my project report

1. Effectiveness of an OSCE
and diagnostic strategies to
assess and diagnose a
clinical case.
TOM LEWIS
HUMAN BIOLOGY
B77024270

2. Introduction
 The main aims of the investigation were to carry out a clinical assessment
of two separate patients, using clinical skills to assess an individual’s
health.
 This assessment was used to trigger a clinical investigation using
biochemical and analytical methods to identify and highlight abnormalities
found upon testing patient serum and urine samples, to ultimately result in
a diagnosis.
 The main hypothesis stated that 'the one to one clinical assessment of a
patients, is the best way to obtain a correct diagnosis of an illness.'

3. OSCE
 Basic clinical assessment and evaluation of patient:
 Gather medical history
 Measure blood pressure
 Measure height and weight to calculate BMI
 Examine face, oral cavity, hands
 Results: Pregnant, reports of headaches with sickness and nausea, ankle
oedema and elevated blood pressure.
 Initial diagnosis: Preeclampsia

4. Material and Methods
 Dipstick Urinalysis
 BCA Protein Assay
 Serum Creatinine Assay
 Serum Urea Assay
 Haematology - Histologically Prepared Blood Smear

5. Results – BCA Protein Assay
(1:10 dilution) Patient sample
had a corrected average
absorbance of 0.187 at 570nm.
Using the y=mx+c equation,
produced from linear line,
protein concentration in the
patient sample was determined:
Y=0.0002x + 0.021
X=(y-c)/m
= (0.187-0.021)/0.0002
=830 (x 10 d.f.)
=8300 ug/ml
Figure 1. In a standard reaction, 10l of each BSA standard concentration
was mixed with 200l BCA working reagent and left to incubate at room
temperature for 30 minutes. The absorbance was measured at 570nm
against a blank which contained 10l water mixed with 570nm of BCA
working reagent.

6. Results – Urea & Creatinine Assays

7. Results – Blood Smear
Normal Blood Smear 10
x
Patient Blood Smear 10x
Figure 2. More morphological
alterations of erythrocytes are visible in
patient blood smear (right) than
healthy blood smear (left) as red blood
cells appear irregular and damaged.

8. Conclusions
 I believe the aims of this investigation have been met as I can confidently
produce a diagnosis, using my results, to be early on-set deteriorating PET
characterised by the increased hypertension and increasing proteinuria.
 In terms of my main hypothesis, one to one clinical assessment of a
patients, is the best and effective way to obtain a correct diagnosis of an
illness.