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CMS OSCE Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what sections of the trigeminal nerve can be tested?

A

corneal
facial
motor
jaw jerk

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2
Q

how to test the corneal aspect of the trigeminal nerve?

A

look up/away
tough wool on each side of cornea
look for blink

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3
Q

how to test the facial aspect of trigeminal nerve?

A

sharp object at forehead/cheek/jaw
repeat with a dull instrument
if anything is abnormal try with temperature or light touch

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4
Q

how to test the facial nerve?

A

look for droop and asymmetry
wrinkle face - feel strength by pushing down
shut eyes tight - bilateral?
grin - check nasolabial grooves

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5
Q

how to test glossopharyngeal and vagus nerves?

A 
if voice is hoarse or nasal
swallow/cough
palate - ulvuar displacement
when pt says ah - symmetrical soft palate
is gag reflex normal
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6
Q

how to test the hypoglossal nerve?

A

articulation of speech

tongue wasting

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7
Q

what is parkinsons disease?

A

degeneration of dopaminergic neurones in the basal ganglia

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8
Q

what are some signs of parkinsons?

A

bradykinesia = mask like face and festination
rigidity
resting tremor
shuffling gait and falls

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9
Q

what are some signs of a previous stroke?

A

intention tremor
hemiplegia
spasticity - because muscle stiffness

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10
Q

what is cerebellar ataxia?

A

loss of co ordination
cerebellar gait
intention tremor

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11
Q

what is intention tremor?

A

low frequency oscillation

increased amplitude of tremor as near end point of voluntary visually guided movement

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12
Q

what is resting tremor?

A

not associated with voluntary movement
pin rolling action of hand
seen in parkinsons

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13
Q

what is essential tremor?

A

voluntary contraction of muscles and no association with any neurological disorder

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14
Q

what is bradykinesea?

A

increased tone of basal ganglia = slowness of action

tremor

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15
Q

what is ABCDE?

A 
airway
breathing
circulation
disability
exposure
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16
Q

what is A?

A

look listen feel
high flow oxygen 15litres/min
suction and airway adjuncts

17
Q

what is B?

A 
resp rate look listen feel
inspection of chest efficacy/effort/cyanosis
palpation - rise/fall
listen - wheeze
sats 
high flow o2
18
Q

what is C?

A

assess - pulses/blood pressure/peripheries colour/temp/CRT

shock - signs of shock, control any bleeding, elevate legs, keep warm

19
Q

what is D?

A

disability
asses CNS
AVPU
BM level

20
Q

what is E?

A

expose and undress - rashes/clinical signs

temp control measures

21
Q

signs of anaphylaxis?

A 
collapse
angioedema
flushing/pallor
resp distress
hypotension
tachycardia
itching
22
Q

treatment of anaphylaxis?

A

ABCDE
999
15litres/min O2
500mg adrenaline IM - 5 min intervals

23
Q

child adrenaline doses?

A

12 = 500mg

24
Q

what are symptoms of severe asthma?

A

cant complete sentences
resp >25
pulse>110
peak flow = 33-50% expected best

25
Q

what are the symptoms of life threatening asthma?

A

silent chest, feeble resp effort, cyanosis, exhaustion, hypotension
pulse

26
Q

how to treat asthma?

A

ABCDE
sit up
2 puffs salbutamol 100mg per puff
additional doses through spacer if not responding

27
Q

signs of an MI?

A

severe, crushing central chest pain, pallor and sweating, nausea and vomiting, breathless, weak pulse, low bp

28
Q

how to treat cardiac emergency?

A

ABCDE
999
GTN 1-2 sprays
300mg oral aspirin

29
Q

phases of a seizure?

A

sudden collapse and loss of consciousness
tonic phase - 30 secs. rigidity and cyanosis
clonic phase - few mins - jerking movements
post ictal confusion

30
Q

how to treat an epileptic seizure?

A 
ABCDE
prevent injury
oxygen 15l/min
check bp/glucose
recovery position when comes around
buccal midazolam 10mg
31
Q

signs of hypoglycaemia?

A 
shaking sweat palpitations
headache
speech slurring
confusion
convulsions and unconscious
32
Q

treatment of hypoglycaemia?

A 
ABCDE
oxygen
10-20 g glucose drink
3 x glucose tablets
1mg IM glucagon
33
Q

what to ask an asthmatic pt in a medical history?

A

is it well controlled?

frequency of attacks?

CMS (42 decks)

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