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OSCE > General examination > Flashcards

General examination Flashcards

1
Q

How long should the middle steps in handwashing take?

A

At least 15 seconds

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2
Q

What does poverty of expression suggest`?

A

Parkinonism

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3
Q

What does a startled expression suggest>

A

Hyperthyrodisim

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4
Q

What does apathy with poverty of expression and poor eye contact suggest?

A

Hypothyroidism

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5
Q

What does agitated expression suggest?

A

Anxiety, hyperthyroidism, hypomania

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6
Q

What can a warm temperature be due to`?

A

Vasodialtion from elevated arterial CO2 levels

Hyperthyroidism

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7
Q

What can cold hands suggest?

A

Vasoconstriction

Can occur in HF

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8
Q

What are different things that can be seen on nails?

A 
Beau's lines
Clubbing 
Leuconychia
Lindsays nails
Kolonychia
Muehrcke's lines
Nail fold telangictasia
Onychomycosis
Pitting
Onchylosis
Splinter haemorrhage
Yellow nail
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9
Q

What does beau’s lines look like and a differential diagnosis?

A

Transerse grooves

Severe illnesss that affects growth of the nail matrix

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10
Q

What does clubbing look like and a differential diagnosis?

A

Loss of angle between nail fold and nail plate

Serious cardiac, respiratory or GI disease

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11
Q

What does leuconychia look like and a differential diagnosis?

A

White spots, ridges or complete discoloration of nail

Duet o trauma, infection, poisoning chemo and vit deficiency

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12
Q

What does Lindsay nails look like and a differential diagnosis?

A

White/btown half and half nails

CKD

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13
Q

What does koilonychoia look like and a differential diagnosis?

A

Spoon shaped depression of nail plate

Iron deficiency anaemia, lichen planus, repeated exposure to detergents

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14
Q

What does Muehrcke’s lines look like and a differential diagnosis?

A

Narrow, white transverse lines

Decreasedd protein synthesos or protein loss

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15
Q

What does nail fold telangiectasia look like and a differential diagnosis?

A

Dilated capillaries and erythema t nail fold

Connective tissue disorder, including systemic sclerosis, systemic lupus erythmatous, dermatoymotisis

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16
Q

What does ONYCHOLYSIs look like and a differential diagnosis?

A

Nail seperate from nail bed

Psoriasis, fungal infection traumam, thyrotoxicosis, tetracyclines

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17
Q

What does onchomyocis look like and a differential diagnosis?

A

Thickened of nail plate with white, yellow or brown discolouration
Fungal infection

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18
Q

What does pitting look like and a differential diagnosis?

A

Fine or coarse pits in nail

Psoriasis, eczema, alopecia areta, lichen planus

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19
Q

What does splinter haemorrhage look like and a differential diagnosis?

A

Small red streaks the lie longintudinally in nail plate

Trauma, IE

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20
Q

What does yellow nails look like and a differential diagnosis?

A

Yellow discoloration ad thickened

Yellow nail syndrome

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21
Q

What are some causes of clubbing?

A

Thoracic- Lung cancer, chronic suppurative conditions” Pulmonary TB, bronchiectasis, lung abscess, empyema and CF, mesothelioma, fibroma, PF
Cardiovascular: Cyanotic congenital heath disease, IE, arteriovenous shunts and aneurys,
GI: Cirrhosis, IBD, Coelcac
Others” Thyrotoxicosis, primary hypertrophic osteoarthropathy

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22
Q

Google the examination for clubbing

A

Ok smelly

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23
Q

When is clubbing likely?

A

If the interphalangeal depth ratio is more than 1
If the nail fold angle is more than 190 degrees
If the Schamroth’s window sign is absent

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24
Q

When does depigmentation occur?

A

Vitiligo

25
Q

What can cause hyperpigmentation?

A

Excess of ACTH

26
Q

What is haemochromatosis

A

Inherited condition of excesive iron absorption results in skin hyperpigmentation due to iron deposits and increased melanin prooduction

27
Q

What is haemosiderin?

A

Product of haemoglobin breakdwon is deposted in the skin of the lower legs following subcutaneous extravastion of blood due to venous insufficiency

28
Q

What can easy brusing be due to?

A

Reflection of skin and connective tissue fragility due to advancing age or glucocorticoid usage

29
Q

What is hypercarotenemia?

A

Occurs due to excessive ingestion of cerotene containing vegetables or in situations of impaired metabolism such as hypothyroidism or anaorexia nervosa
Yellowish discoloration of face, palms and soles bur not sclera

30
Q

What can skin discolouration be due to?

A

Abnormal pigments such as the sallow yellow brownish tinge in CKD
Bluish tinge is due to abnormal haemoglobns such as sulphaemoglibin or methaemoglobin or by drugs such as dapspne

31
Q

What drugs cause abnormla skin colouration and what colour?

A

Mepacrine (yellow)
Amiodarone (bluish grey)
Phenothiazines (slate grey)

32
Q

When is jaundice normally detectable?

A

Above 50 micro mol/l

33
Q

What is pallor?

A

Pallor can result from anaemia in which there is a reduction in circulating oxy haemoglobin in the dermal and subconjunctival capillaries or from vasoconstriction due to cold exposure or sympathetic activation

34
Q

What causes facial flushing?

A 
Fever
Exercise
Heat exposure
Emotional
Mneopause
Androgen deficiency
Carcinoid syndrome
Medullary thyroid cancer
Serotonin syndrome
Food/alcohol ingestion
Neurological
Rosacea
Mastocytoses
35
Q

What BMI is underweight in non asian and asian

A

Under 18.15

36
Q

What BMI is normal in non asian and asian

A
  1. 5-24.9

18. 5-22.9

37
Q

What BMI is overweight in non asian and asian

A

25-29.2

23-24.9

38
Q

What BMI is obese t in non asian and asian

A

30-39.9

25-29.9

39
Q

What BMI is mrobidly obese in non asian and asian

A

More than 40

more than 30

40
Q

What are some causes of oedema?

A

Venous
Lymphatic
Inflammatory
Allergic

41
Q

What are features to note in any lump or swelling?

A 
Size
Position
Attachments- Fixed or mobile
Consistency- Soft to stony hard
Edge- Delineated or ill defined, regular or irregular, sharp or rounded
Surface and shape
Pulsation, thrills and bruits
Infalmmation- Redness, tenderness warmth
Transillumination- Pen torcch. Cystic swelling will light up
42
Q

What can cause a bruit?

A

If blood flow through a lump is increased, a systolic murmur may be heard
With sufficient flow a thrill may be palpable

43
Q

What is the examination sequence?

A

Inspect the lump, noting any change in the colour or texture of the overlying skin
Define the sit and shape of lump
Measure its size and record the findings diagrammatically
Gently palpate for tenderness of change in skin temperature
Feel the lump on one side, see and feel if a bulge occurs on the opposite side. Confirm the flucttion in two planes. Fluctation usually indicates that the lump contains fluid, although some soft lipomas can feel fluctuant
Auscultate for vascular brutis
Transilluminate

44
Q

What size are normal nodes?

A

Less than 0.5cm in diamater

45
Q

What do normal nodes feel like?

A

Soft

46
Q

What do abnormal nodes fee; like?

A

Hodgkins lymphoma is rubbery
TB may be matted
Metastiatic cancer they feel hard

47
Q

What are the facial features of hypothyrodism

A

Sparese, coarse hair and eyebrows, periorbital puffiness, dry, waxy skin, apathetic expression, macroglossia

48
Q

What are the facial features of graves disease

A

Staring appearance due to lid retraction, proptosis, evidence of weight loss

49
Q

What are the facial features of hypopituitarism

A

Pale, often unwrinckled skin with loss of hair

50
Q

What are the facial features of acromegalu

A

Thickened, coarse skin with enlarged nose and frontal bones, prognathism, widely spcaed teeth, macroglossia

51
Q

What are the facial features of cushings syndrome

A

Moon shaped plethroci facries

52
Q

What are the facial features of osteogenesis imperfecta

A

Blue sclera

53
Q

What are the facial features of herediatry haemorrhagic telangiectasia

A

Telangiectasia on and around lips

54
Q

What are the facial features of systemic sclerosis

A

Tight skin constricting mouth, beaking of nose, loss of nasolabial folds

55
Q

What are the facial features of myotonic dystrophy

A

Frontal balding, paucity of expression, bilateral ptsosis

56
Q

What are the facial features of down;’s sdynreome

A

Flat facial profile, upslanting palpebral fissures, snall, low set ears, macroglossia, brushfield spots in iris

57
Q

What are the facial features of SLE

A

Butterfly erythematosu rash on cheeks

58
Q

What does turner’s syndrome look lije?

A

Due to loss of X
Delyaed puberty in girls
Short stature, webbing of neck, small chin, low set ears, low hairline, short fourth finger, increased carrying angle at the elbows and widely spaced nipples

OSCE (45 decks)

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