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Last minute exam cram > Tuesday OSCE > Flashcards

Tuesday OSCE Flashcards

1
Q

straw coloured urine indicates

A

normal

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2
Q

dark coloured urine indicates

A

dehydration

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3
Q

red urine indicates

A

macroscopic haematuria, rifampicin, beetroot or porphyria

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4
Q

brown urine indicated

A

bile, myoglobin, anti-malarial drugs

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5
Q

clear urine would indicate

A

normal

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6
Q

cloudy urine would indicate

A

UTI

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7
Q

frothy urine would indicate

A

nephrotic syndrome

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8
Q

offensive smelling urine would indicate

A

UTI

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9
Q

sweet smelling urine would indicate

A

glycosuria

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10
Q

specific gravity is a measure of

A

urine concentration

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11
Q

key renal questions

A

fever, dysuria, frequency, urgency, haematuria, nocturia, hesitancy, dribbling, poor stream, incontinence, N+V

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12
Q

inspecting the posterior aspect of the spine, what are you looking for?

A

posture of the head, neck + shoulders. check for thoracolumbar scoliosis

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13
Q

inspecting the spine from the side, what are you looking for?

A

cervical lordosis, thoracic kyphosis, lumbar lordosis

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14
Q

why do you ask the patient to shrug their shoulders during palpation?

A

to feel in the supraclavicular fossa for cervical ribs

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15
Q

what are you feeling for in the midline of the spine?

A

spinous processes

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16
Q

two things to check for in the iliac region?

A

iliac crest height, sacroiliac joints

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17
Q

why do you check for chest expansion in palpation of the spine?

A

reduced chest expansion can be a sign of AK

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18
Q

describe the movement of the cervical spine in the spine exam

A

flexion/extension, rotation and lateral flexion

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19
Q

describe the movement of the lumbar spine in the spinal exam

A

flexion (schobers test), extension and lateral flexion

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20
Q

what is schobers test?

A

mark the sacroiliac joints, measure 10cm above 5 cm below , ask patient to bend forward, should increase to 20cm

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21
Q

what are you inspecting the anterior aspect of shoulder for?

A

contour of shoulder, deltoid + trapezium muscle bulk, SC and ACJ joints, clavicle

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22
Q

what are you inspecting the lateral aspect of shoulder for?

A

scars and shoulder contour

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23
Q

what are you inspecting the posterior aspect of shoulder for?

A

SC ACJ joints, supraspinatus and infraspinatus fossa for wasting

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24
Q

what are you inspecting the axilla for during the shoulder exam?

A

scapula symmetry, swellings and scars

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25
Q

what do you palpate in the shoulder exam?

A

SC joints, clavicle, ACJ joint, acromion, long head of biceps, scapula; spine and body.

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26
Q

describe the movements tested in the shoulder exam

A
  1. external rotation
  2. forward flexion
  3. abduction
  4. internal rotation
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27
Q

what is the normal degree of external rotation in shoulder?

A

70o

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28
Q

what is the normal degree of forward flexion in the shoulder

A

150-170o

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29
Q

what is the normal degree of abduction in the shoulder

A

160-180o

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30
Q

what is the normal level of internal rotation in the shoulder

A

T5

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31
Q

what muscles are you testing during scapula winging?

A

serratus anterior, long thoracic nerve

32
Q

what movement tests supraspinatus?

A

like movement like Jobes

33
Q

what movement tests infraspinatus?

A

same movement as external rotation, ask patient to push against your hands

34
Q

what movement tests subscapularis?

A

hand on bum, push off

35
Q

special tests for impingement/rotator cuff pathology in shoulder exam?

A

painful arc, Hawkins-kennedy, Jobes, Scarf test

36
Q

what special tests for instability of shoulder?

A

sulcus, A+P drawer tests, anterior apprehension and relocation, posterior apprehension

37
Q

during the knee exam, patient standing what are you looking for?

A

limb alignment, muscle bulk, popliteal fossae

38
Q

what do you look for during gait?

A

pace, symmetry, gross gait abnormality, walking aids

39
Q

during the knee exam, patient lying on the couch, what are you looking for?

A

erythema, skin changes, bruising, scars, hair changes, swelling

40
Q

during the knee exam, how many sides do you palpate?

A

one side only, affected

41
Q

during the knee exam, straight leg raise is testing what?

A

extensor mechanism

42
Q

what are the two effusion tests during the knee exam?

A

patellar tap and medial gutter sweep

43
Q

what do you palpate for during the knee exam?

A

temperature, tibial tuberosity, effusion, patellar tendon, patellar instability, patellar grind test, medial and lateral joint line, collateral ligaments, cruciate ligaments

44
Q

what test do you do if there is tenderness over the joint line in the knee?

A

Steinnmans, remember to twist the foot! not the leg

45
Q

what stress do you apply to test the medial collateral ligament?

A

valgus stress

46
Q

what movements do you test in the knee exam?

A

flexion, extension

47
Q

what special test is at the end of the knee exam, if indicated?

A

heel height testing

48
Q

three screening questions at the start of the GALS exam?

A

do you have any pain in the joints/muscles/back ATM?
can you dress yourself?
can you get up and down stairs ok?

49
Q

GALS; patient standing in anatomical position what are you looking for?

A

muscle bulk of; shoulder, glutes, quads, calves.
limb alignment; spine, iliac crest height
spine; scoliosis, lordosis and kyphosis
popliteal swellings
foot abnormalities

50
Q

GALS; first movement in the arm section?

A

hands behind head; testing shoulder abduction, external rotation, elbow flexion

51
Q

GALS; describe the arms part of the exam?

A

hands behind head, hands held out
make a fist; assess power grip, hand + wrist function, range of finger movement, squeeze fingers
squeeze MCPs

52
Q

GALS; describe the spine part of the exam?

A

cervical spine; lateral flexion

lumbar spine; lumbar flexion

53
Q

GALS; describe the legs part of the exam?

A 
knees; flexion, extension and crepitus 
hip; internal rotation 
patellar tap 
inspect feet; swelling deformity and callous 
squeeze across MTPs
54
Q

SKIN; important HPC questions to ask?

A 
duration
site and appearance at onset 
details of evolution and spread 
symptoms; itch, pain, burning 
aggravating/relieving factors 
how does it affect you?
55
Q

SKIN; systemic enquiry?

A

mouth/tongue involvement, eye involvement, hair +nail involvement, swellings + lumps anywhere.

56
Q

SKIN; important PMH?

A

atopy, general health, mouth disease

57
Q

SKIN; describe a flat lesion

A

macule 1cm

58
Q

SKIN; describe some raised lesions

A

papule, nodule, plaque, wheal, fluid; vesicle/bulla, cyst, pustule

59
Q

EAR; ototoxic drugs to ask for?

A

gentamicin, diuretics, cytotoxics

60
Q

EAR; important points about occupation?

A

noise exposure

61
Q

describe a normal Webers test

A

heard centrally

62
Q

if webers is louder in the weaker ear, what is this interpreted as?

A

conductive HL

63
Q

if Webers is louder in the better ear, what is this interpreted as?

A

sensorineural HL

64
Q

Describe a positive Rinnes test

A

normal. air conduction is better than bone conduction

65
Q

Describe a negative Rinnes test

A

abnormal, bone conduction is better than air conduction. conductive hearing loss

66
Q

EAR; important PMH to ask

A

recent head surgery/injury , history of ear problems

67
Q

THYROID; what do we need to check with the eyes?

A

exophthalmos
eye movement
lid lag

68
Q

THYROID; what do you we need to check in the hands?

A

dry skin, sweat, tremor, pulse (rate+rhythm)

69
Q

THYROID; what are you palpating for?

A

size, symmetry, consistency, masses, palpable thrill

70
Q

THYROID; what is important in HPC?

A

recent viral illness

71
Q

THYROID; iodine rich foods?

A

Sea stuff (fish, kelp etc), cereals and grains

72
Q

SKIN; treatments for eczema

A

eczema; emollients, avoidance of stimulants, steroids, antihistamine

73
Q

SKIN; treatments for psoriasis

A

Psoriasis; vitamin D, mild steroids, coal tar, phototherapy.

74
Q

SKIN; treatments for acne

A

acne; face wash, benzoyl peroxide, retinoid cream, contraceptive pill, antibiotics, isotretinoin

75
Q

SKIN; treatments for rosacea

A

avoid triggers, topical metronidazole, isotretinoin, tetracycline

76
Q

SKIN; important to ask in suspected skin cancer

A

sun exposure, skin type, immunosuppression, family history

77
Q

SKIN; systematic review of lesions

A

colour, size, flat/raised, border, surface features

Last minute exam cram (5 decks)

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