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GP Conditions > OSCE > Flashcards

OSCE Flashcards

(46 cards)

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1
Q

Abdominal Peripheral

A

Hands - pallor, palmar erythema, koilonychia, leukonychia, Dupuytrens, finger clubbing, temperature, radial pulse

Arms:
Acanthothosis nigricans
Hair loss
track marks

Eyes + Mouth:
Keyser Fleischer rings
Pallor
Angular cheilitis
Corneal arcus
Oral apthous ulcers

Neck LN -> Virchow’s

Ab -> Cullen’s, Grey-Turner, distension, stoma, hernia, masses, striae

Palpate gallbladder, aorta, bladder
Pedal Oedema

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2
Q

Neuro Upper

A

Finger extension and grip

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3
Q

Shoulder MSK

A

Scapula palpation

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4
Q

Renal

A

Hands:

Asterixis
Pallor
Skin turgor

Arm:

Bruising
AV fistula
Pulse and BP

Face:

Uraemia frost
Uraemic fetor
Gingival hypertrophy

Neck:
JVP
Dialysis catheter

Chest:
HS
Lung bases for crackles
Percussion

Abdominal:
Palpate 9
Ballot kidneys
Auscultate bruits

Pitting oedema

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5
Q

COPD Management

A

A-E assessment
Call for senior
Nebulised salbutamol
Nebulised ipratropium
Oral prednisolone 30mg 5 days
Venturi 24-28 -> 88-92%
PO antibiotics -> amoxicillin, clarithromycin, doxycycline
Persistent -> BiPap

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6
Q

XR

A

Rotation

Inspiration -> anterior 5-6 ribs visible, both costophrenic angles and lateral rib edges

Assume PA if no label

Exposure -> left hemidiaphragm visible

CXR:

Airways - Trachea (deviation), carina, bronchi and hilar structures
Breathing - lungs and pleura
Cardiac - heart size and borders
Diaphragm - costophrenic angles
Everything else - mediastinal contours, bones, soft tissue, tubes, valves, pacemakers, aortic knuckle

Area of body xrayed

Bowel and organs:
Dilatation
Gas
Size
Organomegaly

Bones:
Alignment and joint space
Bone - texture
Cortices
Soft tissue - swelling, effusion

Calcification

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7
Q

Coffee bean on AXR -> diagnosis

A

Sigmoid volvulus

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8
Q

LL Neuro

A

Coordination, Romberg’s, Gait, plantars, stand up from chair without using arms

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9
Q

Give 3

A
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10
Q

Hand MSK

A

Hand on pillow
Radial pulse
Palpate thenar and hypothenar bulk
MCP squeeze
Palpate snuffbox

Power and sensation of ulnar (little volar, medial 2 lumbricals), radial (1st dorsal webspace, wrist extension/finger extension) and median (index and thenar eminence, thumb abduction)

Function -> power grip, pincer grip, small object

Tinel and Phalens

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11
Q

Uraemia + microcytic anaemia -> differential?

A

Upper GI Bleed

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12
Q

Management immediately + SOB

A

Bloods, ECG, CXR, ABG

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13
Q

Aortic dissection -> investigations?

A

ECG, CT angiogram

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14
Q

Breast exam

A

Clavicular LN, sub-mammary fold

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15
Q

UMN

A

Pronator drift, proprioception, vibration, finger extension, thumb abduction,

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16
Q

Which investigations can be used for stroke?

A

CT head urgent to rule out haemorrhage and SoLs
Carotid doppler to determine stenosis

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17
Q

Give an investigation for cardio in a ?stroke

A

ECG
Holter for AF

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18
Q

Give some stigmata of IE

A

Clubbing
Splinter haemorrhage
Janeway (brown lesions, painless)
Oslers nodes (red circles on bulk of hands, tender)

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19
Q

What to listen for when hearing crackles to differentiate bronchiectasis and fibrosis?

Study These Flashcards
A

Coarse crackles changing on cough and productive -> bronchiectasis

Fine, end inspiratory with dry cough -> fibrosis

20
Q

Give some signs of decompensated resp + cardio disease

Study These Flashcards
A

Resp -> CO2 retention flap, cor pulmonale
Cardio -> peripheral or pulmonary oedema

21
Q

Give the murmurs found in aortic stenosis

Study These Flashcards
A

Slow rising pulse, reverse S2 splitting

22
Q

Give a facial sign in mitral stenosis + P murmur

Study These Flashcards
A

Loud P2
Mitral stenosis
Both from pulmonary hypertension

23
Q

Which muscle is atrophies the earliest?

Study These Flashcards
A

Vastus medialis

24
Q

What is the most common direction that a TKR might dislocate?

Study These Flashcards
A

Posterior
PCL sometimes cut in TKR

25
Define HS S3 + S4
S3 = overcompliance of ventricles -> seen in dilated cardiomyopathy, systolic HF, S4 = filling into non-compliant ventricles -> hypertrophy, severe aortic stenosis or diastolic heart failure (always pathological)
26
What is Kussmaul's sign indicative of?
Constrictive pericarditis (impaired RV filling) -> increase in JVP with inspiration
27
Give 3 complication groups in transplants
Rejection, recurrence, immunosuppressant side effects
28
Give 3 causes of hyperthyroidism
Graves, toxic multi nodular goitre (iodine deficiency), toxic adenoma
29
Define Pemberton's test
Ask patient to raise arms above head -> check for flushing due to compression of SVC from goitre
30
Give 2 signs to distinguish Graves
Thyroid acropachy Pretibial myxoedema
31
Why ask about trauma in breast history taking?
Fat necrosis
32
Which murmur is associated with bisferiens pulse?
AR
33
What to ask before explaining a procedure?
Indication -> tailor counselling
34
Give 2 red flags for same day assessment in paediatric GORD
Vomiting blood Melaena
35
How to tell difference between AP and PA in CXR?
Look at scapulae within chest wall = AP
36
What type of crackles are heard in pulmonary oedema?
Coarse crackles Reduced breath sounds
37
Give some notes for contraceptive implant (years, mechanism of hormone -3, onset of effect, side effects, red flags)
3 years Progestogen -> prevents ovulation, thickens cervical mucus, thins endometrium Days 1-5 of menstrual cycle -> immediate Over 5 days -> wear barrier protection for 7 days Irregular bleeds, some have usual pattern, tends to improve over time, some don't have any Interactions with medications -> consult with doctor Make sure you are able to feel it, if not, then book appointment to check position Systemically unwell, persistent pain and redness
38
Give 3 side effects of clozapine + monitoring
Agranulocytosis -> first 18 weeks, monitor FBC weekly Cardiac -> ECG + safety net for chest pain, palpitations, leg swelling Constipation -> bowel obstruction
39
Give the weeks for pre-term, very pre-term and severe?
37, 32, 28
40
What should be monitored in cephalohaematoma?
Bilirubin
41
Hair on end, Howell Jolly body, target cell -> diagnosis?
beta-thalassaemia
42
How less should pO2 be compared to % O2?
10 less (e.g. 21 room air -> target 11)
43
What else should you consider in perceptions along with auditory (talking to them or about them, how many voices) and visual hallucinations?
Depersonalisation Derealisation
44
What to ask in current situation for MSE?
Eating, cleaning, work
45
Which anaemia is associated with choriocarcinoma?
alpha-thalasaemia
46
Diabetes
1) Insulin role, high sugar -> low insulin, decreased sensitivity 2) Acute -> UTIs 3) chronic -> sugar in vessels cause damage -> microvascular (eyes, kidneys, hands and feet) Macro -> heart and brain 4) Weight loss, diet, alcohol, smoking, HbA1c every 3-6 months, drug therapies, vaccinations, diabetes nurse follow up

GP Conditions (5 decks)

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