Year 1 LOBS (other)

Question 1

Demonstrate competent management of common first aid scenarios: Sprains & possible fractures, hypoglycaemia and burns, epistaxis, fits and faints

Answer 1

Sprains & Possible Fractures:
Rest, Ice, Compression, Elevation (R.I.C.E) for sprains
Immobilize the affected area for possible fractures
Seek medical attention for severe cases

Hypoglycemia:
Provide fast-acting carbohydrates (e.g., glucose gel, candy, fruit juice)
Encourage the person to eat a snack with complex carbohydrates and protein afterward
Monitor closely and seek medical help if symptoms persist

Burns:
Cool the burn with running water for at least 10 minutes
Cover the burn with a sterile non-stick dressing
Do not use ice or adhesive bandages directly on the burn
Seek medical attention for severe burns or if unsure

Epistaxis (Nosebleed):
Have the person lean forward and pinch the nostrils together
Apply steady pressure for at least 10 minutes
Seek medical help if bleeding is severe or persistent

Fits and Faints:
Ensure a safe environment by removing hazards
Place the person on their side to maintain an open airway
Monitor breathing and provide reassurance
Seek emergency medical assistance if the episode lasts more than 5 minutes or if the person is injured during the event

Question 2

Demonstrate correct handwashing technique and awareness of infection control principles in the clinical setting

Answer 2

hand hygiene
respiratory and cough hygiene
PPE
safe management of care equipment
safe management of the environment
management of laundry
management of blood and body fluid spills
waste management:
- Black – general or household waste.
- Yellow with black stripe – offensive waste.
- Orange – infectious waste.
- Yellow – infectious waste contaminated with medicines and/or chemicals.

Question 3

Apply knowledge of anatomy in a clinical context to help examine bony prominences, limbs, joints and muscles.

Question 4

Demonstrate muscle movements and power

Answer 4

Question 5

Identify and name the movements of the limb joints

Answer 5

Question 6

Accurately locate palpable peripheral pulses

Answer 6

Question 7

Perform Allen’s test and know the indications for its use

Answer 7

Question 8

Accurately identify veins for phlebotomy

Answer 8

Question 9

Perform measurement of vital signs competently (temperature, pulse and respiratory rate)

Answer 9

Question 10

Identify the surface markings of the heart on the chest

Answer 10

Question 11

Demonstrate how to locate the apex beat

Answer 11

Question 12

Identify and distinguish the different heart sounds

Answer 12

Check CVS sounds flashcards

Question 13

Perform blood pressure measurement on a colleague

Answer 13

Check BP flashcards

Question 14

Recognise all the relevant surface anatomy that supports a clinical respiratory exam

Answer 14

Thoracic Cage:
Sternum: Palpate the sternum, including the sternal angle (Angle of Louis), which marks the level of the second rib and the tracheal bifurcation.
Ribs: Count and palpate the ribs, noting any tenderness or deformities.
Clavicles and Scapulae:
Clavicles: Palpate the clavicles for tenderness or deformities.
Scapulae: Assess the scapular position and movement during respiration.
Chest Wall:
Anterior Chest: Observe the shape and symmetry during inhalation and exhalation.
Posterior Chest: Note the spine’s alignment, scapular movement, and the level of the scapulae.

Question 15

Assess expansion of the chest wall

Answer 15

Question 16

Demonstrate and practice percussion of the lungs

Answer 16

Check Resp Cards

Question 17

Recognise normal breath sounds through a stethoscope

Answer 17

Check Resp Cards

Question 18

Locate and identify visible features in the mouth

Answer 18

Question 19

Name the regions of the abdomen and the structures located within each region

Answer 19

Question 20

Demonstrate understanding of the aetiology and description of some types of abdominal pain

Answer 20

| Type of Abdominal Pain | Etiology                                   | Description                                        | Common Causes                                              |
|------------------------|--------------------------------------------|----------------------------------------------------|------------------------------------------------------------|
| Visceral Pain           | Internal organ irritation or inflammation  | Dull, poorly localized pain                         | Gastroenteritis, Constipation, Hollow organ distension      |
| Parietal Pain           | Inflammation of the peritoneum              | Sharp, well-defined pain                           | Perforated peptic ulcer, Peritonitis                          |
| Referred Pain           | Pain felt distant from the source           | Pain perceived in a different location             | Gallbladder inflammation, Pancreatitis                        |
| Colicky Pain            | Sudden, intense pain with periodic waves    | Waves of cramping or spasmodic pain               | Renal colic, Intestinal obstruction                           |
| Gas Pain                | Accumulation of gas in the digestive tract  | Sharp, stabbing pain or bloating                  | Gastrointestinal gas accumulation, Irritable bowel syndrome  |
| Ischemic Pain           | Inadequate blood supply to abdominal organs | Severe, poorly localized pain                     | Mesenteric ischemia, Acute arterial thrombosis                 |
| Appendicitis           | Inflammation of the appendix                | Initially vague, later localized pain             | Obstruction of the appendix lumen                             |
| Biliary Colic           | Gallstone obstruction of the bile duct      | Intermittent, cramping pain in the upper right quadrant | Gallstones                                                  |

Question 21

Practice techniques used in the abdominal examination, including palpation of the abdomen and kidneys and auscultation of bowel sounds

Answer 21

Check abdo cards

Question 22

Practice palpation of the lumbar spine and bony pelvis

Answer 22

Lumbar Spine Palpation:
1. Patient Position:

Ensure the patient is in a comfortable position, preferably lying prone (face down) on an examination table.
2. Landmarks:

Identify key landmarks:
Spinous Processes: Palpate the bony prominences along the midline of the back.
3. Technique:

Use the pads of your fingers or thumbs:
Begin palpation at the sacrum and move upward along the spinous processes of the lumbar vertebrae.
Note any tenderness, asymmetry, or abnormalities.
Palpate the paravertebral muscles on both sides, feeling for tension, tenderness, or trigger points.
4. Vertebral Levels:

Identify the following lumbar vertebral levels:
L1-L2: Palpate just above the iliac crest.
L2-L3: Palpate midway between the iliac crest and the lowest rib.
L3-L4: Palpate just below the lowest rib.
L4-L5: Palpate at the level of the iliac crest.
L5-S1: Palpate the dimples at the base of the spine (posterior superior iliac spines).
Bony Pelvis Palpation:
1. Patient Position:

The patient can be in a supine (lying on the back) or standing position.
2. Landmarks:

Identify key landmarks:
Anterior Superior Iliac Spine (ASIS): Palpate the bony prominences on the front of the pelvis.
Posterior Superior Iliac Spine (PSIS): Palpate the bony prominences on the back of the pelvis.
3. Technique:

Use the pads of your fingers or thumbs:
Palpate the ASIS and PSIS bilaterally, assessing for symmetry and tenderness.
Palpate the iliac crest and the sacroiliac joint area.
Assess the pubic symphysis by palpating the midline of the pelvis.
4. Sacrum:

Palpate the sacrum:
Begin at the base of the spine (coccyx) and move upward along the midline.
Note any tenderness or abnormalities.

Question 23

Demonstrate cervical and lumbar spine movements

Answer 23

Cervical Spine Movements:
1. Flexion:

Ask the person to:
Lower their chin toward their chest.
Assess the range of motion and note any discomfort.
2. Extension:

Ask the person to:
Tilt their head backward, looking toward the ceiling.
Evaluate the range of motion and any restrictions.
3. Lateral Flexion:

Ask the person to:
Bring one ear toward the shoulder without lifting or rotating the shoulder.
Repeat on the other side.
4. Rotation:

Ask the person to:
Turn their head to one side, bringing the chin toward the shoulder.
Repeat on the other side.
Note the range of motion and any asymmetry.
Lumbar Spine Movements:
1. Flexion:

Ask the person to:
Bend forward at the waist, reaching toward the toes.
Assess the forward bending range and any discomfort.
2. Extension:

Ask the person to:
Arch their back backward.
Evaluate the backward bending range and any restrictions.
3. Lateral Flexion:

Ask the person to:
Bend to one side at the waist without rotating the spine.
Repeat on the other side.
4. Rotation:

Ask the person to:
Twist their torso to one side while keeping the hips facing forward.
Repeat on the other side.
Note the range of motion and any asymmetry.

Question 24

Show how to elicit upper and lower limb reflexes

Answer 24

Check neuro exam

Question 25

Demonstrate how to perform and interpret urinalysis

Answer 25

Gather Supplies:

Clean urine specimen container
Urinalysis dipstick
Microscope
Pipettes
2. Collecting the Sample:

Ensure the patient is given clear instructions for collecting a midstream urine sample.
Collect the urine in a clean, sterile container.
3. Visual Examination:

Color: Observe the color of the urine. Normal urine ranges from pale yellow to amber.
Clarity: Assess the clarity of the urine. Normal urine is typically clear.
4. Chemical Analysis (Using Dipstick):

Dip the urinalysis strip into the urine and follow the manufacturer’s instructions for reaction time.
Interpret the color changes on the strip for the following parameters:
pH: Normal range is around 4.5 to 8.
Protein: Presence may indicate kidney issues.
Glucose: Elevated levels may indicate diabetes.
Ketones: Presence may indicate metabolic disorders.
Blood: Detects red blood cells; presence may indicate various conditions.
Bilirubin: Presence may indicate liver dysfunction.
Urobilinogen: Abnormal levels may indicate liver or hemolytic disorders.
Nitrites: Presence may indicate a urinary tract infection.

Question 26

Demonstrate understanding of global functions of the central nervous system and

Answer 26

Motor Function:
Role: Control of voluntary and involuntary movements.
CNS Involvement: Motor cortex, cerebellum, basal ganglia.
Sensory Function:
Role: Interpretation of sensory stimuli (touch, pain, temperature, etc.).
CNS Involvement: Sensory cortex, thalamus.
Cognition:
Role: Higher mental processes including perception, memory, and problem-solving.
CNS Involvement: Frontal and temporal lobes, hippocampus.
Emotional Regulation:
Role: Processing and regulation of emotions.
CNS Involvement: Limbic system (amygdala, hippocampus).
Autonomic Function:
Role: Regulation of involuntary bodily functions (heart rate, digestion, respiratory rate).
CNS Involvement: Brainstem, hypothalamus.
Homeostasis Maintenance:
Role: Regulation of internal balance and stability.
CNS Involvement: Hypothalamus.
Communication:
Role: Transmission of signals between neurons and different parts of the body.
CNS Involvement: Neurons, spinal cord, brain pathways.

Question 27

recognise patterns of deficit associated with central nervous system pathology

Answer 27

Motor Deficits:
Signs: Weakness, paralysis, tremors, lack of coordination.
Pathologies: Stroke, Parkinson’s disease, multiple sclerosis.
Sensory Deficits:
Signs: Altered sensation, numbness, tingling.
Pathologies: Peripheral neuropathy, spinal cord injury.
Cognitive Impairment:
Signs: Memory loss, confusion, difficulty concentrating.
Pathologies: Alzheimer’s disease, traumatic brain injury.
Emotional and Behavioral Changes:
Signs: Mood swings, anxiety, depression.
Pathologies: Mood disorders, traumatic brain injury.
Autonomic Dysfunction:
Signs: Irregular heart rate, blood pressure changes, gastrointestinal issues.
Pathologies: Autonomic neuropathy, spinal cord injury.
Coordination and Balance Issues:
Signs: Ataxia, difficulty walking.
Pathologies: Cerebellar disorders, vestibular dysfunction.
Speech and Language Impairment:
Signs: Slurred speech, language difficulties.
Pathologies: Stroke, aphasia.
Seizures:
Signs: Uncontrolled, abnormal electrical activity in the brain.
Pathologies: Epilepsy, brain tumors.

Question 28

Describe the functions of the 12 cranial nerves

Answer 28

1. Olfactory Nerve (I):
   Function: Sensory (Special Somatic Afferent)
   Role: Responsible for the sense of smell.
2. Optic Nerve (II):
   Function: Sensory (Special Somatic Afferent)
   Role: Primarily responsible for vision.
3. Oculomotor Nerve (III):
   Function: Motor (Somatic Efferent), Autonomic (Visceral Efferent)
   Role: Controls most eye movements and adjusts the size of the pupil.
4. Trochlear Nerve (IV):
   Function: Motor (Somatic Efferent)
   Role: Innervates the superior oblique muscle, contributing to eye movement.
5. Trigeminal Nerve (V):
   Function: Sensory (General Somatic Afferent), Motor (Somatic Efferent)
   Role: Sensory for the face and motor for chewing muscles.
6. Abducens Nerve (VI):
   Function: Motor (Somatic Efferent)
   Role: Controls the lateral rectus muscle, aiding in eye movement.
7. Facial Nerve (VII):
   Function: Sensory (Special Visceral Afferent), Motor (Branchiomotor), Autonomic (Visceral Efferent)
   Role: Controls facial expressions, taste sensation for the anterior two-thirds of the tongue, and tear and saliva production.
8. Vestibulocochlear Nerve (VIII):
   Function: Sensory (Special Somatic Afferent)
   Role: Responsible for hearing (cochlear division) and balance (vestibular division).
9. Glossopharyngeal Nerve (IX):
   Function: Sensory (Special Visceral Afferent), Motor (Branchiomotor), Autonomic (Visceral Efferent)
   Role: Involved in taste sensation, swallowing, and salivation.
10. Vagus Nerve (X):
    Function: Sensory (Special Visceral Afferent), Motor (Branchiomotor), Autonomic (Visceral Efferent)
    Role: Regulates various autonomic functions, including heart rate, digestion, and respiratory rate.
11. Accessory Nerve (XI):
    Function: Motor (Branchiomotor)
    Role: Controls muscles involved in head and shoulder movement.
12. Hypoglossal Nerve (XII):
    Function: Motor (Somatic Efferent)
    Role: Controls tongue movements, particularly during speech and swallowing.

Question 29

Perform basic tests of cerebellar dysfunction

Answer 29

Check Neuro cards
1. Finger-to-Nose Test:
2. Heel-to-Shin Test:
3. Rapid Alternating Movements (RAM):
4. Romberg Test:
5. Tandem Gait Test:
6. Dysdiadochokinesia Test:
7. Hypotonia Assessment:

Question 30

Demonstrate understanding of the concept of dermatomes
Identify dermatomes on a colleague

Answer 30

Question 31

Demonstrate the surface markings of major upper and lower limb peripheral nerves and understand their significance

Answer 31

Median Nerve: carpal tunnel syndrome.
Ulnar Nerve: “funny bone” tennis elbow
Radial: affecting extension

Question 32

Demonstrate the surface markings of major upper and lower limb peripheral nerves and understand their significance

Answer 32

Femoral: supplies muscles involved in hip flexion and knee extension.
Sciatic: Sciatica
Tibial: foot plantarflexion and toe flexion.
Common Fibular: foot dorsiflexion and toe extension.

Question 33

Demonstrate understanding of the concept of myotomes

Answer 33

Question 34

Recognise and describe normal heart sounds

Answer 34

Check CVS cards

Question 35

Demonstrate how to locate the jugular venous pulse (JVP) and measure its height

Answer 35

Check CVS cards

Question 36

Record an accurate 12 Lead ECG and check it is technically correct for interpretation

Please note: You will not be expected to be proficient in reading and in

Answer 36

Check CVS cards

Question 37

Describe the surface landmarks of the abdomen

Answer 37

Question 38

Name the regions of the abdomen and the structures located within each region

Answer 38

Question 39

Be able to accurately describe a lump

Answer 39

Question 40

Practice palpation techniques used in the abdominal exam

Answer 40

Check Abdo cards

Question 41

Calculate Body Mass Index (BMI) and understand its significance

Answer 41

Weight (kg) / Height ^2 (m)

Question 42

Measure waist circumference and understand its significance

Answer 42

Question 43

Measure blood glucose with a standard glucometer

Answer 43

between 4 and to 6 mmol/L before meals.
less than 8 mmol/L two hours after eating.

Question 44

Demonstrate an awareness of problems associated with diabetic feet

Answer 44

Neuropathy:
Description: Diabetes can cause peripheral neuropathy, leading to loss of sensation in the feet.
Consequence: Patients may not feel pain, heat, or cold, making them prone to injuries or infections that go unnoticed.
**Peripheral Arterial Disease (PAD):
**Description: Diabetes can lead to poor circulation, reducing blood flow to the feet.
Consequence: Reduced blood supply hampers the healing process, making wounds and infections difficult to manage.
Foot Ulcers:
Description: Neuropathy and PAD can contribute to the development of foot ulcers.
Consequence: Untreated ulcers can lead to infections and, in severe cases, amputation.

Question 45

Perform a general examination of the neck +/- thyroid gland

Answer 45

Check neck cards

Question 46

Perform an assessment of thyroid status +/- gland examination

Answer 46

Check neck cards