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.

5

Max.Mark

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.

5

Max.Mark

1. Identity 2. Cause3. Time4. Consequence5. Control-cure

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. a) What is his WELLS Score? b) Name 2 other criteria of the WELLS score not listed?

Max.Mark

3

a)b)

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. a) What is his WELLS Score? b) Name 2 other criteria of the WELLS score not listed?

Max.Mark

3

a) 4b)

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

Max.Mark

1

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

Max.Mark

1

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

1. 2. 3. 4.

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

Max.Mark

2

1. ECG 2. D-Dimer assay 3. Blood gases - hypoxia4. CXR5. CT Pulmonary Angiography

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

Max.Mark

2

1. 2. 3. 4.

Name 4 other types of embolus, excluding a DVT.

Max.Mark

4

1. Air 2. Amniotic fluid3. Fat4. Nitrogen

5. Foreign body6. Tumour cells

Name 4 other types of embolus, excluding a DVT.

Max.Mark

4

Please give 2 differences between Heparin and Warfarin.

Max.Mark

2

Heparin Warfarin

Please give 2 differences between Heparin and Warfarin.

Max.Mark

2

Heparin Warfarin

Encourages antithrombin III Inhibits vitamin K epoxide reductase

Acts on the INTRINSIC clotting pathway

Acts on the EXTRINSIC clotting pathway

Fast acting Slower acting (>72 hrs for full effect)

Affects the APTT time Affects the PT time (INR)

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

1. 2.

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

1. During the past month have you often been bothered by feeling down, depressed or hopeless?

2. During the past month have you often been bothered by little interest or pleasure in doing things?