OSCE stuff Flashcards
CVS - Hands (4)
Tar stains
Splinter haemorrhages
Peripheral cyanosis
Clubbing
+ cap refill
CVS - Face (6)
Pale conjunctiva - anaemia
Dentition
Central cyanosis
Mitral facies (rosy cheeks - mitral stenosis)
Corneal arcus - high cholesterol
Xanthelasma - high cholesterol
CVS - finish
BP and pulses (dorsalis pedis and posterior tibial)
ECG for arrhythmias
Look at any available imaging e.g. CXR
Full peripheral vascular exam
Resp - hands (4)
Clubbing
Peripheral cyanosis
Tar stains
CO2 flap - asterix
Resp - face (2)
Pale conjunctiva - anaemia
Central cyanosis
Resp - finish
CVS exam
Temp
Peak flow
Examine any sputum
Look at any available CXRs
Abdo - Hands (8)
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
Abdo - face (6)
Pale conjunctiva - anaemia
Yellow sclera - jaundice
Dentition/mouth ulcers
Angular stomatitis/cheilitis
Tongue disorders
Dehydration
Abdo - abdo inspection
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
Abdo - finish
Soft, non-tender abdomen with no masses or organomegaly and normal bowel signs on auscultation
To complete:
- Hernal orifices
- External genitalia
- DRE
- Temp
- Urinalysis
Upper PNS - process
General inspection
Check for pain
Tone
Power
Coordination (finger to nose, dysdiadochokinesia)
Reflexes (biceps, triceps, brachioradialis)
Sensation (light touch, pain, joint position, vibration)
Upper PNS - finish
Full CN exam
Lower limb PNS exam
Lower PNS - process
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)
Lower PNS - finish
CN exam
Upper limb PNS exam
Shoulder finish
Review any available imaging
Assess C spine and elbow
Neurovascular exam
Knee exam finish
Review any available imaging
Assess hip and ankle joints
Lower limb neurovascular exam
Hip exam finish
Review any available imaging
Assess knee and lumbar spine
Neurovascular exam
Two core symptoms of depression
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
Other typical symptoms of depression
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
Two core symptoms of generalised anxiety disorder
Excessive anxiety and worry, more days than not for 6 months about a variety of events or activities
Difficulty controlling worry
Additional symptoms of generalised anxiety disorder
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
Cranial nerve - finish
Full peripheral nerve exam
Fundoscopy
Otoscope
Depression differentials
Hypothyroid
Menopause
Bereavement
Anxiety
Bipolar
Neurological e.g. dementia
Substance abuse
Medications e.g. PPIs, COCP, methyldopa
Anaemia
Sleep apnea
GAD differentials
Hyperthyroid
Situational anxiety
Adjustment disorder
Arrhythmias
Depression/OCD/PTSD
