#7533 - To Complete My Examination - Medical Finals & OSCEs Notes

To Complete my Examination...

Neuro upper limb

To complete my examination I would like to

• Test [vibration,] pain and temperature sensation

• Complete a vascular examination

• Complete a full neurological examination, including the cranial nerves, lower limbs and gait examinations

• Assess the patient’s autonomic function by doing a lying-standing blood pressure and asking about problems such as urinary retention, constipation and sexual dysfunction

• Assess the patient’s functional ability by asking them to write, do up buttons, open their wallet, walk or climb stairs, and ask about falls

• Take a full history and a collateral history

• Assess the patient’s cognitive ability and mood using the Beck Depression Score or PHQ9 and GPCOG or Montreal Cognitive Assessment

Neuro lower limb

To complete my examination I would like to

• Test [vibration,] pain and temperature sensation

• Examine the sensation of the genitalia and perineal area and sphincter tone and palpate for a large hard bladder to the umbilicus as may be seen in urinary retention due a neuropathic bladder

• Complete a vascular examination

• Complete a full neurological examination, including the cranial nerves and upper limbs examinations

• Assess the patient’s autonomic nervous system status by doing a lying-standing blood pressure and asking about autonomic problems such as urinary retention, constipation and sexual dysfunction

• Assess the patient’s functional ability by asking them to write, do up buttons, open their wallet, walk or climb stairs

• Take a falls history

• Take a full history and a collateral history

• Assess the patient’s cognitive ability and mood using the Beck Depression Score or PHQ9 and GPCOG or Montreal Cognitive Assessment

Respiratory

To complete my examination, I would like to...

• Do a cardiovascular examination

• If appropriate, another system examination e.g. cranial nerves for Horner’s, rheumatological in pulmonary fibrosis

• Examine lymph nodes if not done

• Take a history inc. immunisations, childhood disease if appropriate

• Bedside investigations – blood pressure, pulse oximetry, temperature

• Gain a Peak Flow Rate

• ABG if in an acute situation or needed to assess chronic disease

• Do a CXR and ECG

• Do spirometry

• Assess inhaler technique

• Bloods if specific e.g. blood cultures, FBC, CRP for pneumonia, screening bloods for causes of pulmonary fibrosis, polycythaemia in COPD, iron studies for anaemia, paraneoplastic syndromes

• Look at a sputum sample and possibly send this off for microscopy culture and sensitivity or oramine/Ziehl-Neelsen staining

• Could do a pleurocentesis/chest drain for pleural fluid studies (pH, mC&S, lactate, protein etc.), or to treat pneumothorax etc.

• Could refer for...