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4th Year Finals > OSCEs 2 > Flashcards

OSCEs 2 Flashcards

(105 cards)

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1
Q

What BMI do women have to be for referral to Fertility Clinic?

A

<35

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2
Q

What should fetal heart be on ausculatation?

A

110-160bpm

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3
Q

Name the three types of lie on obstetric examination?

A

Oblique
Transverse
Longitudinal

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4
Q

Name the 5 types of engagement of head on obstetric examination?

A

5/5: Free Float
4/5 Fixing
3/5 Nearly Engaged
2/5 Engaged
1/5 Just palpable
0/5 deep enagaged (ready for birth)

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5
Q

When is there an absolute contraindication to vaginal speculum exam?

A

Antepartum Haemorrhage due to Placenta Praevia

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6
Q

Uterus is commonly in what position?

A

Anteverted Anteflexed

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7
Q

Stages of Obstetric Examination? (7)

A

Position
Inspection: Scars, Striae Graviarium, Linea Nigra
Palpation of Fetal Poles
Fundal Height (after 20 weeks)
Presenting part
Engagement (after 36 weeks)
Auscultation over anterior shoulder

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8
Q

Name the 5 moments of hand hygiene

A

Before patient contact
Before aseptic task
After body fluid exposure risk
After patient contact
After contact with patient surroundings

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9
Q

What model to use for Breaking Bad News? (6)

A

SPIKES

Setting and Listening
Patient Perception
Invitation
Knowledge
Explore Emotion and Empathise
Strategy and Summary

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10
Q

Diarrhoea may be associated with what two endocrine conditions?

A

Hyperthyrodism
Adrenal Insufficiency

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11
Q

Constipation may be associated with what two endocrine conditions?

A

Hypothyrodism or Hypercalcemia

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12
Q

Sweating is associated with what four endocrine conditions?

A

Hyperthyrodism
Phaeochromaocytoma
Hypoglycemia
Acromegaly

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13
Q

In a examination looking for Diabetes what to look for? (9)

A

Weight Loss
Peripheral Pulses
Blood Pressure
Peripheral Vascular Disease
Peripheral Neuropathy
Charcot Foot
Skin Infection
Cataracts and Glaucoma
Diabetic Eye Disease

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14
Q

In an examination looking for thyrotoxicosis what to look for? (10)

A

Weight Loss
FIne Tremor
Palmar Erythema
Tachycardia
Collapse Pulse
Atrial Fibrillation
Proximal Myopathy
Exopthalmus
Lid Retraction and Lag
Goitre

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15
Q

In an examination looking for Hypothyrodism what to look for? (7)

A

Sluggishness
Skin coarse,pale, dry
Bradycardia
Periorbital Oedema
Xanathalasma
Dry/Thin Scalp Hair
Slow Reflexes

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16
Q

What to look for in Cushings Syndrome? (9)

A

Moon Face
Central Obesity
Bruising
Excessive Pigmentation
Proximal Myopathy
Visual Field Defects
Optic Atrophy
Papilloedema
Hypertension

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17
Q

What to look for on Inspection in Diabetic Foot? (7)

A

Shoes
Plantar aspects of feet
Skin. colour and integrity
Pressure damage/ulcers
Signs of infection
Hair loss
Deformity eg bunion (hallux valgus), over riding of toes, charcot joint, joint subluxation, high or flat arches or exostosis

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18
Q

What is exostosis?

A

is a benign bony lump with a cartilage cap that arises usually at the end of the long bones.

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19
Q

What is charcot foot?

A

Progressive degeneration of weight bearing joint due to diminished proprioception, repeated sustained trauma in ankle and joint = destruction

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20
Q

Where are arterial ulcers found?

A

Below ankle

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21
Q

Where to assess vibration in diabetic foot exam? (4)

A

Lateral metatarsophalngeal joint of big toe
midfoot
medial and lateral malleoli
knee

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22
Q

Where to test monofilament in diabetic foot? (5)

A

Apex of 1st and 3rd Toes
1st, 3rd and 5th Metatarsal Heads

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23
Q

What is paroxysmal nocturnal dyspnoea?

A

a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.

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24
Q

Blood Flow through the Heart?

A

Right Atrium > Tricuspid Valve > Right Ventricular > Pulmonary Valve > Pulmonary Artery > Pulmonary Vein > Left Atrium > Mitral Valve > Left Ventricle > Aorta

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25
What does Systole (S1) represent?
Mitral and Tricuspid closure
26
What does Systole (S1) represent?
Mitral and Tricuspid closure
27
Examination of Spine What to do in Inspection? (6)
Observe whole spine and curvatures Cervical and Lumbar - Lordosis Thoracic - Kyphosis Posture of Neck and Head Scars or Sinuses Scoliosis
28
Examination of Spine What to do in feel? (4)
Feel down spine Palpate midline spinous processes Feel sacrolilac joints Feel paraspinal muscle tenderness
29
Examination of spine What to do in move (6)
Flexion Extension Lat Flexion Rotation Lumbar spine flexion and extension Lumbar spine lateral flexion
30
Examination of Spine what to do in neuro? (4)
Straight Leg Raise Reflexes Power/Sensation
31
Which dermatomes to test in spine examination? (13)
C5,C6,C7,C8,T1,T2,L1,L2,L3,L4,L5,S1,S2
32
C5 dermatome covers where?
Regimental badge area
33
C6 dermatome covers where
Thumb
34
C7 Dermatome where
Mid Finger
35
C8 Dermatome where
Little Finger
36
T1 dermatome where?
medial antecubital fossa
37
T2 dermatome where
Axilla
38
L1 dermatome where
Upper medial thigh
39
L2 dermatome where
Medial mid thigh
40
L3 dermatome where
medial side knee
41
L4 dermatome where
medial malleolus
42
L5 dermatome where
dorsal foot
43
S1 dermatome where
lateral heel
44
S2 dermatome where
Back of thigh
45
S3-5 dermatomes cover where?
Rectal tone and bum
46
Which muscle groups to test in spine power examination? (9)
Deltoid Biceps Triceps Finger Flex Finger Abduction Hip Flex Quadriceps Great Toe Dorsiflexion Foot Plantarflex
47
C5 dermatome where?
Deltoid
48
C6 dermatome where?
Biceps
49
C7 dermatome where?
Triceps
50
C8 dermatome where?
Finger Flexion
51
T1 dermatome where?
Finger abduction
52
L1/2 dermatome where?
Hip flexion
53
L3/4 dermatome where?
Quadriceps
54
L5 dermatome where?
Great toe dorsiflexion
55
S1/S2 dermatome where?
Foot Plantarflexion
56
Biceps reflex what dermatomes
C5/6
57
Triceps reflex what dermatomes
C7/8
58
Knee reflex what dermatomes
L3/4
59
Ankle jerk reflex what dermatomes
S1/2
60
The shoulder joint consists of what joints?
Glenohumeral and Acromioclavicular
61
Shoulder examination What to look for on inspection? (7)
Loss of symmetery or deformity Winging of scapula Muscle wasting: deltoid/supraspinatus/infraspinatus Scars, wounds, sinuses, discolouration
62
Shoulder examination Where to feel? (10)
Temperature at joint and adjacent areas Bony Landmarks Acromion Process and along scapula Spine of scapula Greater tuberosity of humerus Ant and Pos Joint Lines of Humerus Supraspinatus Infraspinatus Deltoid Axillary nerve sensation
63
Shoulder examination What to check in move? (4)
Full Extension and Flexion Full Abduction External and Internal Rotation of Shoulder Scapula movement
64
What is a painful arc?
Shoulder examination - pain between 10 and 120 degrees
65
Elbow examination What to look at in look? (10)
Ant, Pos, Medial and Lateral Joints Scars Swelling Wounds Sinuses Rashes Rheumatoid Nodules Evidence of Olecranon Bursitis Deformity and Normal Carrying Muscle Wasting
66
What is the normal carrying angle of elbow in males?
-10
67
What is the normal carrying angle of elbow in females?
-15
68
Where to palpate in elbow examination? (4)
Temp Tenderness over medial (golfers elbow) Tender over lateral epicondyle (tennis elbow) Tender over olecranon process and radial head
69
What is phalen's test?
The wrist is held in full flexion for 60 seconds (reverse prayer sign). The test is positive if patient’s symptoms are elicited by this manoeuvre. For carpal tunnel
70
What is Tinel's Test?
Tinel’s test is performed by lightly tapping over the median nerve as it passes through the wrist. A positive response to the test is denoted by tingling in the thumb, index and middle fingers (distribution of median nerve). for carpal tunnel
71
Hand and Wrist Examination What to look for on looking? (12)
Scars, Wounds or Thinning of Skin Rash Nails: Clubbing, Psoriatic Changes (Pitting Oncyholysis), Splinter Haemorrhages, Nail Fold Vasculitis Posture of Hand Finger Deformity Muscle Wasting Swellings eg Bouchard Nodes (PIP) and Heberden (DIP) Fascial Thickening
72
What is pitting oncycholysis and where can it be found?
Nails it is psoriatic change
73
Where are Bouchard Nodes found?
PIP
74
Where a Hebden Nodes found?
DIP
75
Hand and Wrist examination - What to check for in move? (3)
Straighten then make fist Flex and Extend of MCPJ, PIPJ and DIPJ Phalen/Tinel
76
Hand and wrist examination what to check for in function?
Power Grip Pincer Grip
77
Hand and wrist examination what to check in neuro exam?
Sensation and Power of Median, Ulnar and Radial Nerves
78
Hand wrist examination How to assess radial nerve power?
Resisted finger extension
79
Hand and wrist examination How to assess median nerve power?
Test abductor pollicis brevis. Place hand flat with palm to ceiling. Ask patient to point thumb to ceiling and hold it there whilst you try to push it down.
80
Hand and wrist examination How to assess ulnar nerve power?
testing the interossei by asking patient to spread fingers wide and keep them there whilst you try to squeeze them together.
81
Hand and wrist examination How to test sensation of median nerve?
touch volar tip of index finger and thenar eminence
82
Hand and wrist examination How to test sensation of ulnar nerve?
touch volar tip of little finger and hypothenar eminence
83
Hand and wrist examination How to test sensation of radial nerve
touch first web space on dorsum of hand between thumb and index finger
84
What is the Trendelnburg Test a sign of?
Weak/paralysed abductor muscles (gluteus minimus and gluteus medius of hip)
85
When is Trendelnberg test positive?
Pelvis dips on side of non weight bearing leg
86
What is Thomas test for?
Assessment of fixed flexion deformity of hip - increased lumbar lordosis
87
What to look for on hip examination? (5)
Deformity and Symmetery Scars Swelling Muscle Wasting Leg Length Discrepancy
88
What to feel for on hip examination? (3)
Tender over greater trochanter Apparent leg length discrepancy True length discrepancy
89
Where to measure apparent leg length discrepancy?
xiphisternum to medial malleolus
90
Where to measure true leg length discrepancy?
ASIS to medial malleolus
91
What to check on hip examination movement? (6)
Thomas Test Flexion Rotation - Abduction - Adduction Trendelburg
92
What does a high stepping gait mean?
foot drop
93
What is a knee valgus deformity?
The distal part (tibia) is deviated laterally or away from the midline. A bilateral valgus deformity will give a knock-kneed (Genu Valgum) appearance.
94
What is a knee varus deformity?
The distal part (tibia) is deviated medially or towards the midline. If the deformity is bilateral, it will give a bow legged appearance.
95
What is a patellar tap used for?
Moderate to Large Effusion >50ml
96
What is a bulge tap used for?
Smaller fusions
97
What to check on knee examination inspection? (6)
Symmetry and Alignment Varus or Valgus Deformity Fixed Flexion of Knee Rash Wounds/Scars/Swelling Waste of Quadriceps
98
What to check on knee examination palpation? (7)
Temp Difference Tenderness over patella, extensor mechanism, medial and lateral joints Behind knee for popliteal cysts Effusion
99
What to check on knee examination movement? (5)
Flexion Extension Hyperextension Medial and Lateral Collateral Ligaments Cruciate Ligaments
100
A positive sag (draw) test means what?
Issue with cruciate ligaments in knee
101
Ankle and Foot Examination What to look for? (11)
Nail Changes, Skin Rashes, Scars, Wounds and Calluses Swelling and Muscle Wasting of Calf Muscles Clawing or Hammer Toes Joint Swelling or Hallux Valgus Callus Formation
102
Ankle and Knee Examination what to look for on standing? (4)
Toe alignment Foot arch position Alignment of Hind Foot eg Varus/Valgus Achilles Tendon Swelling or Thickening
103
Ankle and Knee Examination What to feel for? (7)
Temperature over forefoot, mid foot and ankle Lateral and Medial malleolus Fibula Head Bones in Foot Lateral Squeeze MTP Joints for Morton Neuroma Subtalar, Midfoot, Tarsal and Ankle
104
Ankle and Knee Examination What to look at on movement? (3)
Dorsiflexion and Plantarflexion at Ankle Inversion and Eversion at Subtalar Mid Tarsal and Subtalar movements
105
What is a boxers fracture?
Transverse fracture of 5th metacarpal neck

4th Year Finals (37 decks)

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