High Yield OSCE Flashcards

Question

What are the key things to check on fundoscopy?

Answer 1

Red reflex + 3C's Cup (should be 1/3 of the disc) Colour Contour ``` Assess 4 main vessels Check macula (look straight into the light for me) ```

Answer 2

``` VITAMIN Vascular Infective/ inflammatory Trauma Autoimmune Metabolic Iatrogenic/ idopathic Neoplasia ```

Answer 3

Don’t just repeat the data, say what it implies! Point out any red flags, note if it’s an emergency Formulate a management plan for each aspect, justify WHY each action - Always revisit and repeat tests to monitor progress of treatment

Answer 4

- Appearance (clothes, grooming) - Behaviour (eye contact, pyschomotor activity, body language) - Speech (rate, quantity, volume) - Mood (climate, long term mood) and affect (weather, short term mood) + RISK ASSESS - Thought (form and content) - Perception (hallucinations, illusions) - Cognition (orientation, short term memory) - Insight (do they know they have a problem) and judgement (what would you do if you smelt smoke in the house)

Answer 5

TTT RRR SAS ``` Tell me more (then do specific symptoms) Timing Triggers Review previous mental health Risk assess Rule out other differentials (bipolar, psychosis, etc) Substances Affect on other areas of life (family, friends) Summary ```

Answer 6

``` Travel history if infection possible Fevers Fits or faints Eyesight or hearing Swallowing problems SOB Chest pain Tummy pain Bowels or bladder changes Limb weakness ``` How far could you walk, what stops you?

Answer 7

``` SCAM Site, size, shape Colour Associated (redness, peeling) Margins ```

Answer 8

``` I PISS HI I- Introduction and identifiers P- PC/ HPC I- ICE S- Specific differentials in/out S- Sub-history H- History completion (PMHx, DHx, FHx, SHx) I- ICE again and summary ```

Answer 9

SMACK S- Safety of patient M- Medical problems A- Ask a senior (including safeguarding lead) C- Contact social care (i.e. rapid access team) K- Keep clear notes

Answer 10

Get identifiers of who you are taking handover from Get full patient identifiers before starting ``` S = Current situation, any concerns B= Make sure you get PMHx and allergies A= Get obs , any bloods or imaging results, any nursing concerns R= What have you done? What else do they want you to do? What do you want them to do? Make sure you ask whether they have any other concerns and specifically what they need to do with the response + how soon! ``` Always summarise and repeat back

Answer 11

``` Quick history and spikes ICE What is it, what causes Consequences Management - Conservative (including lifestyle, charities, MDT) - Medical - Surgical Follow up + safety-net ```

Answer 12

``` One eye or both? Timing/ speed onset Pain Blurring of vision Photophobia Discharge Systemic (N+V, headache) Trauma POHx - Other episodes, glasses/ contacts SHx - ADL's/ driving ```

Answer 13

Identifiers ALLERGIES - Regular meds (Name/ brand, dose, frequency, time taken, route, indication, duration) - PRN meds - Anything else you get yourself, herbal medicines, creams, oinments, sprays? Any recent changes to medication?

Answer 14

``` Quick history and spikes ICE 1) Had the test before? 2) Why are we doing it? (benefits) 3) How is the test done? (before, during, after) 4) What possible complications? ```

Answer 15

``` --- PAUSE G--- Peak flow ABG Urine dip/ preg test Sputum/ swabs/ cultures ECG Glucose (BM) ```

Answer 16

1- Background to stay and what do they know so far? 2- Where are they being discharged too? 3- Support at home/ follow up? 4- ICE 5- Explain diagnosis/ tests/ new medications/ treatments 6- What follow up is in place? - MDT (district nurse/ OT's/ social work)

Answer 17

1) What drinking/ when/ where/ who with/ why? 2) CAGE 3) Dependence symptoms (Building tolerance, cravings) 4) ICE and effect on family and friends 5) Risk assess