PACES By Heart pinned «This time we are going to practice on solving concern skill. To pass this skill, we need to get at least 10 out of 16. We can get concern marks from 2 consultations and 2 communications (4 marks each).»
Solving concerns
Sample practice 3
Middle age woman presented with puffy face and high colour urine with background history of jt pain and fever. She was admitted in medical ward and investigation showed evidence of glomerulonephritis with SLE. Consult with nephrologist and suggest they will do renal biopsy.
You are SHO in medical ward and your task is to explain disease condition and get consent for renal biopsy.
If patient asked you these questions, how would you solve?
1. Will you accompany me during procedure?
2. Hospital food are not palatable, what can you do for me?
Sample practice 3
Middle age woman presented with puffy face and high colour urine with background history of jt pain and fever. She was admitted in medical ward and investigation showed evidence of glomerulonephritis with SLE. Consult with nephrologist and suggest they will do renal biopsy.
You are SHO in medical ward and your task is to explain disease condition and get consent for renal biopsy.
If patient asked you these questions, how would you solve?
1. Will you accompany me during procedure?
2. Hospital food are not palatable, what can you do for me?
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PACES By Heart
Solving concerns Sample practice 3 Middle age woman presented with puffy face and high colour urine with background history of jt pain and fever. She was admitted in medical ward and investigation showed evidence of glomerulonephritis with SLE. Consult with…
Solving concerns
These kinds of questions are not to assess your clinical knowledge as well as ethical and legal principles.
They are created just to access your communication skills - how well you can deal with a patient.
There is no single right answer. We can answer them in many ways but ...
Bear in mind
- be realistic (don't give impossible answers beyond your limit or not aplicable in real practice)
- be kind and sympathetic (listen carefully and acknowledge them)
♦️ Having a good communication skill is the key in solving these concerns.
These kinds of questions are not to assess your clinical knowledge as well as ethical and legal principles.
They are created just to access your communication skills - how well you can deal with a patient.
There is no single right answer. We can answer them in many ways but ...
Bear in mind
- be realistic (don't give impossible answers beyond your limit or not aplicable in real practice)
- be kind and sympathetic (listen carefully and acknowledge them)
♦️ Having a good communication skill is the key in solving these concerns.
❤7🙏2
PACES By Heart
Picking up physical signs What scar is it? What procedure patient might have undergone?
This is Hockey stick (J shaped scar) done for liver transplant.
These are scars used for liver transplant surgery.
1. Mercedes-Benz scar (Inverted Y)
2. Chevron or Rooftop scar (V shaped)
3. Hockey stick scar (J shaped)
4. Sometimes upper midline scar
💌 Practice Makes Perfect 💯
1. Mercedes-Benz scar (Inverted Y)
2. Chevron or Rooftop scar (V shaped)
3. Hockey stick scar (J shaped)
4. Sometimes upper midline scar
💌 Practice Makes Perfect 💯
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PACES By Heart
https://youtu.be/8819ORRSMts
These kind of short informative videos are also worth to listen to refresh your clinical knowledge. It is also helpful in communicating with patients.
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1. What is this?
2. What are possible causes?
3. If you encounter this in CVS examination station, what are common possible conditions?
2. What are possible causes?
3. If you encounter this in CVS examination station, what are common possible conditions?
PACES By Heart
Photo
1. This is Cental cyanosis (cyanosis involve tongue and lip).
2. Possible causes of central cyanosis (dt decrease arterial oxygen satuation)
- respiratory diseases
- cyanotic heart diseases
- haemoglobinopathies (methaemoglobinaemia)
3. In CVS station, two most common cases are TOF and Eisenmenger syndrome.
2. Possible causes of central cyanosis (dt decrease arterial oxygen satuation)
- respiratory diseases
- cyanotic heart diseases
- haemoglobinopathies (methaemoglobinaemia)
3. In CVS station, two most common cases are TOF and Eisenmenger syndrome.
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1. TOF
-Right ventricular outflow tract obstruction
-RVH
-VSD
-Overriding of aorta
2. Eisenmenger S
- long term complication of unrepaired heart defect (ASD, VSD, PDA) which result in severe pulmonary HT with reversed shunt (right to left)
#Same features
cyanosis and clubbing
RVH (LPSH)
#Differentiation points
TOF
- ESM must be present
- No pul HT (No loud P2 & Palpable P2)
- No LVH
Eisenmenger S
- Severe pul HT must be present
- Functional TR and PR can be heard dt severe pul HT
- Murmur of intracardiac shunt softer or absent because of reversed shunt
- LVH usually present
-Right ventricular outflow tract obstruction
-RVH
-VSD
-Overriding of aorta
2. Eisenmenger S
- long term complication of unrepaired heart defect (ASD, VSD, PDA) which result in severe pulmonary HT with reversed shunt (right to left)
#Same features
cyanosis and clubbing
RVH (LPSH)
#Differentiation points
TOF
- ESM must be present
- No pul HT (No loud P2 & Palpable P2)
- No LVH
Eisenmenger S
- Severe pul HT must be present
- Functional TR and PR can be heard dt severe pul HT
- Murmur of intracardiac shunt softer or absent because of reversed shunt
- LVH usually present
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