OSCE SYMPTOMS Flashcards
Fever
When did it start
Onset
Grade
Pattern
Worse at any time of day/night/morning
Chills and rigor <5
Relieving factors
Aggravating factors
Care given and outcome
Cough
When did it start
Onset
Bouts/barky
Wet/dry
Wet: productive/not productive
Sputum: Colour/consistency/odour
Worse at any particular time of day
Aggravating factors
Relieving factors
Contact with a person with chronic chronic, family history of atopy
Care given
Outcome
Fast breathing/breathlessness
Onset
Duration
Progression: worse at suckling, exertion, at rest
Does it wake the patient
Continuous/persistent/intermittent
Worse at any particular time
Aggravating factors
Relieving factors
Any bluish discolouration of lips, tongue or palms
Noisy breathing
Care given and outcome
Generalised body swelling
Onset
Duration
Site/location
Sequence of progression
Rapid or slow progression
Generalised or localised on onset
Bilateral or unilateral
Present throughout the day or comes and goes
Worse at any particular time of day
Aggravating factors
Relieving factors
Flank fullness/pain
Suprapubic fullness/pain
Change in urine volume
Prior throat or skin infection
Use of herbal medication
Yellowness of the eyes
Care given so far and outcome
Abdominal pain
- When did it start?
- Site of the pain
- Onset: insidious/sudden
- Characterize: stabbing/burning/colicky
- Progression: worsening/resolving
- Radiation of pain
- Any associated diarrhoea, vomiting, melena stool, jaundice or edema
*Aggravating/relieving factors (change in position/eating/starvation)
*Timing of the pain - Any loss of function/swelling
*Limitations cause by pain; severity - Care given so far and outcome
Headache
- When did it start?
- Site (unilateral/bilateral; frontal/generalized)
- Onset: insidious/sudden
- On/off or present throughout the dày
- Severity: mild/moderate/severe
- Character/nature: bounding/throbbing
- Aggravating/relieving factors
- Radiation to the neck
Timing of headache
Visual disturbances/vomiting
Care given/outcome
Vomiting
- When did it start?
*Onset: Insidious/sudden? - Frequency: no of episode/vol of each & total volume +duration of each
- Is it projectile/
- Was it effortless/with effort
- What was the content of the vomitus: recently ingested food/bile stained, blood stained?
- Is it post-prandial/tussive (after eating/coughing)
- Volume of vomitus
- Odor/odorless: foul smelling/not
- Hx of forceful feeding?
- Any aggravating / relieving factors?
- Care given so far and outcome(ORS)
Diarrhoea
- When did it start?
- How many times pt opened bowel in a day + duration (compare to normal)
- Was is it copious/scanty vol
- Is it watery/loose or formed
- Odor: odorless/offensive (foul smelling)
Color of stool - Content: mucoid/bloodyfresh/altered) does it float in water
- Pain on defecation
- Associated Abdominal Pain
- Care given so far and outcome.
Weight loss
- When was it noticed?
- What are the evidence of weight loss? (previous tight fitting clothing)
- What is the feeding habit in a day and quality of meals (demand/interval? Appetite
- Duration of feeing esp. in Breastfeeding
- Any symptoms such as: polyuria, polydipsia, polyphagia(DM)
- Persistent fever, chronic diarrhoea, (HIV).
- Cough, swelling, signs of metastasis (Malignancy)
- Cough, dyspnea, orthopnea, PND(CVS)
- Persistent diarrhoea, steatorhea, vomiting (malabsorption syndrome)
- Cough, chest pain, hemoptysis, night sweats (Resp dx)
- Palpitations/awareness of heartbeats, heat intolerance, neck mass, prominence of eyes, increase appetite, decrease sleep(Thyrotoxicosis)
- Care given so far and the outcome.
SEIZURE
When did it start?
- Is this the first episode? Characterize the seizure(tonic/clonic/tonic-clonic)
- What was px doing when it happens? Any sign or aura before it started? (blinking of eyelids/upward rolling of eyes/loud pitched cry/staring gaze/fall to the ground)
- When was the last meal?
- How was it aborted?
- Any family hx of epilepsy
- Precipitating factors/Relieving factors
*Any part of the body affected?
*Care given
Yellow discolouration of Eye
• When was it noticed? Is it bilateral/unilateral
* Duration
* Onset: Insidious/sudden
- Has it ever disappeared/recurred
- Progression: from what part of the body to which part
- Any itching/hx of past jaundice(CLD)/(Pmshx)
- Color of stool/uriné
- Hand/foot syndrome/bone pain(SCD)
- Blood transfusion hx
- Sibling/family member with similar illness(FSHx)
- Sulphonamides, Naphthalene ball(G6PD)
- Source of drinking water: Hep A(FSHx)
- Malaria infection(PMSHX)
- Hx of neonatal jaundice
- Care given so far and outcome
Pain
- When did it start?
- Site of the pain
- Onset: insidious/sudden
- Characterize: stabbing/burning/colicky
- Progression: worsening/resolving
- Radiation of pain
*Aggravating/relieving factors (change in position/eating/starvation)
*Timing of the pain - Any loss of function/swelling
*Limitations cause by pain; severity - Care given so far and outcome
COLA COLORED URINE
- When was it noticed
*Onset: sudden/insidious - Triggers: drugs (sulfonamide/naphthalene balls/others)
- Suprapubic pain
- Dysuria/frequency
- Foamy urine
- Drugs: statins/rifampicin/beetroot
- Care given so far and outcome
BLOOD IN URINE
- When was it notice?
- Onset: insidious/sudden
- Is it terminal/initial or throughout micturition
- Hx of wadding in streams(Schistosomiasis)
- Hx of trauma
- Hx of URTI
- Any periorbital swelling
- Hx of use of herbal medication
- Hx of pain
- Care given and outcome
Paleness of body
• When was it noticed
• Progressively worsen, or same, or no change since observed Ask for history of trauma
• Loss of blood from any
source(stool,urine, vomitus)
• Yellowish discolouration of the eyes
• Presence of cola-cloured urine
• Any swelling of leg, face, abdomen
• Is patient breathing fast
• History of weight loss
• Poor appetite and food intake
• Intake of medication that can cause haemolysis eg sulphonamide
