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Primary OSCE 39

Created: 26/10/2007
1. Anatomy
Describe the anatomy of the larynx.
- What structure(s) does the superior laryngeal nerve supply?

2. ECG
Describe an ECG showing Wolff-Parkinson-White syndrome.
- Would you administer diltiazem to such a patient?
- Is there a ventricular conduction defect?
- Is a pacemaker indicated?

3. Chest X-ray
You are asked to interpret an X-ray showing acute respiratory distress syndrome and pneumothorax of the upper left lobe.

4. Equipment
You are shown a chest drain bottle.
- Describe its function.
- What is the length of the tube?
- What is the maximum inspiratory pressure during spontaneous ventilation? How will this be affected by airway obstruction?
- What will be the effect of clamping a chest tube?

5. Positioning
- Pressure on ulnar nerve: describe how you would assess motor and sensory function.
- Pressure of radial/axillary nerve: describe how you would assess for neuropraxia.

6. Resuscitation
Demonstrate how to perform basic life support on a 6-year-old child.

7. Examination
You are asked to examine a trauma victim.

8. Simulator manikin
How would you manage a case of intraoperative hypotension?
- Explain your actions to a novice SHO.

9. Equipment check
Carry out a check on an anaesthesia machine.
- Check the Bain circuit.

10. History taking
Take a history from a patient with asthma.

11. Communication
A woman is scheduled for general anaesthesia. She is feeling anxious because her daughter experienced awareness during her Caesarian section.

12. Measurement
You are shown a urinary bladder temperature probe.
- How does it function?
- Describe the Kelvin and Centigrade scales.
- What factors affect heat loss by conduction?

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