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3A > OSCE Omg > Flashcards

OSCE Omg Flashcards

1
Q

In a CN IX Palsy which way will the uvula deviate?

A

Glossopharyngeal.

Uvula deviates AWAY from the side of the nerve palsy

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2
Q

In a CN XII Palsy which way will the tongue deviate

A

Hypoglossal.

Tongue deviates TOWARDS the side of the nerve palsy

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3
Q

Which nerve roots coordinate shoulder abduction?

A

C5

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4
Q

Which nerve roots coordinate shoulder adduction?

A

C6/7

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5
Q

Which nerve roots coordinate elbow flexion?

A

C5/6

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6
Q

Which nerve roots coordinate elbow extension?

A

C7

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7
Q

Which nerve roots coordinate wrist extension?

A

C6

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8
Q

Which nerve roots coordinate wrist flexion?

A

C6/7

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9
Q

Which nerve roots coordinate finger extension?

A

C7

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10
Q

Which nerve roots coordinate finger abduction

A

T1

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11
Q

Which nerve roots coordinate thumb abduction?

A

C8/T1

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12
Q

Which nerve roots coordinate hip flexion?

A

L1/2

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13
Q

Which nerve roots coordinate hip extension?

A

L5/S1

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14
Q

Which nerve roots coordinate hip abduction?

A

L2/3

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15
Q

Which nerve roots coordinate hip adduction

A

L4/5

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16
Q

Which nerve roots coordinate knee flexion?

A

S1

17
Q

Which nerve roots coordinate knee extension?

A

L3/4

18
Q

Which nerve roots coordinate ankle dorsiflexion?

A

L4

19
Q

Which nerve roots coordinate ankle plantarflexion?

A

S1/2

20
Q

Which nerve roots coordinate toe flexion?

A

L5

21
Q

Which nerve roots coordinate ankle inversion?

A

L4

22
Q

Which nerve roots coordinate ankle eversion?

A

L5/S1

23
Q

What are the componenets you should ask about when using Diabetes Risk score?

A

Age, ethnic background, 1st degree relative with DM, hypertension, sex, waist circumference, BMI, common symptoms (polyuria, polydypsia, unexplained weight loss, visual blurring, infection and fatigue)

24
Q

What are the componenets you ask about when using QRISK2 score?

A

Age, Sex, Smoking status, Diabetes status, Antihypertensives use, AF, RA, CKD stage 4/5, Angina/MI in 1st degree relative.
Also = BMI, Systolic BP, Postcode, Ethnicity and Cholesterol/HDL level

25
Q

What are the componenets you ask about when using CHA2DS2-VASc score?

A 
Congestive Heart Failure
Hypertension
Age (65-74 = 1 point, >75 = 2 points)
Diabetes
Sex (female = 1 point)
Stroke history
Peripheral vascular disease
26
Q

What is normal INR on warfarin?

A

2-3

27
Q

What are the componenets you ask about when using Well’s score?

A

Bedridden? Recent major surgeries? Paralysis/immobilisation? History of DVT? Active cancer? Recent flights? COCP/HRT? Smoking?
Examine: pitting oedema, calf swelling >3cm, tenderness, collateral veins, whole leg swelling

28
Q

What are the componenets you ask about when using FRAX score?

A

Previous fracture, parental hip fracture, current smoking/alcohol intake, BMI, glucocoricoid use, RA, secondary oesteoporosis, age, sex, weight, height, femoral neck bone mineral density (DEXA scan)

29
Q

Which medical conditions can cause secondary osteoporosis?

A

Kidney failure, Cushing’s, Coeliac, MS, Hyperparathyroidism, Hyperthyroidism, Diabetes

30
Q

What do the T-score results mean?

A

> = -1 = normal bone density
-1 to -2.5 = oesteopenia
<= -2.5 = oesteoporosis

31
Q

What should you say if you think a patient is high risk based on their QRISK 2 score?

A

Lifestyle advice!
Healthy diet, weight loss, exercise, smoking cessation, disease control - adherance to medicaiton (if not already on medications consider starting)

32
Q

What should you say if you think a patient is at high risk or low risk based on their CHA2DS2VASc score?

A

High risk = anticoagulation/antiplatelet therapy
Low risk = consider anticoaguant therapy (consider risks vs benefits)
Lifestyle advice - healthy diet, exercise, smoking cessation and vitamin K in leafy green veg if on warfarin

33
Q

What should you say if you think a patient is risk based on their Well’s score?

A

Investigations = D-dimer and USS doppler
Treatment = LMW heparin, anticoagulants
Lifestyle adivce = diet, exercise, smoking cessation, other RFs e.g. COCP

34
Q

What should you say if you think a patient is high risk based on their Diabetes Risk score?

A

Diet advice = regular meals, reduce portion sizes and starchy carbs, decrease fat, eat 5 fruits/veg, 2 portions of oily fish, limit sugar, decrease salt and moderate alcohol
Exercise = 150 mins/week, increase HR and RR, build up gradually, walking/gardening/housework/cycling.
If high risk can have tests!
Benefits and effort from change > long term effects of diabetes

35
Q

What is the CHA2DS2VASc score?

A

Calculates the risk of stroke in patients with AF

36
Q

What is the QRISK 2 score?

A

Calculates the risk of CVD in the next 10 years

37
Q

What is HbA1c in diabetes and prediabetes?

A 
Pre-diabetes = 42-48
Diabetes = >48

3A (11 decks)

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