OSCE last year

day 1;
1. pericardium exam, patient ada murmur - i answered pan systolic murmur, mcm mitral
regurgitation, tapi many of my friends dapat dengar murmur lain2..hehe
2. masukkan Continuous Bladder Drainange (CBD) on patient, prepare sterile gloves n equipment
semua, ketar-ketar nak masukkan sebab Dean Proff Latiff ada dalam bilik tu. elok nak inflate balloon,
tercabut pulak syringe.aiyak,ketat pulak balloon ni..sabor2..tapi dapat completekan stesen tu.
3. patient collapse kat ward, masuk je nurse panggil, trus check Airway, Breathing, Circulation, dan
takde pulse, buat chest compression, sambil jerit emergency trolley!! pasang ECG je, ventricular
fibrillation, kena bagi shock..skali lupa charge, gelabah punya pasal, sambung je buat CPR, then shock
lagi, kali ni buat betul. fuh..
4. kaunseling pasal preparation untuk Electroconvulsive therapy on patient with bipolar and on
sodium valproate, lepas kaunseling, die bawak keluar kertas journal, tanya pasal researchhua2..
5. premature baby, 1.5kg, ada symptoms of hypoglycemia, so kena bg dextrose 10%..ketar2 tangan
nak masukkan dan tukar jarum, nasib baik ingat nak flush line before dan after bagi dextrose tu.
sempat tulis dan sign kat medication chart lagi.
6. interpret chest XRAY, pneumothorax, kalau ikut scenario die, diagnosis spontaneous
pneumothorax, pastu examiner tanya apa acute management (needle compression, stabilize, ask for
help, chest drain)
7. kaunseling patient pasal contraception, patient tu businesswoman, anak 3, youngest 2 months old,
still breastfeeding. so die nak jarakkan anak dalam 3,4 tahunmula2 explain pasal available method,
then nak offer noriday sbb die breastfeeding, tapi die tak nak pill, offer pulak injection, tapi yg paling
sesuai intrauterine device la, then kena explain pros n cons die plak.
8. patient sesak nafas dan muka naik biru, kena bagi oxygen to patient. dan kena prepare alatan
untuk intubate patient (MALES), masa susun tu, lupa nak amek air bag, tenung lama2,macam tak
cukup lagi, pastu baru teringat..fuh..nasib baik, pastu examiner tu suruh tunjuk mcm mana nak
intubate patient.
day 2 (2 July 2013)
1. ask patient to perform PEFR dan interpret performance die, pastu ada soklan apa target PEFR
untuk patient asthma (>80%)
2. kaunseling to parents pasal anak dorang kena febrile fit, explain apa disease tu, how to react when
it occurs again, precautionary measures, siap demonstrate guna anak patung lagi
3. prepare instruments untuk episiotomy, dan perform episiotomy repair, sempat jahit dalam 4
suture je, pastu masa habis, dengar citer member lain examiner suruh jahit satu dan tunjuk cara ikat
knot je.
4. examine neck lump, waktu baca soklan kat luar, ingat kes thyroid, skali dorang tampal plastisin kat
leher, dan kat tepi, sah bukan thyroid, so describe lump tu, dan bg differential diagnosis. sempat bg
dua.yeah.
5. patient post-appendicectomy,suruh examine luka bedah, ada nanah dan jahitan terbuka, then
kena review vital signs chart dan medication chart, rupanya patient demam dan antibiotik die dapat
skali je, so kena continue antibiotik, dressing infected wound tu, bukak balik jahitan dan jahit balik
lepas dah settle infection tu. i think i did well here.
6. patient ada fracture shaft of femur, on skin traction, kena perform ward round, serius blur time ni,
pastu cover balik, buat muka cool, tanya patient ada demam ke tak, ada sesak nafas ke tak(to screen
for fat embolism) ada sakit mana2, dan check traction die, rupanya traction tu longgar, tapi tak
betulkan, siap tanya examiner, prof nak saya tarik ke traction ni? haha..blur tul..
7. diabetic patient, kena buat fundoscopy..dah nampak hard exudates, dilated vessels dan laser scars,
tapi pegi cakap diagnosis nonproliferative diabetic retinopathy..apa daaa..
8. okay serius tak ingat satu lagi..dah ingat nanti update