Literatura académica sobre el tema "Clinical exam. eng"
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Artículos de revistas sobre el tema "Clinical exam. eng"
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Karabilgin Ozturkcu, Ozlem Surel, Ozlem Kuman Tuncel, and Damla Isman Haznedaroglu. "Development, implementation and results of Objective Structured Clinical Exam in Psychiatric Association of Turkey Board Exam (eng)." Journal of Clinical Psychiatry 21, no. 3 (2018): 210–21. http://dx.doi.org/10.5505/kpd.2018.89421.
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Zeigelboim, Bianca Simone, Hélio A. G. Teive, Rosane Sampaio, Ari Leon Jurkiewicz, and Paulo B. N. Liberalesso. "Electronystagmography findings in spinocerebellar ataxia type 3 (SCA3) and type 2 (SCA2)." Arquivos de Neuro-Psiquiatria 69, no. 5 (2011): 760–65. http://dx.doi.org/10.1590/s0004-282x2011000600007.
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OBJECTIVE: To describe the alterations observed in electronystagmography (ENG) of patients with spinocerebellar ataxia (SCA) types 2 and 3. METHOD: Sixteen patients were studied and the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluations. RESULTS: The clinical findings in the entire group of patients were: gait disturbances (93.75%), dysarthria (43.75%), headache (43.75%), dizziness (37.50%) and dysphagia (37.50%). In the vestibular exam, the rotatory (62.50%) and caloric (75%) tests were among those which presented the largest indexes of abnorma
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Javed, Asma, Hetal Acharya, and Ian Yanson. "Core psychiatry trainees views on MRCPsych course structure and delivery at East Midlands Deanery." BJPsych Open 7, S1 (2021): S141—S142. http://dx.doi.org/10.1192/bjo.2021.401.
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AimsThe RCPsych curriculum for core training in Psychiatry (2013) requires each Deanery to run regional MRCPsych teaching programme.The East Midlands School of Psychiatry run a local MRCPsych course aimed at all core psychiatry trainees in the deanery. Before the pandemic, the course took place between two venues – Nottingham and Leicester. During the pandemic, the course was delivered via Microsoft teams. We aimed to collect the feedback from trainees regarding the course to help shape the MRCPsych Course programme according to their training needs.MethodWe devised an online Microsoft forms q
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Nakajima, Masami, and B. Tucker Woodson. "S300 – Comparison of Endoscopy Diagrams for Obstructive Sleep Apnea." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (2008): P175. http://dx.doi.org/10.1016/j.otohns.2008.05.476.
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Objectives Most methods of waking and sedated sleep endoscopy evaluating the upper airway in obstructive sleep apnea inconsistently predict surgical results. Goals of exam have been to identify levels of obstruction or levels of tissue vibration. Examinations provide little information on airway structure. A novel method of describing airway collapse using airway structures has been developed. The objectives of this study are to compare sleep and wake examination: 1) during inspiration, and 2) expiration. Methods A retrospective review evaluated waking and sedated clinical endoscopic endoscopy
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Sathe, Nishad, and Erin Bonura. "1128. Online Spaced Education to Teach Microbiology to Medical Students in a Threaded Medical School Curriculum." Open Forum Infectious Diseases 7, Supplement_1 (2020): S593. http://dx.doi.org/10.1093/ofid/ofaa439.1314.
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Abstract Background A strong foundation in microbiology continues to be essential for physicians-in-training. Little research exists examining pre-clinical microbiology education in undergraduate medical education (UME) curricular structures. Further, no study has evaluated the use of a spaced repetition model for pre-clinical UME students studying microbiology in a threaded curriculum. Methods We conducted a prospective cohort design study and enrolled 81 out of 154 (53%) first-year medical students at Oregon Health & Science University from August 2018 through December 2019. The first 18
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Schmidt, Magali Taimo, Renato Anghinah, Luis Fernando Basile, Oreste Forlenza, and Wagner Faride Gattaz. "EEG alpha peak frequency analysis during memorizing of figures in patients with mild cognitive impairment." Arquivos de Neuro-Psiquiatria 67, no. 2b (2009): 428–31. http://dx.doi.org/10.1590/s0004-282x2009000300011.
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OBJECTIVE: To investigate spectral analysis of electroencephalograms (EEG) for the alpha frequency band during rest and cognitive stimulation in healthy adults and individuals with mild cognitive impairment. METHOD: We analyzed 56 EEGs from 28 patients, 7 men and 21 women, 12 of whom (40%) were controls, 16 patients with mild cognitive impairment (60%). Ages ranged from 61 to 83 years. All individuals were patients in the Psycho-geriatric Out-patients Clinic of LIM-27, of the Psychiatric Institute of the Clinicas Hospital of the Faculty of Medicine of the University of São Paulo, IPq-HCFMUSP,
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Guimarães, Inês Elcione, Sylvia Maria Ciasca, and M. Valeriana L. Moura-Ribeiro. "Neuropsychological evaluation of children after ischemic cerebrovascular disease." Arquivos de Neuro-Psiquiatria 60, no. 2B (2002): 386–89. http://dx.doi.org/10.1590/s0004-282x2002000300009.
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The purpose of this study is to associate neuropsychological evaluation with neuroimaging results in children with cerebral tomography indicating ischemic cerebrovascular disease (ICVD). Neuroimaging, neurological exams and neuropsychological instruments were used to evaluate five children. The study revealed that the cognitive and perceptive skills in two children were normal and motor sequele in four cases. The rhythm, visual and speech receptive skills remained unchanged. In four cases the SPECT exam showed regions with hypoperfusion and in four cases the EEG was normal. Neuropsychological,
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Gorantla, Vasavi R., Sarah Tedesco, Merin Chandanathil, et al. "Associations of Alpha and Beta Interhemispheric EEG Coherences with Indices of Attentional Control and Academic Performance." Behavioural Neurology 2020 (February 5, 2020): 1–7. http://dx.doi.org/10.1155/2020/4672340.
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Introduction. Heretofore, research on optimizing academic performance has suffered from an inability to translate what is known about an individual’s learning behaviors to how effectively they are able to use the critical nodes and hubs in their cerebral cortex for learning. A previous study from our laboratory suggests that lower theta-beta ratios (TBRs) measured by EEG may be associated with higher academic performance in a medical school curriculum. Methods. In this study, we tested the hypothesis that TBR and academic performance may be correlated with EEG coherence, a measure of brain con
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Tiret, Emmanuel. "Surgical training in France." Bulletin of the Royal College of Surgeons of England 90, no. 2 (2008): 54–55. http://dx.doi.org/10.1308/147363508x276431.
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In France, medical students spend six years at university. At the end of the first year of study a rigorous selection process is conducted, resulting in only 15% of the students proceeding to the subsequent years. The final medical examination, the examen classant national, a standardised national exam, is taken at the end of the sixth year. It is a written exam, involving the discussion of nine clinical cases.
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Gediminas, Raila, Liseckienė Ida, Jarusevičienė Lina, and Leonas Valius. "Guideline Adherence and the Factors Associated with Better Care for Type 2 Diabetes Mellitus Patients in Lithuanian PHC: Diabetes Mellitus Guideline Adherence in Lithuania PHC." Open Medicine Journal 6, no. 1 (2019): 50–57. http://dx.doi.org/10.2174/1874220301906010050.
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Background: Type 2 diabetes mellitus is one of the most common chronic conditions, which requires appropriate management and care at PHC level, which is described in guidelines. However, guideline adherence at the international arena is insufficient and little is known about the reasons for guideline non-adherence. Objective: The aim of the survey was to analyse to what extent the Lithuanian family practitioners adhere to diabetes guidelines in order to compare to international data and to discover the factors associated with better diabetes care. Methods: The present study is a part of EUPRIM
Tesis sobre el tema "Clinical exam. eng"
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Teixeira, Luisa Gouvêa. "Processo de reparo no cólon descendente equino submetido ou não a distenção luminal : aspectos clínicos, bioquímicos e anatomopatológicos /." Jaboticabal : [s.n.], 2011. http://hdl.handle.net/11449/89068.
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Orientador: José Corrêa de Lacerda Neto<br>Banca: Rosemeri de Oliveira Vasconcelos<br>Banca: Rafael Resende Faleiros<br>Resumo: Avaliou-se por meio de análises clínico-laboratoriais e morfológicas, a evolução cicatricial de dois segmentos distintos do cólon descendente. Os equinos foram alocados em um único grupo e submetidos a três fases experimentais: obstrução experimental (F I), seguida de 13 dias pós-operatórios; anastomose término-terminal (F II) e videolaparoscopia (F III), ambas seguidas, cada uma, de seis dias pós-operatórios. O segmento distendido (SD) foi submetido a 240 minutos de
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Martins, Marilia Compagnoni. "Desenvolvimento da peri-implantite induzida por ligadura em diferentes superfícies de implantes osseointegrados. Análise clínica e radiográfica em cães /." Araraquara : [s.n.], 2000. http://hdl.handle.net/11449/96213.
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Resumo: Foram avaliados, clínica e radiograficamente, as reações de quatro diferentes superfícies de implante frente ao desenvolvimento e progressão da peri-implantite: Ticp: titânio comercialmente puro; TPS: titânio revestido com plasma spray de titânio; HA: hidroxiapatita; Ost. Superfícies tratadas com ácidos. Para tanto, foram utilizados seis cães, cujos pré-molares inferiores e superiores foram extraídos. Decorridos 90 dias, os implantes foram aleatoriamente colocados, e iniciou-se o controle químico e mecânico do biofilme bacteriano; após o período de osseointegração (90 dias) foram coloc
Libros sobre el tema "Clinical exam. eng"
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Winter, Stuart, and Declan Costello, eds. MCQs for ENT. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780198792000.001.0001.
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MCQs for ENT: Specialist Revision Guide for the FRCS is a key resource for candidates preparing to sit the FRCS (ORL-HNS). It contains over 300 single best answer questions and over 70 extended matching questions to help candidates prepare for all aspects of ENT they may face in this challenging exam. Written by expert consultants who have succeeded in the exam, this resource provides comprehensive coverage of theory and practice, including new questions on challenging topics such as electroneurography and voice clinic procedures, and questions on rare topics such as oropharyngeal cancers. All
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Hand, William R. Introduction to Perioperative Crisis Management. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0086.
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Management of perioperative emergencies caused by toxins, whether consumed by a patient or iatrogenic, requires a rapid assessment of patient stability and unique inquiry into the historical and clinical context leading to the patient condition. Unlike many other crises in the perioperative period, toxin-related end-organ instability often has a specific therapeutic agent required for reversal and recovery. In this section, each perioperative crisis will be described according to the pathophysiologic derangements that a clinician will encounter in both physical exam and laboratory findings. Th
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Johnson, Daniel. Mayo Clinic Gastrointestinal Imaging Review. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199862153.001.0001.
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This resource provides an atlas of common abnormalities that affect the gastrointestinal tract and includes all imaging modalities used within GI radiology, as well as plain radiographs, fluoroscopy, ultrasound, CT, MR, angiography, and nuclear medicine. Focusing solely on adult conditions, it features 13 chapters covering a separate organ within the gastrointestinal system and a final exam chapter reviewing all chapter content. Each organ-focused chapter is subdivided into sections related to diseases or findings of that organ. Large, high-quality images are presented so that they can be revi
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Samanta, Jo, and Ash Samanta. Medical Law Concentrate. Oxford University Press, 2018. http://dx.doi.org/10.1093/he/9780198815204.001.0001.
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Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. Med-ical Law Concentrate provides a study and revision guide aiming to cover the es-sential aspects of this rapidly changing field of law. Topics covered include: the contemporary healthcare environment; medical negligence; consent; confidential-ity; and access to medical records. The volume also looks at abortion and prenatal harm, assisted reproduction, clini
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Samanta, Jo, and Ash Samanta. Medical Law Concentrate. 4th ed. Oxford University Press, 2021. http://dx.doi.org/10.1093/he/9780198871354.001.0001.
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Each Concentrate revision guide is packed with essential information, key cases, revision tips, exam Q&As, and more. Concentrates show you what to expect in a law exam, what examiners are looking for, and how to achieve extra marks. Medical Law Concentrate provides a study and revision guide aiming to cover the essential aspects of this rapidly changing field of law. Topics covered include: the contemporary healthcare environment; medical negligence; consent; confidentiality; and access to medical records. The volume also looks at abortion and prenatal harm, assisted reproduction, clinical
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Keogh, Karina A. Vasculitis in the critically ill. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0277.
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The vasculitic syndromes are a heterogeneous group of rare disorders characterized by degrees of inflammation and necrosis of blood vessels with a wide variety of clinical manifestations. Intensive care treatment is most commonly required for vasculitis involving small blood vessels, including capillaries. Involvement of these vessels in the lung causes alveolar haemorrhage, which may lead to respiratory failure. In the kidneys it may cause glomerulonephritis leading to renal failure. Severe cardiac, neurological, and gastrointestinal manifestions can also be seen. Non-vasculitic manifestation
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Schiller, Adalbert, Adrian Covic, and Liviu Segall. Chronic tubulointerstitial nephritis. Edited by Adrian Covic. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199592548.003.0086_update_001.
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Chronic tubulointerstitial nephropathies (CTINs) are a group of renal diseases, characterized by variable interstitial inflammation and fibrosis and tubular atrophy, and a slow course towards end-stage renal disease (ESRD). The causes of CTIN are numerous, including nephrotoxic drugs and chemicals, infections, autoimmune diseases, obstructive uropathies, and metabolic disorders. Taken together, CTIN are responsible for less than 10% of all ESRD cases requiring renal replacement therapy. The clinical manifestations of CTIN typically comprise low-grade proteinuria, leucocyturia, and variably red
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Collis, Rachel, Sarah Harries, and Abrie Theron, eds. Obstetric Anaesthesia. 2nd ed. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780199688524.001.0001.
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Starting work on the labour ward is very challenging for all junior anaesthetists. This handbook is an easily navigated practical reference guide for anaesthetists new to this environment, as well as other members of the labour ward multi-disciplinary team; midwives, obstetricians, and Consultant Anaesthetists who visit labour ward less frequently or only when on-call. It covers all aspects of obstetric anaesthesia that the trainee anaesthetist will encounter during their obstetric training module, and is essential reading for FRCA exam preparation. Since the first edition, there is no doubt t
Capítulos de libros sobre el tema "Clinical exam. eng"
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"Ear, nose, and throat surgery." In Oxford Handbook for Medical School, edited by Kapil Sugand, Miriam Berry, Imran Yusuf, et al. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780199681907.003.0035.
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Chapter 35 provides an overview of ear, nose, and throat (ENT) surgery. The most common presentations encountered in ENT surgery are summarized including acute tonsillitis and quinsy, otitis externa, head and neck cancer, and airway emergencies. A more detailed description of the clinical presentation of common diseases encountered in ENT clinics is provided covering otitis externa, lower motor neuron facial nerve palsy, nasal fractures, acute otitis media, neck lumps, and vertigo. The roles of investigations used to support diagnosis in ENT including audiography, ultrasound, and magnetic resonance imaging are described. The presentation and management of acute presentations in ENT seen in emergency departments including epistaxis, acute peritonsillar abscess, airway emergencies, periorbital cellulitis, including airway assessment are described. An overview of commonly performed ENT operations is provided including tonsillectomy, grommet insertion, thyroidectomy, neck dissection, and tracheostomy. An approach to clinical skills in ENT (including common OSCE stations in exams) is described, including history taking, examination of neck lumps, thyroid exam, and ear examination. Clinical tests of hearing are presented and their interpretation described.
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Zengeya, Stanley Tamuka, and Tiroumourougane V. Serane. "Effective communication in the exam." In The MRCPCH Clinical Exam Made Simple. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199587933.003.0008.
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Communication is not just giving information; rather, it is a two-way process and involves the exchange of information, ideas, and knowledge. Eff ective communication is the key to success and can be achieved only if the receiver understands the exact information the sender is aiming to transfer. Medical communication is the art of speaking clearly and professionally, while reducing the possibility of being misunderstood. It will increase patient satisfaction and trust and improve understanding of treatment and compliance. Examiners consider effective communication to be the most essential skill any doctor requires to deal with the patient’s problems. The General Medical Council has highlighted the importance of communicating well by stating that ‘medical graduates must be able to communicate clearly, sensitively and effectively, not only with patients and their relatives, but also with colleagues and other healthcare professionals’. The Royal College of Paediatrics and Child Heath has put so much emphasis on communication that this is the only skill that is tested in two independent stations in the clinical examination. The College feels that a careful assessment of communication skills distinguishes the good candidates from the bad ones. Often, overseas-trained candidates and non-native English speakers find this station difficult, as they may not have grasped the basic skills of this assessment. In this station, the examiner will watch a communication scenario between the candidate and the patient’s family. It is of utmost importance to read the instructions carefully and understand them. A common mistake is to confuse this station with history taking. The examiner’s task is to observe only and not to ask any questions or make any comments on the candidate's performance. At the end of the episode, the examiner will evaluate the candidate’s performance. The key competence skills required in the communication station are given in table 2.1. Effective communication is a two-way process in which there is an exchange of thoughts, feelings, or ideas towards a mutually accepted goal. Speaking and listening are the two arms of effective communication. One cannot be an effective communicator if both speaking and listening are not mastered. Medical communication starts with speaking, which requires a sender, a message, a medium or channel, and a receiver. The sender encodes a package of information and transmits this by a medium to the receiver. Commonly used media include air, noise, signal, and paper. Content and context are the two elements of information that will be transmitted via the medium. Content is the actual words or symbols. Context is the way the message is delivered, that is the non-verbal components such as body language, facial expressions, posture, gestures, eye contact, and state of emotion. During communication, context is extremely important as it helps the patient and the doctor to understand one another. On receiving the message, the recipient decodes it and can give the sender feedback (figure 2.1).
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Zengeya, Stanley Tamuka, and Tiroumourougane V. Serane. "The principles of physical examination." In The MRCPCH Clinical Exam Made Simple. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199587933.003.0010.
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Examination of the child combines science with art; developing competence in paediatric examination requires both knowledge of the correct technique and hours of hard work and practise. Lack of either will make the examination technique incomplete or inadequate. Perhaps the greatest difficulty an inexperienced doctor faces is to gain the confidence and trust of the child and their carers, while creating an impression of grounded self-confidence. In the examination, one should carry oneself well. This means you should be a good listener, be interested, cheerful, respectful, warm, caring, friendly, empathic, competent, and diplomatic. It is imperative to listen actively to the child and their carers and be as natural as possible—just as you would be with your friend’s child or indeed your own. The examination begins the moment you enter the room. It is essential to understand that the general approach to the physical examination of the child will be different from that of an adult and will vary according to the age of the child. As the child’s cooperation cannot be guarantied, you should remember that it is impossible always to use a set protocol while examining the child. We have listed the essential steps of examination in a particular order so that all areas are covered, but the candidate needs to adapt the examination sequence according to the needs of the child and the situation. As a general rule, anything that will inevitably be uncomfortable or unpleasant for the child (e.g. otoscopy or rectal examination) should be the ‘last act’ of the examination. A common mistake made by nervous candidates is to talk too fast; this is a trait that will always be more exaggerated under the stress of the exam. Pausing at the end of each sentence is an effective way of slowing down. Ensuring that each word is pronounced completely will also lessen the pace of your speech. Talking slowly and clearly with a smile on your face will help to hide nervousness. In this book and the accompanying videos, examinations are performed in a systematic manner. These steps provide a useful framework. Although there can be some flexibility, following the steps listed here will improve your technique.
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Zengeya, Stanley Tamuka, and Tiroumourougane V. Serane. "Examination of the respiratory system." In The MRCPCH Clinical Exam Made Simple. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199587933.003.0012.
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The examination of the respiratory system causes much anxiety among candidates, as many feel the findings are difficult to elicit, particularly in a small child. Just like other systems, having a structured approach makes identification and interpretation of the findings easy. It is important to practise the proper examination technique repeatedly, as this is the best way to improve the skills that are essential to obtain accurate findings. However, the examination itself can be performed in a different sequence depending on the age and the degree cooperation of the child. The examination of the respiratory system is best done in correlation with the available medical history. First, assimilate the available history, which will give an idea of the expected findings and subsequent diagnosis. At the end of the examination, it is important to describe significant findings (table 6.1) with reference to specific surface locations, as shown in figure 6.1. Key competence skills required in examination of the respiratory system are given in table 6.2. These steps are repeated in every system to reiterate their importance and to help you recollect the initial approach of any clinical exam. Also refer to chapter 4. • On entering the examination room, demonstrate your strict adherence to infection control measures by washing your hands or by using alcohol rub. • Introduce yourself both to the parents and the child. • Talk slowly and clearly with a smile on your face. • Establish rapport with the child and parents. • Expose the chest adequately while ensuring their privacy. • Positioning the patient: the child should be undressed appropriately to the waist to allow proper examination. It may be easier to examine an older child when they sit on the edge of the bed, or on a chair. It is preferable to examine younger children on their parent’s lap rather than on a couch separated from the parents, as this can cause much anxiety. Removing a toddler or an infant from his or her parent will most probably yield a screaming child in whom eliciting any physical findings will be virtually impossible.
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Zengeya, Stanley Tamuka, and Tiroumourougane V. Serane. "Examination of the skin and skin appendages." In The MRCPCH Clinical Exam Made Simple. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199587933.003.0020.
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Examination of the skin can provide information about cutaneous or systemic diseases. As always, examination of the skin is best performed in correlation with the available medical history. Even if the examination is conducted in a different order, you should have a systematic method of presenting the findings. Examination comprises inspection and palpation of skin and skin appendages (hair, nails, teeth, and mucous membranes) and is performed in one of two scenarios. 1. The skin may be sequentially examined alongside the examination of other systems (e.g. neurocutaneous syndromes, which are disorders with neurological features, characteristics lesions on the skin, and tumours in different parts of the body) (table 14.1). 2. A dedicated examination of the skin may need to be carried out when it is the suspected primary involved organ and includes evaluation of the hair, nails, teeth, and mucous membranes of the mouth and genitalia. Key competence skills required in examination of the skin are given in table 14.2. Some of the clinical features of common paediatric dermatoses are given in table 14.3. These steps are repeated in every system to reiterate their importance and to help you recollect the initial approach of any clinical exam. Also refer to chapter 4. • On entering the examination room, demonstrate strict adherence to infection control measures by washing your hands or by using alcohol rub. • Introduce yourself both to the parents and the child. • Talk slowly and clearly with a smile on your face. • Establish rapport with the child and parents. • Expose adequately while ensuring their privacy. • Positioning: the patient must be undressed adequately to carry out a complete examination. Inadequate skin exposure with the cloth pushed to one side or lifted momentarily often casts shadows on the skin and is not conducive for proper examination. Infants and very young children should be undressed completely. The younger child is examined preferably on the parent’s lap. Older children can lie down except for the examination of back, which can be examined in the sitting position.
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Zengeya, Stanley Tamuka, and Tiroumourougane V. Serane. "Examination of the central nervous system." In The MRCPCH Clinical Exam Made Simple. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199587933.003.0014.
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Due to the complexity of the diseases and the number of tests involved, examination of the central nervous system (CNS) is relatively difficult in the exam setting. Candidates should realize that an attempt to carry out every aspect of the physical examination of the CNS will take too long and is obviously impractical. Appropriate signs need to be elicited quickly to identify the existence of a lesion, its anatomical localization, and likely pathology. Hence, the examination of this system requires plenty of practise and a polished technique. In the exam, you may be asked to examine, for example, just the motor system, or the upper or the lower limb, rather than an examination of the whole central nervous system. Prepare yourself for a screening examination, which will uncover most signs in a relatively short time. Remember, a detailed assessment of complex disorders is never a part of the MRCPCH Clinical Exam. In this chapter, some areas have been explored extensively, keeping in mind the possibility of a ‘small area’ being examined. As the focus is mainly on examination technique and not theoretical aspects, basic neuroanatomy which has not been dealt with here should be read about elsewhere. Key competence skills required in the neurological examination are given in table 8.1. Neurological assessment begins with the first contact with the child, that is the moment you enter the room. It is necessary to have a predetermined, systematic order of examination so that important signs are not overlooked. However, you should be ready to adapt the examination technique, depending on the child’s age and the level of cooperation (e.g. compliant teenager, difficult toddler). Candidates should realize that a great deal can be learned by inspection before touching the child. Integration of observations with specific findings gathered during the neurological examination will fetch much credit. Candidates are often not expected to reach a diagnosis in a short case. They are expected to define the deficit, decide on the anatomical level, if possible, and then consider the likely causes. Abnormalities commonly seen in the exam include cerebral palsy, hemiplegia, quadriplegia, diplegia, primary myopathy, and hereditary motor sensory neuropathies. It is productive to have a pattern recognition approach to neurological disorders.
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Zengeya, Stanley Tamuka, and Tiroumourougane V. Serane. "Developmental examination." In The MRCPCH Clinical Exam Made Simple. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199587933.003.0017.
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All doctors working with children should have good knowledge of normal developmental milestones, as early diagnosis of developmental problems and appropriate intervention is desirable to improve the outcome. Candidates should be able to identify key warning signals and know the practical relevance of the milestones. ‘Developmental assessment’ is the comprehensive evaluation of a child’s physical, intellectual, language, emotional, and social development, and is an area where most candidates lack competence and confidence. It should be distinguished from ‘developmental screening’, which is a brief, formal, standardized evaluation for the early identification of children at risk of a developmental disorder. In the developmental assessment station, a candidate can be assessed in different ways: a developmental history with the parent and child; assessment of specific developmental domains (such as gross motor skills, fine motor skills, speech, language skills, etc.); or global assessment of an infant or older child. Occasionally, the candidate might be asked to just ‘observe the child’s play’ and comment on the development. The candidate should anticipate and be prepared for these scenarios. In the exam, a detailed assessment of development is impossible, as it is complicated and time consuming. Ideally, observations of the child should take place with several people in varied settings, which is not feasible in the exam. However, useful assessment of a child’s development can be easily performed as part of routine examination. The main purpose of the developmental assessment in the exam is to identify the child’s strengths and weaknesses, the developmental problem, and, if possible, the cause of the problem. The candidate is expected to give an approximate developmental age at the end of the assessment. Before we continue, it is important to understand the commonly used terminology. A child is said to have ‘developmental delay’ when he or she shows a significant lag (more than two standard deviations) in acquiring milestones in one or more domains. Global developmental delay is defined as a delay in two or more developmental domains. ‘Developmental deviance’ occurs when a child develops milestones outside or apparently ahead of the typical acquisition sequence. ‘Developmental regression’ is the loss of previously acquired milestones. Children develop skills in various areas, also called developmental domains: gross motor, speech and language, fine motor, cognitive, personal–social, and emotional.
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"Accreditation and certification in cardiovascular CT." In Cardiovascular Computed Tomography, edited by James Stirrup, Russell Bull, Michelle Williams, and Ed Nicol. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198809272.003.0029.
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Although radiologists and cardiologists receive core training in cardiovascular physiology and imaging, subspecialty practice in CCT requires specific training. To this end, international levels of clinical competency have been established that are now widely accepted. Certification exams in CCT are available via several US and European institutions. Some are linked to the process of accreditation, whilst others (e.g. CBCCT) are separate from that process (but have similar requirements).
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Watkin, Sara, and Andrew Vincent. "New Ways of Interviewing." In The Consultant Interview. Oxford University Press, 2011. http://dx.doi.org/10.1093/oso/9780199594801.003.0017.
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Over recent years there has been a significant move away from the traditional interview format for junior doctor appointments with the increasing use of either competency based interviews (also known as criteria-based interviewing, behavioural interviewing and situational interviews) or assessment centres. Both of these approaches are labour intensive but are felt to ensure a more objective, rather than subjective, approach to choosing the right candidate. Additionally, assessment centres give candidates an opportunity to reinvent themselves between ‘stations’ and a new set of assessors. Assessment centres also give those candidates who naturally struggle with the interview format more opportunities to shine, and for the assessment team to get to the underlying person in more ways. These two approaches are now being explored and utilized in some consultant interviews. Behavioural or competency-based interviews are often being done back-to-back with a traditional interview. Assessment centres are being used more and more for senior appointments, e.g. Medical Director posts, advertised externally. Finally, it is even possible today to find yourself subject to Objective Structured Clinical Examination (OSCE) in an interview situation. However, this is rare but may become more prominent as different colleges take differing approaches to exit exams and final CCT attainment. However, preparation for this, besides what has already been covered in preparing yourself, developing confidence, etc., is beyond the scope of this book. If you find yourself in the unusual position of undertaking an OSCE, then it must be considered in the same light as any other clinical exam, with preparation accordingly. It is likely that new techniques and combinations will be adopted in interviews, as the requirements of consultants evolve and so too do the methods of assessing them. It is important to always find out exactly what will happen to you so that you can be appropriately prepared. These are also known as criteria-based interviewing, behavioural interviewing and situational interviews. They are increasingly used in StR interviews and there have been some trials at consultant interview level.
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Smith, Jodi L. "Pediatric Neurosurgery." In Goodman's Neurosurgery Oral Board Review. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780190055189.003.0012.
Texto completoResumen
The ABNS Oral Examination evaluates an applicant’s knowledge and judgment in clinical neurosurgical practice after an applicant has been an independent practitioner. With the new format, the oral exam is divided into 3 sessions, each consisting of 5 questions. Questions in the first session deal with general neurosurgery, questions in the second session focus on the preidentified area of practice chosen by the applicant (e.g., pediatric neurosurgery), and questions in the third session are based on cases submitted by the applicant. Common pediatric neurosurgical problems treated by neurosurgeons may be included on the American Board of Neurological Surgery Oral Examination in the general neurosurgery session. Therefore, one should be familiar with the neurosurgical management of pediatric cases, including disorders of cerebrospinal fluid dynamics, congenital cranial and spinal malformations, tumors, vascular congenital and acquired disorders, intracranial and spinal infections, and intractable epilepsy. In this chapter, clinical vignettes of common pediatric neurosurgical conditions will be presented including (a) myelomeningocele, (b) craniosynostosis, (c) hydrocephalus, (d) posterior fossa tumors, and (e) moyamoya disease, with the cases subdivided into those that may be seen in the general session (1 to 3) and those more likely to be seen in the subspecialty specific session (4 and 5). The applicant will be given the history, physical examination, pertinent imaging studies, and test results and will then be expected to provide a rational differential diagnosis and plan of management, outline the risks of surgery, and describe the operation, if proposed, and handle intraoperative and postoperative complications that occur.