OSCE Examination Flashcards
when looking at a tremor in the hands, what are we looking for
Flapping tremor ==> Hepatic Encephalopathy + uraemia
When looking at a px nails, what does:
Clubbing Represent
IBD
Coeliac Disease
Cirrhosis
When looking at a px nails, what does:
Leukonychia Represent
Hypoalbuminanaemia ==> Liver cirrhosis // Enteropathy
**white dots on nails
When looking at a px nails, what does:
Koilonychia Represent
Iron deficiency
**scooped nail => enough to drop liquid into it
When looking at a px palms, what does:
Palmar erythema represent
increased oestrogen => inc. hyperdynamic circulation in liver disease / pregnancy
When looking at a px palms, what does:
Dupuytren’s contracture represent
Alcoholism // Liver disease
Overall when looking at the hands, what are all the conditions we are looking out for?
Hepatic Encephalopathy (F.tremor)
Cirrhosis + IBD + Coeliac (Clubbing)
Hypoalbumnaemia in cirrhosis (Leukonychia)
Iron Deficiency (Koilonychia) Increased oestrogen (palmar erythema) Alcoholism // Liver disease (Dupuytren's contracture)
When looking at the px eyes, what does:
Jaundice in the Sclera represent?
Kayser-Fleischer rings represent?
liver disease
Wilson’s disease ==> Copper disease
when looking at the px eyes, what does:
Conjunctival pallor represent
Anaemia*
GI bleeds, malabsorption
When looking at the px eyes, what does:
periorbital xanthelasma represent?
Corneal Arcus represent?
Hyperlipidaemia in cholestasis
hypercholesterolaemia (if under 50)
When looking at the px mouth, what does:
Glossitis // stomatitis represent
Iron / B12 deficiency
when looking at the px mouth, what does:
Aphthous ulcers represent
IBD
when looking at the px mouth, what does a:
Fruity smell indicate?
Feculent indicate?
Ketoacidosis
Obstruction
overall when looking at the face, what are all the conditions we are looking out for?
Liver disease (sclera jaundice)
anaemia (Conjunctival pallor)
Hyperlipidaemia in cholestasis (Periorbital xanthelasma)
Iron/b12 def (glossitis / stomatitis)
IBD (Apthous ulcers)
Ketoacidosis (Fruity smell breath)
B.obstruction (Feculent breath)
when examining the neck, what node are we interested in (left supraclavicular fossa)
what does this indicate
Virchow’s node
==> Gastric malignancy
when examining the back + chest, what is significant if we find 5+ of these
Spider Naevi
When examining the neck and back of px, what are we asking the patient to do?
lean forwards
When examining the chest of the px, what are we asking the patient to do/
Ask px to sit back
What does a loss of axilliary hair indicate when looking at the chest
Inc. in oestrogen levels ==> liver disease // pregnancy
IDA
Malnutrition
When looking at the axillae, what does Acanthosis nigricans represent
darkening // hyperpigmentation
==> T2DM
==> GI Malignancy
When looking at a px with distention, what are the 5 causes of it
5F’s
Fluid Flatus Fat Fetus Faeces
What is the order of palpation of the abdomen
Superficial Deep Liver Spleen Kidney Aorta
how to demonstrate the Rovsing’s sign
What does a positive sign produce
Palpate in LIF//Suprapubic area. Quickly release and pain should be felt in RIF
Positive ==> Appendicitis
how to demonstrate the Murphy’s sign
What does a positive sign produce
Place 2 fingers under the coastal margin in RUQ on mid clavicular line
Ask px to inhale and px should be in pain from inhalation
Positive sign ==> Acute cholecystitis
Hepatomegaly can be caused by what (5)
HCC
Hepatitis
RVF
Leukaemia // Lymphoma
fatty liver // Alcoholic liver disease
