CVS Systems OSCE

Question 1

Preparation:

Answer 1

Introduce
Informed Consent
Wash Hands
Position

Question 2

General Inspection

Answer 2

breathing comfortably?
LOC?
Pain?
Colour?
Amputation
Items of note

Question 3

Hands

Answer 3

Clubbing
Palmar creases (anaemia)
splinter haemorrhages
peripheral cyanosis
tar staining
cap refill

Question 4

Radial pulse

Answer 4

Rate, rhythm character volume
radial-radial - delay
rad-fem delay if indicated
Ulnar pulse
collapsing pulse (raise radial)
Allens test (occlude both, clench and open hand, release ulnar)

Question 5

Arms

Answer 5

Brachial pulse
BP
Xanthomata (hypercholestraemia)

Question 6

Face

Answer 6

Anaemia
Corneal arcus
Xanthalesma 
Central cyanosis
Mitral facies (cyanosed face, rosy cheeks)
dental hygiene

Question 7

Neck

Answer 7

JVP (+hepatojugular reflux)

Palpate carotid pulses

Question 8

Chest (Inspect)

Answer 8

Scars
Pacemakers
Visible pulseation

Question 9

Chest (palpation)

Answer 9

Apex Beat
Heaves (pulse)
Thrills (vibe)

Question 10

Chest (Auscultation)

Answer 10

Listen for murmurs
Apex/Mitral (5 IS, L MCL)
Tricuspid (4 ICS, L sternal edge)
Pulmonary Valve (2 ICS, L Sternal Edge)
Aortic Valve (2ICS, R sternal edge)
Axilla
Carotid pulse (bruits)

Lung bases - pulmonary oedema

Question 11

Abdomen

Answer 11

Palpate Aorta
Auscultate Aorta
Ausultate Iliac and renal arteries (either side of Aorta)
Palpate femoral pulses
Auscultate femoral pulses