OSCE and Clinical History/Consultation Flashcards

A set of practice questions (Q&A style) covering OTC consultations, history taking (WWHAM, SOCRATES, LICEF), red flags, medical/social/family history, travel, diagnosis and OTC treatment, prescription counselling, teaching-back, chaperone consent, respiratory examination, and clinical case concepts as described in the lecture notes.

What does WWHAM stand for in history-taking, and what questions does it cover?

Who is this for? What is this in regard to? How long have you had this issue? What have you done to aid this issue? Are you on any medications for this issue?

What does SOCRATES stand for in pain assessment (as used in the notes) and what questions correspond to each?

Site; Onset (what makes it better or worse); Character (describing dull vs sharp); Radiates (does it go to other areas); Does anything else occur with the pain; How long does it last; Scale 1-10.

What does LICEF cover in history-taking according to the notes?

How this affects day-to-day life; what the patient thinks could be the cause; any worries about the problem; one thing they would be happy to come out of the consultation; how they are feeling generally.

What is the purpose of repeating information back to the patient (teach-back) in a consultation?

To confirm that the patient has understood the information and to ensure shared understanding.

What is the purpose of identifying red flags in history-taking during OTC consultations?

To identify potentially serious symptoms that require urgent action or referral.

How many red flags should be ruled out in the OSCE history-taking steps as per the notes?

At least two red flags.

What questions are typically asked about medications under Medical History?

Are you taking any medications? What are they for? How often are you taking them? Do you take any OTC medications? Do you have other conditions treated by meds? Do you use any creams or ear/eye drops?

What topics are covered under Social History in the notes for history-taking?

Smoking status; alcohol use; illicit drug use; existing allergies.

What questions are asked about Family History in relation to the condition?

Do any close family members (parents/siblings) have medical conditions? Are they taking medications for these conditions?

What travel-related questions are included in history-taking?

Have you recently travelled abroad? Have you had relevant vaccinations before traveling?

What are the key elements to include when explaining a diagnosis and OTC treatment?

Diagnosis explanation; pharmacological advice; non-pharmacological advice; red flags and what to do if they occur.

What are the main components to cover during Prescription Counselling?

Strength and frequency (including any future changes); best time to take; how to administer; storage; side effects; patient warnings; actions for severe side effects; monitoring (time frame and tests); what to do if a dose is missed; what to do if you take too much; stopping instructions; food interactions (e.g., grapefruit); interactions; expiry; warning cards.

What is the purpose of the 'teach back' technique in prescription counselling?

To ensure the patient can repeat and understand the information taught, confirming comprehension.

What is the role of a chaperone in consultations as reflected in the notes?

To provide support and comfort; optional during questioning.

What is the overall structure of the OSCE respiratory examination as outlined?

Introduction; consent; chaperone option; sanitise; general checks; hands; face/eyes; lymph nodes; throat; chest; back; legs; end of examination.

What general checks are performed at the start of the respiratory examination?

Set the bed to a comfortable position; ask for consent; check if patient is comfortable or in pain; note absence of devices; assess breathing and look for use of accessory muscles.

What signs in the Hands section suggest there is no anemia or liver impairment?

No spooning or leukonychia; capillary refill under 2 seconds; no clubbing; no hepatic flap; regular pulse (e.g., 72) and respiratory rate (e.g., 14).

What is the purpose of the 99 test during chest auscultation?

To assess vocal resonance; the patient says 99 and clear sounds indicate normal resonance and no unilateral pathology.

What are the key elements checked in the Back examination during the respiratory OSCE?

No deformities or scoliosis; no sacral oedema; symmetrical breathing; resonance when tapped; clear lung sounds on the back.

What does the Chest auscultation exhibit according to the notes?

Breathing sounds are normal with no wheeze or crackling; patient is asked to take deep breaths to assess symmetry and quality.

How is the apex beat located during the chest examination?

Count down 5 intercostal spaces on the left side to locate the apex beat.

What leg-related checks are performed in the respiratory OSCE?

Assess warmth and swelling; look for signs of DVT; check peripheral pulses (femoral/pedal) for regular flow.

What is the purpose of safety netting in clinical consultations?

Provide guidance on red flags and when to seek urgent help (e.g., NHS 111, A&E) if symptoms worsen or do not improve.

What is meant by a 'Clinical Case' write-up in the notes?

A structured description including patient details, presenting issues, medical/drug history, adherence, social/family history, allergies, travel, vaccination, differential/diagnosis, chosen treatment with rationale, non-pharmacological advice, red flags, safety netting, and follow-up; often updated in the PMR.

What is the role of non-pharmacological advice in the OTC/clinical case notes?

Complement pharmacological treatment with lifestyle, rest, hydration, or other non-drug strategies relevant to the condition.

What should be included when advising about potential interactions and expiry in prescription counselling?

Discuss potential drug–drug or drug–food interactions; check expiry date; remind patient to monitor for interactions that could affect efficacy or safety.

What is meant by 'monitoring' in prescription counselling, and what does it typically involve?

Time frame for review, any required tests or monitoring (e.g., MHRA guidance), and when to re-evaluate the treatment with the clinician.

During the OSCE respiratory exam, what should you do if the patient asks questions at the end?

Thank the patient, invite questions, provide safety netting or follow-up instructions, and ensure proper sanitisation before leaving.