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Flashcards in Resp OSCE Exam Deck (10)
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1

What are the 8 steps required for your introduction in the Respiratory examination?

Wash hands
Introduce yourself
Confirm patient details
Explain the examination
Gain consent
Expose the patient's chest
Position patient at 45o
Ask if the patient has any pain before you begin

2

On general inspection, what does a patient's age indicate?

Young patients - more likely asthma / CF

Older patients - more likely COPD / interstitial lung disease / malignancy.

3

What bedside things might you look for?

Treatments / adjuncts
Oxygen - ILD, COPD
Inhalers - Asthma, COPD
Sputum pots - COPD, Bronchiectasis

4

What features might indicate that a patient is short of breath?

Tripod position
Nasal flaring
Pursed lips
Use of accessory muscles
Intercostal muscle recession
Is the patient able to speak in full sentences?

5

What other features should you be looking for on general inspection in a respiratory examination?

Scars
Cyanosis (<85% Oxygen saturation)
Abnormalities in the chest wall.
Cachexia - v. thin pt, muscle wasting -> malignancy, CF, COPD

6

Describe the different coughs you might see.

Productive (Bronchiectasis / COPD if older / CF if younger)

Dry (Asthma if younger, ILD if older)

7

What might an expiratory wheeze indicate?

Asthma / COPD / Bronchiectasis

8

What might stridor (inspiratory) indicate?

Upper airway obstruction.

9

On inspection of the hands, what 5 features would you be looking for? What might these features indicate?

Tar stains -> smoker

Clubbing -> ILD / Lung ca / Bronchiectasis

Peripheral cyanosis -> Oxygen sats below 85%

Features of rheumatological disease - associated with pleural effusions & pulmonary fibrosis

Skin changes - bruising / thinning of the skin are associated with long term steroid use (ILD / COPD / Asthma)

10

What 6 features should you assess when inspecting the hands?

Temperature: low temp suggests peripheral constriction / poor perfusion

Pulse: rate & rhythm

Resp rate: normal = 12-20 /min

Pluses paradoxus: pulse wave volume decreases with inspiration (asthma / COPD).

Fine tremor: SE of beta 2 agonist use (eg. salbutamol)

Flapping tremor: CO2 retention (type 2 reps failure, e.g.. COPD).