OSCE and Learning points

OSCE :

1) How do differentiate between bronchial and vesicular breath sounds? 

Bronchial sounds (also called tubular sounds) normally arise from the tracheobronchial tree.

- They are heard as loud, harsh and high pitched sounds over the right apex.

- Vesicular sounds normally arise from the finer lung parenchyma.

- They are heard during expiration. 

Vesicular breath sounds are soft, low pitched, predominantly inspiratory, and appreciated especially well at the posterior lung bases. 

2) What is CT scan? 

Computerized Tomography is an X ray scan which combines the series of X ray images taken from different angles around the body and uses computer processing to create cross sectional images of bone, blood vessel and soft tissues.

- It provides more detailed information than a normal X ray. 

3) Furosemide effects on AKI? 

Furosemide is a loop diuretic commonly used to promote diuresis in ill patients with fluid overload.

- It causes greater loss of water than sodium loss, leading to production of hypotonic urine

4) How to clinically know that there is a consolidation in the lung? 

- Expansion of thorax on inspiration is reduced on the affected side.

- Vocal fremitus is increased on the affected side.

- Percussion note is impaired i.e. it appears to be dull instead of resonate.

- Breath sounds are bronchial.

- Vocal resonance is increased.

Learning points :

I learnt about importance of communication in case of taking history.

I learnt that how clinical examination is more important than radiological examination.

I learnt about uses of X ray taking in different angles.

I learnt about the treatment of pneumonia with DKA