Resp/Haem/Derm OSCEs

Question 1

Haematological history

Answer 1

• ask pt story of what happened
• Lymphoma –> lumps or splenomegaly (abdo lump)
• Neutropenia –> recurrent infections? mouth ulcers?
• SH –> driving and recent trvel (DVT)
• Further steps for management?

Question 2

Lymph nodes and abdominal examination

Answer 2

• General inspection
• For any palapble lymph node –> characteristics comment on?
• Further investigations…
• Axillary –> borders
• Lymphadenopathy dx
• Hepatomegaly dx –> >2cm below right costal margin
• Splenomegaly dx –> palpable spleen at left costal margin is splenomegaly
• Anterior triangle anatomy?
• Posterior triangle anatomy?

Question 3

Venepuncture procedure

Answer 3

• Contraindications
• which vein?
• Order of draw

Question 4

Blood tests interp.

Answer 4

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Question 5

Simman scenarios –> DVT –> PE

Answer 5

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Question 6

Simman scenario –> Sickle cell crisis –> neutropenic sepsis?

Answer 6

• Management

Question 6

Simman scenario –> Subdural haemorrhage

Answer 6

• Chronic management –> common complication?

Question 7

Simman scenario –> Sepsis –> eg. leg ulcer infection which leads to sepsis

Answer 7

• order of sepsis six

Question 8

Dermatological history

Answer 8

• Derm-specific questions
• Skin lesion assessment
• Relevant PMH
• Relevant drug hx
• Relevant family hx –> skin cancer, atopic hx?
• Relevant social hx
• Further steps for management?

Question 9

Dermatology images

Answer 9

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Question 10

Respiratory history

Answer 10

• if SOB –> how far can patient walk?
• Vaccination hx
• Family hx –> lung conditions + atopic hx

Question 11

Respiratory examination

Answer 11

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Question 12

ABG procedure

Answer 12

• Contraindications
• how does oxygen therpay affect ABG results
• ABG reference ranges
• Modified Allen’s test
• Offer lidocaine –> 1% 1ml subcut

Question 13

Info giving –> inhaler technique

Answer 13

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Question 14

Peak expiratory flow technique and interp.

Answer 14

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Question 15

ABG interp.

Answer 15

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Question 16

Chest x-ray process and interp.

Answer 16

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Question 17

Lung function tests (spirometry) interp.

Answer 17

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Question 18

Simman scenario –> Acute exacerbation of asthma –> life-threatening

Answer 18

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Question 19

Simman scenario –> Pneumonia –> progressing to sepsis

Question 20

Simman scenario –> Anaphylaxis –> eg. due to co-amoxiclav

Question 21

Simman scenario –> Acute exacerbation of COPD –> leading to type 2 resp. failure

Answer 21

• Presentation –>
• Investigations –>
• Differentials –>
• Acute management –>
• Chronic management –>

Question 22

Simman scenario –> Pneumothorax –> tension?

Question 23

Info giving –> Resp.

Answer 23

• Inhaler technique –> discuss and demonstrate
• asthma management discussion
• COPD management discussion
• Peak flow demonstration

Question 24

Info giving --> Haem.

Answer 24

- Discuss blood test results - Iron-deficiency anaemia discussion

Question 25

Info giving --> Derm.

Answer 25

- Eczema --> what is it + management - Acne --> what is it + management - Application of moisturiser --> fingertip units - Psoriasis --> what is it + management

Question 26

CT scans

Answer 26

- know lung, heart, aorta, pulmonary artery

Question 27

Prescribing --> Haem/derm

Answer 27

- FP10 - Hospital drug chart

Question 28

Prescribing --> Resp.

Answer 28

- FP10 - Hospital drug chart

Question 29

Info giving --> Haem/derm

Answer 29

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