OSCE QUESTIONS prefinals

 OSCE points and questions common for all that all must be prepared to answer in their patients:

<> What bothers your patient the most and what are his active concerns? 

List the problems in your patient in order of patient priorities and requirements 

1, the patient’s main concern is about not being able to eat her food to suffice her appetite and perform the house chores

2, She is not able to even visit the washroom without help and this has also affected her mentally as she didn’t like that she is being dependant on someone 

3, SOB even on rest lead to disturbed sleep

<>Sequence of events :

What was your patient's hourly workflow before the illness and how did it change after? 

BEFORE ILLNESS

She used to wake up at 6 AM and 10 to her house or activities which included the washing the dishes and cooking breakfast and at 10 AM. She used to have a breakfast and breakfast used to consist of rice and curry. After that finish used to clean the household and catch up on talking to her neighbours and she used to have lunch at around two. Then she used to clean the house, then when her  son and daughter in law returns from work, she used to give them some food and tea. After that she spend time with her family and have a dinner at around 8 p.m.. then sleep at around nine or 10 PM. She has sound sleep before her illness and didn’t wake up in the might usually. In the morning when she woke up she felt refreshed. And well rested

AFTER ILLNESS 

After her illness had started the time which she used to wake up changed. She is waking up almost 2 hours late at 8 AM. She gets out of bed eats a few morsels of food and then has to be seated on bed again. She said she is unable to do the dishes or cook as she doesn’t as she find her exerted on standing for long intervals. Even for lunch, she ate only a few marbles of food and then used to go back to her bed. She’s not able to do her household activities or take care of her  family . After a few days, the condition slowly progressed to her, not being able to use the washroom without help. At night, she has sleep disturbances with her waking up a few times because of cough. This resulted in sluggishness in the morning.

<> What are the current diagnostic and therapeutic gaps and what more can the treating team do to fill those gaps?

1, EDUCATION of the patient 

The patient must be educated about the diet modifications that she has to make inorder to maintain low levels of glucose in blood. The frequency of food intake, time intervals, and what portions of food should be eaten should be explained.

Their meals should contain a balance of fibre, complex carbohydrates, fruits and vegetables, pulses for proteins and fats. The misconception aboyt fat being bad for health should be cleared 

Exercise should be included in the daily routine of the patient and wieght reduction should be a priority.

2, MONITORING the patient 

This can be achieved by promoting and implementing telemedicine, where we stay in touch with the patient even after they have discharged from the institution 

Their efforts towards becoming healthier and the progress are recorded to ensure a longterm wellbeing

3, PARALLEL TREATMENT of the ROOT CAUSE that caused the morbidity along with treating the major manifestation of the disease 

HOW HAS OBESITY CONTRIBUTED TO THE MORBIDITY IN THIS PATIENT??

Reference link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5973542/