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Mod 4 OSCE > Mod 4 OSCE > Flashcards

Mod 4 OSCE Flashcards

1
Q

Order of ECG interpretation

A
  1. This is a 12 lead ECG of (Name, DOB, Hospital No.)
  2. Taken on ___
  3. Speed is 25mm/sec, ECG is calibrated
  4. Axis Deviation
  5. Rate
  6. Rhythm strip - Regularity, P-waves (followed by QRS? Shape?), QRS, T waves, PR intervals, QT
  7. Rest of the leads - same? R-wave progression? Poor due to prev MI or obesity. Flutter waves?
  8. Summarise and suggest diagnosis
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2
Q

In normal cardiac axis

A
  • Lead I is normal
  • Lead II is normal (maybe taller than I)
  • Lead III is neutral
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3
Q

P wave too tall

A

RA abnormality

(congenital heart disease, pulmonary disease)

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4
Q

How long should a PR interval be?

A

3 - 5 small squares

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5
Q

QT interval is?

A

Time taken for ventricles to depolarise then repolarise

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6
Q

QRS too wide?

A

Supraventricular - BBB, Brugada, pre-excitation

Ventricular - Ectopic, pacemaker

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7
Q

ST segment elevation

A

STEMI, Pericarditis

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8
Q

T wave represents

A

Ventricular repolarisation

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9
Q

In which leads would you see changes for lateral heart damage?

A
  • I
  • AVL
  • V5
  • V6
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10
Q

How wide should a QRS complex be?

A

< 3 small squares

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11
Q

In right axis deviation

A
  • Lead I is small, neutral, negative
  • Lead II is normal
  • Lead III is normal, maybe taller than II
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12
Q

PR interval too long?

A

1st or 2nd degree heart block

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13
Q

P wave too broad?

A
  • Valve disease, HTN, Cardiomyopathy, Coronary Heart Disease
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14
Q

QRS too tall?

A

Ventricular hypertrophy

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15
Q

In left axis deviation

A
  • Lead I is positive, small
  • Lead II is negative
  • Lead III is negative, taller than II
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16
Q

T wave - too tall?

A

Hyperkalaemia

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17
Q

The anterior surface of the heart is supplied by the?

A

Right Coronary Artery (RCA)

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18
Q

Which leads would you see changes in for septal damage?

A
  • V1
  • V2
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19
Q

Q wave?

A

Previous MI

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20
Q

What should you screen for after RAV and ICE?

A
  1. SOB
  2. Chest pain
  3. Palpitations
  4. Syncope/dizziness
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21
Q

The inferior heart is supplied by?

A

Right coronary artery

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22
Q

ABPI ranges?

A
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23
Q

What view is this?

A

Axial

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24
Q

Questions in Hx of collapse?

A

3 PS:

  1. Prodromal symptoms (how did you feel before collapse? Dizziness/blurred vission/nausea)
  2. Post Event Phenomena (how quickly did you recover? Confusion/Nausea?)
  3. Precipitant - where were you, what were you doing?
25
Q

PR interval

A

Time for conduction through atria and purkinjie fibres (via AVN and Bundle of His)

26
Q

Questions for ACS patient after open questions?

A

Full SOCRATES

27
Q

Questions for post stroke/TIA patient

A
  1. Weakness
  2. Sensation
  3. Visual changes
  4. Speech changes?
  5. Facial Droop?
  6. Onset/duration and frequency?
28
Q

Specific questions for PMHx?

A

Risk factors:

  • HTN
  • DM
  • High cholesterol
  • Heart attack
  • Stroke/TIA
29
Q

History for suspected PVD?

A
  1. Maximum walking distance? Uphill + on flat
  2. Screen for 6Ps (pain, pallor, paraesthesia, paralysis..)
  3. Any ulcers? Gangrene? Rest pain? –> Critical Limb Ischaemia
30
Q

How do you calculate the Rate on ECG?

A
  • 300 ÷ no. of large squares from R-R
  • If irregular, count the no. of QRS complexes x 6
31
Q

haemorrhage shows up on CT as?

A

Bright white areas - hyperattenuation

32
Q

QRS = ?

A

Ventricular depolarisation

(atrial repolarisation occurs now but is masked)

33
Q

Putting on ECGs - Procedure?

A
  • Intro - name, DOB, Hospital no,
  • Explain procedure
  • Ever had done before? Allergies?
  • Expose patient
  • Attach stickies - Ride Your Green Bike (rt hand, clockwise etc)
  • “Lie completely still for me please”
  • Check on screen, capture, print
34
Q

What does this show?

A

intracerebral haemorrhage

35
Q

Ishaemia shows up as

A

dark areas - hypoattenuation

36
Q

What does this show?

A

Loss of Insular ribbon

37
Q

Questions for AF? (5 things)

A
  1. Palpitations? Tap it out
  2. When do they occur?
  3. Any trigger?
  4. How often do they occur?
  5. How long do they last?
38
Q

Which leads would you see changes in if damage had happened to the anterior heart?

A
  • V3
  • V4
39
Q

Questions for FHx

A
  • Any death due to MI <65?
  • Any sudden/unexpected/unexplained death?
40
Q

Septum of the heart is supplied by the?

A

Left Anterior Descending artery (LAD)

41
Q

What does this show?

A

Midline shift

42
Q

What view is this?

A

Coronal

43
Q

What does this show?

A

hyperdense MCA sign

44
Q

ST segment represents?

A

Time between depolarisation and repolarisation of ventricles (start of repolarisation)

45
Q

What does this show?

A

extradural haemorrhage (biconvex)

46
Q

P wave

A

Atrial depolarisation

47
Q

ST segment depression?

A

Angina, NSTEMI

48
Q

T wave - QT interval too short/too long ***

A

Ventricular arrhythmia

49
Q

T wave - inverted?

A

Ischaemia, ventricular hypertrophy, BBB

50
Q

What does this show?

A

subarachnoid haemorrhage

51
Q

Small square = ?

Big square = ?

A

Small square = 0.04s

Big square = 0.2s

52
Q

Which leads would you see changes in if there was damage to the inferior heart?

A
  • II
  • III
  • AVF
53
Q

PR interval too short?

A

Accessory pathway e.g. WPW

54
Q

P wave absent?

A

AF, Flutter, AVRT, AVNRT

55
Q

How do you present a radiology image?

A
  1. Patient details - Name, DOB, Hospital No
  2. Date Taken
  3. Method of Imaging and view
  4. Most obvious abnormality with correct description (attenuation for CT, signal for MRI)
  5. Any other abnormalities, possible negative findings
  6. Differentials
  7. Working Diagnosis
56
Q

The lateral heart is supplied by the?

A

Circumflex Artery

57
Q

What does this show?

A

subdural haemorrhage (crescent shape)

58
Q

What view is thiss?

A

Saggital

59
Q
A

Mod 4 OSCE (2 decks)

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