Muse

OSCE Station 6

Patient scenario:
This is a 23 year old female with pre-OSCE stress disorder. Take a look at her sleep diary and suggest possible diagnosis and management.

0258 - Flops onto lumpy bed. Feet tapping on faces stuck on the headboard of my bed.
0315 - Sitting up on my bedside, reciting, "Hi, my name is Lee Hui Mei. What can I do for you today?"
0336 - I hate hate hate hate hate panic attack insomnia
0430 - Checks time. Change back my message tone and nap a bit I think.
0501 - My morning friend has came out with a solution. If you cant sleep, get someone to sleep to sleep with you. Such ingenious solution. I almost took up that offer.
0830 - I kicked myself up cause I started sweating in the 16 degrees aircond room.
0940 - Stuff myself with 2 packets of Indomee to raise my glycaemic index. Even tried Valsava Manouevre to clear my head. But the paradox? Im not tachycardic, ultimately in the calmest of demeanour, and I still can fb and watch Fringe. No, it is not normal.
1430 - I opened the door and saw Dr Paul. Its a CVS station and I just lost my heart. Literally. *Aish* Sorry Dr Paul but I think I just made you shake your head again.
1520 - My single malt is done for.

Differential Diagnosis
- Panic attack
- Imsomnia
- Intense adrenaline secretion

Management Plan
- Get someone to accompany you to sleep
- Knock your had on the 'X' on the wall,
- Steal hospital supplies and sedate yourself

And no Dr Paul, I dont want to see you in a month time and sorry Dr Hari for the headache I caused you. Candy?

Pluck this out somewhere. And I knew I hit bullseye when I said its either Psychiatry or Emergency Medicine. Kean Guan confirm Surgery. And I think Yee is diving into Dermatology while Sher is sinking into Paeds. Darray proly end up in Patho and Lim in Anaesthesia. He proly accompany patient to bed even, *grins* Figuratively and literally speaking that is. So yeah.. I think my time's up. Ta