OSCE part 2 Flashcards
What history taking questions are asked in Eating Disorder?
SCOF Criteria
-ever made yourself sick
-does food control you
-ever lost one stone
-do you think you are ‘fat’
other:
-constipation
-sleep
-fatigue, feel weak
-concentration
-compensatory behaviour ****
MUST ASK RED FLAG QUESTIONS
What is MEED Criteria
HR <45
Temp <36
ECG abnormality- long QT or sinus bradycardia
Electrolyte abnormality
What history taking questions should be asked in anxiety consult?
-impending doom
-Feeling nervous or restless/tired or fatigued
physical symptoms:
Feeling very hot and sweating/very cold and shivering
Hyperventilation
Rapid heart rate or palpitations
Headache
Nausea
Shortness of breath
Pins and needles
What is the CAGE questionnaire use in alcohol misuse disorder?
CAGE
-Cut down
-annoyed if your friends comment on your drinking
-feel guilty
-eye opener- do you drink to a cure a hangover
What are symptoms of PTSD to ask when taking a history?
-avoidance
-hyperarousal
-agitation
-sleep
What RED flag symptoms MUST be asked in psychiatric history
-periods of being very low then happy
-risk of suicide
-self harm
-do you ever see or hear things that other people do not
What history taking questions should be asked when suspecting Post Partum Depression
(*occurs typically within one month/<4 weeks after child birth)
what red flag questions MUST be asked in eating disorders history?
-periods of being very low then happy
-risk of suicide
-self harm
-do you ever see or hear things that other people do not
What symptoms must be asked for memory loss in an elderly patient?
-hallucinations- lewy body dementia
-impulsive behaviour- fronto-temporal dementia
-stepw-wise-vascular dementia
-depression, anyway passed away-pseudodemenia, pseudohallucinations
-changes in behaviour
-tremor
-medications- polypharmacy
-recent falls- sub-dural haemorrhage (fluctuating symptoms)
-forget words
-harder to understand instructions- broca’s or wernicke’s aphasia
-alcohol intake- delirium tremen
What questions must be asked in a haem consultation?
-brusing
-mouth ulcers
-bleeding gums
-parasthesia
-fatigue
-SOB
-diet!!!!
Medical history- ask about any autoimmune conditions, recent surgeries?
-vegan diet
What symptoms should be asked in a Neurology Comms?
Weakness
Sensory disturbance
Visual disturbance
Speech disturbance
Ataxia
Dysphagia
Reduced level of consciousness
Pa
Vision changes
-parasthesia
-tremor
What am I most likely to forget in an lower neuro examination?
babinski and inversion and eversion of foot -cortico-spinal tract (loss of descending inhibition)
What are the cervical screening questions to ask?
Screening Questions Smear:
-have you had a smear before, how was it
-Explain HPV 16 AND 18!!!!!!!- looks presence of the virus (IMPORTANT)
-have you ever been recalled
-pregnant
-any STI
-want to empty your bladder
-gloves
-CHAPERONE
What must you state before doing a cervical smear or vaginal examination???
Or you will FAIL
Chaperone!
What history taking questions should be asked in a STI history taking comms?
(symptoms)
-discharge
-colour
-thickness
-volume
-thickness
Bleeding:
-painful sex
-bleeding after sex
-periods-heavy and frequent?
-any chance pregnant, when was your last period
What in Social History in an Sexual Health history?
(*MAKE SURE STATE PARTNER, NOT HUSBAND, WIFE)
Social:
-CONSENSUAL sex!
-CONTRACEPTION used
-how many partners do you have
-gender
-type of sex
-transactional sex
-IV drug use an tattoos
-HIV status
What in Medical History must be asked in STI history taking?
Medical:
-to you attend your cervical screening appointments, what has happened with that
-ever had an STI before
-is there a chance you could be pregnant?
-when was your last period
-CONTRACEPTION
-miscarriage
-ever been pregnant before
What questions should be asked in Breast Cancer history
Nipple discharge or bleeding: associated with infection (e.g. mastitis and breast cancer).
Nipple inversion: recent onset nipple inversion is typically associated with breast cancer.
Erythema: associated with breast abscess, mastitis and underlying breast cancer.
Ulceration: typically associated with breast cancer.
Dimpling (peau d’orange): associated with underlying breast cancer.
Fever: may indicate underlying infection (e.g. breast abscess).
Weight loss: may indicate underlying breast cancer.
Malaise: associated with breast abscess and breast cancer.
Lymphadenopathy: typically involving the lymph nodes of the axilla and neck (e.g. breast cancer, breast abscess).
Bone pain: consider the possibility of metastatic breast cancer.
STI symptom questions in male
-discharge- smell, thick, colour, volume
-penile swelling
-painful peeing
What symptoms to ask in carpal tunnel syndrome after general neuro questions?
Tingling, numbness or pain in the distribution of the median nerve (the thumb, index, middle finger and medial half of the ring finger on the palmar aspect)
Loss of grip strength
Clumsiness
The pain of CTS is usually described as being:
Worse at night
Gradual onset
Intermittent
Relieved by shaking/flicking the hand
What MUST I ask for red flags
MUST DO RED FLAGS
