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MCHB full > High Yield OSCE > Flashcards

High Yield OSCE Flashcards

1
Q

What is the best acronym to use for checking through a chest x-ray in an OSCE?

A

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,
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2
Q

How are spirometry results classified?

A

Normal

Restrictive (Low FVC, Low FEV1 but NORMAL FEV1/FVC)

Obstructive (Normal FVC, Low FEV1, and so LOW FEV1/FVC <70%)

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3
Q

What acronym should be used for any pain history?

A

SOCRATES

Site, Onset, Character, Radiation, Associated syx, Time course, Exacerbating or reliving factors, Severity

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4
Q

When asked for a management plan, how should you present your answers?

A

AROCM’S

ABCDE
Referral (do I need a senior or another speciality?)
Observations (what do I need to monitor?)
Conservative (lifestyle, bedside)
Medical
Surgical

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5
Q

When presenting back a patient you have examined in an OSCE, what format should be used?

A

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)

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6
Q

Where is a chest drain ideally inserted?

A

5th ICS

Mid-axiliary line

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7
Q

In what order should an ECG be read?

A 
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
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8
Q

When thinking about investigations in an OSCE what acronym should be used?

A

Investigations (HOBBIDS):

  • History and examinations
  • Observations
  • Bedside
  • Bloods
  • Imaging
  • Differentials (rule out others)
  • Special tests
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9
Q

What symptoms should be asked about in GI histories with regard to red flags?

A 
A- Anaemia
L- Loss of weight
A- Anorexia
R- Recent onset/ progressive
M- Melena/ haematemesis 
S- Swallowing difficulty
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10
Q

What acronym is used for an OBGYN history?

A 
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
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11
Q

What is the acronym used for depression symptoms?

A 
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

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12
Q

What acronym is used for signs of PD?

A

TRAP

  • Tremour
  • Rigidity
  • Akinesia (Bradykinesia)
  • Postural instability
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13
Q

What acronym should be used for cerebellar signs?

A 
DANISH
D- Dysdiadochokinesia 
A- Ataxia
N- Nystagmush
I- Intension tremour
S- Slurred speech
H- Hypotonia
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14
Q

What acronym should be used for GI histories?

A 
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)
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15
Q

What acronym should be used in a cardiovascular history?

A 
STOPPER 
Short of breath
Temperature (fever)
Oedema
Pain
Palpitations
Exercise tolerance 
Risk factors
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16
Q

What acronym is used for red flags in back pain?

A 
TUNA FISH
Trauma
Unexplained weight loss
Nocturnal or neuro symtpoms
Age <18 or >50 (new onset)

Fevers
Immunosupression
Steroids
Hx of cancer

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17
Q

What are the key features of a LOC hx?

A

Before (Triggers, prodromal symptoms)
During (Incontinence, tongue biting, movements)
After (recovery time)

18
Q

What are the life threatening causes of chest pain?

A 
PET MAC
PE
Esophageal rupture 
Tension pneumothorax
MI
Aortic dissection
Cardiac tamponade
19
Q

What symptoms should be asked about in a urological history?

A 
HI PUFF
H- Haematuria
I- Incontinence 
P- Pain (dysuria)
U- Urgency
F- Frequency
F- Fevers
20
Q

What is the acronym for red flags in a headache history?

A 
GP STENT
G- GCS (reduced)
P- Postural (worse lying and coughing)
S- Sudden onset
T- Trauma
E- Eye pain 
N- Neck stiffness
T- Temperature
21
Q

What acronym should be used to remember dermatology histories?

A 
P DIBS
Pain
Discharge
Itching
Bleeding
Systemic (fevers, arthralgia, weight loss)
22
Q

What symptoms should be asked about in a respiratory history?

A 
SUCH WHIP T
SOB
Cough (and sputum)
Unexplained weight loss
Haemoptysis

Wheeze
Hot (temprature)
Intrenchable night sweats
Pain chest

T- Travel history

23
Q

What acronym describes the features of an eye examination?

A 
AFROE
Acuity 
Fields
Reflexes 
Opathalmoscopy 
Eye movements
24
Q

What acronym is used to remember indications for dialysis?

A 
IOU A+E
I- Intoxication (toxins)
O- Overload of fluid
U- Uremia 
A- Acidosis 
E- Electrolytes (hyperkalaemia)
25
Q

What are the key things to check on fundoscopy?

A

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)
26
Q

What surgical sieve should be used when asked for causes of a presentation?

A 
VITAMIN
Vascular
Infective/ inflammatory 
Trauma
Autoimmune
Metabolic
Iatrogenic/ idopathic 
Neoplasia
27
Q

What is the most important aspect of a data interpretation station?

A

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

28
Q

What are the components of an MSE? (8)

A
  • 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)
29
Q

What are the key components of a psych history?

A

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
30
Q

What are the components of a systems review? (10)

A 
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?

31
Q

When doing a dermatological exam, how do you describe a lesion?

A 
SCAM
Site, size, shape
Colour
Associated (redness, peeling)
Margins
32
Q

General history structure?

A 
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
33
Q

How do you manage safeguarding scenario’s?

A

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

34
Q

What are the key features of SBAR handover?

A

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

35
Q

What is the general structure of an explanation station?

A 
Quick history and spikes
ICE
What is it, what causes
Consequences 
Management
- Conservative (including lifestyle, charities, MDT)
- Medical 
- Surgical
Follow up + safety-net
36
Q

Name 7 components of an opthalmology history?

A 
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
37
Q

Components of a medication review? (6)

A

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?

38
Q

What areas must be covered when explaining a procedure?

A 
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?
39
Q

Name 6 bedside tests which could be considered when going through HOBBIS?

A 
--- PAUSE G---
Peak flow
ABG
Urine dip/ preg test
Sputum/ swabs/ cultures 
ECG
Glucose (BM)
40
Q

How should you approach a discharge station? (6 key steps)

A

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)

41
Q

Components of alcohol history?

A

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

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