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OSCE > Examinations > Flashcards

Examinations Flashcards

1
Q

What is the general structure of an examination of a lump or ulcer?

A

Look
Feel
Move
Specific tests - transillumination/auscultation
Regional lymph nodes

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2
Q

What would you do to complete a respiratory examination?

A

Sputum sample, peak flow, sats, CXR

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3
Q

What would you do to complete a cardiovascular examination?

A

Femoral pulses, ophthalmoscopy, 12 lead ECG, lying and standing BP, sats

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4
Q

Which tuning fork do you use for vibration?

A

128Hz

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5
Q

What do you do in the coordination section of the upper limb neuro exam?

A

pronator drift, finger to nose test, finger to own nose with eyes closed, thumb to fingers, dysdiadokinesis, identify coin in hand

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6
Q

What do you do in the coordination section of the lower limb neuro examination?

A

Heel-shin test, gait, rhomberg’s test (eyes open, arms out in front, then eyes closed), ankle clonus

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7
Q

What would you do to complete an upper and lower limb neuro examination?

A

Pain and temperature sensation, nerve conduction studies if indicated, MRI brain/spine, vascular exam of the area

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8
Q

What tuning fork is used for hearing?

A

512Hz

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9
Q

What would would you do to complete a cranial nerve examination?

A

Jaw-jerk reflex, gag reflex, corneal reflex, colour vision, ophthalmoscopy, upper and lower limb neuro exam, cerebellar exam, pain and temperature sensation

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10
Q

What are the components of a cerebellar exam?

A

Speech (british constitution), finger to nose test, H test for nystagmus, dysdiadokinesia, ataxia, stance, heel to toe test, rhombergs

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11
Q

What is murphy’s sign?

A

Gallbladder inflammation - press on right costal margin during expiration - patient inspires and it is painful. Repeat on left side and there should be no pain

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12
Q

What are cullens and grey turners signs?

A

Cullens = bruising around the umbilicus, grey turners - bruising around the flanks

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13
Q

What would you do to complete an abdominal examination?

A

Inguinal lymph nodes, stool sample, hernial orifices, rectal examination, urinalysis, genitalia

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14
Q

What do you do in a GALS exam?

A
  • screening questions
  • inspection
  • gait
  • spine (lumbar spine flexion, neck lateral flexion)
  • shoulders (hands behind head)
  • wrist and hands (MCPs, fist, grip strength, finger to thumb)
  • legs (knee flexion, internal and external rotation of the hip, patella tap)
  • feet (squeeze MTPs)
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15
Q

How would you complete a gals examination?

A

Do a full examination of any areas that were highlighted as abnormal on the screening test. Do a neurological examination of that area and imaging if required

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16
Q

What is Thomas’s test?

A

Assessment of a fixed flexion deformity of the contralateral hip. Put hand under spine while lifting leg

17
Q

What is Trendelenburg’s test?

A

Ask patient to stand on one leg and feel the hips and look for hip drop

18
Q

What would you do to complete a hip/knee examination?

A

Neurological and vascular examination of the lower limb, appropriate imaging, msk exam of adjacent joints

19
Q

What is McMurray’s test?

A

A test for a torn meniscus, straighten leg in external and internal rotation

20
Q

What do you do in a spine examination?

A
  • Look, feel spine
  • cervical spine - up, down, left right, ear to shoulder
  • thoracic - left and right rotation
  • lumbar - flexion, extension, lateral flexion
  • schober’s test (10cm above PSIS and 5cm below)
  • percuss spine
  • gait
  • straight leg raise, bowstring test, femoral stretch test
21
Q

How would you complete a spine examination?

A

Neurological examination of the upper and lower limbs, msk exam of adjacent joints

22
Q

Which muscles abduct the arm?

A

first 15 - supraspinatus
15-90 - deltoid
90 + - serratus anterior and trapezius

23
Q

What muscle does the lift-of test test for?

A

subscapularis

24
Q

How would you complete a shoulder examination?

A

Msk exam of elbow and spine, neurological and vascular exam of the upper limb

25
Q

What do you have to do in a hand examination?

A

-Look, feel hands and elbow, temp, muscles, joints
- sensation - dermatomes and nerves
- vascular - allen’s test, both pulses
- move - fingers, thumb wrist (active then passive)
- function - grip strength, pinch grip, precision

26
Q

What median nerve special tests do you do?

A
  • median nerve sensation
  • thumb abduction - power
  • tinels - tap
  • phalens - upside down prayer - 1 min
  • compression test
27
Q

What ulnar nerve special tests do you do?

A
  • ulnar nerve sensation
  • cross middle and index finger
  • pick up paper
  • abduct fingers against resistance
28
Q

What radial nerve special tests do you do?

A
  • sensation in anatomical snuffbox
  • wrist and finger dorsiflexion against resistance
29
Q

How do you do a peripheral vascular examination?

A
  • hands (radial, ulnar pulses, allen’s test)
  • face: carotid pulses (listen then feel), eyes, lips, tongue
  • examine abdomen and limbs
  • palpate: aorta, femoral, popliteal, dorsalis pedis and posterior tibial pulses
  • fine touch and cap refill in toes
  • power in foot
  • auscultate: carotids, subclavian, aorta, femoral arteries
  • buerger’s test 2 mins
30
Q

What is a buerger’s test?

A

Patient lying down, elevate legs to 45 degrees, hold for 2 mins, patient then hangs legs over the bed, look for colour changes

31
Q

How would you complete a peripheral vascular examination?

A

Blood pressure in upper and lower limbs, sats, doppler, ankle-brachial pressure index (highest BP at ankle, divided by highest BP in arms)

32
Q

How do you do a varicose vein examination?

A
  • inspect legs standing and lying
  • identify sapherofemoral junction (4cm lateral and inferior to public tubercle)
  • cough test with finger over SFJ
  • tap on SFJ
33
Q

How would you complete a varicose vein examination?

A

Tourniquet test, perthes test, dopper US of leg, vascular and neuro exam of lower limb

34
Q

What do you do in a thyroid examination?

A

Hands, tremor, pulses, forearm muscles
face - eyes from all angles, H test, visual acuity
inspect neck from front - water and tongue
palpate - trachea, thyroid, tongue, water
lymph nodes
percuss upper sternum
auscultate for bruits
proximal muscle weakness
ankle reflexes and oedema

35
Q

How would you complete a thyroid examination?

A

Thyroid panel bloods, fundoscopy, CXR - thymoma

36
Q

What do you do in a diabetic foot examination?

A
  • gait, SHOES, feet and legs
  • palpate bones and joints of the foot and ankle
  • temperature
  • pulses - knee, 2 feet
  • capillary refill
  • ankle reflex
  • light touch, pressure, vibration and proprioception
37
Q

How would you complete a diabetic foot examination?

A

pin prick and temp sensation, femoral pulses, neurological and vascular examination of the lower limb

38
Q

How do you structure the presentation of findings?

A

Today I performed a … exam on … a … year old M/F, on general inspection they looked comfortable at rest. There was nothing around the bedside to indicate … pathology.

OSCE (4 decks)

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