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Primary OSCE 54

Created: 29/9/2010
1. Communication
Discuss the need for a preoperative blood test with a 28-year-old needle-phobic Afro-Caribbean man.

2. Examination
Carry out a full respiratory examination in a normal 65-year-old male subject.

3. Incident management
Describe the types, worrying features and management of bradycardia.

4. Anatomy
You are shown a line diagram of a larynx and asked to identify structures, including nerves and muscles (intrinsic and extrinsic).

5. Skills
You are shown a picture of a grade 3 intubation. Describe your approach.
- What manoeuvre is needed to aid tracheal intubation?
- How would you distinguish an oesophageal intubation?
- You are shown three capnograph traces and asked to identify them.

6. Equipment
You are to identify a temperature probe. You are also asked about thermistors. Discuss their relationship using graphs.
- You are asked about core temperature and sites for measurement.
- Discuss radiation and the factors affecting it

7. History taking
Take a history from a pregnant woman with ankylosing spondylitis, for epidural pain relief. She has a previous history of difficult intubation.

8. Simulator manikin
You are asked to diagnose a tension pneumothorax.

9. Equipment
You are asked about the CardioQ monitor and how it works.
- How should the probe be placed?.
- You are shown three traces and asked to interpret them.

10. Equipment
Describe the different types of lasers and their uses.
- What does the acronym “Laser” mean?
- Discuss laser safety (give three factors).
- Discuss endotracheal tubes (metal vs normal) and their specific characteristics.

11. Safety
How many people should check a unit of blood, and what information should be checked?
- How do people die from severe transfusion reactions?

12. History taking
Take a history from a claustrophobic asthmatic patient about to undergo a computed tomography (CT) of the head because of migraines. (Failed CT under sedation).

13. Anaesthetic machine check
Carry out a check on an anaesthetic machine with the following errors: empty vaporiser, two O rings on one side, no spare O2 cylinder, no power to the O2 analysis device.

14. Statistics
You are provided with various types of data with alpha and beta errors, and asked to interpret them.

15. Data interpretation
You are shown some arterial blood gas data from a patient with respiratory acidosis and asked to interpret them.

16. ECG
You are shown an ECG of trifasicular block and asked to interpret it.

17. CT scan
You are shown a head CT on a computer screen showing an extradural haematoma and skull fracture, and asked to interpret it.

18. Anatomy
You are asked about the anatomy of the vertebral column. You are shown a model of the cervical spine, showing the atlas and axis.
- Identify the pedicles, lamina and foramen.
- How do the atlas and axis articulate?

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