OSCE

Question 1

Fundal height should be approximately gestational age in weeks +/- how many cm?

Answer 1

3cm

Question 2

Oedema in a pregnant lady should ring alarm bells of what?

Answer 2

Pre-eclampsia

Question 3

Too big for gestational age can suggest what?

Answer 3

Polyhydramnios, macrosomia, molar pregnancy

Question 4

Too small for gestational age can indicate what?

Answer 4

Oligohydramnios, intra-uterine growth retardation

Question 5

What is a normal foetal heart rate?

Answer 5

110-160

Question 6

Where should we listen for a foetal heart rate?

Answer 6

Over baby’s anterior shoulder

Question 7

Which way should the tape measure be when recording fundal height?

Answer 7

Face down

Question 8

The P in ITPCRS for neurological examination stands for what?

Answer 8

Power AND Pronator drift

Question 9

Which tuning fork should we use for vibration sense in neurological examination?

Answer 9

Large

Question 10

Pretibial myxoedema and exophthalmos are indicative of what?

Answer 10

Graves’ disease

Question 11

What will happen to a goitre swelling on swallowing water?

Answer 11

Ascend

Question 12

Limited external rotation of the shoulder is indicative of what?

Answer 12

Adhesive capsulitis

Question 13

Dupuytren’s thickening on hand examination are suggestive of what?

Answer 13

Alcoholic disease

Question 14

Phalen’s test involves holding the hands in what position for how long?

Answer 14

Reverse prayer sign for 60 seconds
- will stimulate carpal tunnel symptoms

Question 15

In Tinel’s test what nerve are we tapping over?

Answer 15

Median nerve

Question 16

How do we calculate rhythm from an ECG rhythm strip?

Answer 16

300 divided by how many big squares between QRS peaks

Question 17

Wide QRS complexes can be caused by what?

Answer 17

Hyperkalaemia, SVT

Question 18

Narrow QRS complexes can be caused by what?

Answer 18

Atrial flutter, atrial fibrillation

Question 19

What are the 3 first steps in treating a STEMI or NSTEMI?

Answer 19

Analgesia, 300mg aspirin, O2 if sats below 94%

Question 20

Give 3 ways we can treat hyperkalaemia

Answer 20

Salbutamol nebulisers, IV insulin, calcium resonate

Question 21

How do we treat VF?

Answer 21

CPR, de-fibrillation, epinephrine, amiodarone

Question 22

What is a normal fasted cap BG value?

Answer 22

3.9-5.5mmol/l

Question 23

Fasted cap BG of over what value indicates diabetes?

Answer 23

7.0mmol/l

Question 24

Random or 2 hour post load cap BP of what value indicates diabetes?

Answer 24

11.1mmol/l

Question 25

What should we do if a cap BG suspects diabetes?

Answer 25

Request a venous lab measurement, screen for associated problems such as hypertension and hypercholesterolaemia

Question 26

A cap BG value of below what is classed as hypoglycaemia?

Answer 26

Below 4.0mmol/l

Question 27

High cap BG in a known diabetic raises concern over what?

Answer 27

DKA

Question 28

What is the immediate management of an unconscious patient with hypoglycaemia?

Answer 28

IM glucagon

Question 29

What does a patient need to do before taking a dose of an inhaler?

Answer 29

Breathe out

Question 30

How long should patients hold their breath after taking a dose of an inhaler?

Answer 30

10 seconds

Question 31

What position does the leg take if the neck of femur is fractured?

Answer 31

Shortened and externally rotated

Question 32

Ataxic gait indicates a lesion where in the brain?

Answer 32

Cerebellum

Question 33

The Trendelenburg test tests for what?

Answer 33

Weak or paralysed hip abductors

Question 34

High stepping gait indicates what?

Answer 34

Foot drop

Question 35

Which special test(s) should be carried out in hand examination?

Answer 35

Tinel’s and Phalen’s

Question 36

Which special test(s) should be carried out in hip examination?

Answer 36

Thomas and Trendelenburg

Question 37

Which special test(s) should be carried out in knee examination?

Answer 37

Patellar tap (+/- bulge test for smaller effusions if no patellar tap) and posterior/anterior drawer test - POSTERIOR FIRST

Question 38

Which special test(s) should be carried out in ankle and foot examination?

Answer 38

Lateral squeeze for Morton’s neuroma

Question 39

Fine tremor is related to which medication?

Answer 39

Salbutamol inhalers

Question 40

Flapping tremor/aterixis is related to what?

Answer 40

Hypercapnia - consider COPD, T2RF

Question 41

Which assessment can we undertake in primary care for depression?

Answer 41

PHQ-9

Question 42

How long should we advise patients that it takes for SSRIs to start taking effect?

Answer 42

2-4 weeks

Question 43

Common side effects of SSRIs include?

Answer 43

GI upset, anxiety, suicidal ideation

Question 44

Minimum how long should antidepressants be continued for once remission has been reached?

Answer 44

6 months

Question 45

What is the typical urine output?

Answer 45

0.5ml/kg

Question 46

Nitrites in the urine is indicative of what?

Answer 46

UTI

Question 47

Bilirubin in the urine is via what type of hyperbilirubinaemia?

Answer 47

Conjugated E.g. pancreatic cancer

Question 48

DKA will show what type of urinary pH?

Answer 48

Low

Question 49

How often should thyroid function tests be taken until function has stabilised post hypothyroidism diagnosis?

Answer 49

Every 3 months

Question 50

When should levothyroxine be taken?

Answer 50

In the morning on an empty stomach, 30 minutes before eating

Question 51

Which 2 drugs can be used in hyperthyroidism?

Answer 51

Carbimazole, propylthiouracil