Respiratory

Question 1

what is included in the introductory phase of the OSCE?

Answer 1

• Wash hands /PPE
• Confirm patients name and DOB
• Gain a history of the patient
• Gain consent

Question 2

What should be included in patient history for COPD?

Answer 2

• Medical history
• Current medications
• Smoking history
• Current respiratory symptoms
• Is this similar to previous exacerbations?

Question 3

what are common clinical signs in a respiratory exam?

Answer 3

• Older patients are more likely to have COPD.
• Cyanosis
• SOB
• Cough
• Wheeze
• Pallor
• Oedema
• Cachexia
• Scars

Question 4

What equipment can help identify respiratory conditions?

Answer 4

• Vital signs - SPO2, RR, ECG?, Radial
• IPAP
• Cigarettes/ vapes,
• Inhalers
• Prescription

Question 5

what to assess on hands?

Answer 5

• Colour - i.e. cyanosis (hypoxaemia).
• Tar staining - smoking - COPD
• Skin changes - bruising / thin skin can be a sign of steroid use
• Joint swelling or deformity
• Finger clubbing
• Tremor
• Asterixis

Question 6

What is finger clubbing a sign of?

Answer 6

• Lung cancer, interstitial lung disease, cystic fibrosis, bornchiectasis,
• Assess by placing index fingers back to back, if there is not Schamroth’s window, they have clubbing

Question 7

what is a fine tremor a sign of?

Answer 7

• Asthma / COPD
• Ask patient to put hands out and observe for a tremor - commonly a sign of a beta 2 agonist (Salbutamol) - may also see tachycardia

Question 8

what is asterixis?

Answer 8

• flapping tremor
• flapping motion of the hand commonly caused by CO2 retention such as COPD.
• Ask patients to stretch hands out and cock hands backwards for 30 seconds