Leave me alone !!! 1 OSCE by Naanu Neenu

 
You have 3 minutes reading time. This OSCE will run for a maximum of 7 minutes.

Scenario:

Mrs Band is 83 year old lady who has been unwell for last 2 weeks.She has been brought in by the family as she has not been eating and drinking and has not been mobilising well.Family is worried that she is quite unwell and needs to stay in the hospital. Take history, ask for examination findings from the examiner in the room and inform further management plan to Mrs Band.

Instructions for the candidate

you dont have to examine the patient. Mrs Band's Daughter Badgerine is with the patient.

Domains being examined

  • Medical Expertise
  • Prioritisation And Decision Making
  • Communication
  • Health Advocacy
 
The candidate has 3 minutes reading time. This OSCE is expected to run for a maximum of 7 minutes.

For the actor

Mrs Band:
you are 83 years old ,living with your son as your carer.
You have been feeling unwell for last 2-3 weeks.You have very bad sore throat and have not been able to eat or drink well due to the pain.No Nousea or vomitting.you feel tired all the time and dont have any energy to move around.you feel that you might be having temps but not sure as it has not been checked.you have chills and hot sweats 2-3 times a day.you do not have any pain in chest ,cough or phlegm.You dont have any trouble breathing.
If asked you deny having any abdo pain,urine symptoms.
Your legs have been swollen for quite sometime and you have been taking water tablets for the same.The swelling has increased in last 2-3 weeks.
You deny any other symptoms if asked.

Past Medical history:
Heart valve problems
Heart failure
HTN
no history of heart attacks,Diabetes,lung or kidney problems.

Meds :
water tablets
Aspirin
BP tablets
Vitamins

Family:
daughter lives away from you.
Son is staying with you and looks after you.


Daughter Badgerine:

you stay in brisbane and have come to see Mum 2 days ago.Mum looks so different to what she was before.Seems like she has lost a lot of weight.not eating and drinking.not walking around as before and needs help with everything now.
You are worried that she might have some thing bad happening and wants it checked before she heads back to brisbane in 2 days.not sure her brother would cope looking after mum as he has his own problems.



For the examiner

when asked about examination findings or at 5 min mark give examination findings as follows:

HR 90 regular
BP 110/60
RR16
SaO2 91% RA
Temp: 38.4

Throat: Erythematous +++,ulcers over pharynx, Tonsils not visible.
Chest: good air entry bilaterally,nil wheeze or crackles.
HS dual, Pan systolic murmur Grade 5 radiating to Axilla.
Abdo soft. non tender hepatomegaly 1-2 cm below costal margin.
CNS generalised weakness.nil focal.
PEdal edema ++,pitting
nil raised JVP.

if asked:
urine negative
BSL 5.5
ECG nil arrhythmia,nil acute.

Domains Assessment Objectives

Medical Expertise

Prioritisation And Decision Making

Communication

Health Advocacy

Other Assessment Notes


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