Summary
OSCE Summary
- Course
- Institution
Breakdown of content in osce stations
[Show more]
Seller
Follow
aqsaahmed
Content preview
PHA333 OSCEOTC
ASMETHODA
What brings you in today (PC)? Is this for yourself? Can I confirm your name and age? Do you take any prescribed
medication? Do you take any extra medication non-prescribed, over the counter, herbal or illicit? How long has this
been going on and have you tried anything for this problem, if so, what have you tried? Is this the first time this has
happened or has it happened before (history), do you have any ideas on what could’ve caused it, or is there anything
that makes it better or worse? Do you have any other symptoms (ask questions specific to the condition)? Do you
have … (danger symptoms specific to the condition)? Do you have any allergies?
Migraine
Questions: Is the pain on one side of the head? Are there any other symptoms such as sensitivity to light or sound, or
nausea and vomiting?
Red flags: Symptom history (lasting over 24 hours, changed symptoms, first time and over 50, four or more attacks
per month), atypical symptoms (unilateral motor weakness, double vision, clumsy and uncoordinated movements,
tinnitus, reduced level of consciousness, seizure like movements, rash), hypersensitivity to sumatriptan (other drugs
or excipients), history of seizures, MI, CVA, TIA, COC use, St John’s wort, contraindications (hepatic/renal
impairment, prophylactic use of sumatriptan, IHD, coronary vasospasm, cardiac arrhythmia, PVD, HPT), interactions
(DA agonists, MAOIs, 5HT1 agonists, TCAs, SSRIs/SNRIs), risk of heart disease, 3 or more CV risk factors, under 18,
over 65, pregnant, and breastfeeding.
OTC recommendation: Imigran recovery (Sumatriptan – only to be used if appropriate*), take one 50mg tablet as
soon as possible at start of headache, second dose can be taken at least 2 hours after first if symptoms come back
(don’t take if not responded to first dose), don’t take more than 2 tablets in 24 hours or for the same attack.
Migraleve Pink (paracetamol, codeine and buclizine), good for associated nausea/vomiting, used in migraine not
relieved by paracetamol, ibuprofen or aspirin alone.
*Diagnosed migraine by doctor or pharmacist, established history of migraine (5+ migraine attacks over a year), and
ineffective treatment with simple analgesics.
Lifestyle: Keep a headache diary to identify triggers, immediately use analgesia, adopt a dark and quiet environment,
have good sleep hygiene, ensure adequate diet and fluid intake, caution with COCs, try using a cold compress.
Tension headaches
Questions: Dull, aching pain in forehead, temples of back of neck. May be mild nausea but profound nausea and
vomiting do not occur. Non-pulsating, bilateral, with pressing or tightening quality.
Red flags: Associated use of COCs, high temperature (>38 degrees), frequent treatment failure, severe headache
lasting >4 hours, suspected ADR, associated drowsiness, unsteadiness, visual disturbances (blackout) or vomiting,
associated neck stiffness, suspected injury/trauma, different to past headaches, children under 12.
OTC recommendations: Paracetamol (1-2 500mg tablets 4 times a day), ibuprofen (1-2 200mg tablets 3 times a day,
10 days’ limit), ibuprofen lysine (Nurofen express 684mg caplets max strength; 1 caplet 3 times a day, 4 hours in
between), combination products (Syndol; paracetamol, doxylamine and caffeine; 2 tablets 4 times a day).
Lifestyle: Alleviate stress, check sleep hygiene, check for anxiety/depression, check posture, do exercised, reduce
screen use or take regular breaks, avoid codeine/dihydrocodeine, try acupuncture.
Other headaches
Sinus headache: Deep, dull ache on side of nose and around eyes, after a cold. If yellow/green mucous, refer. If not,
give pain killer with a decongestant; Vicks Sinex decongestant capsules, Otrivine adult nasal drops.
, Insomnia
Questions: Is it psychological, has a difficult event occurred recently? Is it an environmental problem, shift changes,
flights? Is it physical, is there an underlying issue (e.g. restless leg syndrome, coughing, itching, back pain, etc.)? Or is
it due to medication, does the patient take any medication that can be disturbing sleep?
Red flags: Transient (few days) and short term (up to 4 weeks) insomnia can be treated OTC, but chronic (> 4 weeks)
should always be referred. On other medication (interactions), any other diagnosed illness, suspected depression,
pregnant or breastfeeding women, under 16 or elderly, associated alcohol or drug dependence, and unsuccessfully
tried a sleep remedy before.
OTC recommendations: Nytol one a night (diphenhydramine hydrochloride 50 mg; 1 tablet 20 minutes before going
to bed, not for under 16. Nytol herbal; 2 tablets one hour before bedtime, not for children.
Lifestyle: Sleep hygiene (avoid caffeine and nicotine 4-6 hours before bedtime, avoid alcohol and heavy meals before
bedtime, establish routine sleeping and waking times, ensure bedroom environment encourages sleep (light,
temperature), try having a warm bath or milky drink before bed) CBT and relaxation techniques (deep breathing).
Sprains and strains
Questions:
Red flags: Severe pain on movement (suspected fracture), persistent pain even when at rest, feeling of numbness,
symptoms that haven’t improved over 48 hours (treatment failure). For joint pain, accompanying symptoms such as
fever, tiredness or a general feeling of being unwell. Diabetes, other medication, pregnant or breastfeeding. Severe
arthritis.
OTC recommendations: Paracetamol or Ibuleve gel (ibuprofen 5%w/w); thin layer on affected area up to 3 times
daily, not for under 12. Not working ibuprofen?
Lifestyle: PRICE (protect, rest, ice, compression and elevation) not HARM (heat, alcohol, running and massage) for
48-72 hours.
Back pain
Questions: When did it start? Sudden or gradual onset? Pain location, character and intensity? Pain radiating?
Aggravating or relieving factors? Causes of pain?
Red flags: Back pain associated with abnormal urination, pain radiating down the leg below the knee, numbness in
leg, foot, groin or rectal area, fever, nausea or vomiting, swelling in the area, symptoms caused by direct injury (e.g.
after an accident), symptoms that haven’t improved after 2-3 weeks.
OTC recommendations: Not paracetamol. NSAIDs first line – ibuprofen, ibuprofen gel. Deep heat – heat rub. Deep
freeze – cooling.
Lifestyle: Get back to normal activities, staying active, avoiding bed rest – making sure not to lose muscle strength
leading increased muscle stiffness, pain and discomfort. Relaxation to reduce tension.
Atopic eczema
Questions: Presence of itch? History of other atopic disease, e.g. asthma, hay fever? Dry, red, itchy skin.
Red flags & OTC recommendations: same for dermatitis.
Irritant and allergic contact dermatitis
Questions: Allergen: nickel, antibiotics, preservatives, fragrances, etc. Allergy: red rash, inflammation, vesicles, itchy,
any area of body affected, repeated exposure leads to dry, scaly, thickened skin. Irritants: water, urine, strong
acids/alkalis, bleach, detergents, abrasives, etc.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller aqsaahmed. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $20.82. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
78834 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now