Station 1: (Procedure Station: Blood pressure recording)

Transcription

1 Station : (Procedure Station: Blood pressure recording) Check the Blood pressure of this patient accurately within 5 mmhg of the actual recorded BP Bed or couch, stool for candidate, BP apparatus, stethoscope, patient, assessor, instructions to candidate and checklist for the examiner Greet the patient and take consent Expose the arm, adjust the height of the apparatus Check BP by palpatory method Check BP by auscultatory method Record findings Take leave

2 Station 2: (Communication skills station: Counseling diabetic patient) Instructions to the candidate: Counsel this patient with type 2 diabetes of 0yrs duration regarding care of his feet to prevent diabetic foot and its complications. A table, 2 chairs, assessor, instructions to candidate and checklist for the examiner Introduces self to the patient and takes consent Explains briefly the effect of long standing hyperglycemia on the peripheral blood vessels Informs the patient regarding the need for good glycemic control and regular foot care by a trained person Tells the patient about the use of appropriate footwear to prevent injuries Informs the patient about the need and method of self examination of feet Rapport with the patient Asks the patient if he has any doubts and Allows the patient to talk Ends the conversation politely and takes leave

3 Station 3: (Response station: Interpretation of urine report) Instructions to the candidate This is a report of a routine and microscopic examination of a mid stream sample of centrifuged urine of an elderly male patient with fever and dysuria. Urine: Routine/Microscopy Colour: Light yellow ph: 6.0 Sp. gravity.020 Protein Negative Sugar Negative Microscopy WBC/hpf RBC/hpf Casts /hpf 20 /hpf Not present. What are the abnormal features on the Urine report? 2. What is the most probable diagnosis? 3. What would be the next two relevant investigations while initiating specific treatment? 4. What specific choice of treatment needs to be initiated on an OPD basis? 5. What underlying condition would need to be considered in this elderly man? A table, a chair, Urine report as above, instructions to candidate and checklist for the examiner Question Answer Score What are the abnormal features on the a) WBC/hpf >5 /hpf Urine report? b) RBC/hpf >2 /hpf 2 What is the most probable diagnosis? Uncomplicated Urinary Tract Infection 3 What would be the next two relevant a) Urine Culture and Sensitivity investigations while initiating specific treatment? b) Renal Ultrasound including the bladder/prostate 4 What specific choice of treatment needs to be initiated on an OPD basis? 5 What underlying condition would need to be considered in this elderly man? Oral Antibiotics (Amoxycillin; Cotrimoxazole; st Gn Cephalosporin) Benign Prostatic Enlargement/Bladder neck obstruction/malignancy Prostate Total score 5

4 Station 4: (Procedure Station: Visual acuity testing) Check the distant visual acuity of the patient and interpret the findings. Two chairs for patient & candidate, Snellen s chart fixed at a distance of 6metres, pinhole, trial frame, blank lens to occlude the eye, patient or simulated patient who is instructed to read only upto 6/8 without pinhole and 6/6 with pinhole, assessor, and instructions to candidate and checklist for the examiner Greet the patient and take consent Explain the procedure to the patient Check visual acuity in each eye separately using trial frame with occluder to close the eye not being examined Recheck visual acuity with the pinhole Interpret the significance of improvement in visual acuity with pinhole as the reduced vision is due to refractive error Take leave

5 Station 5: (Procedure Station: Urine Dipstick) Ascertain the amount of glucose in the sample of urine provided using urine dipstick Urine Dipsticks, urine sample Procedure event Score Wear Gloves 2 Check the dipsticks: Are they in-date? Check silica gel crystals are present in the container to ensure the sticks have been kept dry 3 Uses the dipstick correctly Remove one strip from the bottle and replace the cap immediately. for each Does not touch the reagent areas of the strip. Completely immerse reagent areas of the strip into the specimen and then remove immediately. 4 Does the reading of the color change correctly A. Wait the desired amount of time (30 sec for glucose) B. Hold the dipstick parallel to the ends of the tube, not to the length of the tube Total score 5