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OSCE Revision > Procedures > Flashcards

Procedures Flashcards

1
Q

What medications can be given via SC injection?

A

LMWH and insulin

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2
Q

At what angle do you pierce the skin for a SC injection?

A

45 degrees

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3
Q

What are 4 causes of tachycardia?

A

anxiety, supraventricular tachycardia, hypovolaemia, hyperthyroidism

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4
Q

What are 4 causes of bradycardia?

A

healthy athletic individuals, atrioventricular block, medications, sick sinus syndrome

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5
Q

What is a cause of bradypnoea?

A

opiate overdose

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6
Q

What is a cause of tachypnoea?

A

acute asthma

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7
Q

What are causes of low specific gravity in urine?

A

conditions that result in the production of dilute urine such as diabetes insipidus and acute tubular necrosis

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8
Q

What are causes of raised specific gravity in urine?

A

Conditions that result in the production of strong urine dehydration, glycosuria (e.g. diabetes mellitus) and proteinuria (e.g. nephrotic syndrome)

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9
Q

What causes raised nitrites in urine?

A

Nitrites are a breakdown product of gram-negative organisms such as E.Coli: UTI

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10
Q

What can altered levels of urobilinogen in the urine be caused by?

A

The presence of increased levels of urobilinogen in the urine can be caused by haemolysis (e.g. haemolytic anaemia, malaria).
Low levels of urobilinogen can be caused by biliary obstruction.

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11
Q

What does raised leukocyte esterase in urine indicate?

A

Leukocyte esterase is an enzyme produced by neutrophils and therefore, when positive, it indicates the presence of white cells in the urine:

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12
Q

What is right axis deviation associated with?

A

right ventricular hypertrophy

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13
Q

What does a prolonged PR interval suggest?

A

AV block

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14
Q

What is a first degree heart block?

A

a fixed prolonged PR interval

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15
Q

What is second degree heart block also known as?

A

Mobitz typwe 1 heart block or Wenckebach phenomenon

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16
Q

What are typical ECG findings in Mobitz type 1 AV block?

A

include progressive prolongation of the PR interval until eventually the atrial impulse is not conducted and the QRS complex is dropped
AV nodal conduction resumes with the next beat and the sequence of progressive PR interval prolongation and the eventual dropping of a QRS complex repeats itself.

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17
Q

What is a delta wave on an ECG?

A

A delta wave is slurring of the upstroke of the QRS complex. This occurs because the action potential from the SAN is able to conduct to the ventricles very quickly through the accessory pathway, and thus the QRS occurs immediately after the P wave, making the delta wave.

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18
Q

What could be a cause of a tall QRS complex on an ECG?

A

vetricular hypertrophy

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19
Q

What can isolated Q waves indicate?

A

they can be normal

they can indicate a previous MI

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20
Q

What does ST depression show?

A

ST depression ≥ 0.5 mm in ≥ 2 contiguous leads indicates myocardial ischaemia.

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21
Q

What are some causes of tall T waves?

A

Hyperkalaemia (“tall tented T waves”)

Hyperacute STEMI

22
Q

What may flattened T waves represent on a ECG?

A

Flattened T waves are a non-specific sign, that may represent ischaemia or electrolyte imbalance.
These become larger the slower the bradycardia

23
Q

What view of the heart do leads V1 and V2 represent?

A

septal

24
Q

A patient is noted to have an abnormally shortened PR-interval on their ECG. What is the most likely cause?

A

Wolff-Parkinson-White syndrome

25
Q

What view of the heart do leads I, aVL, V5 and V6 represent?

A

lateral

26
Q

What would it suggest if lead I became more positive than lead II and lead III became negative?

A

left axis deviation

27
Q

What view of the heart do leads V3 and V4 represent?

A

anterior

28
Q

What view of the heart do leads II, III and aVF represent?

A

inferior

29
Q

Name all 4 views of the heart and the corresponding leads.

A

Septal - V1 and V2
Anterior - V3 and V4
Inferior - II III avF
Lateral - I avL V5 V6

30
Q

What may ST depression be caused by?

A

ischaemia

31
Q

What might hypercalaemia show up on an ECG?

A

short QT

32
Q

What may a prominent U wave on a ECG be caused by?

A

hypokalaemia

33
Q

What can S1Q3T3 be caused by?

A

PE

34
Q

What may pericarditis show up on the ECG?

A

PR depression and saddle shape ST interval

35
Q

What is the FEV1/FEV ratio in obstructive disease?

A

reduced because FEV1 is low but FEV is normal

36
Q

What is the FEV1/FEV ratio in restrictive disease?

A

normal because both FEV1 and FEV are reduced

37
Q

Give some examples of obstructive lung disease

A

asthma, COPD, bronchiestasis, CF

38
Q

Give some examples of restrictive lung disease

A

obesity, spinal abnormalities such as kyphosis, ILD, pulmonary fibrosis

39
Q

Which side does the trachea deviate to with a pneumothorax?

A

away from the pneumothorax

40
Q

What may a flat diaphragm indicate on a CXR?

A

COPD

41
Q

What does blunting of costphrenic angles on a CXR show?

A

pleural effusion

42
Q

What is the meniscus sign?

A

crescent shape costophrenic angle on CXR

43
Q

What can a meniscus sign indicate?

A

pleural effusion

44
Q

Describe the CXR findings of a patient with heart failure

A 
Alveolar shadowing 
B-lines
Cardiomegaly 
Diversion of blood to upper lobe 
Effusion
45
Q

What may a stable chronic COPD patient ABG result show?

A 
pH normal
O2 low
CO2 high
bicarb high
resp failure type 2 
fully compesated respiratory acidosis
46
Q

What may a patient hyperventilating show on an ABG blood test?

A 
pH high (alkalosis)
O2 high
CO2 low
bicarb normal
respiratory alkalosis 
lungs overdrive
47
Q

What may a heaving apex beat indicate?

A

aortic stenosis

48
Q

What may a narrow pulse pressure indicate?

A

aortic stenosis

49
Q

What are some symptoms of aortic stenosis?

A

syncope, exertional dysponea, angina

50
Q

What are signs of mitral regurgitation?

A

AF, thrusting displaced apex beat, pulmonary hypertension, palpitations

51
Q

Where might a mitral regurgitation murmur radiate to?

A

left axilla

OSCE Revision (3 decks)

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