1 / 35

GI Medicine

GI Medicine. PULSE: Preparation for Finals Tutor name. TuBS attendance. https://tutorialbooking.com/. Session overview. Common GI conditions for the OSCE How to present your findings Overview of clinical signs Case presentations and questions. What is the purpose of an OSCE?.

adina
Download Presentation

GI Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. GI Medicine PULSE: Preparation for Finals Tutor name

  2. TuBS attendance • https://tutorialbooking.com/

  3. Session overview • Common GI conditions for the OSCE • How to present your findings • Overview of clinical signs • Case presentations and questions

  4. What is the purpose of an OSCE? “This station tests a student’s ability to perform an appropriate focussed physical examination, demonstrating consideration for the patient, and to report back succinctly describing the relevant findings. It also tests a student’s clinical judgement i.e. the ability to decide the differential diagnosis, choose investigations and formulate a management plan.”

  5. Common GI conditions in the OSCE • Chronic liver disease • Abdominal masses • Renal disease and transplant • (Surgical abdomen and scars covered elsewhere)

  6. Presenting your findings • What were you asked to do? • What were your key positive findings? • What were the important negative findings? • What does this mean? • How would you complete your examination, and what investigations would you do?

  7. Example case presentation • I was asked to examine the GI system of this 48 year old lady. • On examination I found that she had stigmata of chronic liver disease, being spider naevi, jaundice and shifting dullness. • There was no evidence of encephalopathy. • The differential diagnosis for this patient would be causes of CLD such as alcohol, NAFLD and infective hepatitis. • I would like to do LFTs and an ultrasound of the liver to confirm my diagnosis.

  8. Completing your examination • I would like to examine: • Groins, external genitalia • I would like to look at: basic observations (including…) • I would like to perform: • PR examination, pregnancy test, urinalysis

  9. Further investigations

  10. Clinical signs Practise presenting!

  11. What are these and what GI pathology are they associated with?

  12. What are these and what GI pathology are they associated with?

  13. Case 1

  14. Case 1 • 58 year old man, looks well from end of bed • Hands/arms – AV fistula left arm, no recent puncture marks over site • Face – nil of note • Abdomen – scar in left flank posteriorly. Scar in left flank anteriorly with palpable mass underneath ~5cm, solid. Nil else of note. • Legs – mild pitting oedema to mid-shins. Please present your findings.

  15. Case 2

  16. Case 2 – general appearance • Slim woman, aged ~40s, looks well • Mouth normal • JVP +2 cm

  17. Case 2 - abdomen • Soft • Distended • Palpable liver 2cm, rough edge, no spleen

  18. Case 2 – continued • Palpable flank masses – very large, ~20x8 cm • Ballotable • Resonant to percussion, non-tender • ?move with respiration • No shifting dullness • No palpable bladder • Legs normal Please present your findings.

  19. Case 3

  20. Case 3 • 45 year old male On examination…. • Comfortable at rest, • Hands – Nil of note • Arms – Nil of note • Face – Nil of note • Legs – Nil of note

  21. Case 3 - abdomen • Non-tender hepatomagaly to 8cm below the costal margin. • Non-tender splenomegaly to the umbilicus. Please present your findings.

  22. Case 4

  23. Case 4 60 year old male. On examination….. Comfortable at rest,

  24. Case 4 - hands • Weak holding hands up, has coarse asterixis

  25. Case 4 - face

  26. Case 4 – abdomen/legs Small scar 3-4 cm lateral to umbilicus Abdomen non-tender No organomegaly Positive to shifting dullness Please present your findings.

  27. Session summary • Common GI conditions for the OSCE • How to present your findings • Overview of clinical signs • Case presentations and questions • CKD (RRT), hepatosplenomegaly, liver failure with ascites

  28. Please complete TuBS feedback • Tutor details • For more information on Examining for Finals sessions: • examiningforfinals@gmail.com • www.sefce.net/pulse • With thanks to previous contributors: • Dr Emma Claire Phillips • Dr Kristina Lee • Dr Aman Shams (GI SpR) • updated by Isla Cameron (FY2)

More Related