Scribd Feed for kenners

Intravenous ß2-agonists in paediatric acute severe asthma

Tue, 29 Apr 2008 16:08:53 GMT

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

Clinical Pathology Course Handbook 2006-2009

Mon, 24 Sep 2007 11:57:19 GMT

UNIVERSITY OF CAMBRIDGE SCHOOL OF CLINICAL MEDICINE ADDENBROOKE’S HOSPITAL CLINICAL PATHOLOGY COURSE HANDBOOK FOR STUDENTS 2006 - 2009 *Clinical Pathology Handbook CONTENTS THE COURSE.................................................................................................................................... 3 Aims.............................................................................................................................................................................. 3 Help ..........................................................................................

Breaking Bad News 8

Tue, 27 Mar 2007 11:15:55 GMT

School of Clinical Medicine, University of Cambridge Stage 1 OSCE Station: Breaking Bad News Candidate Instructions (these instructions will be provided to you one week prior to the examination) This is a 10 minute station + 2 minutes reading time This station assesses your ability to break bad news to a patient. You are: A surgical PRHO at Addenbrooke’s Hospital. You are seeing a patient who requires a below knee amputation for ischaemia/insipient gangrene, due to atherosclerosis. You have not seen this patient before. Today you are seeing: Jo(e) Smith Age: 40 - 60 Scenario: The patient i

CCS Breaking Bad News Letter

Tue, 27 Mar 2007 11:07:55 GMT

Clinical Skills Centre Barry Smith Clinical Skills Centre Manager Klaudine Simpson Clinical Skills Tutor Bleep: 151 606 Tel: 01223 586698 Email: barry.smith@addenbrookes.nhs.uk Bleep: 151 686 Tel: 01223 586630 Email: klaudine.simpson@addenbrookes.nhs.uk Clinical Skills Unit Level 1, Box 168 Hills Road Cambridge Cambridgeshire CB2 2QQ Tel: 01223 596117 Friday, 23 March 2007 Dear Student, Re: Stage 1 OSCE April 2007 Please find enclosed a copy of the Candidate Instructions for Breaking Bad News, one of the five CCS/communication stations. It is important that you come prepared for this statio

Sample Instructions for OSCE History

Tue, 27 Mar 2007 11:07:51 GMT

UNIVERSITY OF CAMBRIDGE SCHOOL OF CLINICAL MEDICINE STAGE I OSCE – Gathering Information: Station: Candidate instructions This is a 12 minute station This station assesses your ability to gather information from a patient You are: A student doctor in stage 1 in your surgery attachment at Addenbrooke’s Hospital Today you are seeing: Age: Setting Mr. --------- is sitting in an out-patient consulting room. He has a routine appointment to see a consultant surgeon. Task: You have asked by the consultant to talk to Mr -------- first to: • discover why the patient has come up to hospital •

OSCE Instruction Letter

Tue, 27 Mar 2007 11:07:47 GMT

Clinical Skills Centre Barry Smith Clinical Skills Centre Manager Klaudine Simpson Clinical Skills Tutor Bleep: 151 606 Tel: 01223 586698 Email: barry.smith@addenbrookes.nhs.uk Bleep: 151 686 Tel: 01223 586630 Email: klaudine.simpson@addenbrookes.nhs.uk Clinical Skills Unit Level 1, Box 168 Hills Road Cambridge Cambridgeshire CB2 2QQ Tel: 01223 596117 Instructions to candidates at the start of the Stage I OSCE, 3rd,4th, 5thApril 2007 • • • • Please report to the back of the Clinical Skills Centre (Outside room 1) 15 minutes before the start of your circuit session time You MUST be

OSCE Mark Schemes 8-14

Tue, 27 Mar 2007 11:00:02 GMT

*******

OSCE Mark Schemes 1-7

Tue, 27 Mar 2007 10:59:39 GMT

*******

Respiratory Exam (RCT)

Tue, 27 Mar 2007 10:59:24 GMT

Examination Of The Respiratory System by Dr. Rosie C Taylor 1. General Introduce yourself to the patient. Explain to the patient what you are going to do by asking them “I would like to examine your chest, do I have your permission to do this?” To examine the respiratory system, the patient should be undressed to the waist and sitting at 45° for the measurement of the JVP. In women the breasts should be covered with a blanket. Look at the patient carefully-making it obvious to the examiner that you are doing this. In particular you should check whether the patient is in respiratory distre

Limbs Exam (RCT)

Tue, 27 Mar 2007 10:59:23 GMT

Neurological Examination Of The Limbs by Dr. Rosie C Taylor 1. General Introduce yourself to the patient Explain to the patient what you are about to do by asking them “I would like to examine your arms and legs, do I have your permission to do this?” In order to examine the limbs, the patient's arms and legs should be fully exposed but it is possible to leave the trunk covered with a blanket. A neurological examination of the limbs can be subdivided into inspection and the assessment of motor function, coordination, sensory function and gait. A useful mnemonic for this is "when testing p

GI Exam (RCT)

Tue, 27 Mar 2007 10:59:22 GMT

Examination Of The Gastrointestinal System by Dr. Rosie C Taylor 1. General Introduce yourself to the patient Before beginning to examine the gastrointestinal system ask the patient to lie flat. Make sure their head is resting on a pillow and their arms are lying loosely by their sides. Cover the patient’s chest and legs with separate blankets. Check with the patient that they are comfortable before proceeding with the examination. Stand back for a couple of seconds and look at the patient carefully-making it obvious to the examiner that you are doing this. All that is really necessary at th

CVS Exam (RCT)

Tue, 27 Mar 2007 10:59:21 GMT

Examination Of The Cardiovascular System by Dr Rosie C Taylor 25.03.2000 1. General Introduce yourself to the patient Explain to the patient what you are about to do by asking them “I would like to examine your heart and check the pulses, do I have your permission to do this?” Spend time getting the patient in the correct position, lying at an angle of 45 measurement of the JVP. -this is important for the Make sure that the patient’s upper and lower parts are covered with separate blankets-this will allow you to expose the upper or lower body, leaving the other well clad. Spend some tim

CNS Exam (RCT)

Tue, 27 Mar 2007 10:59:20 GMT

Examination Of The Cranial Nerves by Dr. Rosie C Taylor General Introduce yourself to the patient. Explain to the patient what you are about to do by asking them “I would like to examine the nerves in your head and neck, do I have your permission to do this?” In order to examine the cranial nerves the patient should be sitting up. You will need the following equipment: 1. Snellen chart 2. hatpin 3. ophthalmoscope 4. cotton wool 5. tuning fork In general you examine the cranial nerves in numerical order. The only exception to this is considering cranial nerves 2,3,4 and 6 together as these

Medical Mnemonics

Tue, 27 Mar 2007 10:59:19 GMT

PD Byrne – 1999 patrick.byrne@lycos.com Mnemonics for Medicine & Surgery Basic Signs & Symptoms Chills & Rigors CAMP Cholangitis, Abscess, Malaria / Meningitis, Pylonephritis / Pneumonia Itch, Non-dermatological causes of DULL JAM DM, Uraemia, Lymphoma, Leukaemia Jaundice, Anaemia, Myxoedema Non-pitting lower limb oedema MI CHAM Milroys, infection (filariasis), Congenital, Hypothyroid, Allergy, Malignancy Shock HEN SCAM Hypovolaemia, Endocrine (adrenal, thyroid), Neuropathic (autonomic) Spinal cord injury/ Sepsis, Cardiac, anapyhlaxis/ anaesthesia, anti HPT, Massive PE Cardiology No apex b

Examination of the Respiratory System

Tue, 27 Mar 2007 10:59:17 GMT

James Wight Examination of the Respiratory System • Wash your hands. • Introduce yourself to the patient, and ask permission to examine them. • Expose the patient, and position them at 45°. Inspection Look around the bed Look at the patient Oxygen mask/nasal prongs, sputum pot, drips, PEFR, inhalers, nebuliser, cigarettes Comfortable at rest, cyanosis, breathless, use of accessory muscles, scars (eg following a rib for pneumonectomy), asymmetry, deformity, hyperexpansion (Barrel chest), pectus carinatum, pectus excavatum, cachexia, radiotherapy marks, chest drain Clubbing (purulent lu

Examination of the Peripheral Neurological System

Tue, 27 Mar 2007 10:59:16 GMT

James Wight Examination of the Peripheral Neurological System Upper limb Inspection • Observe for muscle wasting, fasciculations, tremor and abnormal posture. • Ask pt to hold arms at 90°, then shut eyes. Observe for pronator drifting – indicates upper motor neuron pathology Tone • Ask patient to completely relax and go floppy • Flex, extend, supinate and pronate wrist and elbow in one fluid movement. Power Shoulder Elbow Wrist Fingers Ask patient to make ‘chicken wings’. Push down on their upper arm (testing C5), and push up on their upper arm (testing C6,7,8) Ask patient t

Examination of the Central Nervous System

Tue, 27 Mar 2007 10:59:15 GMT

Becca Poore and James Wight Examination of the Central Nervous System I – Olfactory Ask patient if they have noticed a change in their sense of smell Ask patient to sniff though both nostrils and then one at a time Identify common odours (coffee, peppermint) II – Optic Acuity - Test near and far vision (with glasses on – chart 6m away) – test each eye separately Fields – Test by confrontation – patient looks at your nose – you waggle your fingers (move towards centre) – one eye at a time (both you and pt). Check for neglect (one or both fingers waggling – both eyes open) Bli

Examination of the Cardiovascular System

Tue, 27 Mar 2007 10:59:13 GMT

James Wight Examination of the Cardiovascular System • Wash your hands. • Introduce yourself to the patient, and ask permission to examine them. • Expose the patient, and position them at 45°. Inspection Look around the bed Look at the patient Look at the hands GTN spray (IHD), oxygen mask/nasal prongs, drips (eg IE), cigarettes Comfortable at rest, cyanosis, breathless, scars (eg midline sternotomy for CABG, left axillary scar for mitral valve replacement), pacemaker boxes, syndromes (Marfan’s, Down’s, Turner’s), cachexia Clubbing (congenital cyanotic heart disease, IE, atrial

Examination of the Abdomen

Tue, 27 Mar 2007 10:59:12 GMT

James Wight Examination of the Abdomen • Wash your hands. • Introduce yourself to the patient, and ask permission to examine them. • Expose the patient, and lie them flat. Inspection Look around the bed Look at the patient Oxygen mask/nasal prongs, drips, cigarettes, special foods, diabetic diet Comfortable at rest, wound drain, catheter, NG tube, jaundice, scratch marks, spider naevi, gynaecomastia, striae, bruising, anaemia, pigmentation, cachexia, dehydration, abdominal distension, abdominal masses, scars (rooftop, Lshape, Mercedes-Benz, subcostal, midline, Lanz, Hockeystick, inguin

OSCE Mark Schemes 15-21

Tue, 27 Mar 2007 10:59:10 GMT

*******