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ESA Style Question. A 69 year old man presents to his GPs with a swollen tender right calf that is 4cm larger than his left calf on examination. . Please list five belief dimensions. Max. Mark. 5.

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slide2

A 69 year old man presents to his GPs with a swollen tender right calf that is 4cm larger than his left calf on examination.

Please list five belief dimensions.

Max.

Mark

5

slide3

A 69 year old man presents to his GPs with a swollen tender right calf that is 4cm larger than his left calf on examination..

Please list five belief dimensions.

Identity

Cause

Time

Consequence

Control-cure

Max.

Mark

5

slide4

You manage to elicit that he has no ideas, lots of concerns and expects you to make him better. You find out he has recently been diagnosed with lung cancer, has been bed ridden for the past 3 days and has pitting oedema on his affected leg.

What is his WELLS Score?

Name 2 other criteria of the WELLS score not listed?

a)

b)

Max.

Mark

3

slide5

You manage to elicit that he has no ideas, lots of concerns and expects you to make him better. You find out he has recently been diagnosed with lung cancer, has been bed ridden for the past 3 days and has pitting oedema on his affected leg.

What is his WELLS Score?

Name 2 other criteria of the WELLS score not listed?

4

Max.

Mark

3

slide6

You are worried that this man may go on to develop an embolus. What is the definition of an embolus?

Max.

Mark

1

slide7

You are worried that this man may go on to develop an embolus. What is the definition of an embolus?

  • A mass which travels through the vasculature tree and becomes lodged so as to obstruct blood flow

Max.

Mark

1

slide8

This man does indeed go on to develop a Pulmonary Embolism PE. What 4 investigations would you like to perform?

Max.

Mark

2

slide9

This man does indeed go on to develop a Pulmonary Embolism PE. What 4 investigations would you like to perform?

ECG

D-Dimer assay

Blood gases - hypoxia

CXR

CT Pulmonary Angiography

Max.

Mark

2

slide11

Name 4 other types of embolus, excluding a DVT.

Air

Amniotic fluid

Fat

Nitrogen

Foreign body

Tumour cells

Max.

Mark

4

slide14

You notice that this gentleman looks rather down so decide to screen him for depression.

What are the 2 questions you would use?

Max.

Mark

2

slide15

You notice that this gentleman looks rather down so decide to screen him for depression.

What are the 2 questions you would use?

  • During the past month have you often been bothered by feeling down, depressed or hopeless?
  • During the past month have you often been bothered by little interest or pleasure in doing things?

Max.

Mark

2