Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OSCEs > Consenting and explaining procedures > Flashcards

Consenting and explaining procedures Flashcards

1
Q

What is an OGD?

A

Oesophagogastroduodenoscopy
Camera test, tube goes through mouth, down gullet, through stomach into small intestines
Looking for ulcers/swelling/polyps and reasons for your symptoms/bleeding
May take biopsies, painless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

SE of OGD?

A

Sore throat, drowsiness (if sedated)
Bleeding, infection, perforation
Dental complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Plan for after OGD?

A

Can go home after a few hrs
May be drowsy
Cannot drive, must be picked up
F/u with GP, sent report in a few weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Causes of epigastric pain after eating?

A 
GORD/oesophagitis
Gastric/dusodenal ulcers
Biliary colic
Pancreatitis
Obstruction
Mesenteric ischaemia
Cardiac chest pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Initial investigations for someone with epigastric pain?

A 
Obs (BP, HR, RR, temp)
ECG & trop (cardiac)
LFTs, amylase (pancreatitis)
USS (gall stones)
AXR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why would a pt need an USS for abdo pain?

A

Look for gallstones and liver cysts/abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you describe US to a pt?

A

Invisible and silent sound waves
Look at reflections of organs in abdomen
Creates image on screen
Like sonar (bats, whales, ships)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Details of abdo USS

A

Nil by mouth
Radiologist does it
15-20mins
Cold gel on skin and probe pressing you

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explanation of gallstones and management

A

Gall stones are stones formed in you gall bladder, near your liver
When you eat fatty food, the gall bladder squeezes and stones press against it causing pain
Can lead to pancreatitis or cholecystitis
If found, reduce fatty food consumption and will need surgery at some point to remove them
Surgery within 3 days or after 6weeks no pain from biliary colic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Signs of cholangitis?

A

Abdo pain
Jaundice
Fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Risks of cholecystectomy?

A

Immediate: Pain, bleeding, bile leak, damage to common bile duct, conversion to open, anaesthetic complications
Late: infection, retained stone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do an appendicectomy?

A

Concerned about infection of appendix

To prevent pt getting more ill (sepsis) and perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Risks of appendicectomy

A

General anaesthetic
Bleeding, pain, infection
Damage to surrounding structures (bowel)
Converting to open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Details of appendicectomy

A 
Put to sleep
Key hole surgery, small cuts RIF, belly button & middle
Find and cut out appendix
Takes couple of hours
Home next day if well
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you explain a colonoscopy to a patient?

A

Camera test where a thin tube is passed into the back passage to look at the bowel
Look for causes of anaemia/change in bowel habit/pain/bleeding
May see inflammation, ulcers, polyps, growth
May take biopsies (painless)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you explain the procedure of a colonoscopy?

A

Take sachets mixed with water night before and morning of test
Don’t eat breakfast, need to clear out bowel
Given sedation and pain relief beforehand
Lie in fetal position on side and doctor put tube in, can see images on screen
May take biopsies (painless)
Can go home after a few hrs but will be drowsy so cannot drive
F/U in opt clinic
Give leaflet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risks of colonoscopy?

A

Pain, bleeding, infection, perforation

See Dr if: temperature, excessive PR bleeding, abdo pain

18
Q

What tumour markers do you test for in suspected colon cancer?

A

AFP

CEA

19
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangio-pancreatography

20
Q

How do describe ERCP to a pt?

A

A long thin tube is put into your mouth-stomach-gut until the area where the pancreas & CBD enter the gut
Contrast medium is released and Xrays taken
Looks for gallstones and tumours
Can get rid of gallstones and take biopsies of growths
Could have a stent put in temporarily to keep opening patent

21
Q

SE of ERCP?

A 
Drowsiness
Sore throat
Bleeding, infection, perforation of gut
Damage to bile/pancreatic ducts
Pancreatitis, death
22
Q

Other info to give to someone undergoing ERCP

A 
Sedation
NBM 6hrs
May not always work
MRCP alternative to diagnose but not treat
Probably go home tomorrow if all is well
23
Q

SE of TURP

A

Urinary incontinence, urinary retention
Erectile dysfunction, retrograde ejaculation
Bleeding, infection, pain
Damage to bladder
TURP syndrome of fluid overload and hyponatraemia due to irrigation
Anaesthetic risks

24
Q

Ix for BPH

A 
DRE
PSA
Biopsy
USS
Urodynamics
25
Q

Describe CVS

A

Chorionic villus sampling
Done between 11-14th week of pregnancy
Offered if higher risk of Down’s syndrome, Edward’s syndrome, Patau syndrome or FH and abnormality seen for sickle cell, CF, thalassaemia
Sample of cells from placenta
Abdominally or cervically
0.5-1% risk of miscarriage
Done for diagnosis and given support +/- option of TOP

26
Q

Describe amniocentesis

A

Done between 15-20 weeks
Offered if higher risk of Down’s syndrome, Edward’s syndrome, Patau syndrome or FH and abnormality seen for sickle cell, CF, thalassaemia
Sample of cells from fluid around baby
USS to avoid baby, needle through abdomen
0.5-1% risk of miscarriage
Done for diagnosis and given support +/- option of TOP

27
Q

Risks of amniocentesis

A 
Failure
Miscarriage
Infection
Injury to baby
Rhesus disease in the newborn
28
Q

Red flags after amniocentesis/CVS

A 
Severe abdo pain
Contractions
PV bleeding
Watery loss from vagina
Fever
29
Q

Describe a liver biopsy

A 
Sample of cells taken from area in liver
Diagnose cysts/cancer/parasite
Needle through abdomen, guided by US
Gel and US probe on skin, clean skin, local anaesthetic, biopsy needle 
Observed for bleeding then home same day
F/U in clinic once lab results are back
30
Q

Advice for after biopsy

A

Risks: bleeding, pain, infection
See doctor if evidence of infection or fever or abdo pain
No contact sports for a few days

31
Q

What tests need to be done before liver biopsy?

A

Clotting, LFTs, platelets

G&S

32
Q

Complications of a lap chole?

A

Pain, bleeding, infection, damage to local structures
Bile leak
Conversion to open

33
Q

After care for lap chole?

A

Should take at least a week off work
Observed for a few hrs then home that day or next day
Seek help if wound looks infected or abdo pain

34
Q

What is murphey’s sign?

A

Inspiratory catch observed during palpation of the RUQ when asking pt to breathe in
Absence of it on the other side

35
Q

What is courvoisier’s law?

A

A non-tender enlarged gall bladder is unlikely to be gallstones (more likely malignancy)

36
Q

Where is a chest drain inserted?

A

5th intercostal space

Slightly anterior to mid axillary line

37
Q

Post chest drain procedure

A

Drain bottle needs to be kept below level of insertion
Kept in overnight
Removed when stopped/slowed drianing
Sample will be taken and sent to lab to investigate cause

38
Q

What should pleural aspirate be investigated for?

A

Transudate versus exudate
Transudate clear, low protein, due to heart failure, liver failure, nephrotic syndrome
Exudate cloudy, high protein, due to infection or malignancy
Measure protein level & LDH
Microscopy & culture (gram stain & Acid fast bacilli stain)

39
Q

How would you explain an LP?

A

Happens under local anaesthetic
Needle put through space in spine into space around spinal cord
Small sample of fluid taken and sent to lab
To diagnose/exclude SAH

40
Q

What do you ask for on the CSF lab form?

A

MC&S, PCR, protein, WCC, glucose

41
Q

List 3 categories for causes of urinary retention and 2 examples of each

A

Obstructive: BPH, calculi
Drugs: opioids, anticholinergics
Neuro: cauda equina, spinal stenosis

OSCEs (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions