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Year 4 > OSCE > Flashcards

OSCE Flashcards

1
Q

Causes of a midline sternotomy scar

A
    • leg scar - CABG or valve replacement with CABG

- valve replacement

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2
Q

Causes of an elevated JVP

A
  • RHF
  • Volume overload
  • PE
  • Constrictive pericarditis
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3
Q

Causes of an elevated JVP with decreased BP

A
  • Tension pneumothorax
  • Cardiac tamponade
  • Massive PE
  • Severe asthma
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4
Q

Causes of a fixed elevated JVP

A
  • SVC obstruction
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5
Q

Causes of cannon a waves

A
  • Complete heart block
  • Ventricular ectopic beats
  • Ventricular tachycardia
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6
Q

Causes of giant V waves

A
  • Tricuspid regurgitation
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7
Q

Causes of central cyanosis

A
  • Hypoxic lung disease
  • Right-to-left cardiac shunt e.g. cyanotic congenital heart disease, Eisenmenger’s syndrome
  • Methaemoglobinaemia e.g. drugs, toxins
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8
Q

Causes of peripheral cyanosis

A
  • Peripheral vascular disease
  • Raynaud’s syndrome
  • Heart failure
  • Shock
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9
Q

Causes of an irregularly irregular pulse

A
  • AF
  • Ventricular ectopic beats
  • Complete heart block with variable ventricular escape
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10
Q

Causes of an absent radial pulse

A
  • Congenital heart disease (usually bilateral)
  • Arterial embolism
  • Atheroma
  • Previous arterial line
  • Previous coronary angiogram
  • Cervical rib
  • Coarctation of the aorta
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11
Q

6 causes of AF

A
  • Rheumatic heart disease
  • Ischaemic heart disease
  • Thyrotoxicosis
  • Pneumonia
  • PE
  • Alcohol
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12
Q

Causes of pulsus paradoxus

A
  • Cardiac tamponade
  • Constrictive pericarditis
  • Restrictive cardiomyopathy
  • Severe asthma/COPD
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13
Q

Causes of Kussmaul’s sign

A
  • Cardiac tamponade
  • Constrictive pericarditis
  • Restrictive cardiomyopathy
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14
Q

Causes of a non-palpable apex beat

A
  • Adipose tissue
  • Pneumothorax
  • Emphysema
  • Pleural or pericardial effusion
  • Displaced apex beat
  • Dextrocardia
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15
Q

Causes of a heaving apex beat

A
  • Aortic stenosis
  • Hypertension
  • Hypertrophic obstructive cardiomyopathy
  • Coarctation of the aorta
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16
Q

Causes of pericarditis

A
  • Viral (Coxsackie)
  • Bacterial/fungal infection
  • Post-MI
  • Dressler’s syndrome
  • SLE/RA/scleroderma
  • Uraemia
  • Malignancy
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17
Q

Causes of a 3rd heart sound

A
  • May be normal in <30s
  • CCF
  • MR
  • AR
  • Large anterior MI
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18
Q

Causes of a 4th heart sound

A
  • AS
  • hypertension
  • HOCM
  • post-MI fibrosis
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19
Q

Causes of cardiac failure

A
  • IHD
  • Cardiomyopathy
  • Constrictive pericarditis
  • Arrhythmia
  • Drugs (negative inotropes)
  • MR
  • AR
  • Fluid overload e.g. renal failure, IV fluids
  • VSD
  • AS
  • Hypertension
  • Anaemia
  • Pregnancy
  • Hyperthyroidism
  • Paget’s
  • Cor pulmonale
  • Primary pulmonary hypertension
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20
Q

Indications for lobectomy/pneumonectomy

A
  • Bronchogenic cancer
  • Bronchiectasis
  • Trauma
  • TB
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21
Q

Causes of interstitial lung disease/pulmonary fibrosis

A
  • Cryptogenic fibrosing alveolitis
  • Bird fancier’s lung
  • Farmer’s lung
  • ASbestosis
  • Silicosis
  • Coal miner’s pneumonoconiosis
  • Systemic disease e.g. SLE, RA, Sarcoid, systemic sclerosis
  • Drugs e.g. methotrexate, amiodarone, radiotherapy
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22
Q

Causes of Horner’s syndrome

A
  • Stroke
  • Tumour
  • MS
  • Syringobulbia
  • Spondylosis
  • Neurofibroma
  • Pancoast tumour
  • Cervical rib
  • Trauma/birth injury (Klumpke’s)
  • Carotid artery aneurysm
  • Sympathectomy
  • Cluster headache
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23
Q

Causes of fine bibasal crepitations

A
  • Pulmonary oedema

- Interstitial lung disease

24
Q

Causes of coarse bibasal crepitations

A
  • Bronchiectasis
  • CF
  • Bibasal pneumonia
25
Q

Causes of transudate pleural effusion

A
  • Left ventricular failure
  • Volume overload
  • Hypoalbuminaemia
  • Meig’s syndrome
26
Q

Causes of exudative pleural effusion

A
  • Pneumonia
  • TB
  • PE
  • RA
  • SLE
  • Malignancy
27
Q

Causes of transudative ascites

A
  • CLD
  • RHF
  • Volume overload
  • Hypoalbuminaemia
  • Constrictive pericarditis
28
Q

Causes of exudative ascites

A
  • SBP
  • TB
  • Pancreatitis
  • Malignancy
29
Q

Causes of hepatomegaly

A
  • Viral hepatitis
  • EBV
  • Malaria
  • Hepatic abscess
  • Sarcoid
  • Amyloid
  • NAFLD
  • Haemochromatosis
  • Lymphoma
  • Leukaemia
  • Myeloproliferative disease
  • Haemolytic anaemia
  • PBC
  • PSC
  • Primary HCC
  • Metastatic deposits
  • RHF
  • Tricuspid regurgitation
  • Budd-Chiari syndrome
30
Q

Causes of hepatosplenomegaly

A
  • Viral hepatitis
  • EBV
  • Malaria
  • Sarcoid
  • Amyloid
  • Lymphoma
  • Leukaemia
  • Myeloproliferative disorders
  • Haemolytic anaemia
31
Q

Extra-intestinal manifestations of IBD

A
  • Finger clubbing
  • Mouth ulcers
  • Episcleritis
  • Conjunctivitis
  • Erythema nudism
  • Pyoderma gangrenosum
  • Seronegative spondyloarthropathy
  • PSC (especially UC)
  • Amyloidosis (especially Crohn’s)
32
Q

What would cause an apparent leg length shortening?

A
  • Fixed flexion deformity of the hip

- Fixed abduction e.g. OA

33
Q

What would cause a true leg length deformity?

A
  • Previous femur fracture
  • Previous tibia fracture
  • Growth disturbances
  • NOF
  • OA
  • Hip dislocation
34
Q

Indications for a total hip replacement

A
  • OA
  • RA
  • DDH
  • Displaced intra-capulse NOF in a young patient
35
Q

Extra-articular features of RA

A
  • Malaise
  • Lethargy
  • Low grade fever
  • Weight loss
  • Pericarditis
  • Pericardial effusion
  • Pleural effusion
  • Pulmonary fibrosis
  • Pneumoconiosis
  • Renal amyloid
  • Polyneuropathy
  • Mononeuritis monoplex
  • Carpal tunnel
  • Atlanto-axial subluxation
  • Scleritis
  • Episcleritis
  • Keratoconjunctivitis sicca
  • Sjogren’s syndrome
  • Anaemia
  • Thrombocytosis
  • Decreased WCC
36
Q

Features of RA on x-ray

A
  • Loss of joint space
  • Bony erosion
  • Periarticular osteoporosis
  • Deformity
  • Soft tissue swelling
37
Q

Features of OA on x-ray

A
  • Loss of joint space
  • Osteophytes
  • Subchondral sclerosis
  • Bone cysts
38
Q

Key side effects of all DMARDs

A
  • Bone marrow suppression
  • Hepatotoxicity
  • Rash
  • GI upset
39
Q

Signs of an LMN lesion

A
  • Normal or reduced tone
  • Reduced power
  • Reduced reflexes
  • Downward plantars
  • Normal coordination
  • Wasting
  • Fasciculations
40
Q

Signs of an UMN lesion

A
  • Increased tone
  • Reduced power
  • Brisk reflexes
  • Upward plantars
  • Reduced downward
  • Clonus
41
Q

Signs of an extra-pyramidal lesion

A
  • Rigidity
  • Normal power
  • Normal reflexes
  • Downward plantars
  • Reduced coordination
  • Resting tremor
  • Bradykinesia
  • Postural instbaility
42
Q

Signs of a cerebellar lesion

A
  • Reduced tone
  • Normal power
  • Normal reflexes
  • Downward plantars
  • No coordination
  • Intention tremor
  • Nystagmus
  • Cerebellar speech
43
Q

Causes of an olfactory nerve palsy

A
  • Trauma
  • Frontal lobe tumour
  • Meningitis
44
Q

Causes of an optic nerve palsy

A

Monocular blindness

  • MS
  • GCA

Bitemporal hemianopia

  • Pituitary adenoma
  • Internal carotid artery aneurysm

Homonymous hemianopia
- Anything behind chiasm e.g. stroke, tumour, abscess

45
Q

Causes of an oculomotor nerve palsy

A
  • Diabetes (partial, pupils spared)
  • PCA aneurysm
  • Raised ICP with tentorial herniation
46
Q

Causes of a trochlear nerve palsy

A
  • Orbit trauma
47
Q

Causes of a trigeminal nerve palsy

A
  • Idiopathic - trigeminal neuralgia
  • Acoustic neuroma
  • Herpes zoster
48
Q

Causes of an abducens nerve palsy

A
  • Skull fracture involving petrous temporal bone
  • Nasopharyngeal carcinoma
  • Raised ICP (false localising sign)
49
Q

Causes of a facial nerve palsy

A
  • Bell’s palsy
  • Malignant parotid tumour
  • Ramsay Hunt sundrome
  • Sarcoid (often bilateral)
  • Stroke/tumour (forehead spared)
50
Q

Causes of a vestibulocochlear nerve palsy

A
  • Excessive noise levels
  • Meniere’s disease
  • Furosemide
  • Aminoglycoside antibitoics (genatmicin)
51
Q

Causes of a bulbar nerve palsy (9-12)

A
  • MND
  • Diphtheria
  • Polio
  • MG
  • GBS
  • Syringobulbia
  • Bilateral stroke
  • MS
52
Q

Cause of a nerve palsy of cranial nerves V, VII, VIII, (and sometimes IX, X)

A
  • Cerebellopontine angle tumour (acoustic neuroma or meningioma)
53
Q

Cause of a nerve palsy of cranial nerves V, VII and VIII

A
  • Paget’s disease of the bone
54
Q

Cause of a nerve palsy of cranial nerves III, IV & VI

A
  • Cavernous sinus thrombosis
55
Q

Causes of ptosis

A
  • CN III palsy
  • Horner’s syndrome
  • Congenital
  • MG
  • Myotonic dystrophy

Year 4 (11 decks)

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