour Myogenic (muscular) defect Features of underlying condition Hypothyroidism Any myopathy 46 Examinations: 8 Speech Dysphonia: speech volume (weak respiratory muscles and vocal cords) Conditions Specific signs Cause Myasthenia gravis Fatigability (ask patient to say letters of alphabet/count to 100) Nasal quality Poor swallow Sternotomy scar Antibodies to acetylcholine receptor Thymoma Guillain–Barré syndrome History of infection (gastroenteritis) Ascending weakness Various infections Autoimmune Idiopathic Vagal nerve palsy Dysphonia Uvula dropping away from side of lesion Trauma Compression Medullary pathology Vocal cord weakness/paralysis Hypothyroidism Recurrent laryngeal nerve damage: • Tumour • Surgery Signs of hypothyroidism Hints and tips for the exam The speech station is can be tricky.

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