OSCE prep

Question 1

What additive is used in each blood bottle?

Answer 1

Purple - EDTA to bind calcium
Blue - Sodium citrate to bind calcium
Yellow - silica separating gel + red silica
Dark green - heparanised / sodium heparin

Question 2

What is the order of blood bottles?

Answer 2

Blue - Bring 
Red - 
Yellow - Your
Green - green 
Purple - Pens

Question 3

What does each bottle test?

Answer 3

Blue - D-dimer, INR, APTT
Purple - FBC, reticulocytes, blood film, blood folic acid, monospot, acth, g6dp testing,
Pink - (alternative to purple)group and save, crossmatch, coombs test
Red - alternative to yellow (Arsenal)
Yellow - hormones (cortisol, calcitonin, bhcg, gh, igf), enzymes, tumour markers, toxins, drugs (genta)
Grey - glucose + lactate
Dark green - sodium

Question 4

What about colours of culture bottles?

Answer 4

Aerobic: blue lid bottle
Anaerobic: purple lid bottle
Mycobacterium: black lid bottle

Question 5

MRSA swab colour

Answer 5

Black

Groin and nose

Question 6

Where should limb leads be placed?

Answer 6

Ulnar styloid and malleolus

Question 7

How long should you wipe a site for?

Answer 7

30 seconds, then 30 seconds to dry

Question 8

What angle should the cannula be?

Answer 8

10-30

Question 9

What is the pH of urine?

Answer 9

4.5-8

Question 10

What are the causes of high urobilogen?

Answer 10

Haemolysis

Question 11

What are the causes of low urobilogen?

Answer 11

Biliary obstruction

Question 12

What is the cause of a low pH?

Answer 12

Starvation
Diabetic ketoacidosis
Other causes of metabolic acidosis (e.g. sepsis)

Question 13

What colour is urine normally?

Answer 13

Straw and clear

Question 14

What does darker urine suggest?

Answer 14

Dehydration

Question 15

What are the causes of high pH?

Answer 15

Urinary tract infection

Conditions that cause metabolic alkalosis (e.g. vomiting)

Question 16

Why should you not do venepuncture where two veins join?

Answer 16

There are often valves present, making venepuncture more difficult

Question 17

When should you remove the tourniquet?

Answer 17

Before removing the needle

Question 18

How should you collect blood cultures?

Answer 18

Aerobic before anaerobic

Question 19

During fundoscopy what might you see in diabetes?

Answer 19

Dot and blot haemmorhages
Microaneurysms 
Neovacularisation 
Hard exudates 
Cotton wool spots

Question 20

What further tests can you do after a fundoscopy exam?

Answer 20

Retinal photography
Ambler chart tests
Ishiara charts
Blood pressure
Glucose

Question 21

What are druzen?

Answer 21

Yellow, dead material in macular degeneration

Question 22

What is a cherry red spot?

Answer 22

Retinal artery occlusion

Question 23

What stain is used for corneal abrasions?

Answer 23

Flouroscein

Question 24

What is a hypopyon?

Answer 24

Hi-poppy-an is infection of the anterior chamber

Question 25

What are signs of acute angle closure glaucoma?

Answer 25

``` Significant eye pain Vomiting Reduced visual acuity Photophobia Haloes in vision Circumciliary conjunctival injection Hazy cornea Mid-dilated unreactive pupi ```

Question 26

What is a good way to remember what to ask in a urinary history?

Answer 26

FOUND HINTS ``` Frequency Output Urgency Nocturia Dysuria Hesitancy Irritation Neoplasm Terminal dribbling Stream ```

Question 27

What can be used to remember causes of abdominal pain in a female?

Answer 27

``` PID Endometriosis Torsion Ectopic Ruptured cyst ```

Question 28

What are the ranges for glucose?

Answer 28

4.0 to 5.9 mmol/L under 7.8 mmol/L Diabetes UK

Question 29

What is a good to comment on for pulse?

Answer 29

BITS Bounding? Aortic regurgitation, anxiety Irregular? AF Thready? Haemmorhage Slow rising? Aortic stenosis

Question 30

What are the signs for AR?

Answer 30

AR! A WITCH Brave witches don't make potions quickly ``` Bounding pulse Watterhammer De musset Mullers sign Pulsation in neck Quicke's sign ```

Question 31

How do you assess the hands in a cardio exam?

Answer 31

JOCKS TBC

Question 32

What are the symptoms of aortic stenosis?

Answer 32

Sharon Always remembers to say exercise intolerance ``` Syncope Angina Reduced exercise TAVI SOB ```

Question 33

What are the signs and symptoms for mitral regurgitation?

Answer 33

``` Swollen hands and feet Excessive urination Lightheaded Fatigue SOB and cough Holosytolic ```

Question 34

What does the S3 represent?

Answer 34

VenTRIcular gallop. Sometimes physiological and pregnancy.

Question 35

What does S4 represent?

Answer 35

Stiff door - aortic stenosis

Question 36

What can you comment on for a murmur?

Answer 36

Timing (the) - AS (early systolic), MR (pan systolic), AR (early diastole), MS (mid diastole). ASK MR ARMS Duration (doctor) - pan Location (likes) - 2nd ICS Grade (giving) - 1 to 6 Levine scale Shape (students) - Crescendo, decendo, cresecendo, decendo Radiation (really) - carotids Pitch (poor) - high e.g. MR Quality (questions) - rumbling or blowing

Question 37

What is personalised care?

Answer 37

Address the ideas, concerns and expectations of patients in to account

Question 38

What is a chronic disease?

Answer 38

a condition lasting for more than 3 months that cannot get better through medication and vaccines

Question 39

What is a good way to address salient points of LTC?

Answer 39

Diagnosis Information Medication ``` Housing Occupation Utilities Support Emotions ```

Question 40

Why is personalised care important?

Answer 40

We are not the same people are holistic beings. Full time person, part time patient.

Question 41

What is the quote by a Osler?

Answer 41

A good doctor treats the patient. A great doctor treats the patient with the disease/

Question 42

What other theories are there for LTC?

Answer 42

``` The term “biographical disruption” was coined in 1982 by British sociologist Michael Bury [1] to describe the experience of chronic illness and the way in which a life-threatening illness breaks an individual’s social and cultural experience by threatening his or her self-identity. Locus of control Folkmanns appraisal Similarity attraction Biopsychosocial model ```

Question 43

Three reasons why personalised care is important?

Answer 43

Adherence Understanding Autonomy

Question 44

According to the campaign for loneliness, what percentage of people feel lonely?

Answer 44

45%

Question 45

Causes of metabolic acidosis?

Answer 45

Diabetic ketoacidosis, lactic acid, salicylic acid Severe diarrohea without anion gap Loss of bicarb without generation of anions

Question 46

Causes of metabolic alkalosis

Answer 46

Antacids and vomiting | NG drainage

Question 47

Causes of respiratory acidosis?

Answer 47

Type 1 and type 2 resp failure

Question 48

Causes of respiratory alkalosis?

Answer 48

Anxiety, pain,