Investigations in your Cases... 3 key categories to remember | PLAB 2, SCA

which investigations should I be doing in my roleplay scenario number one and number two when should I be mentioning them in my roleplay case these are two of the commonest questions that I get asked at the Academy in our mock exams and when doing roleplay practice for exams like plat 2 cpsa SAA and many other osy type exams where you're doing an assessment and then managing a situation I'm Dr am Aurora from Aurora Medical Education and this video is going to talk about some key categories of Investigations to allow you to think about when should I be talking about these in the second half but also could I bring any into the first half I the data Gathering part as well this is a really common line that I hear when people are practicing with things like plat 2 or cpsa so you've done a data Gathering you've done an examination but as part of that examination people start saying things like this Mrs X thank you for answering all those questions what I'd like to do is a full examination and also I'd like to be doing a full blood count blood test a renal function a TFT an LF a urine test a chest x-ray an arterial blood gas and an ECG is that okay if I go now if that is you this shows a bit of uncertainty about what you can achieve as a clinician at that point and what you need to be arranging at a later Point I.E people tend to bring all of this as part of data Gathering and mention it as part of the examination so I'm going to talk about three categories of Investigations that are going to make it very easy and obvious as to when you should be talking about these things in your roleplay scenario so let's firstly clarify one thing you can do certain investigations as part of data Gathering and you can do certain investigations as part of a management plan they shouldn't be all in the first half or all in the second half it depends on how quickly you get the results so category number one of Investigations are those investigations that you can get results for right now these are the ones that should be part of your examination discussion I.E in the first part of the consultation these are the investigations that are going to influence what you can do in the second half for example things like a urine dipstick this is an example of investigation that you should be doing in the first half of a consultation cuz you literally can grab a urine sample grab a stick dip it and find out what you might change in terms of how you might manage that case other examples things like an ABG arterial blood gas things like an ECG if you have one to hand things like a pregnancy test these are all things that you can do at the bedside and therefore they come into category one of Investigations either things that you would do as part of your examination that you can get results for now that can influence what you do directly in the second half the second category of Investigations are things that you can do right now as part of your assessment but you're not going to get the results for until later on a couple of hours down the line these are things like arranging blood tests whether it's full blood count renal function liver function function firew function test hba1c or it's things like doing a chest x-ray for example or an abdominal x-ray these are investigations that you can arrange literally there and then but they're not going to influence your initial management plan I you're doing these to try and confirm a diagnosis rule out something serious but it's something that you need to do here and now these are not to be put in the first half of your consultation because they're not going to influence what you do in the second half they are the first part of your second half there are investigations that you're going to arrange now that will help determine what happens in the next 2 24 hours for example so when you sit down and you talk about the Aurora first minute of management the golden first minute of management that we talk about in our other videos you might say for example Mrs X there's a couple of things going through my mind it could be this this or this and there are a few things that we need to have a bit of a chat about in terms of taking this forward number one we can talk about treatments and talk about how we're going to manage your pain and your difficulty in breathing example but number two I want to talk about some investigations that I want to arrange now that can help us get closer to a diagnosis things like x y and Zed okay so second line investigations are those that you do at the early part of management but they're not going to influence what you do in the examination phase so don't mention them in examination now the third set of Investigations the third category are those investigations that you yourself are not going to arrange whether it's before you examine or after examine but invest ation that are likely to happen at some point in the future for example if someone's admitted to a hospital this is going to happen on the ward for example if you're doing an urgent referral to a clinic the kind of Investigation that's going to happen at the clinic this might be things like an MRI scan of somebody's knee or a biopsy of somebody's mole or an OGD an endoscopy that might happen at some point in the near future these investigations are not ones that you yourself are going to organize now but the ones that might come a little bit later on in the patient Journey so they become almost another issue and one of the other things that we can talk about Mrs X is some of the investigations that might happen when you reach the clinic or when you're admitted to hospital do you see the subtle difference between Category 3 and Category 2 and the even bigger difference between categories 2 and three and category number one this is very important to get clear in your mind when you're doing your role plays and Mock and when you come to the academy this is the kind of stuff that we do in terms of simplifying your approach to allow you to manage your time in the consultation a little bit better now I'm going to quickly summarize those three important categories again in a second but just before we go on don't forget the coupon Aurora video 10 for 10% off any resource or package on the Aurora Medical Education website whether it's our full Academy plus program our ultimate package our goal package videos audios flashcards or anything else that you may find of value so to summarize remember you can bring investigations both in the first half of part of data Gathering and also the second half in terms of management but when you do that depends on the three categories of Investigations category number one those investigations that you can do right now that you get an answer for right now that are going to influence what you do in the second half these can happen in data Gathering as part of an examination phase category two those investigations that you are going to arrange at this point but you're not going to get answers to immediately things like blood tests things like x-rays for example and then category three investigations that are going to happen later on in the patient's Journey probably not arranged by you yourself things like CT scans typically things like biopsies for example and things like Scopes when you get these three categories clear in your mind I promise you how you tackle investigations and the clarity of thought that you demonstrate when you talk about investigations shows that you really have understood what you're able to achieve in a short period of time as a clinician in ably I really hope this helps hopefully we get to see you at the Academy or in one of our courses or mock very very soon you know the # canvas will pass # I went with Aurora have a super [Music] day

Channel: Dr. Aman Arora - Arora Medical Education

Views: 2,850

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Id: dwbG01AqnJo

Length: 7min 22sec (442 seconds)

Published: Wed Nov 22 2023