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OSCE > HLB > Flashcards

HLB Flashcards

1
Q

When doing a respiratory examination, what is indicated by a finding of: Cold peripheries

A

Hypovolemia

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2
Q

When doing a respiratory examination, what is indicated by a finding of: Clubbing

A

Fibrosis
Lung Cancer
Bronchiectasis/ CF

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3
Q

When doing a respiratory examination, what is indicated by a finding of: Cap refil >2secons

A

Hypovolemia or hypoxia

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4
Q

When doing a respiratory examination, what is indicated by a finding of: Fine tremour

A

Salbuatmol use

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5
Q

When doing a respiratory examination, what is indicated by a finding of:Flapping tremour

A

CO2 retention

COPD- T2 resp failure

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6
Q

When doing a respiratory examination, what is indicated by a finding of:Raised JVP

A

R heart failure secondary to pulmonary hypertension

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7
Q

When doing a respiratory examination, what is indicated by a finding of: Drooped eyelid, contricted pupil, sunken eyes

A

Horner’s syndrome

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8
Q

When doing a respiratory examination, what is indicated by a finding of: Dullness to percussion

A

Consolidation, fluid, tumor or collapse

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9
Q

When doing a respiratory examination, what is indicated by a finding of: Stony dull to percussion

A

Pleural effusion

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10
Q

When doing a cardiovascular examination, what is indicated by a finding of: Jayneway lesions

A

Endocarditis

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11
Q

When doing a cardiovascular examination, what is indicated by a finding of: Oslers nodes

A

Endocarditis

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12
Q

When doing a cardiovascular examination, what is indicated by a finding of: Splinter haemorrhages

A

Endocarditis

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13
Q

When doing a cardiovascular examination, what is indicated by a finding of: Clubbing

A

Endocarditis, cyanotic congenital heart disease (i.e. tetrology of fallot or patent ductus arteriorsus)

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14
Q

When doing a cardiovascular examination, what is indicated by a finding of: Raised JVP

A

Right heart failure

Fluid overload

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15
Q

When doing a cardiovascular examination, what is indicated by a finding of: Malar flush

A

Mitral stenosis

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16
Q

When doing a cardiovascular examination, what is indicated by a finding of: Corneal arcus

A

Hypercholesterolaemia

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17
Q

When doing a cardiovascular examination, what is indicated by a finding of: Xanthelasma

A

Hypercholesterolaemia

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18
Q

When doing a cardiovascular examination, what is indicated by a finding of: Angular stomatitis

A

IDA

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19
Q

When doing a cardiovascular examination, what is indicated by a finding of: Poor oral hygiene

A

Can be a route of spread for infective endocarditis

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20
Q

When doing a cardiovascular examination, what is indicated by a finding of: Sternotomy scar

A

Previous CABG or valve surgery

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21
Q

When doing a cardiovascular examination, what is indicated by a finding of: Ejection systolic murmur

A

Aortic stenosis

louder on expiration

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22
Q

When doing a cardiovascular examination, what is indicated by a finding of: Pan systolic mumur

A

Mitral regurgitation

Louder with expiration and roll onto left

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23
Q

When doing a cardiovascular examination, what is indicated by a finding of: Early diastolic murmur

A

Aortic Regurgitation

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24
Q

When doing a cardiovascular examination, what is indicated by a finding of: Mid-late diastolic murmur

A

Mitral stenosis

Rumbling, low pitched

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25
Q

Where would an ejection systolic murmur radiate to?

A

Carotid arteries

26
Q

Where would a mid-late diastlic murmur radiate to?

A

The axilla

27
Q

How would you accentuate a murmur if you suspected aortic stenosis?

A

Hold expiration

28
Q

How would you accentuate a murmur if you suspected mitral stenosis?

A

Ask Px to roll onto L hand side

Hold expiration

29
Q

How would you accentuate a murmur if you suspected Aortic Regurgitation?

A

Ask Px to lean forward

Hold expiration

30
Q

How would you accentuate a murmur if you suspected Mitral Regurgitation?

A

Ask Px to roll onto L hand side

Hold expiration

31
Q

How would you accentuate a murmur if you suspected it was left sided?

A

Hold expiration

32
Q

How would you accentuate a murmur if you suspected it was right sided?

A

Hold inspiration

33
Q

Name 6 things you could check when examining for Aortic Stenosis?

A 
Ejection systolic mumur
Made louder by expiration
Radiates to caroitds
Slow rising pulse
Narrow pulse pressure
Powerful apex beat
34
Q

Name 4 things you could check for when examining for mitral regurgitation?

A 
Pansystolic murmur
Radiates to axilla
Louder when on left side + expiration 
Apex beat displaced to the left
AF possible with mitral problems
35
Q

Name 6 things you could check for when examining for aortic regurgitation?

A 
Early diastolic murmur 
Louder when leaning forward + expiration
Radiates to carotids 
Wide pulse pressure
Collapsing pulse
Capillary nail bed pulsation (Quinke's sign)
36
Q

Name 4 things you could check for when examining for mitral stenosis?

A

Rumbling mid-late diastolic murmur
Radiates to axilla
Louder on left lean + epxiration
Malar flush

37
Q

When starting a patient on a statin, what monitoring must be done?

A

Cholesterol and LFT’s before

Check again in 1-3 months and again at 12 months

38
Q

How should a patient be advised to take a statin (including lifestyle changes due to medication)?

A

OD at night

Avoid grapefruit and cranberry juice

39
Q

What must a patient being counselled for a statin be cautioned on if they develop a chest infection?

A

Statins interact with macrolides (clarithromycin)

40
Q

What are the common SE of statins?

A

Headache, tummy pain, diarrhoea

41
Q

What is the rare but serious complication of statins?

A

Stain induced myopathy > rhabdomyolysis

Any muscle pain/ weakness/ cramps go and see GP (do CK)

42
Q

What are the names of the two waves you see in a JVP?

A

A wave and V wave

43
Q

JVP is a way of assessing pressure in which part of the heart?

A

Right atrium

44
Q

A JVP will be raised in which heart conditions?

A

R sided heart failure
CCF
Fluid overload

45
Q

A patient is on warfarin for how long if they have had a provoked DVT?

A

3 months

46
Q

A patient is on warfarin for how long if they have had an unprovoked PE?

A

6 months

47
Q

A patient is on warfarin for how long if they have had an unprovoked DVT?

A

6 months

48
Q

A patient is on warfarin for how long if they have had a provoked PE?

A

3 months

49
Q

A patient is on warfarin for how long if they have had a recurrent DVT when on warfarin already?

A

Lifelong

50
Q

A patient is on warfarin for how long if they are on it for stroke prevention due to AF?

A

Lifelong

51
Q

What advice should be given regarding warfarin and pregnancy?

A

Avoid in 1st trimester or if planning to be pregnant

52
Q

What drinks should be avoided when on warfarin?

A

Cranberry juice

53
Q

What are the most common SE’s which must be counselled for warfarin?

A

More likely to bleed!

54
Q

What are the first 6 things you should check on a CXR?

A 
Name/ DOB
Date of X-ray
Quality 
Rotation
Area covered 
PA or AP
55
Q

What is the ABCDE of a CXR interpretation?

A 
A- Airway and mediastinum
B- Breathing (lung field)
C- Circulation (heart) 
D- Diaphragm 
E- Extra
56
Q

What blood tests should be done when counselling a patient to start an ACEI?

A

Renal function before starting then 7-10 days after starting

57
Q

What absolute contraindications should be checked for a patient planning to start an ACEI or an ARB?

A

Hx Angioedema
Pregnancy
Renal artery stenosis
Moderate aortic stenosis

58
Q

What is the first line anti-hypertensive for a diabetic patient with a BP of 147/89 on ABPM?

A

ACEI

For all diabetics regardless of age

59
Q

If the patient is afro-caribbean what medication should be started after amlodipine to control BP?

A

ARB

Always before ACEI in afro-carribean, even if diabetic

60
Q

What is first line treatment for angina?

A

Statin, aspirin, GTN spray for as required

1st line: Beta blocker (Verapamil or diltazem if CI)

61
Q

Name the key area’s to check in a hydration status examination?

A

IV fluids, temprature, pulse (volume), BP (sitting and standing), sunken eyes, dry mouth, JVP, carotid volume, cap refil on sternum, skin turgor, ausculate lung bases, ascites, peripheral oedema

62
Q

How would you state the completion of examination for hydration status exam?

A

History + obs chart
Check U+E’s
Check fluid balance chart

OSCE (6 decks)

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