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Clinical Skills II- OSCE > Surgery OSCE > Flashcards

Surgery OSCE Flashcards

Frank Jones Rt Sided Thyroid Nodules

1
Q

Presenting Complaint

A

Right Sided Thyroid Nodule

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2
Q

Presenting Situation

A

A 45-year-old male presented to surgery with right-sided thyroid masses by PCP (primary care physician). I have been feeling tired for the past few months and is very concerned

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3
Q

Opening Statement

A

I have been feeling tired and my PCP found a mass on my thyroid

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4
Q

How long have you been feeling tired?

A

2 months

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5
Q

Any weight gain

A

gained 5 pounds

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6
Q

Any trouble waking up

A

Have trouble waking up despite getting 8 hours of sleep

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7
Q

Have any pain

A

No

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8
Q

Have difficulties swallowing

A

No

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9
Q

Pain in the ears

A

No

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10
Q

Any anxiety or depression

A

No

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11
Q

Any tremors

A

No

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12
Q

Changes in neck over the past month

A

No

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13
Q

Noticed any changes in vision

A

No

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14
Q

Any sensitivity to temperature

A

I am sensitive to cold temperature

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15
Q

How often you have a bowel movement

A

Once a day

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16
Q

Any vomiting or diarrhea

A

No

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17
Q

Any weight loss

A

No

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18
Q

Any changes in the color of bowel movement

A

No changes

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19
Q

Any past skin disorders

A

Had radiation for acne as a teenager

20
Q

Any changes in hair

A

Barber mentioned that my hair is getting thinner

21
Q

Any allergies

A

No

22
Q

Are you able to feel the mass in neck

A

No

23
Q

Any chronic medical conditions

A

No

24
Q

Any long term medications the patient is on

A

No

25
Q

Any surgical history

A

pilonidal cyst removal at 16 and wisdom teeth removed at 17

26
Q

Are you married

A

Yes been married for 15 years

27
Q

Do you have children

A

No

28
Q

Any unprotected sexual encounters in the past two years.

A

No

29
Q

Do you drink?

A

Yes I drink a glass of wine with meals on the weekend mostly dinner

30
Q

Do you smoke currently

A

No

31
Q

Do you have a smoking history

A

Yes I smoke a pack of cigarettes a day for 10 years.

32
Q

Do you do illicit drugs

A

No

33
Q

Any family medical history

A

Your mother had a goiter in her teens but was treated with medications a long time ago. The father has no medical history. Both parents are currently healthy.

34
Q

How old are you

A

45 year old

35
Q

Date of birth

A

January 7th 1979

36
Q

Differential diagnosis

A

Benign Thyroid Nodule with Goiter
Malignant Thyroid Nodule
Hypothyroidism
Anemia

37
Q

Question regarding the malignant mass can be suspected for cancer

A

Can this be cancer?

38
Q

Question testing the empathy of suspected malignant mass

A

Doc tell me straight I am going to die from this?

39
Q

Thyroid Exam Finding

A

A firm 2.0 cm nodule is noted in the lower Rt. Lobe of the thyroid.

40
Q

Size of the thyroid (Thyroid Exam Finding)

A

The thyroid is approximately 27 gms in size (slightly enlarged)

41
Q

Neck Exam Finding

A

No masses or enlarged lymph nodes are identified in the posterior auricular, preauricular, submandibular, sternocleidomastoid, supraclavicular or posterior triangle lymph nodes

42
Q

Cardiac Exam Finding

A

Tachycardic, regular rate and rhythm without murmurs, gallops, or regurgitation

43
Q

Any lab work that was done by the PCP

A

No

44
Q

When was the right-sided thyroid nodule discovered by the PCP

A

4 weeks ago and referral was made 3 1/2 weeks ago

45
Q

Pulmonary Exam Finding

A

Tachypneic, breath sounds, equal bilaterally and clear without rales or Ronchi

46
Q
A

Clinical Skills II- OSCE (5 decks)

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