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Summary

Discover the importance of thorough investigations and the power of asking the right questions in diagnosing and resolving complex medical cases. This session aims to train medical professionals in handling vague or unusual cases and encourages effective use of medical investigations such as full blood counts, X-rays and neurological assessments. The importance of reading patient history, managing patient care and the need for thorough physical examinations to rule out significant risk factors will be covered. Simulated cases throughout the session will provide real-time learning experiences and encourage thought-provoking discussions.
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Description

PLAB 2 mock practice scenarios: Are you struggling to find a dedicated study partner? Are you still in the dark about the exam style? Are you petrified about the upcoming exams? Do you feel like attending an academy fell short of your expectations? Have you been devastated by failing in previous attempts? **Look no further, we are here to help you ace this exam! We will be your study partner!** Our sessions will consist of all aspects covered in PLAB 2 including history taking, counselling, ethical scenarios, prescription writing and Simman. We will cover extensively on interpersonal skills, time management, clinical management and MOST IMPORTANTLY, how NOT to be SCRIPTED!

Learning objectives

1. Understand the importance of thorough examination in identifying the correct diagnosis, even if initial symptoms provided are vague. 2. Develop strategies for effectively managing a vague case, including conducting a head-to-toe assessment and ordering relevant investigations. 3. Recognize the importance of identifying risk factors for conditions such as AAAs in the patient's social history. 4. Improve skills in good doctor-patient communication, notably in dealing with patient concerns and explaining the reasoning behind recommended procedures. 5. Learn how to apply the principles of being a safe doctor by ruling out all potential red flags in a case.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

You know, how did I get this muscle sprain? I was just sitting there. Ok. Um, I can't really, I can't really tell why you got it, but I would also like to run some few investigations for you and, um, hopefully we will be able to assess on what it is if that's all right with you. Ok. Yeah. So II would like to draw some blood tests for you, which includes a full blood count s and therapy as well as a back X ray. Mhm. Would you be happy to do that? Yeah. Yeah, that's fine. Do whatever that you need to. Ok. And then, um, we'll have a chat right after, but at the, uh, for the time being, let me give you some something stronger for the pain and to make you feel less uncomfortable. Ok. Yeah. All right. Do you, do you have any questions at all? No, you've answered all my questions. Thank you very much doctor. All right. So, like I spoke about, like we talked about, let me run this for my senior. Um, also get you the blood test and the, um, X ray and then hopefully we don't find anything sinister? All right, thank you very much. Move on to the patient. Finish the stations perfectly on time. But so uh this is this station. Um I've, I've put this day I put this case on just as a trick just as a lesson for everyone else. Sometimes the stations will come on as quite vague. You don't know what it is. But in this case, what do you think it was if I told you it's not back sprain because on examination of the back, there's no tenderness and patients can move. Sorry. It's a bit of trick. It's a bit of trick trick case this one. So this is an outtake aneurysms case shocking, isn't it? It is ok. Yeah, this is why during the exam if you don't ask, you don't get, if you don't do the examinations, you won't get. If you mention I'm gonna do a quick abdomen exam, I'm gonna examine your abdomen. Then they will tell you that uh positive. Um uh there will be um a mass in the abdomen. So it's a bit of a train station. It's more of a lesson to everyone else who is doing. Uh I'm not, I'm not doing this on pa not not being um not, not being mean, but it's just a really good lesson to all the candidates during the exam where some of the patients will come off quite vague. So what you can do is mention all the examinations that you can do, I'm just gonna do a quick general physical examinations on yourself to check your back, check your abdomen, check everything else. Do some neurologic again. They were negative, it's not a negative marking where um you've say too many things and they, they will, they, if, if it's not relevant to the case, they won't give it to you. But if you don't ask for it, you're not gonna get it if that makes sense. Yeah, it does. So in this case, if you say I'm gonna do an abdomen, I'm just gonna have a look at your abdomen quickly and check your back passage. Then we're gonna give you a paper with a positive and expansive mass in the abdomen. Then you know, oh wait, cause I know what this case is. All right. Yeah, I think there's also sometimes just I was gonna say there's like clues in the scenario. So like try and take in that you're, you're in A&E the age of the patient and they just want you to be safe. So as soon as you see like a person over 60 with some kind of back pain immediately, there's certain things you want to rule out. So even though it's really vague and it could easily be a back sprain, you want to think I want to rule out a AAA just from the, the points that you have and where you are. So it makes it a bit easier. Yeah. So it's more about being a safe doctor and, and the next, the next takeaway from this station will be if you don't ask for it, you are not gonna get it. Yeah, I think it's quite helpful to like if you, if something is really vague, just almost approach it in an at E so just cover your respiratory, cover your abdomen, check for signs of DVT, like try and do a rough at e just to structure yourself when something's really vague because then they could give you like those hints to what they're looking for. Ok? Because during the exams, when sometimes you will come across a case where it's new where um it's nobody's gone through the case before with yourself. It's something that you've not practiced before. So you get nervous. So what would be really helpful like I should say would be the A three assessment and be a safe doctor. Rule out all the red flags that um that you think that could happen. But in terms of history, taking in terms of management, everything you did. Well, so you did for you, you asked all the questions but it's just um you didn't ask the right one, you didn't get the right one. It's not, it's not the end of the world, but it's just a practice, which is a good thing. But the lessons in this from this case will be if it's vague, don't be nervous, be a safe doctors get all the investigations that you can think of. Just say it out loud. I'm gonna do a quick physical examinations on you. I'm gonna check your tummy, check everything else. Mm. So, the head to toe assessment if you don't know, but if it's quite a clear cut, um, I'm gonna check your back and you've got tenderness, patient is not able to move. And then he would tell you I was gardening yesterday. I was doing some umn visit a, a activity and then I had the pain so you know, it can be back pain. Yeah. And I think also this is where your social history is really important so that they've mentioned the hypertension cause that's when you really want to go in and do your smoking and alcohol and lifestyle because they're all the risk factors for AAA. So it's good that you mentioned all of that as well. Yeah. Yeah. There's just a question in the chat, I think. Yeah. Um The pain should be deep complaint of discomfort, nausea, vomiting. Um So in this case, they will just tell you no other symptoms. Normally they won't have any other, sometimes they will have nausea but it's not specific. So you just Yeah, and the pain is normally more like throbbing pain where it's a bit, it's continuous, it won't go away and yeah, that's pretty much it. So any questions anyone so far? Yeah, you, you can say um so everyone can, it's easy to say general physic exam, but you have to say what you want to examine. Yeah, I think cover, just try to cover like like the at. So just say I would listen to the chest, I would check the abdomen. I would check for signs of DVT. Just the routine things you can mention them quite quickly and they, they will give you the findings. Rectal exam is also a good one to remember any kind of back pain or neuro exam. Yes. Right. I think that comes to the end of our time, our sessions. Um Thank you everyone for attending the session. I hope it's been helpful. Um The patient exam. Um So uh this la I'm just gonna take the last question. Do we always expose the patients to examine? So, um again, it depends, but if it's a combined patients where it normally would come, I think it's quite popular nowadays where if you have to expose them, you expose them but with dignity. So if you just look at the abdomen, you can just have a quick look at them, just expose the abdomen and that's all I just wanted. Sorry. II think ma just asked earlier, she'd said um she'd asked about teaching stations. I only remember from my year that there was only a teaching ecg that you had to teach a medical student as one of the stations. I don't know if you had anything else done this, but I think it's good to be familiar with teaching things like that. Yeah, there's a dipstick as well. Uh, Dipstick. Um, that was, that's so far. There's the two popular ones. Yeah. Um, I haven't come across anything which is new. No, neither have I. Yeah. All right. Everyone I think that comes to the end of the sessions. Thank you very much for attending. Uh, we try to run sessions on this kind of sessions every two weeks, but depending on availability. Anyway, uh we'll send out the um informations closer to point. We have got the exact ones. Um Thank you for thank you and results for coordinating and helping to run the sessions. Um Yeah, I think that would be all good luck to those whose having eczema. Yeah. Um yeah, that would be all from my, from me. Thank you very much guys. Take care, everyone, take care. Bye bye.