Pemeriksaan Thorax - Video OSCE | HMKU FK Unud

Summary

In this video script, a doctor conducts a thorough examination of a patient presenting with chest pain and shortness of breath. The doctor takes the patient's medical history, including family history of asthma, and performs a physical assessment that includes inspection, palpation, percussion, and auscultation of the thorax. The findings suggest a potential asthma diagnosis, confirmed by wheezing sounds during auscultation and a history of asthma in the patient's father. The doctor prescribes medication, advises lifestyle changes such as avoiding smoking and alcohol, and encourages regular exercise to maintain good health.

Takeaways

• 😀 The doctor introduces themselves and begins a consultation with the patient, who is experiencing chest pain and difficulty breathing.
• 😀 The patient shares that they have been feeling chest pain for three days and have difficulty breathing, with a family history of asthma.
• 😀 The doctor asks about the patient's smoking and alcohol consumption habits, confirming that the patient does not have a history of smoking or drinking alcohol.
• 😀 The doctor plans to perform a thoracic physical examination to assess potential issues in the chest area and clarify the diagnosis.
• 😀 The doctor explains the procedure for the examination, including the need for the patient to remove clothing to facilitate the assessment of the thorax.
• 😀 The examination involves four key steps: inspection, palpation, percussion, and auscultation to assess the patient's chest and lungs.
• 😀 The doctor conducts the inspection, looking for any abnormalities such as bruises, scars, or changes in the chest walls, and observes the patient's breathing pattern.
• 😀 During palpation, the doctor checks for any tenderness, abnormal vibrations, or air pockets in the chest by applying pressure at different points on the thorax.
• 😀 The doctor also performs percussion to listen for abnormal sounds in the chest, noting a hyperresonant sound in the patient's lungs.
• 😀 Auscultation follows, where the doctor uses a stethoscope to listen for any abnormal lung sounds, detecting wheezing, which is a key sign of asthma.
• 😀 After completing the examination, the doctor diagnoses the patient with asthma, likely triggered by family history and symptoms, and prescribes medication accordingly.
• 😀 The doctor advises the patient to stay active, avoid smoking and alcohol, and follow up with the clinic if symptoms worsen or if there are new concerns.

Q & A

What symptoms did the patient report during the consultation?

The patient reported chest pain for three days and difficulty breathing, feeling like their breath was heavy.

What is the significance of asking about the patient's family medical history?

The doctor asked about the family medical history to identify any genetic or hereditary conditions that could be relevant to the patient's symptoms. It was revealed that the patient's father had asthma, which could indicate a familial predisposition to respiratory issues.

What medical condition did the doctor suspect based on the examination?

The doctor suspected asthma based on the physical examination, family history, and the patient’s symptoms, including wheezing sounds during auscultation.

What physical examination techniques were used during the consultation?

The doctor used inspection, palpation, percussion, and auscultation during the thoracic physical examination. These techniques were employed to assess the patient's chest and respiratory system.

What findings did the doctor observe during the inspection of the thorax?

During the inspection, the doctor observed that the patient's chest walls were symmetrical and there were no visible abnormalities such as bruises, scars, or enlarged veins.

Why was palpation performed during the examination, and what was the result?

Palpation was performed to check for any abnormal sensations such as tenderness, crepitus, or unusual movement in the chest. The result showed no significant abnormalities in the thoracic region.

How did the doctor assess the patient’s breathing during the examination?

The doctor assessed the patient's breathing by observing the frequency and movement of the chest during inhalation and exhalation. The patient’s breathing rate was 16 breaths per minute, which was considered normal.

What did the doctor find during percussion of the chest?

During percussion, the doctor found a hyperresonant sound, which could suggest an underlying respiratory issue such as asthma or hyperinflation of the lungs.

What was the significance of the wheezing sound heard during auscultation?

The wheezing sound heard during auscultation is indicative of airway constriction, a common symptom in asthma. This further supported the doctor’s suspicion that the patient might be experiencing an asthma attack or exacerbation.

What advice did the doctor give to the patient after the examination?

The doctor prescribed medication for asthma and advised the patient to maintain a healthy lifestyle by exercising, avoiding smoking and alcohol, and seeking medical attention if symptoms worsened.