i had my plab 2 today that is 5 th july
i thought i must post the stations for all u guys . . .
well basically all stations clearly mentioned what they expect from u in that partcular station, like CLINICAL EXAMINATION SKILL, HISTORY TAKING AND MANAGEMENT , COMMUNICATE AND COUNSELL, PRESENTING A PRECISE HIST TO UR CONSULTANT 2 UR CONSULTANT ETC..
the stations were. . .
1.do resp. system examination in this 45 yrs old patient with chr. cough, (no history) INCLUDING PEFR.
*well what i did was i staretd with gen. exam, then inspection palpation percussion and auscultation. i didnt find any particular findings there,but the pt probably had some adventious sounds as i learnt later from others.
second thing is that i reported my findings to my examiner and as the 5 min bell rang i saw the PEFR instrument. then i just mentioned "if time would have permitted i would have done PEFR"
well thats it god, guys plz comment whats going to happen of me in this station
2.do sensory sys. examination of limb in this pt with diabetese( old lady very coperative)
*i started directly with vibration sense. . then position sense. . the fine touch. . .then pain sensation. . . then went for reflexes but the 5 min bell rang .
worst thing was that i didnt summarise to the examiner nor did i give a running commentary.
3.suture a sharp cut wound local anesthesia given but wound is not cleaned, pt explained and consent taken, ur gloved
*i started by asking the examiner for a syringe to flush the wounds. . . he said assume it is flushed then i said that i asume the area is draped i tear open the inner pack from the tray and picked the needle with forceps then gave the first suture, the mistake i think i did here was that when brought out the needle from the other edge i pulled it long to the sidefor some distance and that i think the examiner didnt like and he instatntly marked C on a sheet where there were number of headings to mark, may pulling needle is wrong as it may risk anyone standing nearby etc.
whatever i completed the first suture and as pierced the second suture the 5 min bell rang so i just left it. . .
4.record B.P of this girl who has dizziness on standing
*i must admit that the girl was very attractive she was desi i believe, in the midst of all the tention i couldnt but admire her. . .anyways. . .
i could record the sitting BP and jotted down on a piece of paper with all the details . but i didnt get the standing BP and time over.
so i said to examiner that i would appologise patient and attempt again.
well the sitting BP was 98/60 and most of my collegues got the same and also none of them was able to recod the standing BP.
5.CPR child 6yrs, in your ward. cyanosed unconscious
* i did as per the protocol, when i wa doing the chest compression she asked me not to break the manikin (may be i was using too much of force, or my looks? ).i was doing in 1:5 ratio.
then i stopped and said i would continue till 1 min and the call 222, the examiner blurted out " u continue i will tell u when it is 1 min" so i continued meekly and after some time she said it is 1 min so i got up and said that i will call 222, she said ok , then i again started the 1:5 thing,
she asked till how long will u do i said either till the pt comes back, or help arrives or till i am exhausted.
6.talk to this mother whos child is crying a lot no other complain, she was examined by consultant and all was normal, all investigations were normal, and baby was discharged , she has come again after few hours with again same complain, u as SHO have eaxamined and everything is normal.talk to mother.. . . (howz that)
*well this worst of all stations and none of us all was really able to pacify the irritated lady, she was constantly barking what to do for the crying baby, itried to ask if the baby is rolling his legs or any other complains she said no., i tried to explain her that her baby is allright and she neednt worry but she kept saying what r u for if ur not able to find what the problem is etc etc. ultimately i said i would like u to meet my cosultant .
7.20 yrs lady with ammenorhea of 9 mths, take history and tell examiner ur DD
* i ruled out pregnancy
ruled out ocps any other medications
ruled out anorexia nervosa
ruled out pcod
finally gave DD as anorexia nervosa PCOD
later i learnt from others that it was stress induced; her boyfriend had left her , she was having exams also.
so god knows whats going to happen of me here plz comment.
8.talk to mother baby with polyuria polydipsia,heavy glycosuria, raised BSL. dietician has talked to her, talk of medicine only
* i told her that it is DM
she asked is it sever, i said the condition is not serious instatntly but he will have problems later in life.
i explained whats DM , insulin and its affect etc
i warned her of future complications of kidney eyes bloodvessels tc.
i told her its not curable but definately it is controlable.
i told her about insulin injections
i told her about to watch out for signs of hypoglycemia
i told her little about lifestyle etc
9.PR bleeding old man of 62 yrs age since last 10 days , take hist and discuss DD with examiner.
*took detailed history, tarry stools,pt was on diclofinac for last few months for his hip osteoarthritis.gave to the examiner DD as drug induced gastritis, upper git malignancy, and diverticulitis.
10.old man with red urine take hist and discuss mangement
* took detaieled hist, pt had dribbling of urine and had to get up in midst of night to wee
told him that it is probably due to prostate enlargement
examiner asked for investigation i said USG, IVP
wanted to tell CT scan but couldnt tell
11.pt is being discharged after some condition ( i forgot), prescribed simvasttatin, enalapril and aspirin explain him.
*explain him all about dosages as was prescribed on the form given,
asked side effects for aspirin told gastric discomfort, for enalapril told cough, for simvastatin i said i will discuss with consultant ang get back to u
12.venipuncture and take blood in a case of anaemia
* did every thing right but removed the arm torniquett after everything was overthat is i had taken blood in vacutainer and removed the needle than i remembered of the torniquet
plz tell me when is the right time to remove the torniquett
13.talk to consultant about a patient who is collapsed after few hours after hemicollectomy.( TPR chart provided ).
*i thhink i didnt go systematically, when i started on the phone i told him all the findings given to him then i said what i did immediatly i.e send blood for grp and cross matching, put IV line and started fluids and inform the OT staff.
consultant asked what u think it is, i said it is internal haemorhage,
he said any thing else i said may be septicemia, LVF
he asked what i want him to do. i said can u come here and have a look at the patient.
* i felt a mass on abdominal palpation and bimanual palpation , i described the mass and said that it is a bit hard and it may be fibroid
he said that it is right.
comments. . .
15.KCO of hodgkins lymphoma has taken all analgesics in all doses but pain not relieved, is given sustained release morphine sulphate by consultant, explain to pt.
* told him about morphine , assured him of minimal chances of getting addicted
told him side effects like difficulty in passing urine , stools
ruled out if he is asthamatic
forgot about nausea and vomitting
told him about PCA if needed.
Note: Originally posted in RxPG PLAB 2 Forum