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Primary OSCE 8

Created: 7/9/2004
1. You are shown a photograph of a cylinder:
- Identify entonox.
- What is its composition?
- What precautions should be taken in regard to its storage?
- What is pseudocritical temperature?
- Why is it important?
- What are the hazards of using it below the critical temperature?
- Who can prescribe it?

2. Communication
A Jehovah’s witness with menorrhagia, with a haemoglobin level of Hb 8.1 g/dl presents for abdominal hysterectomy.
- Obtain a special consent from the patient.

3. History
A 25-year-old Afro-Caribbean man presents. He is well built, and his history reveals that he has undergone a day-case arthroscopy, and has beens the vicitim of a road traffic accident, after which he underwent a laparotomy and splenectomy.
- Can you rule out sickle cell disease?

4. History
A fit young woman presents for hysterectomy. Her medication history reveals that she has been told that she is taking some medicines to "increase her blood level". Ask her if she has a history of anaemia, or if there is a history of anaemia in the family. Although she has had no previous operations, you should also ask about any history of a bone marrow test.

5. Cranial nerve examination
Examine cranial nerves 3 to 12 on an actor.
- Give some explanation while you perform this examination.

6. Airway examination
Carry out an airway assessment on an actor.
- What is his Mallampati score?
- Show how you would examine the patient
- You are asked about any intubation problem.

7. Coronary circulation
- Discuss the coronary circulation, explaining arterial and venous drainage.
- What do you understand by sinus of Valsalva and what is its physiological importance?
- What are the chordae tendinae and what is their physiological importance?
- How many leaflets are there in the mitral valve?
- What are the pressures in the heart chambers?
- You are asked about an angiogram showing a stenosis of the left anterior descending artery, and asked to identify the defect.
- What is the probable cause?

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