High Yield OSCE Flashcards
What is the best acronym to use for checking through a chest x-ray in an OSCE?
I- Identifiers (Name, date etc.)
Q- Quality (position, AP/PA, exposure, rotation)
Airway - Trachea, follow through Breathing - Lung markings Circulation - Heart, aorta Diaphragm- Costophrenic angles Everything else - Lines, NG tube,
How are spirometry results classified?
Normal
Restrictive (Low FVC, Low FEV1 but NORMAL FEV1/FVC)
Obstructive (Normal FVC, Low FEV1, and so LOW FEV1/FVC <70%)
What acronym should be used for any pain history?
SOCRATES
Site, Onset, Character, Radiation, Associated syx, Time course, Exacerbating or reliving factors, Severity
When asked for a management plan, how should you present your answers?
AROCM’S
ABCDE
Referral (do I need a senior or another speciality?)
Observations (what do I need to monitor?)
Conservative (lifestyle, bedside)
Medical
Surgical
When presenting back a patient you have examined in an OSCE, what format should be used?
SCIBAR
S- Summerise key findings
C- Complete (to complete I would…)
—– I - Investigations (split into the below)
—– B- Bedside (what can I do here and now?)
—– A - Aetiology (Hx for causes, bloods, imaging etc.)
R- Referral (does this patient need a senior or another speciality)
Where is a chest drain ideally inserted?
5th ICS
Mid-axiliary line
In what order should an ECG be read?
Identifiers Check rate Check rhythm Check axis (I and avF leaving each other = Laxis, reaching towards each other is Raxis) P waves PR interval QRS complex ST Segment T and U waves
When thinking about investigations in an OSCE what acronym should be used?
Investigations (HOBBIDS):
- History and examinations
- Observations
- Bedside
- Bloods
- Imaging
- Differentials (rule out others)
- Special tests
What symptoms should be asked about in GI histories with regard to red flags?
A- Anaemia L- Loss of weight A- Anorexia R- Recent onset/ progressive M- Melena/ haematemesis S- Swallowing difficulty
What acronym is used for an OBGYN history?
BADD (Acute) MOSCIS (General) B- Bleeding (Post-coital, IMB, PMB) A- Abdominal pain D- Discharge D- Dysparenuinia
M- Menstrual Hx O- Obstetric hx S- Smears and vaccinations C- Contraception I- Infections (STI's) S- Sexual history
What is the acronym used for depression symptoms?
SAG CLASS BAP S- Sad (mood) A- Apathy (loss of enjoyment) G- Guilt C- Concentration L- Loss of appetite A- Agitation or reduced movements S- Sleep S- Suicide
BAP - Bipolar, alcohol/drugs, psychosis
What acronym is used for signs of PD?
TRAP
- Tremour
- Rigidity
- Akinesia (Bradykinesia)
- Postural instability
What acronym should be used for cerebellar signs?
DANISH D- Dysdiadochokinesia A- Ataxia N- Nystagmush I- Intension tremour S- Slurred speech H- Hypotonia
What acronym should be used for GI histories?
PRAWN SHY P- Pain R- Reflux or dysphagia A- Appetite and weight loss W- Waterworks N- Nausea and vomiting S- Stools (diarrhoea/ constipation) H- Hot (fever)` Y- Yellow (jaundice)
What acronym should be used in a cardiovascular history?
STOPPER Short of breath Temperature (fever) Oedema Pain Palpitations Exercise tolerance Risk factors
What acronym is used for red flags in back pain?
TUNA FISH Trauma Unexplained weight loss Nocturnal or neuro symtpoms Age <18 or >50 (new onset)
Fevers
Immunosupression
Steroids
Hx of cancer
What are the key features of a LOC hx?
Before (Triggers, prodromal symptoms)
During (Incontinence, tongue biting, movements)
After (recovery time)
What are the life threatening causes of chest pain?
PET MAC PE Esophageal rupture Tension pneumothorax MI Aortic dissection Cardiac tamponade
What symptoms should be asked about in a urological history?
HI PUFF H- Haematuria I- Incontinence P- Pain (dysuria) U- Urgency F- Frequency F- Fevers
What is the acronym for red flags in a headache history?
GP STENT G- GCS (reduced) P- Postural (worse lying and coughing) S- Sudden onset T- Trauma E- Eye pain N- Neck stiffness T- Temperature
What acronym should be used to remember dermatology histories?
P DIBS Pain Discharge Itching Bleeding Systemic (fevers, arthralgia, weight loss)
What symptoms should be asked about in a respiratory history?
SUCH WHIP T SOB Cough (and sputum) Unexplained weight loss Haemoptysis
Wheeze
Hot (temprature)
Intrenchable night sweats
Pain chest
T- Travel history
What acronym describes the features of an eye examination?
AFROE Acuity Fields Reflexes Opathalmoscopy Eye movements
What acronym is used to remember indications for dialysis?
IOU A+E I- Intoxication (toxins) O- Overload of fluid U- Uremia A- Acidosis E- Electrolytes (hyperkalaemia)
What are the key things to check on fundoscopy?
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)
What surgical sieve should be used when asked for causes of a presentation?
VITAMIN Vascular Infective/ inflammatory Trauma Autoimmune Metabolic Iatrogenic/ idopathic Neoplasia
What is the most important aspect of a data interpretation station?
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
What are the components of an MSE? (8)
- 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)
What are the key components of a psych history?
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
What are the components of a systems review? (10)
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?
When doing a dermatological exam, how do you describe a lesion?
SCAM Site, size, shape Colour Associated (redness, peeling) Margins
General history structure?
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
How do you manage safeguarding scenario’s?
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
What are the key features of SBAR handover?
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
What is the general structure of an explanation station?
Quick history and spikes ICE What is it, what causes Consequences Management - Conservative (including lifestyle, charities, MDT) - Medical - Surgical Follow up + safety-net
Name 7 components of an opthalmology history?
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
Components of a medication review? (6)
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?
What areas must be covered when explaining a procedure?
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?
Name 6 bedside tests which could be considered when going through HOBBIS?
--- PAUSE G--- Peak flow ABG Urine dip/ preg test Sputum/ swabs/ cultures ECG Glucose (BM)
How should you approach a discharge station? (6 key steps)
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)
Components of alcohol history?
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
