REVISION SESSION BY CONFIDENCE

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REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 7:55 am

REVISION SESSION:

https://confidence.ac/revision_sessions ... tempts/new

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ABOUT CLINICAL SKILLS AND NEUROLOGY MULTIPLE TRUE/FALSE QUESTIONS

Question #1

: Typical signs of an upper motor neurone lesion include
TRUE OR FALSE

Muscle wasting 1

Increase of muscle tone 2

Brisk relexes 3

Muscle fasciculations 4

Extensor plantar response 5
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Re: REVISION SESSION

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 8:01 am

Ans q 1
F T T F T

Explanation

Wasting occurs in LMN lesions. In UMN disuse atrophy occurs

Fasciculations also occur in LMN lesions
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Re: REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 8:06 am

Question #2

ABOUT CLINICAL SKILLS, EMERGENCY MEDICINE, AND EXAMINATION SKILLS
SINGLE BEST ANSWER

In the Emergency Department you are asked by the nurse to see a patient who has been brought in following a collapse.
On assessment patient * opens eyes in response to a painful stimulus,* localises to the painful
stimulus and speaks some incomprehensible words
The patient is unable to follow a simple one-stage command

What is the Glasgow Coma Scale score of this patient?
10
11
8
12
9
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Re: REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 8:09 am

Ans Q 2
9

Explanation
https://confidence.ac/revision_sessions ... ts/1069689

Glasgow Coma Scale is an important part of your initial assessment.
.Score can be 3-15
In this case * score of 5 for motor response,* score of 2 for verbal response and* score of 2 for eye opening. Total of 9/15 indicates moderate injury
https://confidence.ac/revision_sessions ... ts/1069689

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Glasgow Coma Scale

The new structured approach to assessment of the Glasgow Coma Scale improves accuracy, reliability and communication.
Read the instructions below to learn more.
Download the Assessment Aid to this new structured approach.
Download the GCS Aid
http://www.glasgowcomascale.org/download-aid/


Serial findings should be documented on a coma scale chart. The observations can then be clearly communicated and the trends rapidly appreciated so that any improvement or deterioration in a patient's condition can be seen.
Deterioration in a patient's condition should precipitate urgent medical review in order to identify any remediable factors that have contributed to this change : This assessment may include performing cranial imaging (usually computed tomography (CT)) to identify problems such as haematomas, contusions or brain swelling.
In addition to plotting trends (styles) on a coma scale chart, a patient's ratings (changes) can be documented numerically as a short hand aid to quickly record findings (e.g. E2V4M6). However, when describing the patient always use the full criteria alongside the numbers to ensure that the assessment is accurately understood.
The short hand numbers can also be added together to give a total Coma Score (e.g. E2V4M6 = 12). This provides an overview summary of the severity of the patient's condition, but this score does not communicate the more informative detailed description of each response, which should always be used in addition to the score in clinical care of an individual patient.

-: The 3 criteria to record are
EYE OPENING (1
VERBAL RESPONSE (2
MOTOR RESPONSE (3

It is important to note, for example, that a total score of 8 could be E2V2M4 or E1V1M6, with very different implications for the severity of the patient's condition.


Recording the Glasgow Coma Scale

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CHECK
Identify any factors that might interfere with your assessment

OBSERVE
Observe for spontaneous behaviours in any of the three components of the GCS

STIMULATE
Verbal and physical stimuli will be needed in patients without spontaneous behaviours
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Re: REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 10:34 am

REVISION SESSION: 30/04/2016
TODAY'S TOPICS: CLINICAL SKILLS.

Question #3

ABOUT CLINICAL SKILLS AND GENERAL SURGERY MULTIPLE TRUE/FALSE QUESTIONS
false OR true

: Recognised features of peritonitis include :

Pain which is made worse by movement or coughing 1

Rebound tenderness 2

A soft abdomen 3

Hyperactive bowel sounds 4

Leucopenia 5
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Re: REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 10:54 am

ans
Q 3

T T F F F

Explanation

Peritonitis means inflammation of the peritoneum and typically causes : # constant, severe abdominal pain that is # worsened by* movement, or * pressure.
Coughing or percussion over the affected area may produce a marked increase in pain
Rebound tenderness is a typical feature of peritonitis and signifies local peritonitic inflammation
Peritonitis typically causes a rigid abdomen.
Bowel sounds are usually absent in peritonitis.
Leucopenia is not a typical feature. The white cell count is usually, though not always, raised in peritonitis.

https://confidence.ac/revision_sessions ... ts/1069834
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Re: REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » السبت إبريل 30, 2016 11:15 am

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Re: REVISION SESSION BY CONFIDENCE

مشاركةبواسطة دكتور كمال سيد » الجمعة أغسطس 26, 2016 10:54 am

Question #1

ABOUT CLINICAL SKILLS SINGLE BEST ANSWER

You are the house officer on-call for the General Medical wards. You are called to see a 45-year old man with severe lower abdominal pain. On examination you find a large abdominal mass arising from the pelvis. It is tender to touch, soft and dull to percussion. He opened his bowels earlier today. What would be the next best action to alleviate his symptoms?
Analgesia.
Urethral Catheterisation.
Antibiotics.
CT scan.
ERCP.

answer
Urethral Catheterisation.
This can be very uncomfortable for the patient. With catheterisation you should immediately relieve the pain. Diagnosis can be confirmed with bladder ultrasound if readily available.
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