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OSCE > Extras > Flashcards

Extras Flashcards

1
Q

What are the Korotkoff sounds?

A

Sounds heard over brachial artery as pressure released from cuff
1-tapping=systolic as bp>cuff pressure so turbulent flow
2-murmurs between sys and Dias
3-loud, crisp tapping sound
4-within 10mmHg above diastolic=thumping and muting
5-silent=cuff pressure=diastolic

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2
Q

Which out of PT, APTT, bleeding time and platelets is affected by warfarin?

A

Increase in PT

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3
Q

Which out of PT, APTT, bleeding time and platelets is affected by DIC?

A

Increase in PT, APTT and bleeding time, reduction in platelets

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4
Q

Which out of PT, APTT, bleeding time and platelets is affected by haemophilia?

A

Increase in APTT

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5
Q

Which out of PT, APTT, bleeding time and platelets is affected by aspirin?

A

Increased bleeding time

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6
Q

Which out of PT, APTT, bleeding time and platelets is affected by thrombocytopenia?

A

Increase in bleeding time, decrease in platelets

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7
Q

Which out of PT, APTT, bleeding time and platelets is affected by early liver failure?

A

Increase in PT

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8
Q

Which out of PT, APTT, bleeding time and platelets is affected by late liver failure?

A

Increase in PT, APTT and bleeding time

Decrease in platelets

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9
Q

If INR>1.0, what does this mean in terms of clotting?

A

Less clotting/longer to clot

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10
Q

What is the auscultatory gap?

A

Period of abnormal silence during the Korotkoff phases (normally second)
Pulse can be palates during this period so this helps prevent underestimation of BP

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11
Q

What is a tympanitic percussion sound and when would it be heard?

A

Drum-like over abdominal air

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12
Q

What is a resonant percussion sound and when would it be heard?

A

Normal chest sound from the air

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13
Q

What is a hyper-resonant percussion sound and when would it be heard?

A

Higher pitch in pneumothorax or COPD

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14
Q

What is a dull percussion sound and when would it be heard?

A

Lower pitch due to solid mass or liquid (organ, ascites or cancer or pneumonia)

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15
Q

What is a stony dull percussion sound and when would it be heard?

A

Pleural effusion

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16
Q

What is a thrill?

A

Palpable murmur

17
Q

What is a heave?

A

Feel your hand move and is a sign of left ventricular hypertrophy

18
Q

What is rombergs sign used for?

A

To distinguish between sensory and cerebellum ataxia. Sensory ataxia is a proprioception deficit so visual correction is lost when eyes are closed and person becomes more unsteady (+ve rombergs)

19
Q

Which modalities does dorsal column carry?

A

Fine touch, vibration, proprioception

20
Q

What modalities does spinothalamic tract carry?

A

Pain, temperature, crude touch, pressure

21
Q

A unilateral lesion between the midbrain and the medulla will cause what pattern of sensation loss?

A

All sensations contralaterally as both dorsal columns and spinothalamic have deccusated

22
Q

A hemi-section of the spinal cord will cause what pattern of sensory loss?

A

Spinothalamic already deccusated so pain/temp/crude touch/pressure lost contralaterally
Dorsal columns not yet deccusated so proprioception/fine touch/vibration lost ipsilaterally
This is brown-sequard syndrome

23
Q

A lesion in a peripheral nerve will cause what pattern of sensation loss?

A

Loss of all sensations to that dermatome

24
Q

Why does an UMN lesion cause hyperreflexia?

A

UMN has inhibitory effect on reflex so without this the reflex is more pronounced

25
Q

A negative Rinnes on the left ear means what?

A

Conductive hearing loss in left ear

26
Q

A negative webers means?

A

Either conductive hearing loss on ipsilateral side to where they hear it loudest or sensorineural loss contralaterally to where they hear it loudest

27
Q

Give some causes of conductive hearing loss

A

Ear wax, perforated eardrum, otitis externa, foreign body, otitis media, otosclerosis

28
Q

Give some causes of sensorineural hearing loss

A

Meningitis, gentamicin/furosemide, cochlear damaged by skull base fracture, neuroma

29
Q

List some plasma protein bound drugs

A 
Warfarin
Phenytoin
Gliclazide (Sulphonylureas)
Aspirin (NSAIDs)
Methotrexate
Amlodipine (Dihydropyridine)
Sodium valproate

OSCE (2 decks)

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