OSCE Examinations Flashcards
Name four signs you may see on the LL of someone with charcot-marie tooth disease?
High arch foot
Inverted champagne bottle calves
Muscle wasting (and other LMN signs)
Sensory deficit
What tuning fork for hearing tests?
512hz for Rinne
512hz/ 256hx for Weber
What are the components of a peripheral venous exam?
(All general intro/ inspection)
- Scars, venous eczema, lipodermatosclerosis
- Full ulcer inspection (venous ulcers often around medial malleolous)
Palpate varicosities (temp, check pain etc)
Check pulses for art supply
Trendelenburg tourniquet test
- To complete do doppler of veins to r/o DVT + peripheral arterial + ABPI as needs normal for compression stocking
How do you determine between great and small saphenous vein?
Great saphernous = Medial side of leg
Small saphernous = Lateral
How do you perform trendelenburg test?
Lie patient flat
Lift leg up and milk veins
Place tourniquet on sapherofemoral junction (2-3cm lateral and below pubic tuburcle)
Ask patient to stand
- If veins fill = defect is inferior to tourniquet
- If veins don’t fill = defect it as or superior to tourniquet
How should Rombergs test be interpreted?
Positive result = Get’s worse on closing eyes
- Positive = Sensory ataxia
- Negative (doesn’t change) = Cerebellar ataxia
Give 3 indications for a lobectomy?
Malignancy
Abcess
TB
Inflammation
DDx sternotomy scar?
CABG
Valve replacement
A patient has bilateral fine inspiratory crackles and reduced breath sounds on the lower right hand side? Differential?
Pulmonary oedema (fine inspiratory crackles) - Pleural effusion (reduced breath sounds at lower right, if it was crackles could be consolidation)
How do you distinguish between arterial and venous ulcers?
Arterial - Painful, punched out, well defined, on pressure points
Venous- No pain, shallow, sloughy, medial malleolus
Components of diabetic foot exam?
Gait Inspection (ulcers, art/ venous skin changes) Palpation (temp, cap refil, pulses) Sensation (monofilament, vibration) Proprioception - Check footwear
Differential diagnosis bilateral lower limb weakness?
Guillian barre (LMN)
Transverse myelitis (UMN)
Compression spinal cord (disc, tumour etc)
Cauda equina syndrome
Stroke (where the nerves decussate for bilateral)
Non-neurological
Unilateral weakness of one limb, ddx?
Stroke (UMN)
Peripheral nerve lesion (LMN)
NMJ disorder
Unilateral facial weakness ddx?
Stroke (UMN - contralateral)
Bells - Ipsilateral
What should you always do when you see an ECG or CXR in an OSCE?
Ask for another to compare