OSCE 3 Flashcards
(33 cards)
Invx and management of orbital cellulitis?
Bedside
- optho exam
- obs
- ENT exam
- microbiology swab of conjunctiva
Bloods
- check for infection
Imaging
- CT orbits
Manage
- urgent referral to optho/paeds
- continual monitoring
Medical
- IV Abx
Surgical
- if abscess = drainagw
Hearing loss causes
Conductive
- AOM
- Glue ear
- Blocked wax
- Choleastoma
- Osteosclerosis
- Foreign body
Sensironeural
- Presbycusis
- vestibular schwannoma
- noise-induced
- gentamicin
Haematuria urgent referrals
How is gout managed?
Conservative
- cut down on red meat and alcohol
- regular exercise and weight loss
Medical
- 1. NSAIDS (if not tolerated -> colchine)
2. Allopurinol to be started after acute flare and then maintained through further attacks
SWIFT for MSK exams
Scars/skin changes
Wasting of muscles
Involuntary movements
Fasculiations
Tremor
Shoulder exam
- loss of ER
- weak on ER, IR and beginning of arc
Loss of ER
- frozen shoulder
- glonohumeral arthritis
weak
- rotator cuff tear
Causes of shoulder pain
MSK
- frozen shoulder
- impigment syndrome
- trauma/fracture
- arthritis
- tendonitis
- cuff tear
- dislocation
Rheum
- PMR
- polymyositits
Referred pain
- referred gallbladder/ectopic
Management of golfers/tennis elbow
Physio + rest + NSAIDS
What neck lump doesn’t move on swallowing?
What moves on protursion of tongue?
dont’t move - ?cancerous, lymph nodes and brachial cleft cysts
Tongue - thyroglossal cyst
What happens in RAPD test
If light swung if bad eye - both will dilate rather than restrict
- due to CNII problem in that side
Causes of swollen disc
Bilateral = papilloedema (in context of raised ICP)
Papillitis (seen in optic neuritis) -> MS
CRVO (+ stormy sunset apperance)
Malignant HTN
Osteosclerosis
Chronic onset hearing loss in adults
Strong FH
Increased cup:disc ratio
Gluacoma
Some findings in diabetic retinopathy
Cotton wool spots
Micro-haemorraghes
Exudates
Neo-vascularisation
Pale and with cherry red spot on fundoscopy
CRAO
What is used to assess if unstable angina should get invasive angiography?
GRACE score
Suicide risk assessment
Before
- What was happening before?
- How long had you thought about it?
- Had you hoped to be found?
- Did you leave a note/change a will?
During
- Method - how did you get it? any drugs or alcohol?
- Alone?
- Where?
- did you want to die at the time?
After
- What do you remember after it happened?
- How do you feel now?
- What would happen if you were to leave hopsital?
- We want to support you to no longer feel like this - what does that support look like for you?
Psych hx
- hx of self-harm/previous suicide
- ever hear or see things others dont
- any mental health diagnosis
- fh of mental health
rest hx
Causes of psychosis
Schizophrenia
Depression
Delirium
Drugs -> ecstasy and steroids
Encephalitis
Neurosyphilis
Mania
Dementia types
Lewy body dementia
Frontotemporal
Alzhemiers
vascular
Drug management of alzhemiers
Donepezil
Rivastigime
(they don’t stop/slow down or reverse dementia but can temporarily help with memory and thinking)
Invx of ascietes
Management of ascietes
Ascietic fluid tap
Conservative
- Na+ restricted diet
Medical
- spriolacactone
Surgical
- theraputic paracentesis
What can cause raised troponin?
MI
Aortic dissection
Heart failure
Tachy/brady arrythmias
4Cs for C.diff
Co-amox
Clindamycin
Cephalosporin
Ciprofloxacin
What meds can worsen asthmatics?
NSAIDS and beta-blockers
