PCM OSCE Introduction to PE

Question 1

4 techniques of examination

Answer 1

inspection
auscultation
percussion
palpation

Question 2

auscultation

Answer 2

dull = fluid
flat = solid
tympanic = air

Question 3

stethoscope diaphragm

Answer 3

higher frequency sounds (breath and heart)

Question 4

stethoscope bell

Answer 4

lower frequency sounds (bruits)

Question 5

BP cuff width

Answer 5

40% upper arm circumference

Question 6

BP cuff length

Answer 6

80% upper arm circumference

Question 7

normal vitals

Answer 7

HR 60-100
RR 14-20
BP 120/80
T 97.8-99

Question 8

direct pupillary light reflex

Answer 8

when light shined in the eye, ipsilateral pupil constricts

Question 9

consensual pupillary light reflex

Answer 9

when light shined in the eye, contralateral pupil constricts

Question 10

ear exam children <12 months

Answer 10

pull down, out and back

Question 11

ear exam children >12 months

Answer 11

pull up, out and back

Question 12

patellar DTR

Answer 12

L4

Question 13

achilles DTR

Answer 13

S1

Question 14

biceps DTR

Answer 14

C5

Question 15

brachioradialis DTR

Answer 15

C6

Question 16

triceps DTR

Answer 16

C7

Question 17

0+ reflex

Answer 17

reflex absent

Question 18

1+ reflex

Answer 18

somewhat diminished; low normal

Question 19

2+ reflex

Answer 19

average; normal

Question 20

3+ reflex

Answer 20

brisker than average

Question 21

4+ reflex

Answer 21

very brisk, hyperactive, with clonus

Question 22

+0 strength

Answer 22

no contraction

Question 23

+1 strength

Answer 23

barely detectable

Question 24

+2 strength

Answer 24

active movement with gravity eliminated

Question 25

+3 strength

Answer 25

active movement against gravity

Question 26

+4 strength

Answer 26

active movement against gravity and some resistance

Question 27

+5 strength

Answer 27

active movement against full resistance without evidence of fatigue; normal

Question 28

dermatome landmarks

Answer 28

``` C4 - top of shoulder C6 - radial aspect of forearm C8 - 5th digit T4 - nipple line T10 - umbilicus L5 - great toe S1 - posterolateral calf/little toe ```

Question 29

normal capillary refill

Answer 29

<2 seconds

Question 30

0 pulse

Answer 30

absent

Question 31

+1 pulse

Answer 31

diminished, barely palpable

Question 32

+2 pulse

Answer 32

average intensity; normal

Question 33

+3 pulse

Answer 33

strong, full

Question 34

+4 pulse

Answer 34

bounding

Question 35

testing for edema

Answer 35

press firmly 5 seconds over the dorsum of foot anterior tibia behind medial malleolus

Question 36

0 edema

Answer 36

absent

Question 37

1+ edema

Answer 37

barely detectable (2mm), disappears rapidly

Question 38

2+ edema

Answer 38

slight indentation (4mm), 10-15 seconds

Question 39

3+ edema

Answer 39

deeper indentation (6mm), >1 minute

Question 40

4+ edema

Answer 40

very marked indentation (8mm), 2-5 minutes