OSCE questions

T.gowthami 

Roll no 132

Case : https://132gowthami.blogspot.com/2023/12/long-case.html

PREFINAL EXAMINATION-OSCE QUESTIONS 

 Question 1:How to prevent the complications of diabetes ?

 Reference: https://www.cdc.gov/diabetes/library/features/prevent-complications.html

• Follow a healthy eating plan.
• Be physically active for at least 150 minutes a week (just 30 minutes, 5 days a week).
• Manage your ABCs:
  • A: Get a regular A1C test to measure your average blood sugar over 2 to 3 months; aim to stay in your target range as much as possible.
  • B: Try to keep your blood pressurebelow 140/90 mm Hg (or the target your doctor sets).
  • C: Control your cholesterol levels.
  • s: Stop smoking or don’t start.

  
  

• Lose weight if you’re overweight—just a 5% to 7% weight loss lowers the risk for complications. That’s 10 to 14 pounds for someone who weighs 200 pounds.
• Take medicines as instructed, and talk to your doctor if you have questions about or problems with your medicine.
• Make and keep appointments with your health care team (primary care doctor, dentist, foot doctor, eye doctor, and dietitian).

Question 2:How to diagnose COPD ?

Spirometry

Other lung function tests:

    Peak expiratory flow (PEF) test

Fractional exhaled nitric oxide (FeNO) test

Fractional exhaled nitric oxide (FeNO) tests

Arterial blood gas test

Lung imaging tests:

Chest computed tomography (CT) scan

Chest X-ray

Reference: https://www.nhlbi.nih.gov/health/copd/diagnose

Question 3:How to diagnose obstructive sleep apnea?

Reference:https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/diagnosis-treatment/drc-20352095

Polysomnogram or home sleep apnea test reveals:

• >15 predominantly obstructive respiratory events per hour of sleep OR
• >5 predominantly obstructive respiratory events per hour of sleep and at least 1 of following:

• Daytime sleepiness, nocrestorative sleep, fatigue, or Insomnia
• Waking with breath holling, gasping, or choking
• Observed loud snoring, breathing interruption, or both
• Hypertension, mood diserder, cognitive dysfunction, schemic heart disease, stroke, congestive heart failure, atrial fibrillation, or diabetes type 2

Question 4:Features of LV failure and COPD.

LV failure 

Shortness of breath

Orthopnea

S3 Gallop indicative of elevated left ventricular pressure

Cardiomegaly

COPD

Symptoms

Productive cough

Wheeze

Breathlessness 

Signs

Tachypnoea

Intercoastal indrawing

Pursing of lips on expiration

Reduced chest expansion

Lungs are hyperinflated

Loss of the normal cardiac and liver dullness.

Barrel shaped chest

Reference: Kumar and Clark's Clinical Medicine. 

Question 5:What are different types of nerve fibres and their susceptibility to damage? 

Reference : Ganong's review of medical physiology. 

   

Learning points from my case discussion:

1) I have learnt about the importance of diet modifications , physical exercise in preventing complications of diabetes 

2) difference between diagnosis of COPD and OSA 

3) features of LV failure and COPD

4) causes of shortness of breath 

5) detailed history of the patient in evaluating diabetes .