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Primary OSCE 66

Created: 1/11/2012
1. Scans
You are shown a CT scan showing an extradural haematoma and are asked to interpret it.

2. Scans
You are shown a lateral chest X-ray showing pneumonia and are asked to interpret it.

3. Equipment
What is a mono-auricular stethoscope?
- What are its uses?
- Discuss the diagnosis of air embolism.
- Discuss the treatment of air embolism.

4. Anatomy
Describe the anatomy of the brachial plexus (including cords, branches, nerves, dermatomes).

5. Communication
Reassure an ex-intravenous drug user who is worried that he may have caught HIV from his partner and also that receiving perioperative opiates will lead to addiction again.

6. History taking
Take a history from a 71-year-old male presenting for a routine operation. He is fit and healthy.

7. History taking
Take a history from a 35-year-old female presenting for laparoscopy. She has a history of sickle cell disease.

8. Examination/skills
You are asked to perform an epidural on a simulator manikin and asked some questions on needles. What are the relative merits of the saline versus the air technique. What are the maximum doses of local anaesthetics that can be used?

9. Resuscitation
You are asked to demonstrate resuscitation on a simulator manikin with ventricular tachycardia. Demonstrate the safe use of a defibrillator. You are asked some questions on advanced life support.

10. Examination/skills
You are asked to examine jugular venous pressure (JVP) and asked questions on JVP measurement and differential diagnosis.

11. Simulator manikin
You are asked to examine a simulator manikin. The “presenting” features include aortic stenosis with a slow rising pulse, an aortic stenosis murmur, and first-degree heart block on the ECG.

12. Equipment
Discuss the different types of paediatric laryngoscopes and the relative merits of a bulb versus fibreoptic light source.

13. Skills/Anatomy
You are asked to demonstrate an ankle block on a person, and answer questions on the nerve serving the ankle/foot.

14. Resuscitation
You are asked questions about bradycardia and advanced life support.

15. Equipment
You are asked questions about temperature measurement devices.
- Discuss the mechanisms of action of the thermocouple and the tympanic thermometer.
– What errors are associated with them?

16. Skills
You are asked to change a tracheotomy tube which is 2 weeks old. There is no exchange catheter/bougie available. You are asked questions on this.

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