Internal Medicine Department 2008 Students OSCE Check List

Check List for Patient with GIT Disease

1) Proper History Taking 1
A patient presented with GIT Bleeding. Counsel him

a) General:
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Greet the patient and stand on his RT side Introduce yourself with a friendly greeting Give your name and status Explain the purpose of your interview Maintain good eye contact Listen attentively Facilitate verbally and non-verbally Duration of symptoms Color of blood upper: bright red(fresh)or coffee ground(altered) lower: hematochazia or melena Appearance of vomitus (undigested food, gastric contents, bile) Presence or absence of melena Amount of bleeding Number of attacks Associated loss of consciousness or dizziness Associated symptoms: epigastric pain, weight loss, anorexia, change in bowel habits Associated medical conditions: chronic liver disease, peptic ulcer. Drug history: ingestion of aspirin, NSAIDS, corticosteroids. Special habits: Smoking, alcohol ingestion.

b) Focused History:

Question:
What are your immediate second steps in examination?

2) Proper History Taking 2

A patient presented with Acid Related Disorders. Counsel him

a) General:
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Greet the patient and stand on his RT side Introduce yourself with a friendly greeting Give your name and status Explain the purpose of your interview Maintain good eye contact Listen attentively Facilitate verbally and non-verbally Abdominal pain (site, radiation, severity, duration, relation to food, aggravating or relieving factors) Vomiting (frequency, amount, relation to pain, relieves pain or not, color, sour and frothy or previous day's food) Heart burn (relation to food, relieving factors, does it occur on lying down, AlexmedOnline Association For Medical e-learning www.AlexmedOnline.com/Students

b) Focused History:

Internal Medicine Department 2008 Students OSCE Check List associated bitter taste in mouth) Dyspepsia Regurgitation Dysphagia (solids or fluids, upper or lower, painful or not- odynophagia) Haematemesis and / or melena Bowel habits Respiratory complain (chronic cough, chocking, hoarseness of voice, wheezing) Loss of weight (duration, associated loss of appetite) Drug history: ingestion of aspirin, NSAIDS, antiplatlets, corticosteroids Special habits: Smoking, alcohol ingestion.

Question:
Select 2 important investigations to be done in this case

3) Proper History Taking 3

A patient presented with Diarrhea. Counsel him

a) General:
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Greet the patient and stand on his RT side Introduce yourself with a friendly greeting Give your name and status Explain the purpose of your interview Maintain good eye contact Listen attentively Facilitate verbally and non-verbally Duration Number of bowel motions per day (Frequency) and when Relation to meals or specific diet Color, formed, unformed, frothy, watery Float Presence of blood or mucus Presence of tenesmus Abdominal pain Dyspepsia, distension, flatulence Loss of weight Lower limb swelling

b) Focused History:

Question:
Select 2 important investigations to be done in this case GOOD LUCK

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