Experience form another candidate
UK- castle hill hospital. 29 th sept 2018:
.
Scenarios are same
Old man with collapse. History of loose motions and vomiting 3 days. While taking history her daughter tells that he is on lithium for 11 years without any follow up
concern was:
- Is it a stroke… I said no
- If not a stroke then what… I said increase in lithium levels causing all this
- Now what will you do?
…I will keep a watch on lithium levels and involve kidney specialist - Will also involve mood doctors to decide about lithium
- Will stop lithium for now
Examiner: what is the diag?
How will you treat him?
What inv… serum osmolality and urine osmolality
What about spot Na … will it be high or low
What is the cause of tremors?
St 4
pt on theophylline now gets admitted with pneumonia ( not well controlled and many admissions in past) develops seizures. Taxi by profession
: concerns:
Why has this happened
Who is responsible
What will you do to prevent this from happening again
Whom to complain
What about my job.
Any restrictions on driving
I said we will file incident report as there is system in place so that these things don’t happen.
I will check at what level there has by a mistake.
I will stop theophylline rt now and consult chest sp for alternative medicine.
We will discuss this in weekly meeting and update you about the corrective measures taken.
I will write in capital letters that this mediation should not be given without checking levels.
DVLA question
I said I am not sure about the exact restriction. I will check DVLA at a glance( booklet) and website and get back to you in next 30 min.
: I also said that I will give you a list of medicines which can alter the theophylline levels either way and you should give this list to the treating doctors so that they are aware of this. But the examiner was not very convinced with this as he thought that this was not very practice
If you still want to complain then there is PALS where you can give either verbal or written complain and they will get back to you with acknowledgement in three days and report in 28 days. You can also speak to sister in charge about this.
: I also told him that I will write a letter to your employers so that they can give an alternative position like taking bookings on phone rather than driving