OSCE- PREFINALS
Case report:-
Q.What is the best method to perform hba1c test with highest sensitivity?
The optimal cut-off for diagnosing diabetes in previously undiagnosed adults with HbA1c was estimated as 6.03% with pooled sensitivity of 73.9% and specificity of 87.2%. The optimal cut-off for Fasting Plasma Glucose was estimated as 104 milligram/dL with a sensitivity of 82.3% and specificity of 89.4%.
At present recommended threshold of 6.5%, HbA1c is more specific and less sensitive in diagnosing the newly detected diabetes in undiagnosed population from community settings.
Q.What is insensible fluid loss? How does it effect of syncope.
Insensible fluid loss is the amount of body fluid lost daily that is not easily measured, from the respiratory system, skin, and water in the excreted stool. The exact amount is unmeasurable but is estimated to be between 40 to 800mL/day in the average adult without comorbidities. A total loss of approximately 600 to 800mL/day characterizes 30 to 50% of all water loss, contingent on the level of water consumed. Thus insensible water loss is a significant component of water balance and needs to be routinely monitored.
Clues to hypovolemia include hydration of mucous membranes, skin turgor, resting heart rate, and intensity of peripheral pulses. Additionally, blood pressure particularly orthostatic changes and urinary output, are also important indicators of fluid status gleaned from a physical examination.
LEARNING POINTS:-
1.What is syncope and it's common causes.
2.clinical conditions which have centripetal obesity and muscle wasting.
3.What is insensible fluid loss and it's significant role in syncope.
4.best method to estimate hbA1c levels with highest sensitivity.
5.pedal edema and it's causes.
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