Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OSCE > Derm/Ophthalmology/ENT > Flashcards

Derm/Ophthalmology/ENT Flashcards

1
Q

What are some specific symptoms you should ask about any skin lesion or rash?

A

Pain, itch, bleeding, discharge/crusting (also remember to ask about systemic symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some risk factors that it is important to ask about in a dermatological history?

A

Sun exposure, sunbed use, skin type, previous sunburn (particularly blistering)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If a patient presents with a generalised skin condition, what are some other areas that it is useful to examine?

A

Nails, scalp and mucus membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What two terms can be used to describe a flat area of skin of altered colour? What is the difference between these terms?

A

Macule and patch - a macule is < 1cm diameter and a patch is > 1cm diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What two terms can be used to describe a solid, raised, palpable lesion? What is the difference between these terms?

A

Papule and nodule - a papule is < 0.5cm diameter and a nodule is > 0.5cm diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What term is used to describe a lesion with raised edges and a flat surface > 1cm diameter?

A

Plaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What two terms can be used to describe a raised, clear, fluid filled lesion? What is the difference between these terms?

A

Vesicle and bulla - a vesicle is < 0.5cm diameter and a bulla is > 0.5cm diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What term is used to describe a pus containing lesion of < 0.5cm diameter?

A

Pustule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When describing a rash or non-pigmented lesion, it is best to work through general inspection, morphology and any additional features. What things should you comment on under general inspection?

A

Isolated/widespread/generalised? Where is the lesion? If there are multiple- comment on symmetry/asymmetry and discrete/confluent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When describing a rash or non-pigmented lesion, it is best to work through general inspection, morphology and any additional features. What things should you comment on under morphology?

A

Size and shape of the lesion? Raised or not? Fluid filled or not? Then come up with appropriate terminology to describe the lesion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When describing a rash or non-pigmented lesion, it is best to work through general inspection, morphology and any additional features. What things should you comment on under additional features?

A

Colour? Border? Additional things e.g. crusting, bleeding, weeping?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What things should you comment on before going on to use the ABCDE approach to describing a pigmented skin lesion?

A

Isolated/widespread/generalised? Where is the lesion?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe what is meant by the ABCDE approach to describing a pigmented skin lesion?

A

Asymmetry, border, colour, diameter, elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If you suspected a bacterial skin lesion, what type of investigation should you do?

A

Bacterial swab (blue) for microscopy, culture and sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If you suspected a viral skin lesion, what type of investigation should you do?

A

Viral swab (red) for PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the most likely investigation to do for a skin lesion where malignancy is suspected or a non-infective rash where diagnosis is required?

A

Biopsy for histopathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What investigations are required for immediate IgE mediated allergic skin reactions?

A

RAST IgE levels and skin prick test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What investigation is used for delayed type allergic skin reactions?

A

Patch testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ideally, where should skin scrapings be taken from?

A

The periphery of the affected area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of scalpel should be used to take skin scrapings?

A

A rounded scalpel, e.g. number 15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

If you suspect a fungal skin lesion, what type of investigation should you do?

A

Skin scrapings for mycology (microscopy and culture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If you suspect an infestation related skin lesion, what type of investigation should you do?

A

Skin scrapings for microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What specific symptoms should you ask about in an ophthalmic history?

A

Visual changes, red eye, eye pain/photophobia, discharge, headaches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What additional questions should you ask in the past medical history of someone with an eye problem?

A

Have they ever had any problems with their vision or eye? Do they use glasses/contact lenses?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Should patients wear glasses/contact lenses during assessment of visual acuity?

A

Yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

If visual acuity is not 6/6, what should you do next? What is the purpose of this?

A

Repeat the examination using pinholes- if this improves the visual acuity, this suggests that a refractive error is likely the cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What should you do next if a patient is unable to read a Snellen chart, even with the pinholes?

A
  1. Repeat at 3m, 2. Repeat at 1m, 3. Assess hand movements, 4. Assess light response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What two questions should you ask before performing a visual field exam to ensure that gross vision is normal?

A

Can you see my whole face? Can you see both my hands?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are all of the different aspects of eye examination?

A

General inspection, visual acuity, visual fields, colour vision, pupillary reflexes, fundoscopy, eye movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the three aspects of visual field examination that you can test?

A

Movements of fingers in quadrants, moving a pin in from quadrants, blind spot testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

In an ideal world, what would you want to do before starting examination with an ophthalmoscope?

A

Darken the room and give the patient dilating eye drops (e.g. tropicamide 0.5%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

At what setting should you have the ophthalmoscope when assessing for the red reflex? Absence of the red reflex can be a sign of what?

A

0 / cataracts or retinal detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Before starting to examine the back of the eye, at what setting should you have the ophthalmoscope?

A

10 (and then work down to keep it focussed)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What three things should you comment on when describing the optic disc after fundoscopy or if presented with a picture?

A

Contour, colour, cup: disc ratio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

After doing a fundoscopy, what things should you comment on?

A

The optic disc, the vessels and the macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do you look at the macula when performing fundoscopy?

A

Ask the patient to look directly into the light

37
Q

The swinging light reflex assesses for what? What is this caused by?

A

Relative afferent pupillary defect (RAPD) - caused by damage between the optic nerve and chiasm

38
Q

What is seen in a relative afferent pupillary defect?

A

There is paradoxical dilatation of the affected pupil when a light shines in it

39
Q

What should happen during the accommodation reflex?

A

The pupils should constrict and converge

40
Q

What are the different eye reflexes that should be assessed during examination?

A

Direct and consensual pupillary reflexes, swinging light reflex, accommodation reflex

41
Q

Describe the normal contour of the optic disc?

A

The border of the disc is clear and well-defined

42
Q

If the borders of the optic disc are blurred, what may this suggest?

A

Papilloedema (swelling of the disc) secondary to raised ICP

43
Q

Describe the normal colour of the optic disc?

A

Orange-pink coloured circle with a pale centre

44
Q

An optic disc that is more pale than usual is suggestive of what?

A

Optic atrophy (can be secondary to optic neuritis, advanced glaucoma or ischaemic events)

45
Q

Describe the normal cup: disc ratio of the optic disc?

A

The normal ratio is 0.3, with the cup taking up approximately 1/3rd of the height of the disc

46
Q

What does an increased cup: disc ratio suggest?

A

Loss of healthy neuro-retinal tissue which can occur in glaucoma

47
Q

What can be seen in this image?

A

Proliferative retinopathy

48
Q

What can be seen in this image?

A

Drusen, suggestive of dry ARMD

49
Q

What can be seen in this image?

A

Very pale retina, suggestive of central retinal artery occlusion

50
Q

What can be seen in this image?

A

Previously laser treated diabetic retinopathy

51
Q

What can be seen in this image?

A

Retinal detachment

52
Q

What can be seen in this image?

A

Retinal haemorrhages associated with central retinal vein occlusion

53
Q

What can be seen in this image?

A

Retinal haemorrhages, associated with central retinal vein occlusion

54
Q

When looking at an image on fundoscopy, how can you tell if it is the right or left side?

A

The disc will be on the side that it is (i.e. if disc is on the left side of the image, it is the left eye)

55
Q

What can be seen in this image?

A

Hypertensive retinopathy

56
Q

What can be seen in this image?

A

Hypertensive retinopathy

57
Q

What can be seen in this image?

A

Increased cup to disc ratio suggestive of glaucoma

58
Q

What are some signs of hypertensive retinopathy on fundoscopy?

A

Flame haemorrhages

Cotton wool spots

Papilloedema

Hard exudates

59
Q

What can be seen in this image?

A

A pale optic disc, suggestive of optic atrophy

(this has many possible causes including glaucoma, retinal damage, ischaemia)

60
Q

What sign of diabetic retinopathy can be seen here?

A

Microaneurysms

61
Q

What sign of diabetic retinopathy can be seen here?

A

Dot and blot haemorrhages

62
Q

What sign of diabetic retinopathy can be seen here?

A

Cotton wool spots

63
Q

What can be seen in this image?

A

Non-proliferative diabetic retinopathy

64
Q

What can be seen in this image?

A

Non-proliferative diabetic retinopathy

65
Q

What can be seen in this image?

A

Proliferative diabetic retinopathy

66
Q

What can be seen in this image?

A

Proliferative diabetic retinopathy

67
Q

Describe what type of hearing loss is depicted on this audiogram?

A

Mixed hearing loss on the left side

68
Q

What can be seen in this image?

A

Cholesteatoma

69
Q

Describe what type of hearing loss is depicted on this audiogram?

A

Conductive hearing loss on the right side

70
Q

What can be seen in this image?

A

A bulging tympanic membrane, suggestive of acute otitis media

71
Q

Describe what type of hearing loss is depicted in this audiogram?

A

Sensorineural hearing loss on the right side

72
Q

What can be seen in this image?

A

A red, bulging tympanic membrane suggestive of acute otitis media

73
Q

What can be seen in this image?

A

Otitis media with effusion

74
Q

What can be seen in this image?

A

Otitis media with effusion

75
Q

What can be seen in this image?

A

Perforated tympanic membrane

76
Q

What can be seen in this image?

A

Perforated tympanic membrane

77
Q

In children presenting with an ear or hearing problem, what should you specifically ask about?

A

Their language and hearing milestones

78
Q

What symptoms should you ask about in all patients presenting with ear problems?

A

Hearing loss, ear pain, discharge, tinnitus, vertigo

79
Q

What risk factor should you always ask about in patients presenting with hearing loss?

A

Loud noise exposure

80
Q

What are some ototoxic drug groups you should be aware of?

A

Aminoglycosides, quinines, platinum-based chemotherapy agents

81
Q

Describe the steps of examining the ear and vestibular system?

A

Examination of the external ear and ear canal

Otoscopy (comment on appearance, cone of light, tympanic membrane)

Rinne and Weber’s tests (512Hz fork)

CNVIII +/- cerebellar exam

82
Q

On an audiogram, what symbols are representative of the right side?

A

Circle (air conduction) and < symbol (bone conduction)

83
Q

On an audiogram, hearing above what volume is considered normal?

A

20 DB

84
Q

On an audiogram, what symbols are representative of the left side?

A

X = left side air conduction, > = left side bone conduction

85
Q

Which type of hearing loss will show only decreased air conduction and therefore an air-bone gap on an audiogram?

A

Conductive

86
Q

Which type of hearing loss will show decreased air and bone conduction on an audiogram?

A

Sensorineural

87
Q

On an audiogram, conductive hearing loss at 2000Hz is suggestive of what diagnosis?

A

Otosclerosis

88
Q

On an audiogram, sensorineural hearing loss at high frequencies bilaterally is suggestive of what diagnosis?

A

Prebycusis

89
Q

On an audiogram, sensorineural hearing loss at 4000Hz bilaterally is suggestive of what diagnosis?

A

Hearing loss due to loud noise exposure

OSCE (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions