PEBC OSCE flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Triage red flags

Chest pain, sudden weakness, facial droop, difficulty speaking, severe breathlessness at rest, BP >180 with symptoms, or glucose <4 mmol/L with altered consciousness require immediate emergency referral.

Pediatric weight estimation

For children 1-12 years, estimated weight (kg) = (age in years × 2) + 8. Use measured weight when available and never exceed the adult dose.

Minor ailment exclusions

Refer patients with symptoms >10 days, fever >38.5°C in adults, any fever in infants <3 months, pregnancy, immunosuppression, recent hospitalization, blood in stool/urine, or unilateral leg swelling.

Pain assessment scales

Use numeric rating scale (0-10) for adults, Wong-Baker FACES for children 3-8 years, and FLACC for infants or non-verbal patients. Reassess 30-60 minutes after analgesic.

Prescription legal requirements

A valid prescription must include patient name, drug name, strength, dosage form, quantity, directions, date, and prescriber name, signature, and identifier. Verify all before dispensing.

Cockcroft-Gault CrCl formula

CrCl (mL/min) = [(140 − age) × weight (kg)] / [0.814 × SCr (µmol/L)], multiplied by 0.85 for females. Use to adjust renally cleared drugs.

Generic vs therapeutic substitution

Generic substitution replaces a brand with an equivalent generic under provincial formulary rules. Therapeutic substitution changes to a different drug and requires prescriber authorization.

Controlled drug verification

Confirm prescriber authority, check the provincial monitoring program for double-doctoring, verify quantity and directions, and follow tamper-resistant prescription requirements for controlled drugs.

Prime-check-close counselling

Open by asking what the patient already knows, provide key information (indication, administration, side effects, when to seek help), confirm understanding via teach-back, and close with a follow-up plan.

MDI inhaler technique

Shake, exhale, seal lips, press and inhale slowly, hold breath 10 seconds, wait 30-60 seconds between puffs, and rinse mouth after inhaled corticosteroids.

Warfarin counselling points

Maintain consistent vitamin K intake, avoid alcohol binges, report bleeding or bruising, use a soft toothbrush, inform all providers, and attend INR monitoring. Watch for interactions with amiodarone, antibiotics, and NSAIDs.

Hypoglycemia treatment

Take 15 g fast-acting carbohydrate (e.g., 15 g glucose, 125 mL juice), recheck blood glucose in 15 minutes, and repeat if still low. Follow with a snack if next meal is >1 hour away.

Teach-back method

Ask the patient to explain in their own words how they will take the medication and what to do if a dose is missed. This confirms comprehension rather than mere recall.

Drug therapy problem categories

Unnecessary drug, needs additional drug, ineffective drug, dose too high, dose too low, adverse drug reaction, and non-adherence. Identify and resolve each during medication review.

Follow-up scheduling intervals

Acute conditions: 3-7 days. New medication: 1-2 weeks. Chronic stable conditions: every 3-6 months. High-risk drugs (warfarin, insulin, opioids): within 1 week or per monitoring plan.

Best possible medication history

Obtain from at least two sources (patient interview, pharmacy records, prescriber records), compare with current orders, resolve discrepancies, and communicate to the next provider at transitions.

Deprescribing principles

Identify drugs with no ongoing indication, high harm risk, or misalignment with goals of care. Taper rather than stop abruptly for benzodiazepines, PPIs, opioids, and corticosteroids.

SBAR communication

Situation, Background, Assessment, Recommendation. Use for urgent prescriber calls and handoffs. Keep concise and include patient identifiers.

Intervention documentation

Record date, time, prescriber contacted, reason, recommendation, outcome, and follow-up plan in the patient record. Include patient identifiers and your signature.

Cultural safety

Recognize personal biases, use interpreters when needed, respect patient beliefs and preferences, and involve family as the patient wishes. Provides care that is respectful of cultural identity.

Informed consent elements

Patient must be competent, informed of risks, benefits, and alternatives, and consent voluntarily. Minors: age of consent varies by province; mature minor doctrine may apply.

Confidentiality laws

Protect personal health information under provincial privacy laws (e.g., PHIPA in Ontario) and PIPEDA federally. Disclose only with consent or as required by law.

Record retention period

Retain prescription and patient records for the period required by the provincial regulatory college, often 10 years from the last entry, and longer for minors.

Error disclosure

Disclose medication errors to the patient and prescriber promptly, apologize, document the event, and implement prevention strategies. Follow mandatory reporting requirements.

Dose calculation formula

Dose = (desired dose / stock strength) × stock volume. For weight-based dosing: dose (mg) = dose (mg/kg) × weight (kg). Convert units before calculating.

C1V1 = C2V2 dilution

Use to calculate dilution volumes. Example: to make 500 mL of 1% solution from 10% stock, V1 = (1% × 500 mL) / 10% = 50 mL stock plus 450 mL diluent.

Alligation method

Ratio of parts = (higher % − desired %) : (desired % − lower %). Used to mix two concentrations to achieve a target strength.

Mosteller BSA formula

BSA (m²) = √[(height (cm) × weight (kg)) / 3600]. Used for chemotherapy and some pediatric dosing when BSA-based dosing is required.

IV flow rate formula

Drops/min = (volume (mL) × drop factor (gtt/mL)) / time (min). Infusion rate (mL/h) = volume (mL) / time (h). Verify drop factor on tubing package.

Percentage concentration conversions

% w/v = g/100 mL; % w/w = g/100 g; % v/v = mL/100 mL. 1:1000 = 0.1%; 1:10,000 = 0.01%. Convert ratios to percentages before calculating.

Documentation standards

Record date, time, patient identifiers, reason for encounter, assessment, intervention, outcome, follow-up, and signature. Use objective, factual language and avoid judgmental terms.

Adverse drug reaction reporting

Document reaction, severity, date, suspected drug, and action taken. Report serious or unexpected reactions to Health Canada (Canada Vigilance) and flag the patient profile.