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4th Year Finals > OSCEs 2 > Flashcards

OSCEs 2 Flashcards

1
Q

What BMI do women have to be for referral to Fertility Clinic?

A

<35

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2
Q

What should fetal heart be on ausculatation?

A

110-160bpm

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3
Q

Name the three types of lie on obstetric examination?

A

Oblique
Transverse
Longitudinal

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4
Q

Name the 5 types of engagement of head on obstetric examination?

A

5/5: Free Float
4/5 Fixing
3/5 Nearly Engaged
2/5 Engaged
1/5 Just palpable
0/5 deep enagaged (ready for birth)

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5
Q

When is there an absolute contraindication to vaginal speculum exam?

A

Antepartum Haemorrhage due to Placenta Praevia

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6
Q

Uterus is commonly in what position?

A

Anteverted Anteflexed

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7
Q

Stages of Obstetric Examination? (7)

A

Position
Inspection: Scars, Striae Graviarium, Linea Nigra
Palpation of Fetal Poles
Fundal Height (after 20 weeks)
Presenting part
Engagement (after 36 weeks)
Auscultation over anterior shoulder

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8
Q

Name the 5 moments of hand hygiene

A

Before patient contact
Before aseptic task
After body fluid exposure risk
After patient contact
After contact with patient surroundings

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9
Q

What model to use for Breaking Bad News? (6)

A

SPIKES

Setting and Listening
Patient Perception
Invitation
Knowledge
Explore Emotion and Empathise
Strategy and Summary

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10
Q

Diarrhoea may be associated with what two endocrine conditions?

A

Hyperthyrodism
Adrenal Insufficiency

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11
Q

Constipation may be associated with what two endocrine conditions?

A

Hypothyrodism or Hypercalcemia

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12
Q

Sweating is associated with what four endocrine conditions?

A

Hyperthyrodism
Phaeochromaocytoma
Hypoglycemia
Acromegaly

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13
Q

In a examination looking for Diabetes what to look for? (9)

A

Weight Loss
Peripheral Pulses
Blood Pressure
Peripheral Vascular Disease
Peripheral Neuropathy
Charcot Foot
Skin Infection
Cataracts and Glaucoma
Diabetic Eye Disease

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14
Q

In an examination looking for thyrotoxicosis what to look for? (10)

A

Weight Loss
FIne Tremor
Palmar Erythema
Tachycardia
Collapse Pulse
Atrial Fibrillation
Proximal Myopathy
Exopthalmus
Lid Retraction and Lag
Goitre

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15
Q

In an examination looking for Hypothyrodism what to look for? (7)

A

Sluggishness
Skin coarse,pale, dry
Bradycardia
Periorbital Oedema
Xanathalasma
Dry/Thin Scalp Hair
Slow Reflexes

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16
Q

What to look for in Cushings Syndrome? (9)

A

Moon Face
Central Obesity
Bruising
Excessive Pigmentation
Proximal Myopathy
Visual Field Defects
Optic Atrophy
Papilloedema
Hypertension

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17
Q

What to look for on Inspection in Diabetic Foot? (7)

A

Shoes
Plantar aspects of feet
Skin. colour and integrity
Pressure damage/ulcers
Signs of infection
Hair loss
Deformity eg bunion (hallux valgus), over riding of toes, charcot joint, joint subluxation, high or flat arches or exostosis

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18
Q

What is exostosis?

A

is a benign bony lump with a cartilage cap that arises usually at the end of the long bones.

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19
Q

What is charcot foot?

A

Progressive degeneration of weight bearing joint due to diminished proprioception, repeated sustained trauma in ankle and joint = destruction

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20
Q

Where are arterial ulcers found?

A

Below ankle

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21
Q

Where to assess vibration in diabetic foot exam? (4)

A

Lateral metatarsophalngeal joint of big toe
midfoot
medial and lateral malleoli
knee

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22
Q

Where to test monofilament in diabetic foot? (5)

A

Apex of 1st and 3rd Toes
1st, 3rd and 5th Metatarsal Heads

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23
Q

What is paroxysmal nocturnal dyspnoea?

A

a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.

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24
Q

Blood Flow through the Heart?

A

Right Atrium > Tricuspid Valve > Right Ventricular > Pulmonary Valve > Pulmonary Artery > Pulmonary Vein > Left Atrium > Mitral Valve > Left Ventricle > Aorta

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25
Q

What does Systole (S1) represent?

A

Mitral and Tricuspid closure

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26
Q

What does Systole (S1) represent?

A

Mitral and Tricuspid closure

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27
Q

Examination of Spine
What to do in Inspection? (6)

A

Observe whole spine and curvatures
Cervical and Lumbar - Lordosis
Thoracic - Kyphosis
Posture of Neck and Head
Scars or Sinuses
Scoliosis

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28
Q

Examination of Spine
What to do in feel? (4)

A

Feel down spine
Palpate midline spinous processes
Feel sacrolilac joints
Feel paraspinal muscle tenderness

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29
Q

Examination of spine
What to do in move (6)

A

Flexion
Extension
Lat Flexion
Rotation
Lumbar spine flexion and extension
Lumbar spine lateral flexion

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30
Q

Examination of Spine
what to do in neuro? (4)

A

Straight Leg Raise
Reflexes
Power/Sensation

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31
Q

Which dermatomes to test in spine examination? (13)

A

C5,C6,C7,C8,T1,T2,L1,L2,L3,L4,L5,S1,S2

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32
Q

C5 dermatome covers where?

A

Regimental badge area

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33
Q

C6 dermatome covers where

A

Thumb

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34
Q

C7 Dermatome where

A

Mid Finger

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35
Q

C8 Dermatome where

A

Little Finger

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36
Q

T1 dermatome where?

A

medial antecubital fossa

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37
Q

T2 dermatome where

A

Axilla

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38
Q

L1 dermatome where

A

Upper medial thigh

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39
Q

L2 dermatome where

A

Medial mid thigh

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40
Q

L3 dermatome where

A

medial side knee

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41
Q

L4 dermatome where

A

medial malleolus

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42
Q

L5 dermatome where

A

dorsal foot

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43
Q

S1 dermatome where

A

lateral heel

44
Q

S2 dermatome where

A

Back of thigh

45
Q

S3-5 dermatomes cover where?

A

Rectal tone and bum

46
Q

Which muscle groups to test in spine power examination? (9)

A

Deltoid
Biceps
Triceps
Finger Flex
Finger Abduction
Hip Flex
Quadriceps
Great Toe Dorsiflexion
Foot Plantarflex

47
Q

C5 dermatome where?

A

Deltoid

48
Q

C6 dermatome where?

A

Biceps

49
Q

C7 dermatome where?

A

Triceps

50
Q

C8 dermatome where?

A

Finger Flexion

51
Q

T1 dermatome where?

A

Finger abduction

52
Q

L1/2 dermatome where?

A

Hip flexion

53
Q

L3/4 dermatome where?

A

Quadriceps

54
Q

L5 dermatome where?

A

Great toe dorsiflexion

55
Q

S1/S2 dermatome where?

A

Foot Plantarflexion

56
Q

Biceps reflex what dermatomes

A

C5/6

57
Q

Triceps reflex what dermatomes

A

C7/8

58
Q

Knee reflex what dermatomes

A

L3/4

59
Q

Ankle jerk reflex what dermatomes

A

S1/2

60
Q

The shoulder joint consists of what joints?

A

Glenohumeral and Acromioclavicular

61
Q

Shoulder examination
What to look for on inspection? (7)

A

Loss of symmetery or deformity
Winging of scapula
Muscle wasting: deltoid/supraspinatus/infraspinatus
Scars, wounds, sinuses, discolouration

62
Q

Shoulder examination
Where to feel? (10)

A

Temperature at joint and adjacent areas
Bony Landmarks
Acromion Process and along scapula
Spine of scapula
Greater tuberosity of humerus
Ant and Pos Joint Lines of Humerus
Supraspinatus
Infraspinatus
Deltoid
Axillary nerve sensation

63
Q

Shoulder examination
What to check in move? (4)

A

Full Extension and Flexion
Full Abduction
External and Internal Rotation of Shoulder
Scapula movement

64
Q

What is a painful arc?

A

Shoulder examination - pain between 10 and 120 degrees

65
Q

Elbow examination
What to look at in look? (10)

A

Ant, Pos, Medial and Lateral Joints
Scars
Swelling
Wounds
Sinuses
Rashes
Rheumatoid Nodules
Evidence of Olecranon Bursitis
Deformity and Normal Carrying
Muscle Wasting

66
Q

What is the normal carrying angle of elbow in males?

A

-10

67
Q

What is the normal carrying angle of elbow in females?

A

-15

68
Q

Where to palpate in elbow examination? (4)

A

Temp
Tenderness over medial (golfers elbow)
Tender over lateral epicondyle (tennis elbow)
Tender over olecranon process and radial head

69
Q

What is phalen’s test?

A

The wrist is held in full flexion for 60 seconds (reverse prayer sign). The test is positive if patient’s symptoms are elicited by this manoeuvre. For carpal tunnel

70
Q

What is Tinel’s Test?

A

Tinel’s test is performed by lightly tapping over the median nerve as it passes through the wrist. A positive response to the test is denoted by tingling in the thumb, index and middle fingers (distribution of median nerve). for carpal tunnel

71
Q

Hand and Wrist Examination
What to look for on looking? (12)

A

Scars, Wounds or Thinning of Skin
Rash
Nails: Clubbing, Psoriatic Changes (Pitting Oncyholysis), Splinter Haemorrhages, Nail Fold Vasculitis
Posture of Hand
Finger Deformity
Muscle Wasting
Swellings eg Bouchard Nodes (PIP) and Heberden (DIP)
Fascial Thickening

72
Q

What is pitting oncycholysis and where can it be found?

A

Nails it is psoriatic change

73
Q

Where are Bouchard Nodes found?

A

PIP

74
Q

Where a Hebden Nodes found?

A

DIP

75
Q

Hand and Wrist examination
- What to check for in move? (3)

A

Straighten then make fist
Flex and Extend of MCPJ, PIPJ and DIPJ
Phalen/Tinel

76
Q

Hand and wrist examination
what to check for in function?

A

Power Grip
Pincer Grip

77
Q

Hand and wrist examination what to check in neuro exam?

A

Sensation and Power of Median, Ulnar and Radial Nerves

78
Q

Hand wrist examination

How to assess radial nerve power?

A

Resisted finger extension

79
Q

Hand and wrist examination

How to assess median nerve power?

A

Test abductor pollicis brevis. Place hand flat with palm to ceiling. Ask patient to point thumb to ceiling and hold it there whilst you try to push it down.

80
Q

Hand and wrist examination

How to assess ulnar nerve power?

A

testing the interossei by asking patient to spread fingers wide and keep them there whilst you try to squeeze them together.

81
Q

Hand and wrist examination

How to test sensation of median nerve?

A

touch volar tip of index finger and thenar eminence

82
Q

Hand and wrist examination

How to test sensation of ulnar nerve?

A

touch volar tip of little finger and hypothenar eminence

83
Q

Hand and wrist examination

How to test sensation of radial nerve

A

touch first web space on dorsum of hand between thumb and index finger

84
Q

What is the Trendelnburg Test a sign of?

A

Weak/paralysed abductor muscles (gluteus minimus and gluteus medius of hip)

85
Q

When is Trendelnberg test positive?

A

Pelvis dips on side of non weight bearing leg

86
Q

What is Thomas test for?

A

Assessment of fixed flexion deformity of hip - increased lumbar lordosis

87
Q

What to look for on hip examination? (5)

A

Deformity and Symmetery
Scars
Swelling
Muscle Wasting
Leg Length Discrepancy

88
Q

What to feel for on hip examination? (3)

A

Tender over greater trochanter
Apparent leg length discrepancy
True length discrepancy

89
Q

Where to measure apparent leg length discrepancy?

A

xiphisternum to medial malleolus

90
Q

Where to measure true leg length discrepancy?

A

ASIS to medial malleolus

91
Q

What to check on hip examination movement? (6)

A

Thomas Test
Flexion
Rotation
- Abduction
- Adduction
Trendelburg

92
Q

What does a high stepping gait mean?

A

foot drop

93
Q

What is a knee valgus deformity?

A

The distal part (tibia) is deviated laterally
or away from the midline. A bilateral valgus
deformity will give a knock-kneed
(Genu Valgum) appearance.

94
Q

What is a knee varus deformity?

A

The distal part (tibia) is deviated medially
or towards the midline. If the deformity
is bilateral, it will give a bow legged
appearance.

95
Q

What is a patellar tap used for?

A

Moderate to Large Effusion >50ml

96
Q

What is a bulge tap used for?

A

Smaller fusions

97
Q

What to check on knee examination inspection? (6)

A

Symmetry and Alignment
Varus or Valgus Deformity
Fixed Flexion of Knee
Rash
Wounds/Scars/Swelling
Waste of Quadriceps

98
Q

What to check on knee examination palpation? (7)

A

Temp Difference
Tenderness over patella, extensor mechanism, medial and lateral joints
Behind knee for popliteal cysts
Effusion

99
Q

What to check on knee examination movement? (5)

A

Flexion
Extension
Hyperextension
Medial and Lateral Collateral Ligaments
Cruciate Ligaments

100
Q

A positive sag (draw) test means what?

A

Issue with cruciate ligaments in knee

101
Q

Ankle and Foot Examination

What to look for? (11)

A

Nail Changes, Skin Rashes, Scars, Wounds and Calluses
Swelling and Muscle Wasting of Calf Muscles
Clawing or Hammer Toes
Joint Swelling or Hallux Valgus
Callus Formation

102
Q

Ankle and Knee Examination

what to look for on standing? (4)

A

Toe alignment
Foot arch position
Alignment of Hind Foot eg Varus/Valgus
Achilles Tendon Swelling or Thickening

103
Q

Ankle and Knee Examination

What to feel for? (7)

A

Temperature over forefoot, mid foot and ankle
Lateral and Medial malleolus
Fibula Head
Bones in Foot
Lateral Squeeze MTP Joints for Morton Neuroma
Subtalar, Midfoot, Tarsal and Ankle

104
Q

Ankle and Knee Examination

What to look at on movement? (3)

A

Dorsiflexion and Plantarflexion at Ankle
Inversion and Eversion at Subtalar
Mid Tarsal and Subtalar movements

105
Q

What is a boxers fracture?

A

Transverse fracture of 5th metacarpal neck

4th Year Finals (37 decks)

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