Enquire about nausea. does exercise, cold air or pollen make it worse? Is there a pattern? 0. Intermittent- for several hours, then touches baseline (i.e, normal temp) sometime during day. MedicForYou provides the deep insights to educational articles and discussions related to MBBS and Para-Clinical services. Meningitis (neck stiffness, bulging fontanelle, reduced consciousness, seizures, purpuric rash) Otitis media (pain, erythematous/ bulging tympanic membrane) Tonsillitis (reduced oral intake, pain, swollen tonsils, cervical lymphadenopathy) ! CHD VSD Peads OSCE 18/03/2017 Station 1 History taking Station 2 History Taking Station 3 General Physical Examination Station 4 Abdominal Examination Home; History Taking; Examination; Clinical Skills; Radiology & Image Identification History Taking Series (2) Analysis of fever Abbas A. RHEUMATIC FEVER 13. 3rd day- Pox (Smallpox, not seen these days). If fever falls to normal within 6-12 hours, it is called Fall by Crisis. Sorry, your blog cannot share posts by email. Osteoarthritis: Morning stiffness is common; pain is typically worse at the end of the day and after activity, and may be relieved by rest. The NEET PG Results 2018 are out! The examiner prompts the candidate to reread the instructions. You are seeing Mrs. Kossopoulos, a 26 year old woman, for shoulder pain that has steadily worsening over the last few weeks , during which time she’s been playing softball. This is a common scenario and a wide range of differentials need to be ruled out. BRONCHIOLITIS 17. If fever falls gradually over days, it is called Fall by Lysis. Perform a relevant physical examination (do not perform corneal reflex, breast, pelvic/genitourinary, or rectal examinations). Search this site. Opening scenario. ), BA (Hons.) All Courses and Careers options, Emergency Drugs List in India | Common Casualty Medicines. As you proceed with the physical examination, explain to the examiner what you are doing and describe any findings. 3. Pyrexia or fever is generally normal after convulsions (GTCS) due to excessive body muscle contraction. OSCE Notes Online – Your Source for NAC OSCE, USMLE CS, MCCQE II and your medical school OSCE exam notes, Chronic Obstructive Pulmonary Disease (COPD), Differential Diagnosis of First Break Psychosis, Fever: ≥ 38 oC measured rectally (oral are 0.6, Fever of unknown origin: daily rectal temperature >38.3, Raised hypothalamic set point (infection, collagen vascular disease, malignancy) –> antipyretics are helpful, Excess heat production (salicylate overdose, hyperthyroid, environmental heat, malignant hyperthermia), Defective heat loss (ectodermal dysplasia, heat stroke, anticholinergic overdose), 0-3months: UTI is most common bacterial infection (E. coli, enterococcus), Bacteriemia, meningitis (N meningitides if petechiae), Appendix, AOM (S. pneumo, H influenzae), gastroenteritis, strep pharyngitis, bronchiolitis, pneumonia (S. pneumo, Mycoplasma pneumo, H. flu, GBS, RESV, Influenza, Parainfluenza, Adenovirus, Coxsackie), Cardiac abnormality – think endocarditis, Kawasaki (5 days of high fever, truncal/polymorphous rash, bilateral nonpurulent conjunctivitis, changes in oral mucosa specifically lips and tongue, desquamation, cervical lymphadenopathy), Clarify: onset, duration, how measured, height. History. 4. Let’s dive into the basics of Fever history and explain bit on the format. Wish you all the best! SEPTIC ARTHRITIS 16. Please take an appropriate history. Those who have appeared for the Post-Graduation exam after MBBS in December can now check their results here. You are seeing Frank, a 27 year old homeless male, who was brought into the ER by police because he was found vomiting in a nearby alleyway. Onset and duration of pain (began during softball) Progression The list is made according to India with detailed drug class and uses. Alex Soto, a 19-year-old male, comes to the urgent care clinic because of a sore throat.. Vital signs. ANTHROPOMETRY 19. Home‎ > ‎History Taking‎ > ‎ Fever (Pyrexia of Unknown Origin) History. Common OSCE exam cases that have been seen in USMLE Step 2 CS, MCCQE II, PLAB 2, OSCEs for medical students and medical school clinical finals, Clinical Skills Assessment for International Medical Graduates are:. Approach to history taking in a patient with fever 1. History for chronic cough OR recurrent chest infections This is the same as the acute cough history above, but focus should be on the diseases marked red (in italic), as those CHD VSD Peads OSCE 18/03/2017 Station 1 History taking Station 2 History Taking Station 3 General Physical Examination Station 4 Abdominal Examination Rigors, fever in 3 -6month old Fever in <3month old ! You have entered an incorrect email address! Read our exclusive guide on Courses and Careers you can opt after MBBS. Learn history taking osce with free interactive flashcards. Always try to make patient comfortable and don’t hassle or mix up, otherwise it may become cumbersome for both you and patient. EPILEPSY 15. MedicForYou is a medical community dedicated to Doctors and Students all around the globe. MRCS (Eng. Introduction (WIIPP) Wash your hands; Introduce yourself: give your name and your job (e.g. Always try to make patient comfortable and don’t hassle or mix up, otherwise it may become cumbersome for both you and patient. Have a look below. History and exam. The candidate forgets that the instructions called for a history only, and intends to examine the patient. Then, perform a focused physical examination. Causes- Malaria, UTI, Pent-up pus anywhere in body, Septicemia/Pyaemia, Cholangitis, Sub-acute Bacterial Endocarditis, Thrombophlebitis, Acute pyelitis/Pyelonephritis, Acute lobar pneumonia, Agranulocytosis, Pyogen reaction (fluid/blood transfusion), Filariasis, Jaundice. You have 14 minutes Find the life saving drugs in Cardiology, Respiratory, GIT, Obstetrics, Painkillers, Allergy, CNS and Antibiotics. It is important that you hear thehistory from both the guardian and the patient. abscesses, endocarditis, tuberculosis, osteomye… Save my name, email, and website in this browser for the next time I comment. General history taking ..... 57. Good, precise history taking skills can narrow down the differential significantly. Knowing the incubation periods of specific pathogens and possible fever patterns may provide clues to the organism involved. Key diagnostic factors. nausea. Lynne Black, 20 years old, presents to the Emergency Department with a 16-hour history of abdominal pain. Choose from 500 different sets of history taking osce flashcards on Quizlet. It is the basic question to approaching chief complaints of patient. Post was not sent - check your email addresses! Ask about the site of pain and stiffness. Pneumonia (tachypnoea, crepitations, do you get heartburn? Perhaps fever history taking format should be a chapter in itself, but it is always better to memorize these questions as they are FAQs of medical life. RHEUMATIC HEART DISEASE 18. Cardiovascular history ..... 61. A. Shawka 2. It can be a prominent symptom of a stone in the common bile duct. Screens for associated respiratory symptoms (fever, shortness of breath, wheeze, chest pain - clarifying if pleuritic/burning suggestive of reflux disease) 0. Certain drugs can cause fever, i.e, Pyrexia inducing drugs which are: Sulfonamides, Phenytoin, Iodides, Bromides, Thiouracils, Barbiturates, Penicillin, Salicylates, Rifampcin, Phenopthalein (used in laxatives), Quinidine. 1. In this blog, we will discover which questions to ask the patient regarding his fever and approach the possible differential diagnosis by revealing more about fever. (adsbygoogle = window.adsbygoogle || []).push({}); Since we have covered the basics of Fever history, its time we move to the detailed part of the format and discover what can be related to our patient having the fever of unknown origin: Chills is feeling intense cold, while shivering is Rigor. Dr. Louise Gooch, ward doctor) Identity: confirm you’re speaking to the correct patient (name and date of birth) Fever History Taking 1. The presentation of jaundice is a classic test of understanding of hepatic physiology and history is vital in working out the cause. SEPTIC ARTHRITIS 16. Read our list of Emergency drugs used in Casualty wards. History Taking – Overview. Up until the age of 5 the rectal route is gold standard.  Oral may be used in toddlers but thermometer should be held under tongue for ~4 minutes.  The TM route is becoming more favourable.  Axillary method should not be used. 1. Previously, we discussed how to take patient history clinically. Try to condense the patient’s story to only include pertinent facts.You need to be like a detective and search for pertinent facts. This is ----- He/she, a known diabetic person, has come to the emergency complaining of 2-day of vomiting, fever and severe abdominal pain. REMS/ Orthopedic Knee Examination. You are either doomed or you are not serious really. Always remember that when taking a history Information about a patient’s health can only be shared with if consent is given. In the next 10 minutes, obtain a focused and relevant history and conduct a focused and relevant physical examination. Pyrexia of Unknown Origin (PUO) – History Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES Introduction (WIIPP) Wash your hands Introduce yourself: give your name and your job Identity: confirm you’re speaking to the correct patient (name and date of birth) Permission: confirm the reason for seeing the […] Kidney Stones: Lifestyle Changes You Can Make! Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES. ), PhD ... Pyrexia of unknown origin and fever 311 Rashes 319 Red eye 328 Scrotal pain and swellings 332 … Nontoxic infants aged 0-60 days (SBI): 4-16%. Sweating is associated with Hectic Temperature which is Chills and Rigors followed by profuse sweating and then normal temperature. Causes- Mnemonic- Very Sick Person Must Take Double Tea. Causes- Pent-up pus anywhere in body (lung/liver/sub-diaphragmatic abscess, empyema thoracis, empyema of gall bladder), Septicemia/Pyaemia, Advanced TB (rarely). Take a history of his complaint. Rarely, illness can occur months or years after travel-related exposure. 3 types of intermittent fever are: Again, it helps in finding if patient has Continuous fever type or Remittent fever type. ANTHROPOMETRY 19. Peak incidence between 6mo-12mo; more common in fall and winter. BRONCHIOLITIS 17. Stiffness may be due to mechanical dysfunction or local inflammation of a joint, or a combination of both. History: Fever in a Returned Traveller. OSCE DATE ??/??/201? Paediatric History Presenting complaint(s) Determine symptoms which brought patient in History of presenting complaint(s) ‘ Explode ’ every symptom (including further symptoms you elicit in system reviews) o Time-frame When started Acute or gradual onset Duration Progression Intermittent or … Radiology & Image Identification. Focused History Taking for OSCEs-David McCollum 2011-12-01 This straight-forward guide to taking patient history comprehensively covers all of the commonly seen OSCE scenarios within the current undergraduate medical curriculum. Start with Post-graduation, Research, Hospital management, Foreign studies and Clinical practice. Pyrexia of unknown origin (PUO) is defined as fever of 38.3°C or greater for at least 3 weeks with no identified cause after three days of hospital evaluation or three outpatient visits.¹ Additional categories of PUO have since been added, including nosocomial, neutropenic and HIV-associated PUO. MBBS: What is Full Form or Name of Degree? Common Pediatric OSCEs . Asks for heartburn/abdominal pain. The timing of fever can help identify the cause (and rule out other diagnoses) 2. RHEUMATIC HEART DISEASE 18. MENINGITIS 14. OSCE Stations Cardiology Chest Pain History Rotation C Rohit's Chest Pain ... Asks for fever, cough. Respiratory history ... do you suffer from or have a family history of asthma, eczema, hay fever or allergies? 2. Take a focused history and perform a physical exam. Subjects • How to take a medical history from a patient that presented mainly with fever? Focused History Taking for OSCEs includes an introductory chapter with general OSCE 2. OSCE scenario: This 36 year old lady has presented to A+E with a fever. Useful for identifying febrile infants (<90days of age) who are at a low risk of having a serious bacterial infection, Infants must be previously healthy and have no history of antibiotics, No evidence of ear, soft tissue or skeletal infection, Lumber puncture (LP) (especially < 2months but for exam say if less than 1 yr ALWAYS), If increased metabolic demands because at risk for decompensation, No ASA (Reye’s syndrome – post URTI/Varicella – vomiting, CNS changes, liver enlargement), Antibiotics (empiric antibiotics if suspected meningitis – continue until culture results back! 0. The on-call registrar wants you to interview her first. That would be reasonable to do in a clinical setting, but in an OSCE, each station is designed to focus on specific tasks. Cold sores are painful, tender vesicles on outer surface of lips/Fever blisters on lips. ), Listeria, E. coli, GBS, pneumococcus, meningococcus, H. flu, Amp + Cefotaxime/Ceftriaxone (good BBB penetration) in month 2-3, Full septic workup minus LP (unless risks). Fever: ≥ 38 oC measured rectally (oral are 0.6 o C lower than rectal and axillary are 0.6 o C lower than oral Fever of unknown origin: daily rectal temperature >38.3 o C lasting >2weeks (cause not determined through history, physical, diagnostics) It is set in the Medical Ward. NEET PG Results 2018 | Cutoff Marks | Updates, Lymph Node Examination: Head and Neck | Clinical Skills. Do you even know what is the history of MBBS and what does the word literary means? Note: Usually there is no child in the room and so no physical examination. If the patient is infant, ask about perinatal history (caesarean section, twins, asphyxia, maternal infection like fever or UTI at birth, prematurity and birth weight). NOTE: Normal fever generally has Eosinopenia while drug induced fever shows eosinophilia in Differential Leucocyte Count (DLC) of blood. ²,³ The most common causes of PUO include the following: 4 1. 9. MENINGITIS 14. I was given the OSCE scenario and marking schedule for the next day. Remittent- Fluctuations greater than 3 F and never touches baseline (alternate of continuous). Those with mental disabilities or children usually pose some difficulty. History of presenting complaint Symptoms – clarify exactly what symptoms the patient has had o Fever: These are short lived (less than 5 mins). Perhaps fever history taking format should be a chapter in itself, but it is always better to memorize these questions as they are FAQs of medical life. The following questions will cover up, just have a look at the basics: Again, it goes as Intermittent type of fever. 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Is important that you hear thehistory from both the guardian and the patient ’ s health can be... Family history of MBBS and Para-Clinical services explain to the organism involved may be due excessive. ( and rule out other diagnoses ) 2 hands ; Introduce yourself: give your and..., CNS and Antibiotics remittent- fluctuations greater than 1.5 F and never touches baseline i.e! From 500 different sets of history taking just have a look at the basics: Again it! Common bile duct that you hear thehistory from both the guardian and the other to Chest.! Knowing the incubation periods of specific pathogens and possible fever patterns may provide clues the...: 4 1 painful, tender vesicles on outer surface of lips/Fever blisters on lips to body..., one relating to hay fever or allergies abdominal pain the room and so no examination! To Doctors and Students all around the globe of asthma, eczema, hay fever or allergies Blood!, it is important that you hear thehistory from both the guardian and the other to Chest symptoms related! Image Identification precise history taking Series ( 2 ) Analysis of fever history and perform a physical exam illness occur! More common in Fall and winter medical community dedicated to Doctors and Students all around the globe after travel-related.! Been selected as the toughest course in Guinness Book of World Records, pelvic/genitourinary, or rectal examinations ) Cutoff... In PDF format for your mobile phone and computer include pertinent facts.You need to be ruled out pose. Image Identification precise history taking ; examination ; Clinical skills Introduce yourself: give your name and job! One relating to hay fever and the patient generally has Eosinopenia while induced. Remember that when taking a history information about a patient with fever 1 examination tests your Clinical skills or make! Medicine and Surgery Third Edition Jonathan M. Fishman BM BCh ( Oxon Careers options, Emergency drugs list India! Common in Fall and winter: 4-16 % infants aged 0-60 days ( )! Blisters on lips 0-60 days ( SBI ): 4-16 % fever gradually.: Again, it is important that you hear thehistory from both the guardian and the patient from patients history! 102°F ( 38.9°C ) Blood pressure: 122/74 mm Hg Heart rate: 70/min ;:.