OSCE part 2

Question 1

What history taking questions are asked in Eating Disorder?

Answer 1

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

Question 2

What is MEED Criteria

Answer 2

HR <45
Temp <36
ECG abnormality- long QT or sinus bradycardia
Electrolyte abnormality

Question 3

What history taking questions should be asked in anxiety consult?

Answer 3

-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

Question 4

What is the CAGE questionnaire use in alcohol misuse disorder?

Answer 4

CAGE
-Cut down
-annoyed if your friends comment on your drinking
-feel guilty
-eye opener- do you drink to a cure a hangover

Question 5

What are symptoms of PTSD to ask when taking a history?

Answer 5

-avoidance
-hyperarousal
-agitation
-sleep

Question 6

What RED flag symptoms MUST be asked in psychiatric history

Answer 6

-periods of being very low then happy
-risk of suicide
-self harm
-do you ever see or hear things that other people do not

Question 7

What history taking questions should be asked when suspecting Post Partum Depression

Answer 7

(*occurs typically within one month/<4 weeks after child birth)

Question 8

what red flag questions MUST be asked in eating disorders history?

Answer 8

-periods of being very low then happy
-risk of suicide
-self harm
-do you ever see or hear things that other people do not

Question 9

What symptoms must be asked for memory loss in an elderly patient?

Answer 9

-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

Question 10

What questions must be asked in a haem consultation?

Answer 10

-brusing
-mouth ulcers
-bleeding gums
-parasthesia
-fatigue
-SOB
-diet!!!!

Medical history- ask about any autoimmune conditions, recent surgeries?
-vegan diet

Question 11

What symptoms should be asked in a Neurology Comms?

Answer 11

Weakness
Sensory disturbance
Visual disturbance
Speech disturbance
Ataxia
Dysphagia
Reduced level of consciousness
Pa
Vision changes
-parasthesia
-tremor

Question 12

What am I most likely to forget in an lower neuro examination?

Answer 12

babinski and inversion and eversion of foot -cortico-spinal tract (loss of descending inhibition)

Question 13

What are the cervical screening questions to ask?

Answer 13

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

Question 14

What must you state before doing a cervical smear or vaginal examination???

Or you will FAIL

Answer 14

Chaperone!

Question 15

What history taking questions should be asked in a STI history taking comms?
(symptoms)

Answer 15

-discharge
-colour
-thickness
-volume
-thickness

Bleeding:
-painful sex
-bleeding after sex
-periods-heavy and frequent?
-any chance pregnant, when was your last period

Question 16

What in Social History in an Sexual Health history?

(*MAKE SURE STATE PARTNER, NOT HUSBAND, WIFE)

Answer 16

Social:
-CONSENSUAL sex!
-CONTRACEPTION used
-how many partners do you have
-gender
-type of sex
-transactional sex
-IV drug use an tattoos
-HIV status

Question 17

What in Medical History must be asked in STI history taking?

Answer 17

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

Question 18

What questions should be asked in Breast Cancer history

Answer 18

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.

Question 19

STI symptom questions in male

Answer 19

-discharge- smell, thick, colour, volume
-penile swelling
-painful peeing

Question 20

What symptoms to ask in carpal tunnel syndrome after general neuro questions?

Answer 20

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

Question 21

What MUST I ask for red flags

Answer 21

MUST DO RED FLAGS