OSCE- PREFINAL

OSCE AND LEARNING POINTS:

December 04, 2023

Blog link : https://143vankadothsaiteja.blogspot.com/2023/12/60-year-old-female-with-ckd-on.html

OSCE QUESTIONS :

Preload and Afterload:

Preload :

Preload is volume of blood received by the heart. Basically preload is stretch.It is the ventricular stretch at the end of diastole. Occurrence : during diastole Depends on : The amount of ventricular filling. Preload is a volume. Affecting factors : venous blood pressure and the rate of  venous return. 

Afterload :

 Afterload is the pressure that the Chambers of the heart must generate in order to eject blood out of heart. Occurrence : during systole Depends on :

The arterial blood pressure and vascular tone. Afterload is a pressure. Affecting factors : systemic vascular resistance and pulmonary vascular resistance 

JVP WAVES:

JVP waveform

The JVP has its own waveform which consists of 5 parts:

A wave

X descent (part 1)

C wave

X descent (part 2)

V wave

Y descent

https://gramproject.com/diagram/jvp-waveform/

Furosemide Administration:

Furosemide is available in oral and intravenous formulations. The administration of oral furosemide can be in the form of tablets or an oral solution. Intravenous furosemide is twice as potent as oral furosemide.

https://www.ncbi.nlm.nih.gov/books/NBK499921

Causes of left heart failure :

Common causes are : Acute MI especially if involves left ventricle, chronic hypertension, dysrhythmias especially tachydysrrthithmias

https://www.sciencedirect.com/science/article/pii/S0085253819302765

LEARNING POINTS:

 I have learnt how important is to take detailed history before jumping into conclusions 

I have learnt how important is the daily routine and and her occupation ( place of work and what type of work she does ) to know the cause 

I have learnt how essential it is to build communication with the patient and gain her confidence for treating the patient

https://www.japi.org/v2c4b4b4/effective-patient-physician-communication-ndash-a-concise-review#:~:text=Effective%20communication%20needs%20the%20physician,clues%20about%20the%20patient's%20health.