Cardiac Exam- OSCE

Question 1

Answer 1

Anterio-lateral Thoracotomy Scar

Open Chest Massage
Emergancy Access to pericardium

Question 2

Answer 2

Clubbing

4 stages clubbing

• Increases ballotability “boggy” nail bed
• Obliteration of nail bed angle
• Convex nail fold
• Drumsticking

Causes

Any disease featuring chronic hypoxia

Congenital cyanotic heart disease (most common cardiac cause)

Subacute bacterial endocarditis

Atrial myxoma (benign tumor)

Tetralogy of Fallot

Question 3

Answer 3

Corneal Arcus

Deposits of cholesterol and lipids

• Age
• Hypercholesterolaemia

Question 4

Answer 4

Peripheral Cyanosis

• raynauds
• hypotension
• peripheral vascular disease
• heart failure

Question 5

Answer 5

Dental Carries

periodontal atherosclerosis

infective endocarditis

Question 6

Answer 6

High arched palate

Marfan’s

Ehlers Danlos

other syndromes -

• mitral valve prolapse
• aortic aneurysm

Question 7

Answer 7

Janeway Lesion

non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms

Infective endocarditis

Question 8

Answer 8

Malar Flush

Mitral Stenosis

Question 9

Answer 9

Osler’s Nodes

Osler nodes are red-purple, slightly raised, tender lumps, often with a pale centre. Pain often precedes the development of the visible lesionby up to 24 hours. They are typically found on the fingers

Infective Endocarditis

Question 10

Answer 10

Permanent pacemaker

Question 11

Answer 11

Subconjuctival Pallor

Anaemia

Question 12

Answer 12

Pallor of palmar creases

anaemia

Question 13

Answer 13

Pectus Excavatum

Marfans
Auscultation of the chest can reveal displaced heart beat and valve prolapse. There can be a heart murmur occurring during systole caused by proximity between the sternum and the pulmonary artery.

Question 14

Answer 14

Splinter Haemorrhages

Dark red/brown vertical lines seen at the top of the nail. They are small emboli lodged in the nail capillaries damaging vessel walls and causing localised haemorrhage.

Causes include trauma, bacterial endocarditis, scleroderma, and other autoimmune conditions. Vasculitis hyercholesterolaemia

Question 15

Answer 15

Sternotomy Scar

Open heart surgery

• Transplant
• Valve replacement
• congenital defect correction
• CABG

Question 16

Answer 16

Tendon Xanthoma

Hypercholesterolaemia

Question 17

Answer 17

Xanthalasma

macrophages that have taken up fat cells or cholesterol and have become transformed into foam cells

hypercholesterolaemia