Pl post 10 april stations

Discussion in 'Plab 1 and 2 forum' started by Partha Sarkar, Apr 12, 2013.

  1. 1>mother has 11 month child with bleeding pr-hx station and give ur d/d to the examiner
    i took a detail history,all was negative except his elder brother had similar condition
    my d/d were acute gastroenteritis,family polypsis,acute intussception,bleeding disorder and my time was up


    2>abg station-i was able to get the blood but the needle was too tight to be discharge in sharp bin,i verbilize and finish up the station.


    3>ear exam and otoscope-it was otitis media with rt sided conditive deafness


    4>post mi counselling-i told and address concern about smoking,alcohol,exercise,diet,exercise and stress


    5>dm foot exam-i did inspection,palpation,fine touch,pain touch as well as position touch and was about to do vibration and the time was up


    6>whiplash injury but was depression station

    i started by saying sorry u had a accident and u look to had low mood.mood was 1/10,then all depression question and famish question and patient also had patient had a plan to harm himself.examiner asked me about diagnosis and i told it is severe depression along with suicidal thought.

    7>intelligent manniques-i approach the manniques as a real patient and asked about chest pain,sob was positive and patient also had fever,no history of asthma,no medication,smoking was present,cough with green sputum,no travel history abroad as well as no heart condition and dvt.
    then i told the examiner that since my patient spo2 is decreasing in the patient and i am highly thinking of acute infective excerbation of copd i will put vanchuri mask,i was searching for the mask then examiner told assume.i also told the examiner that i would like to give pain killer iv morphine to my patient. it is put then i did all examination and i found wheeze as well as crepation.then examiner told me what is ur diagnosis then i told that acute infective exacerbation of copd,then she told to look at the monitor then i saw bp was decreasing and pulse increasing then i told i would open 2iv bore cannule and give iv fluid to patient.then station was up

    8>gout counselling-grips was done and i asked him how much does he know about his condition as well as what he wants to know......then he asked about gout,i explain then suddenly he told i am talking bendrofluthiazide then i told him thank u very much for informing about it then i told it is not good in gout then i will review his medication through cardiologist.he asked me about diet..i explain about not to take red meat and beer....he told he is talking nsaid(ibuprofen),and its well controlled then at last he told i dont have any concern now,then i told him about website and gout society.at last i asked him do u use computer then he said i am very fond of it..then i told him to look patient.co.uk as well as search more in google and come to us for regular visit.

    9>lady was covering her head---i approach and did my grips then asked what is bothering u..she told me that light is bothering her then i asked my examiner to dim the light.she told me that she has headache which is very severe then i graded it was 9/10.i rule out all meningits,sol,gcs,glaucoma,head injury,cluster headache.she had migraine.i asked is it similar then she told its different,she had stopped talking medication.i was talking her do u want any painkiller then she was talking nurse is about to give me.at last i told her...at this moment we need to admit you and do ct-scan to rule out subarachoid hge,then also have to relieve ur medication for migraine

    10>army guy with chest pain,fever and sob was present. examination showed that he had crackles in his lung base.history station and d/d to examiner.
    my diagnosis was pneumonia and my d/d were pleurisy,pneumo thorax,p/e,herpes zooster and my time was up

    11>it was telephone conversation-it had x-ray of fracture of lt humerus and in chest x-ray was callus formation in rt ribs.child also had bruising and mother after leaving the child was not answering the phone regarding future question.i told the ped on call consultant that i am suspecting NAI,he asked me why?i told history is not correlating with examination as well as investigation of x-ray.I told i have taken care of wound and inform orthopedic team,done skeleton survey,send routine blood test as well as blood coagulation screen,planning to look child's name in child's protection act.....then told that i have inform my register and he asked me ur help where to inform social service or not...he told i will come to help u,thank you.

    12>lymphoreticular exam-i knew this station will come as i was going to my first station on the way,i saw this so was practicing in my rest station. i did grips and ask him to undress as he was wearing shirt.
    i checked his tonsil with light,ideally posterior rhinos-copy for adenoids.then did lymph nodes in neck including anterior and posterior cervical chain +supra and infra clavicular nodes,
    i did axillary all 5 as well as trochlar.i think examiner was more concern with our technique as i took time to feel with pulp of my finger,then told i will ideally do ct-scan for thymus and para-aortic lymph nodes,i did palpation of liver and spleen,fluid dullness my percussion.he told me not to do inguinal as well as popliteal lymph node.i checked edema,pulse,then time was up

    13>post op counselling about Hemiarthroplasty except pain management as it was explained by an-aesthetic...grips was done and her first question was about pain management and i told her has my anesthetic colleagues,come and explained to u.she insisted me to tell it about..so i thought i should address her concern about examiner told me have u read ur task....then i told her not to squat and cross her legs.she asked me when i can move,i told her it is advisable to move around after 2 days as there is high risk of forming clots in ur legs.i also told about infection and possible complication about surgery.i also explain that re-opertion needed to be done in 15 yrs time for prosthetic hip and time was up...i think i mess this station

    14>suturing-i only did 1 suture..it was good and was about to put next but time was up....i verbalize that i will throw this needle in sharp bin

    15>pv bleeding----i try to rule out all causes fibroid,endometriosis,ca of cervix,instrumentation,post pills,bleeding disorder,trauma,pap smear was done,it was normal...anemia i try to rule out .her age was 47yrs and her last menses was 2weeks ago....i was literally tired in this station so i did ask about hot flushes as it could have been pre-menopausal bleeding..but it was painless bleeding for 6 months...in d/d i didnt mention DUB and pre-menopausal bleeding.

    16>uti -nitrites in urine with bph on examination,70yrs old guy came with fever-
    i am literally confuse as i dont know whether i did this station right or wrong...
    i asked how much patient knows about his condition then then he told he had buring sensation in urine and investigation was done and told one doctor will come and tell me what has happened..
    i reassure them that i am that doctor and he has water work infection as well as gland called prostate near our water pipe has been enlarged...he asked me how it has happened doctor...i told him becoz of this enlarged gland it causes stagnant of urine and it provide good environment for growth of bugs.he asked me what you will do then i told me we have to start iv antibiotic rt now....suddenly he told me he had penicillin allergy then i reassure him that we will start antibiotic that doesn't content penicillin and later do urine sensibility test to find out which antibiotic is best for him.
    and i told him it is good u r here since u can also do treatment for ur enlarged gland too,there are medical and surgical option and surgical option is better than medical option but have to do more tests to do that.i also told if u treat this enlarged gland when u r still admitted to the hospital,u dont have to come to the hospital again and again with the same problem...my time was up

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