Cardio OSCE

Question 1

Femoral pulse

Answer 1

Inferior to the midpoint of the inguinal ligament

Question 2

Popliteal pulse

Answer 2

In political fossa (immediately posterior to the knee joint)

Question 3

Posterior tibial

Answer 3

Between the posterior border of the malleolus and the achilles tendon

Question 4

Dorsalis pedis

Answer 4

Lateral to the tendon of extensor hallucis longus on the dorsum of the foot

Question 5

Burger’s test

Answer 5

Pallor elevation, reactive hyperaemia on dependency is a positive result. Indicates significant PAD

Question 6

Thrills

Answer 6

tsk-tsk-tsk= palpable murmur

Question 7

Heave

Answer 7

sustained left parasternal suggests right ventricular hypertrophy or left atrial enlargement, apex heave suggests left ventricular hypertrophy -aortic stenosis, systemic hypertension and hypertrophic cardiomyopathy.

Question 8

Apex

Answer 8

5th intercostal space, mid clavicular (L)

Question 9

Tricuspid area

Answer 9

4th intercostal space, L

Question 10

Aortic area

Answer 10

2 intercostal space, R

Question 11

Pulmonary area

Answer 11

2nd intercostal space, L

Question 12

Clubbing

Answer 12

seen in 10% of patients with subacute infective endocarditis, seen in congenital cyanotic heart disease (Fallot’s tetralogy)

Question 13

Koilonychia

Answer 13

Fe deficiency, haemochromatosis, endocrine disorders (acromegaly, hypothyroidism)

Question 14

Splinter haemorrhage

Answer 14

Infective endocarditis

Question 15

Corneal arcus

Answer 15

hyperlipidaemia. This is a creamy yellow discolouration at the border of the iris and cornea caused by precipitation of cholesterol crystals

Question 16

Xanthelasma

Answer 16

hyperlipidaemia, yellowish cholesterol plaques around the eyelids and periorbital area

Question 17

Malar flush

Answer 17

low CO, mitral stenosis

Question 18

Peripheral cyanosis

Answer 18

when peripheral vasoconstriction and stasis of blood in the extremities leads to increase peripheral oxygen extration e.g. in congestive heart failure, circulatory shock, Reynaud’s (abnormalities of the peripheral circulation)

Question 19

Cap refill

Answer 19

5s, should return in 2s

Question 20

Lean forward

Answer 20

Aortic regurgitation

Question 21

Roll over

Answer 21

Mitral stenosis