OSCE Examinations

Question 1

Name four signs you may see on the LL of someone with charcot-marie tooth disease?

Answer 1

High arch foot
Inverted champagne bottle calves
Muscle wasting (and other LMN signs)
Sensory deficit

Question 2

What tuning fork for hearing tests?

Answer 2

512hz for Rinne

512hz/ 256hx for Weber

Question 3

What are the components of a peripheral venous exam?

Answer 3

(All general intro/ inspection)
- Scars, venous eczema, lipodermatosclerosis
- Full ulcer inspection (venous ulcers often around medial malleolous)
Palpate varicosities (temp, check pain etc)
Check pulses for art supply
Trendelenburg tourniquet test
- To complete do doppler of veins to r/o DVT + peripheral arterial + ABPI as needs normal for compression stocking

Question 4

How do you determine between great and small saphenous vein?

Answer 4

Great saphernous = Medial side of leg

Small saphernous = Lateral

Question 5

How do you perform trendelenburg test?

Answer 5

Lie patient flat
Lift leg up and milk veins
Place tourniquet on sapherofemoral junction (2-3cm lateral and below pubic tuburcle)
Ask patient to stand
- If veins fill = defect is inferior to tourniquet
- If veins don’t fill = defect it as or superior to tourniquet

Question 6

How should Rombergs test be interpreted?

Answer 6

Positive result = Get’s worse on closing eyes

• Positive = Sensory ataxia
• Negative (doesn’t change) = Cerebellar ataxia

Question 7

Give 3 indications for a lobectomy?

Answer 7

Malignancy
Abcess
TB
Inflammation

Question 8

DDx sternotomy scar?

Answer 8

CABG

Valve replacement

Question 9

A patient has bilateral fine inspiratory crackles and reduced breath sounds on the lower right hand side? Differential?

Answer 9

Pulmonary oedema (fine inspiratory crackles)
- Pleural effusion (reduced breath sounds at lower right, if it was crackles could be consolidation)

Question 10

How do you distinguish between arterial and venous ulcers?

Answer 10

Arterial - Painful, punched out, well defined, on pressure points
Venous- No pain, shallow, sloughy, medial malleolus

Question 11

Components of diabetic foot exam?

Answer 11

Gait
Inspection (ulcers, art/ venous skin changes)
Palpation (temp, cap refil, pulses)
Sensation (monofilament, vibration)
Proprioception 
- Check footwear

Question 12

Differential diagnosis bilateral lower limb weakness?

Answer 12

Guillian barre (LMN)
Transverse myelitis (UMN)
Compression spinal cord (disc, tumour etc)
Cauda equina syndrome
Stroke (where the nerves decussate for bilateral)
Non-neurological

Question 13

Unilateral weakness of one limb, ddx?

Answer 13

Stroke (UMN)
Peripheral nerve lesion (LMN)
NMJ disorder

Question 14

Unilateral facial weakness ddx?

Answer 14

Stroke (UMN - contralateral)

Bells - Ipsilateral

Question 15

What should you always do when you see an ECG or CXR in an OSCE?

Answer 15

Ask for another to compare