End of 4th Year OSCE Surgery Oct. – 2008 AL 2003
laminiroyahoo.com
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OSCE OS!E "O!
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"n#trument# $ !rocedure# "maging $ other " % Communication Communication #&ill# Clinical #cenario#
"n#trument# $ !rocedure#
'eedle#
'eedle# (4)* +hite * A,#ce## drainage (8)* !in& (-)* Yello 2()* )reen – /lood culture 22)* /lac& 23)* /lue * " in1ection#'AC 24)* ed * SC in1ection# 25)* Orange – 66 #clerothera7y 2)* /ron – "n#ulin SC antou% /C) 9": in1ec.; 2<)* A#h 2-)* :ar& orange
Suture needle# Straight Cur=ed ound ,ody Cutting Standard >a7ered e=er#e
>raumatic Eyed Atraumatic Eyele##
Suture needle#
Suture needle#
Suture material 'atural Synthetic
A,#or,a,le 'on*a,#or,a,le ono*?lament ulti*?lament /raided
Suture material A,#or,a,le Synthetic
'on* a,#or,a,le
'atura l
Synthetic
ono !olygleca7rone Catgut 9onocryl; ?lame !olydia%anone nt !olyglyconate
!oly7ro7yl ene
9ono#yn a%on;
ulti !olyglycolic acid ?lame 9Centicryl :e%on; nt !olyglactin 96icryl;
'atural
9!rolene;
!olyamide 'ylon !olye#ter
/lac& #il&
Suture material
Suturing method# Continuou# • •
Sim7le Su,cuticular
"nterru7ted • •
Sim7le attra## *
6ertical @oriontal
Suturing method#
Cannula
Cannula (4)*Orange ()*)rey
+ide ,ore
(<)*+hite (8)*)reen 20)*!in& 22)*/lue 24)*Yello 2)*!ur7le
!aediatric
"6 Buid# •
Cry#talloi d# 0.- #aline •
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0.45 #aline 0.(8 #aline @artmannD# #olution
5 (0 de%tro#e Colloid# •
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@ES Al,umin
L! S7inal needle
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F#e#
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Contraindication#
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Com7lication#
E7idural needle
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F#e#
)a,rielD# #yringe
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F#e# Sclero#ent almondoli=e oil
5 7henol in
') yleD# tu,e
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Length
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Hi7hi#ternum
!hiltrum G >ragu# G
') yleD# tu,e •
F#e# eeding :iagno#tic
Oe#o. atre#ia $* >O il& #can )a#tric a#7irate Small ,oel /a meal
>hera7eutic
)a#tric la=arge )a#tric decom7re##ion A# a drain tu,e catheter
') yleD# tu,e •
Correct 7o#itioning (.Cough 2."n1ect air 3.A#7irate 4.Fnder ater ,u,,ling 5.CH .Correct length
"C tu,e Che#t drain
"C tu,e Che#t drain "C 7uncture I "C a#7iration I "C tu,e in#ertion >horaco#tomy
"C tu,e Che#t drain •
Site – Safe triangle
"ndication# (. !neumothora% u •
e >en#ion 7 r a e !er#i#tent ecurrent > h t i c Large in elderly 7t. 6entilated 7t.
2.>raumatic haemo7neumothora% 3.alig. 7leural eJu#ion 4.Em7yema 5.!o#t o7. * >horacotomy c l a y h 7 ! r o
"C tu,e Che#t drain :aily a##e##ment (.!tD# condition 2.>u,e functioning •
/u,,ling luid le=el Singing of Buid column
3.A77aratu# Fnder ater #eal Clam7ing Le=el of the ,ottle
Airay# – Oro*7haryngeal )uedel
Airay# – Oro*7haryngeal )uedel
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Length
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"n#ertion
Airay# – LA
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Sie# 3cm * K 4cm *
Airay# – E>> CuJed – #oft hard FncuJed einforced 'on*reinforced 'orth 7ole South 7ole
Airay# – E>>
Airay# – E>>
Airay# – E>>
or children
Airay# – E>>
or #urgerie#)A in 7rone 7o#ition
Airay# – E>>
or neuro eye #urgerie#
Airay# – E>> •
Sie – ": in mm 2.0 2.5 3.0 4.0 <.0 <.5 8.0 8.5 -.0
!reterm !reterm >erm ( year Children G Age4 $ 4 Adult female# Adult male# Large 7hy#iMue
Airay# – E>> •
:uration E>>
I >racheal #teno#i# < day# >racheo#tomy •
F#e# aintain airay 6entilation – "!!6 Admini#ter drug# !re=ent a#7iration emo=e #ecretion#
Airay# – >racheo#tomy tu,e#
Airay# – >racheo#tomy tu,e#
Airay# – >racheo#tomy tu,e# •
"ndication# F77er airay o,#truction !rolonged !rolonged mechanical =entilation >o >o remo=e remo=e retained retained #ecretion# #ecretion# in L> L> >o >o reduce dead #7ace
Airay# – >racheo#tomy tu,e#
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Com7lication# !neumothora% @aemorrage Surgical em7hy#ema >u,e di#7lacement Steno#i#
Frinary catheter# (. Sim7le ru,,er catheter 2. oley catheter 3. !aulD# tu,e 9Condom catheter; 4. Self intermittent catheter 5. etal catheter
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F#e#
Frinary catheter
N. ) oleyD# #elf retaining 2 ay urinary catheter 3ay catheter u,,er 6# Silicone catheter# ale# * ( ) emale# – (4 )
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Frinary catheter
Self intermittent catheter
Am,u
>ray#
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F#e#
o#Muito artery force7
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F#e#
Laryngo#co7e#
Laryngo#co7e#
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"ndirect – Laryngeal mirror
!o#terior rhino#co7y mirror
E%ternal ?%ator#
E%ternal ?%ator#
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"ndication# !el=ic fracture# – Fn#ta,le /leeding
'on–union Com7ound fracture# Lim, lengthening
C!
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ecent change# – A>LS 2005 guideline# @and# o=er the centre of the che#t 302 che#t com7re##ion# All 3 :C Shoc&# – each 30P
"maging $ Other " %
H – CH erect
H – CH erect •
A,normality – Air under the dia7hragm
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Cau#e# !erforated 7e7tic ulcer !erforated ,oel u7tured a77endi% •
!re#entation
Acute a,domen
H – A,domen #u7ine
Small inte#tinal o,#truction
Large inte#tinal o,#truction
H – A,domen #u7ine •
A,normality :ilated ,oel loo7#
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Cau#e#
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!re#entation
Acute a,domen
H – A,domen #u7ine
H – A,domen erect
H – QF/ "6F
H * QF/
"6F
H – QF/ "6F
Stag horn calculu#
"6F
H – @i7
H – @i7
Other fracture# – H $ !O! ca#t#
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Colle#D – di#tal radial
Other fracture# – H $ !O! ca#t#
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Colle#D – di#tal radial
Other fracture# – H $ !O! ca#t#
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Sca7hoid
!aediatric radiology
:ou,le ,u,,le a77earance
:ia7hragmatic hernia
C> * /rain
C> * /rain •
Le#ion A hy7er den#e ,icon=e% #ha7ed area in the right tem7oro*7arietal region
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Condition S acute E:@
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Cau#e#
>rauma – :amage to middle meningeal artery •
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e#u#citation @"O Craniotomy R e=acuation
C> * /rain
C> * /rain •
Le#ion A cre#cent #ha7e hy7er den#e area in left tem7oro* 7arietal region $ idline #hift
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Condition LS acute S:@
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Age grou7
Elderly – +ide S: #7ace due to ,rain atro7hy
C> * /rain
C> * /rain •
Le#ion A cre#cent #ha7e large hy7o den#e area in left tem7oral region $ idline #hift
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Condition LS chronic S:@
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Cau#e#
Alcoholic Elderly folloing recurrent fall# Child a,u#e
C> * /rain
Cere,ral a,#ce## in LOcci7ital area
C> * /rain
SA@
C> * /rain
"C@
Criteria for admi##ion after head in1ury •
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Altered le=el of con#ciou#ne## S&ull fracture 'eurological #ym7tom# or #ign# :icult a##e##ment * drug# alcohol 'o re#7on#i,le care gi=er
C> * /rain "ndication# for C> #can •
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)CS T (3 at any 7oint #ince the in1ury Su#7ected o7en or de7re##ed #&ull fracture Any #ign of ,a#al #&ull fracture !o#t*traumatic #eiure ocal neurological de?cit "f )CS U 8
G
"ntu,ation R =entilation
Audiogram
Conducti=e hearing lo## •
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+a% im7action Otiti# media Oto#clero#i#
Audiogram Sen#orineural hearing lo## Acou#tic neuroma eningiti# Ototo%ic drug# 'oi#e induced
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Communication #&ill#
Con#ent for "% S%
/A":E: /* ,ene?t# * ri#&# A* alternati=e# " * inMuiry :* deci#ion E * education :* documentation
Short ca#e C2 !2 E2 > C * con#ent – )reet "ntroduction E%7lain C * cha7erone ! * 7o#itioning ! * 7ri=acy E * e%7o#ure E * e%amination > * than&ing
Clinical #cenario#
Flcer#
Flcer#
O#tomy
O#tomy
O#tomy
