Download - Checking Cardio
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Valvular heart disease
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Common valvular heart disease for OSCE Single valve disease
Mitral stenosis (MS)Mitral regurgitation (MR)Aortic stenosis (AS)Aortic regurgitation (AR)Tricuspid regurgitation (TR)
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Common valvular heart disease for OSCE
DiseasePositionLocationStethoscopeMurmur RadiationMSApexBellLoud S1, OS, DRMNoMRApexDiaphragmPSMLt. axillaASAVA (2nd Rt ICS)DiaphragmClick, SEMCarotid a.ARErbs pointDiaphragmDBMNoTRTVA (LLSB)DiaphragmPSMNo
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Scenario
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(60 ) (25 )3. 1 (15 )
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Skill
CompleteSequence Doctor-Patient relationship
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Cardiovascular examination
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Peripheral Central (vascular) (Cardiac)
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, neck vein engorgement, carotid artery radial pulse water hammer thrill ventricular heaving apex beatCardiovascular examination (1)
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heart apex (MR) apex bell (MS) (AR) radiation carotid artery (AS)Cardiovascular examination (2)
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Pitfall (skill)The most dangerous (1) 25 50
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Pitfall (skill)The most dangerous (2) OSCE : skill evaluation > knowledge evaluation
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Pitfall (skill), neck vein engorgement,
: Neck vein : -
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3 important things to do
Not only to see or to say
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Correct : sternocleidomastoid muscleIncorrect 2
carotid artery
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Correct : 2
Incorrect
Radial pulse
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water hammer
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Pulse palpationWater hammer
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thrill valvular area heaving LV RV heaving
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Heaving palpationLV heavingRV heaving
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Thrill palpation
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Apex beat
Most of all : OK
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Auscultation valvular areaSome : forget
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Dont forget heart apex (MR)
apex bell (MS)
(AR)
radiation carotid artery (AS)
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Doctor-Patient relationshipCommunication : OK But precordium !!! May be its not OK
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The last recommendation
(finding & diagnosis)v.s.