OSCE Questions - Oral Defense Flashcards

Flashcards covering key concepts from the OSCE oral defense questions focusing on the ABCDE framework.

What sound indicates occlusion from the tongue due to impaired consciousness?

Snoring

What sound indicates fluid in the oropharynx due to impaired consciousness?

Gurgling

What sound indicates laryngeal oedema, possibly from anaphylaxis?

Stridor

What sound indicates laryngospasm, possibly from asthma or GORD?

Stridor

What airway obstruction is indicated by choking?

Inhaled foreign body obstructing oral pharynx, larynx, or trachea

Describe paradoxical chest movement and what it indicates.

Chest wall moves inward when inhaling and outward when exhaling. Indicates a complete upper airway obstruction or a flail chest.

If the mucous membrane is pale, what does this indicate?

Poor perfusion

If the mucous membrane has a bluish tinge, what does this indicate?

Hypoxaemia (low oxygen levels in the blood)

Name acute conditions that can cause low oxygen saturations.

Pulmonary Embolism, aspiration, COPD, asthma, pneumonia, pulmonary oedema, opiate toxicity

What can cause asymmetrical chest expansion?

Pneumothorax, lobar collapse, and pleural effusion

Displacement towards the cause during tracheal palpation indicates what?

Lobar collapse

Displacement away from the cause during tracheal palpation indicates what?

Tension pneumothorax and large pleural effusion

Why is it important to inspect the rate and depth of a patient’s breathing?

High RR > 25 min – warning that the patient may deteriorate suddenly. Reduced depth – a sign of atelectasis or consolidation.

Dullness during chest percussion indicates what?

Consolidation, lobar Collapse and pleural Effusion

Hyperresonance during chest percussion indicates what?

Air trapping or Pneumothorax

Why is it important to inspect the effort of the patient’s breathing?

An increase in the work of breathing can lead to respiratory exhaustion and then respiratory arrest.

What does Kussmaul's breathing indicate?

Metabolic acidosis, particularly DKA

What do Cheyne-Stokes respirations indicate?

Fluctuating low CO2 levels – possible heart failure or stroke

What do Biot’s respirations indicate?

Damage to the respiratory centre - stroke, trauma, or raised Intracranial pressure.

Why is it important to inspect the chest for chest deformity?

Chest deformity decreases the effectiveness of respiratory compensation and increases the risk of rapid deterioration.

What does bubbling of subcutaneous tissue suggest?

Surgical emphysema – suggests a pneumothorax until proven otherwise

What does a barrel-shaped chest indicate?

Hyperinflation (air trapping) indicates advanced COPD

Why is it important to assess for Abdominal distension?

It limits diaphragmatic movement worsening respiratory distress.

Why is it important to assess for the patency of Chest drains?

Displaced or occluded drains may be ineffective and cause sudden patient deterioration.

What does a bluish tinge in the nail bed indicate?

Peripheral cyanosis from Hypoxaemia

What do cool and pale hands/digits indicate?

Poor perfusion

What does skin mottling indicate?

Poor microcirculation

What does cold peripheral temperature with extended capillary refill time indicate?

Vasoconstriction - possible hypovolaemia, cardiogenic or obstructive shock

What does warm peripheral temperature with extended capillary refill time indicate?

Vasodilation – Possible C02 retention, infection, sepsis or anaphylaxis. Late-stage Sepsis may present cold and mottled.

Name causes of tachycardia (>100).

Hypovolaemia, arrhythmia, infection, hypoglycaemia, anxiety, pain

Name causes of bradycardia (HR<60).

Acute Coronary syndrome, electrolyte abnormalities, beta-blockers

What does a bounding pulse indicate?

Aortic regurgitation, CO2 retention

What does a weak, thready pulse indicate?

Hypovolaemia

What does an irregular pulse indicate?

The need for further investigations (12-lead ECG). Indicates the presence of possible Atrial fibrillation, ventricular ectopic or escape beats.

What does urine volume < 0.5mL /kg/hr indicate?

Reduced cardiac output and increased risk of acute kidney injury

What does urine volume above 1.5mL /kg/hr indicate?

DKA, diuretics

What do underfilled or collapsed peripheral veins indicate?

Hypovolaemia and difficult cannulation

What does distension of the Jugular vein indicate?

Heart failure or fluid overload

What does Asynchrony between the peripheral and carotid pulse indicate?

Aortic Dissection, Aortic Stenosis or Peripheral Arterial Disease (PAD)

Hypotension can be caused by?

Decompensated shock, opioids, and diuretics.

Hypertension can be caused by?

Hypervoleamia and a stroke.

Why is it important to assess the consciousness level?

A decreased consciousness level can cause airway obstruction and be a sign of critical illness.

Name conditions that can cause acute deterioration in a patient’s level of consciousness.

Acidosis, Hypoxia, Hypercapnia, Hypoglycaemia

What is the likely cause of pinpoint pupils?

Opioid overdose

What is the likely cause of dilated pupils?

Tricyclic antidepressant overdose

What is the likely cause of asymmetrical(unequal) pupillary size ?

Stroke, raised intracranial pressure

What is the likely cause of Fixed and dilated pupils?

Severe Hypoxia to the brain, or damage to the oculomotor nerve from raised ICP

What is the likely cause of Reduced Consensual Eye Reaction?

Stroke, raised intracranial pressure

Why is it important to assess the Pain score using SOCRATES?

It helps to understand the cause and significance of the pain to help determine the best treatment.

Why is it important to assess core temperature?

Pyrexia indicates infection or inflammatory response. High risk of cardiac arrest in Hyperthermia >40◦c or hypothermia <35.1◦c. A pyrexia or a temperature < 36°c may be caused by sepsis

Why is it important to identify what medication a patient is taking when assessing core temperature?

Paracetamol, NSAIDS, Aspirin can mask pyrexia and can cause a lower NEWS 2 score

Pallor may be due to what?

pale underlying anaemia or poor perfusion

Not reported painful areas may indicate?

identify undiscovered injury.

Rashes may indicate?

Allergic reaction, meningitis, Sepsis.

Bruising may indicate?

coagulation disorders or trauma.

Swelling may indicate?

calves for swelling, and tenderness - deep vein thrombosis.

Wounds may indicate?

Active bleeding, or infection.

Bone displacement may indicate?

fracture

Distension may indicate?

internal bleeding

Drains may indicate?

surgical drains for blood loss, fluid loss, and evidence of infection