Short Case
Short Case
------
Neonatology
- Newborn examination
- Prematurity
Neurology
- Floppy infant (not finished)
- Neurology: CN / Upper limb / lower limb = done
Respiratory
- Respiratory Examination
Haematology
- The haematological system
- Thalassaemia not done ?combine with haem as very similar
Renal
- Renal examination
Wash hands
2 mins
-----------------------------------------------------------------------------------------------
START WATCH
Introduction
Ex (kindly) at 1 min (thinking what might have cause eg HTN, and what might HTN cause?
Interpret Ex at 10mins
Break (10m): repack, next door, wash hands
-----------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
(don't ask parents to leave, don't use bulldog)
Marking
Be prepared
Be kind, and respectful (recover)
Be observant of signs and pain
Be slick
Be bright
Don't panic: do simple things well, discuss findings including if they don't find and possible DDx, they will prompt to help pass if you provide a pathway, one short small percentage
Take care with left V right
Lay language with pt, technical with examiners
------
Neonatology
- Newborn examination
- Prematurity
Neurology
- Floppy infant (not finished)
- Neurology: CN / Upper limb / lower limb = done
Respiratory
- Respiratory Examination
Haematology
- The haematological system
- Thalassaemia not done ?combine with haem as very similar
Renal
- Renal examination
Wash hands
2 mins
- Stem (Name, age, body system)
- Bag
- Visualise
- Watch
-----------------------------------------------------------------------------------------------
START WATCH
Introduction
- Intro: "Good Morning / Afternoon, I'm ... / Sticker
- Washed: "I have Washed my hands outside"
- Stem: "I have been asked to see X, an Xyo, and examine their X
- Intro "You must be X?, G'day, who have you brought with you? Nice to meet you both.
- Position
- Exposure
- Pain: During the exam if anything makes you uncomfortable or causes you pain please let me know"
Ex (kindly) at 1 min (thinking what might have cause eg HTN, and what might HTN cause?
- General Inspection (EWGOD)
- Equipment: There is no medical Equipment
- Well: X looks Well
- Growth and puberty: I would estimate their height as borderline for their age, their weight appears adequate, ie out pot proportion, but it would be important to confirm this on Growth charts, Puberty
- Short stature: chronic disease...
- Wasting: chronic disease (FTT), neurological
- Macrocephaly, Microcephaly
- Other Obvious: Asymmetry, Skin, Scars
- Dysmorphology: There are no unusual (Dys)Morphologic features, they resemble their parents
- triangular facies’ of Alagille syndrome
- Front and back: Hands > Head > Chest > Abdo > Legs
- Obs: Are any Observations available
- Inspection
- Auscultation
- Does it hurt > Palpation
- Percussion
Interpret Ex at 10mins
- I was asked to see X, an Xyo, and examine their X
- I found...
- Should time permit I would also like to examine... look for causes other causes of finding, and other thing findings may cause
- Lab (haem, micro, biochem...
- Imaging
- Sleep
- Oximetry
- ECG
- EEG
Break (10m): repack, next door, wash hands
-----------------------------------------------------------------------------------------------
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
(don't ask parents to leave, don't use bulldog)
Marking
- Approach: Introduce to patient, Asks permission for sensitive aspects, Respects modesty, Anticipates to pain, Apologises and Modifies if pain.
- Technique: Fluent, Systematic Ex, with adjustment as necessary
- Accuracy: Identifies signs, reports negatives, doesn't find signs that aren't present
- Interpretation: Dx and DDx suggests Ix
- Ix: Interprets and integrates with Ex including if inconsistent
Be prepared
Be kind, and respectful (recover)
Be observant of signs and pain
Be slick
Be bright
Don't panic: do simple things well, discuss findings including if they don't find and possible DDx, they will prompt to help pass if you provide a pathway, one short small percentage
Take care with left V right
Lay language with pt, technical with examiners