OSCE stuff Flashcards

1
Q

CVS - Hands (4)

A

Tar stains
Splinter haemorrhages
Peripheral cyanosis
Clubbing
+ cap refill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CVS - Face (6)

A

Pale conjunctiva - anaemia
Dentition
Central cyanosis
Mitral facies (rosy cheeks - mitral stenosis)
Corneal arcus - high cholesterol
Xanthelasma - high cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

CVS - finish

A

BP and pulses (dorsalis pedis and posterior tibial)
ECG for arrhythmias
Look at any available imaging e.g. CXR
Full peripheral vascular exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Resp - hands (4)

A

Clubbing
Peripheral cyanosis
Tar stains
CO2 flap - asterix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Resp - face (2)

A

Pale conjunctiva - anaemia
Central cyanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Resp - finish

A

CVS exam
Temp
Peak flow
Examine any sputum
Look at any available CXRs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Abdo - Hands (8)

A

Clubbing
Leuconychia (loo-coy-ni-kia) - low albumin
Koilonychia (koy-lee-ni-kia) - iron deficiency
Palmar creases (pale) - anaemia
Palmar erythema (red palms) - cirrhosis, haemochromatosis, wilson’s
Spider-naevi - liver disease
Dupuytren’s contracture - liver disease
Hepatic flap - if jaundiced for liver failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Abdo - face (6)

A

Pale conjunctiva - anaemia
Yellow sclera - jaundice
Dentition/mouth ulcers
Angular stomatitis/cheilitis
Tongue disorders
Dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Abdo - abdo inspection

A

Obvious swellings, lumps or distention
Pulsation and peristalsis
Caput medusae - portal hypertension
Cullen’s sign (bruising around umbilicus) - acute pancreatitis
Grey Turners sign (bruising on side) - acute pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Abdo - finish

A

Soft, non-tender abdomen with no masses or organomegaly and normal bowel signs on auscultation
To complete:
- Hernal orifices
- External genitalia
- DRE
- Temp
- Urinalysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Upper PNS - process

A

General inspection
Check for pain
Tone
Power
Coordination (finger to nose, dysdiadochokinesia)
Reflexes (biceps, triceps, brachioradialis)
Sensation (light touch, pain, joint position, vibration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Upper PNS - finish

A

Full CN exam
Lower limb PNS exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Lower PNS - process

A

Gait + heel shin (coordination)
Romberg
General inspection
Check for pain
Tone - inc clonus
Power
Reflexes (knee, achillies, babinski)
Sensation (light touch, pain, joint position, vibration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Lower PNS - finish

A

CN exam
Upper limb PNS exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Shoulder finish

A

Review any available imaging
Assess C spine and elbow
Neurovascular exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Knee exam finish

A

Review any available imaging
Assess hip and ankle joints
Lower limb neurovascular exam

16
Q

Hip exam finish

A

Review any available imaging
Assess knee and lumbar spine
Neurovascular exam

17
Q

Two core symptoms of depression

A

During the last month have you often been bothered by feeling down or feeling hopeless?
Do you have little interest or pleasure in doing things?

Must have one of the above, most days, most of the time for a least 2 weeks

18
Q

Other typical symptoms of depression

A

Fatigue/loss of energy
Worthlessness/inappropriate guilt
Recurrent thoughts of death, suicidal thoughts or idealisation/attempts
Diminished ability to think/concentration
Agitiation
Insomnia/hypersomnia
Significant appetite and/or weight loss

19
Q

Two core symptoms of generalised anxiety disorder

A

Excessive anxiety and worry, more days than not for 6 months about a variety of events or activities
Difficulty controlling worry

20
Q

Additional symptoms of generalised anxiety disorder

A

Must have at least 3 for 6+ months in addition to core symptoms
- feeling of tension and restlessness
- easily fatigued
- difficulty concentrating/mind going blank
- irritability
- significant muscle tension
- difficulty sleeping

21
Q

Cranial nerve - finish

A

Full peripheral nerve exam
Fundoscopy
Otoscope

22
Q

Depression differentials

A

Hypothyroid
Menopause
Bereavement
Anxiety
Bipolar
Neurological e.g. dementia
Substance abuse
Medications e.g. PPIs, COCP, methyldopa
Anaemia
Sleep apnea

23
Q

GAD differentials

A

Hyperthyroid
Situational anxiety
Adjustment disorder
Arrhythmias
Depression/OCD/PTSD