Exam (elaborations)
Osce- asthma
- Module
- Osce
- Institution
- The University Of Aberdeen (Aberd)
A step by step detailed guide on answering OSCE station specific to a patient with asthma and scoring those extra points.
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Asthma educationo Triggers: dust, animal hair, odors, URIs cold air, exertion and stress
o History
Cough, dyspnea, episodic wheezing, and /or chest tightness. Historical
features suggesting sever asthma include a history of frequent ER visits,
intubations and PO steroid use. Symptoms often worse at night or early
morning.
o Physical Exam
Tachypnea, tachycardia, prolonged expiratory duration , decreased O2 sat
(late sigh), decreased breath sounds, wheezing, hyperresonance, accessory
muscle use, and possibly pulsus parasoxus.
o Differential
Kids: aspiration, broncholitis, bronchopulmonary dysplasia, CF, GERD,
vascular rings, pneumonia
Adults: CHF, COPD, GERD, PE, foreign body, tumor, sleep apnea, anaphylaxis
o Treatment
ABGs reveal mild hypoxia and respiratory alkalosis
Normalizing in pCO2 in acute exacerbation warrents close observation ,
indicates impending failure
Peak flow is diminished – spirometry demonstrates decreased FEV1.
CBC may show eosinophilia
CXR may show hyperinflation
Definitive dx with bronchial hyperresponsiveness test with a methacholine
challenge.
o Treatment
Acute: oxygen, bronchodilators, steroids
Chronic: regularly inhaled bronchodilator and/or steroids, systemic steroids,
cromolyn, or theophylline.
Avoid allergins/triggers
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