1) Identify the tools and it’s function•Peak flow meter•To assess the force expiratory flow rate

2) Give two indication of the above tool.•Bronchial asthma•Chronic obstructive disease

3) Demonstrate the technique of using the above tool.•Do it in standing position,make sure the mark is at the level zero,breath in and out slowly for a few times•Then take a deep breath•With nose closed,expired forcefully

OSCE – respi

OSCE – CVS, emergency

52 y/o Malay man, a smoker for 20 years presented with left sided chest pain for 2 hrs, a/w sweating and palpitation

52 y/o Malay man, a smoker for 20 years presented with left sided chest pain for 2 hrs, a/w sweating and palpitation

1. Comment on the ECG strip 1. Sinus ryhthm2. Heart rate :300/3:100 beats per minute3. St elevation over lead III and aVF

2. What is your diagnosis based on history and ECG strip 1. Inferior myocardial infarction

3. What is the risk factor that you can elicit from the history related to your diagnosis

1. age;old age2. Sex:man3. Chronic smoker

4. Outline your management

Question:

• Check the cardiac enzyme,coagulation profile etc• Rule out any broncoconstrion disease• General management– Bed rest– ECG monitoring– Oxygen therapy,aim O2 saturation>93%– Analgesia

• Sublingual GTN/morphine/IV GTN

• Thormoblytic therapy– Aspirin– Atreptokinase– GTN