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Medicine 2 > OSCE > Flashcards

OSCE Flashcards

1
Q

What position should a patient be in for cardio exam?

A

45 degree angle

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2
Q

What do you check fingers for in cardio exam?

A

Peripheral cyanosis

Clubbing - ask to put fingers together

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3
Q

What would you check the mouth for in cardio exam?

A

Pallor

Central cyanosis

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4
Q

What do you check eyes for in cardio exam?

A

Conjunctival pallor

Lipid deposits

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5
Q

What does raise JVP in cardio exam indicate?

A

Right-sided heart failure

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6
Q

What do you look for on chest of patient during cardio exam?

A

Pacemaker
Scars
Check in axillary region too

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7
Q

How do you feel for an apex beat during cardio exam?

A

Start infero-lateral and move up and medically
Place hand where you would expect to find it
Use fingers of other hand to check it is in 5th intercostal space

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8
Q

How do you feel for right ventricular heave?

A

Place one hand in centre of chest

Heal of hand would be pushed up if positive

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9
Q

How do you feel for thrills during cardio exam?

A

At each valve location
Place hand horizontally
Start infero-lateral and move up
Mitral, tricuspid, pulmonary aortic

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10
Q

How do you auscultate the 4 valve sounds?

A

Place diaphragm of stethoscope at mitral valve location
Feel carotid pulse in neck at same time
This is to determine first heart sound
Work way up

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11
Q

How do you auscultate for carotid bruits?

A

Use diaphragm of stethoscope on each side of neck

Ask patient to take and hold deep breath in

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12
Q

What do you look for in hands for abdominal exam?

A 
Clubbing
Palmar erythema (caused primarily by pregnancy or secondary by liver cirrhosis)
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13
Q

What do you check the mouth for in abdominal exam?

A

Pallor

Ulcers

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14
Q

What do you check the eyes for in abdominal exam?

A

Lipid deposits

Anaemia

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15
Q

What are 5 things you check the abdomen for in abdominal exam?

A 
Scars
Hernias
Cachexia
Brushing
Abdominal distension
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16
Q

How do you approach patient for abdominal exam?

A

Kneel down to patients level

Cover lower half with a sheet

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17
Q

How do you do liver palpation?

A

Ask to take deep breath in
Use finger-tip palpation
Start in RLQ

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18
Q

How do you percuss liver?

A

Start in RLQ

Should be by edge of costal margin

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19
Q

How do you do spleen palpation?

A

Support left loin with left hand
Start in RLQ
Ask to take deep breaths in
Use finger-tip palpation

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20
Q

How do you do kidney palpation?

A

1 hand in renal angle
1 hand underneath parallel to recurs sheath
Ask to take deep breaths in
Lower border may be palpable upon deep inspiration

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21
Q

How do you do descending colon palpation?

A

Finger-tip palpation

To LLQ

22
Q

How do you do aortic palpation?

A

Both hands on opposite sides of umbilicus

Pulsation, not expansive movements

23
Q

How do you auscultate for bowel sounds?

A

Listen for 15 seconds
Normal sounds every 5-10
High-pitched gurgling

24
Q

What do you check hands for in respiratory examination?

A

Peripheral cyanosis

Clubbing

25
Q

What do you check mouth for in respiratory exam?

A

Central cyanosis

Pallor

26
Q

What do you check eyes for in respiratory exam?

A

Conjunctiva pallor for anaemia

27
Q

What do you check chest for in respiratory exam?

A

Scars from thoracotomy
Bruising
Pain

28
Q

What do you do when feeling the trachea in respiratory exam?

A

Warn it’s uncomfortable

Check it’s central

29
Q

How do you check chest expansion in respiratory exam?

A

Place both hands on chest on costal margin

Check they rise equally

30
Q

What do you have to remember to state once you have finished the respiratory exam?

A

That you would repeat it on the back

31
Q

What do you check the bottle for in urine dipstick test?

A

BBE

Time to wait for results once dipped

32
Q

What are the causes of glucose in urine?

A

Diabetes

Kidney damage

33
Q

What are the causes of blood in urine?

A

UTI

Kidney stones

34
Q

What are causes of protein in urine?

A

Dehydration’s
NSAIDs
Inflammation

35
Q

What are the causes of ketones in urine?

A

Diabetes
Starvation
ED

36
Q

What are the causes of alkaline urine?

A

Excessive vomiting

Kidney disease

37
Q

What are the causes of acidic urine?

A

Diabetic ketoacidosis

Diarrhoea

38
Q

What are the causes of leukocytes in urine?

A

UTI

Kidney stones

39
Q

What are the causes of nitrites in urine?

A

UTI

40
Q

What are the causes of positive specific gravity in urine?

A

Dehydration
Vomiting
Kidney failure

41
Q

What are causes of misleading results in urine dipstick?

A

Out of date strips
Improperly stored strips
Checked at wrong times after dipping

42
Q

What are causes of false positive blood in urine?

A

Exercise
Dehydration
Period

43
Q

What are causes of false positive leukocytes in urine?

A

Urinary retention

44
Q

What are causes of false positive protein in urine?

A

Concentrated urine from dehydration

45
Q

What are causes of false negative glucose in urine?

A

+ vitamin C

46
Q

What are causes of false negative ketones in urine?

A

Delayed examination

47
Q

What are causes of false positive nitrites in urine?

A

Contamination

Exposure to air

48
Q

What are causes of false negative specific gravity in urine?

A

Alkaline urine

49
Q

What must you state after you exam each eye?

A

Optic disc is clear
Retinal vessels are visible
Macula is clear

50
Q

What is the estimated systolic pressure?

A

Point when radial pulse disappears when cuff is inflated

Medicine 2 (29 decks)

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