University of Manchester - Finals OSCE Revision Checklist
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This is a revision checklist I made whilst preparing for my finals OSCE in 2018. Knowing what I do now about education theory, this is essentially a sort of 'reverse timetable' which can be a useful revision tool. Having separate columns which indicate if I have covered a topic more than once ensures that you are partaking in some kind of 'spaced repetition' process. It means that you create a checklist of all topics based on thoroughly double-checking the curriculum; I did this based on what has come up in previous years. If any students would like a modifiable version of this, email me at anahitaasharma@gmail.com
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University of Manchester - Finals OSCE Revision Checklist
- 1. HLB – OSCE CHECKLIST – CARDIOLOGY & HAEMATOLOGY Revised Practiced Confident Task History – Tiredness History – Shortness of breath (COPD, PE, CAP, GORD) History – Chest pain History – Palpitations History – Intermittent claudication (& impotence) History – Lower limb oedema History – Unilateral leg swelling History – Cough (incl. haemoptysis) History – Weight loss History – Night sweats Examination – Cardiovascular (CABG/sternotomy, valve replacement, PPM) Examination – Respiratory (P.E., pneumothorax, pleural effusion, pneumonia, thoracotomy) Examination – DVT-focused, PE Examination – Peripheral vascular (arterial) Examination – Peripheral vascular (venous, DVT) Examination – JVP Examination – Lymph nodes Skills – BLS/ALS Explanation – Use of inhaler Interpretation – CXR Interpretation – ECG Interpretation – Spirometry Interpretation – FBC, Troponins Interpretation – ABG Interpretation – X-rays, Tests, for Myeloma Explanation – Statins, Beta-blocker, Post–M.I. medications, PCI Explanation – Warfarin, NOAC Explanation – Iron tablets, iron-deficiency anaemia Explanation – AAA repair Explanation – Antibiotic therapy & completion of course Explanation – Asthma, COPD, emphysema Explanation – Angina, Hypertension, Heart failure, Atrial fibrillation Explanation – Bone marrow biopsy Explanation – Non-Hodgkin’s Lymphoma, Lymphoma, Leukaemia, AML, Chemotherapy for metastatic disease, Myeloma Prescribing – AHF, M.I., Secondary prevention, Antihypertensives Prescribing – Wheeze, Antibiotics for HAP/CAP More scenarios: http://www.osce-aid.co.uk/communicationscenarios.php http://osce-stations.blogspot.co.uk Cardiology & Haematology Cases 1. Anaemia 2. Coagulopathy 3. Lymphadenopathy 4. Hypertension 5. Acute coronary syndrome 6. Heart failure Respiratory Cases 1. Asthma 2. COPD 3. Pneumonia 4. Lung carcinoma 1
- 2. NME – OSCE CHECKLIST – RENAL/UROLOGY Revised Practiced Confident Task History – Dysuria, renal colic History – Change in urinary habits History – Haematuria Examination – Testicular Examination – Hydration status Examination – Fistula/CRF/Tenchkoff Catheter Explanation – Renal stones Explanation – Enlarged prostate Explanation – Finasteride/tamsulosin Explanation – Renal infection (Upper/Lower UTIs) Cases 1. Sepsis 2. Renal failure 3. Obstructive uropathy 4. Bladder pathology 5. Urinary tract infections 2
- 3. NME – OSCE CHECKLIST – ENDOCRINOLOGY Revised Practiced Confident Task History – Tiredness (Thyroid disorder, Diabetes) History – Weight gain/loss Examination – Cushing’s Examination – Acromegaly Examination – Neck (thyroid, thyroidectomy) Explanation – Thyroxine Explanation – Metformin Explanation – Corticosteroid therapy Explanation – Hyperthyroidism Explanation – Hypothyroidism Explanation – Type I Diabetes mellitus Explanation – Type II Diabetes mellitus Interpretation – HbA1c, Glucose Interpretation – Synacthen, adrenal tests, TFTs Cases 1. Diabetes 2. Thyroid disorders 3. Adrenal disorders 3
- 4. NME – OSCE CHECKLIST – GASTROENTEROLOGY/GENERAL SURGERY Revised Practiced Confident Task History – Change in bowel habit, incl. PR bleed (IBS, IBD, Bowel cancer) History – Nausea & vomiting (Haematemesis) History – Dysphagia (Benign stricture) History – Swollen abdomen History – Diarrhoea History – Weight loss Interpretation – LFTs Interpretation/Explanation – Barium meal Examination – Abdomen (hepatosplenomegaly) Examination – Stoma (incl. urostomy) Examination – Tenckhoff catheter Examination – Rectal Examination – Hernia Interpretation – AXR Explanation – CXR Explanation – Endoscopy (OGD & colonoscopy) Explanation – Gallstones Explanation – H. pylori-induced dyspepsia Explanation – Peptic ulcer disease Explanation – Hepatitis Explanation – B12, folate deficiency Explanation – Inflammatory bowel disease (UC, Crohn’s) Explanation – Diverticulosis/diverticulitis Explanation – Coeliac disease Explanation – Irritable bowel syndrome Explanation – Barrett’s Oesophagus and surveillance Cases 1. Hepatobiliary disease 2. Peptic ulcer and oesophageal disease 3. Diseases of lower GI tract 4. Irritable Bowel Syndrome 5. Inflammatory bowel Disease 4
- 5. M&M – OSCE CHECKLIST – NEUROLOGY/NEUROSURGERY, OPTHALMOLOGY, ENT, Revised Practiced Confident Task History – Headache – Migraine, 1° (tension, cluster, trigeminal neuralgia),intracranial (meningitis, GCA, SAH, ICP), extracranial (glaucoma, sinusitis), other (IVT, intracranial haemorrhage, infection) History – Falls History – Back pain - mechanical, cauda equina syndrome, neurogenic claudication (spinal stenosis), prolapse, infection, metastasis History – Parkinson’s disease – tremor History – Multiple sclerosis History – Meningitis History – Hand pain History – TIA History – Fits History – Loss of consciousness (syncope) History – Funny turns/vertigo (peripheral, central) History – Weakness - stroke, cord compression History – dysphagia History – Expressive dysphasia History – Visual loss/disturbance – stroke, oculomotor palsy, M.S., cerebellar syndrome, senile macular degeneration, hypertensive retinopathy, diabetic retinopathy, glaucoma, CRA occlusion, CVO occlusion, papilloedema History – Confusion (delirium) Explanation – Multiple sclerosis, Stroke/TIA, Epilepsy, GCA (breaking bad news), Migraine, Parkinson’s Explanation – Epilepsy (incl. driving) Explanation – Antiepileptic agents (incl. safety in pregnancy) Explanation – Medications and management post-TIA/stroke Examination – Cranial nerves Examination – Visual system, Fundoscopy Explanation – Cataracts, glaucoma Examination – Otoscope, hearing, balance Explanation – Tonsillectomy, Otitis media History – Sore throat Explanation – Sore throat, glandular fever Examination – Parkinsonism Examination - Neurofibromatosis Examination – Hands Examination – Lower limbs Examination – Peripheral neuropathy – Diabetic foot Examination – Upper limbs Examination – Cerebellar Examination – Extraventricular drain, ventriculoperitoneal shunt Prescribing – Antiepileptic agents (levitiracetam) Explanation/Prescribing – Levodopa Interpretation – CSF More scenarios: http://www.osce-aid.co.uk/communicationscenarios.php http://osce-stations.blogspot.co.uk Neurological examinations • Peripheral neuropathy • Hemiplegia/paraplegia • Myotonic dystrophy • Proximal myopathy • Motor neuron disease • Cerebellar syndrome • Cervical myelopathy • Median/ulnar/radial nerve palsy • Parkinson’s • Charcot-Marie Tooth • Oculomotor palsy • Horner’s Neurology Cases 1. Epilepsy 2. Headache 3. CNS disorders (Parkinson’s, Stroke, MND) 4. Acute limb weakness Ophthalmology cases 1. Gradual loss of vision 2. Red eye 3. Ophthalmoplegia 4. Emergencies ENT cases 1. Dysphagia 2. Otorrhoea 3. Hearing loss 4. Facial palsy 5. Otalgia 6. Epistaxis 7. Rhinosinusitis and septal deviaiton 8. Hoarseness 9. Neck lumps Geriatrics 1. Delirium 2. Falls 3. Frailty 4. Incontinence 5
- 6. M&M – OSCE CHECKLIST – ORTHOPAEDICS & RHEUMATOLOGY Revised Practiced Confident Task History – Back pain - mechanical, cauda equina syndrome, neurogenic claudication (spinal stenosis), prolapse, infection, metastasis History / Prescribing – # NOF History – Falls History – Polyarthritis / joint pain, orthopaedic (OA, septic), rheumatological (RA, gout, spondyloarthropathy, SLE, enteropathic), traumatic, pseudogout, connective tissue disease, adhesive capsulitis, transient synovitis, post-infective, viral History – Hand pain History – Polymyalgia rheumatica Explanation – Temporal arteritis Explanation – Methotrexate – rheumatoid arthritis Explanation – Consent for surgery – arthroplasty (hip surgery) Explanation/Interpretation – X-ray (hips, knees, hands) Explanation – Osteoarthritis, osteoporosis, rheumatoid arthritis, ankylosing spondylitis, gout Examination – Shoulder Examination – Spine Examination – Cervical spine (neck pain) Examination – Hip Examination – Knee Examination – Hands (osteoarthritis, rheumatoid arthritis) Examination – Ankle and foot Examination – Elbow Examination – Skin (scleroderma) Examination – Paget’s disease Prescribing – Analgesia (# fingers) Prescribing – Steroids Explanation/Prescribing – Bisphosphonates Orthopaedic & rheumatology cases 1. Acute fractures and osteoporosis 2. Back pain 3. Arthritis 4. Connective tissue disease 6
- 7. NEUROVASCULAR ASSESSMENT – AIDE-MEMOIR ROOT DERMATOME MYOTOME REFLEX C5 Over deltoid - axillary nerve Shoulder abduction Biceps, supinator C6 Radial forearm/ thumb (dorsal/ palmar) - lateral cutaneous nerve of forearm Elbow flexion Biceps, triceps, supinator - brachioradialis, C7, radial nerve C7 Middle finger (dorsal/palmar) - median nerve Elbow extension - triceps, C7, radial nerve Triceps C8 Little finger (palmar/dorsal), ulnar forearm - ulnar nerve Finger flexion Nil T1 Medial antecubital fossa - medial cutaneous nerve of forearm Finger abduction - interossei, median and ulnar nerves Nil L2 Medial upper thigh Hip flexion – iliopsoas, L1/L2, lumbosacral plexus Nil L3 Medial lower thigh Knee extension - quadriceps, L3/L4, femoral nerve Knee L4 Medial calf Ankle dorsiflexion - tibialis anterior, L4/L5, deep fibular nerve Knee L5 1st dorsal webspace, lateral calf, dorsum of foot Great toe dorsiflexion - extensor hallucis longus, L5, deep fibular nerve Nil S1 Lateral sole, posterolateral calf Plantarflexion - gastrocnemius, S1, posterior fibular nerve Ankle OTHER LOWER LIMB: Peripheral motor nerves • Hip extension - gluteus maximus, L5/S1, inferior gluteal nerve • Knee flexion - hamstrings, L5/S1, sciatic nerve OTHER UPPER LIMB: Peripheral sensory nerves • 1st dorsal webspace - radial nerve Peripheral motor nerves • Median nerve - LOAF 1
- 8. M&M – OSCE CHECKLIST – PSYCHIATRY Revised Practiced Confident Task History – Psychosis – schizophrenia, delusional disorders, bipolar disorder, psychotic depression, delirium, dementia, drug-induced, puerperal, epilepsy, SOL History – Deliberate self-harm – Overdose History – Depression, psychotic depression, post-natal, adjustment disorder History – Bipolar disorder, mania History – Alcohol use History – Illicit drug use History – Anxiety – panic attack, generalised, phobic (agoraphobia, social, specific), PTSD, somatisation, hypochondriacal History – Eating disorders – bulimia, anorexia nervosa, weight history History – Delirium, dementia, amnesia – collateral – MCI, amnestic syndromes, pseudodementia, paraphrenia Explanation – Dementia (breaking bad news) Explanation – SSRIs, treatment for depression Explanation – Lithium Explanation – Olanzapine (atypical antipsychotics), Schizophrenia History / Explanation – Diazepam Explanation – Refusal of consent (capacity assessment) Explanation – Ethics Explanation – Schizophrenia Examination – Cognitive assessment Prescribing – SSRI Psychiatry cases 1. Dementia 2. Affective disorders 3. Schizophrenia 4. Substance misuse 2
- 9. F&C – OSCE CHECKLIST – PAEDIATRICS Revised Practiced Confident Task Case 1 History/Explanation – Acute cough/wheeze/coryza History/Explanation/Interpretation – LRTI (pneumonia, bronchiolitis, croup, foreign body, VIW) History/Explanation – Chronic cough (asthma, CF) History/Explanation – Allergy (food) History/Explanation – Eczema Explanation – Use of inhalers and PEFR History/Explanation – Cystic fibrosis History/Explanation – Coeliac disease History/Explanation – Failure to thrive History/Explanation – GORD History/Explanation – Weight loss Examination/Interpretation – Growth chart Case 2 History/Explanation – Non-accidental injury History/Explanation – Constipation and soiling Explanation – SUDI History/Explanation/Interpretation – Paediatric haematology (anaemia incl. iron-deficiency, AML, ALL, CML) History/Explanation – Fever History/Explanation – Bruising History/Explanation – Rash History/Explanation – Enuresis Case 3 History/Explanation – Meningitis Explanation/Interpretation – Lumbar puncture & CSF results Explanation – Immunisations, MMR History/Explanation – Vomiting History/Explanation – Headache History/Explanation – Otitis media History – Fits, faints and funny turns; convulsions Explanation – Epilepsy Explanation – Febrile convulsion Explanation – Septic screen History/Explanation – UTI Case 4 History – Developmental history (e.g. delayed walking, sitting; motor development; social/behavioural) Explanation – Cerebral palsy, developmental delay, autism spectrum disorder (incl. Asperger’s), ADHD, Down Syndrome History/Explanation – Hip pain Examination – Upper & lower limb neurological Case 5 History/Explanation – Behavioural and conduct disorders, deliberate self- harm, child psychiatry, psychosis History/Explanation – Precocious puberty History/Explanation – Delayed puberty History/Explanation – Acne History/Explanation – Acute abdominal pain (appendicitis, testicular torsion) History/Explanation – Testicular pain/swelling (undescended testis, inguinal hernia, hydrocoele) History/Explanation – Diarrhoea (IBD, coeliac disease, gastroenteritis) History/Explanation – Type 1 Diabetes Mellitus Case 6 Explanation – Screening tests – bloodspot, audiology, 72-hour and 6-week check History/Explanation – Jaundice, neonatal jaundice (physiological, pathological) Explanation – Pyloric stenosis, Hirschprung's disease, IBD, gastroenteritis, cow’s milk intolerance Explanation – Congenital hypothyroidism Explanation – Heart murmur (e.g. AVSD) History/explanation – Heart failure Explanation – Kawasaki’s disease Explanation – Complications of prematurity Practical Examination – Cardiovascular (innocent murmur) Examination – Abdominal Examination – Respiratory Examination – Testicular Examination – Knee Examination – Cranial nerve Examination – Neuro UL/LL (check Gower's) Examination – pGALS (3 screening questions) History/Explanation – Sickle cell disease History/Explanation – Weight gain Examination/Explanation – Paediatric/Neonatal BLS History/Explanation – Newborn exam More scenarios: http://www.osce-aid.co.uk/communicationscenarios.php http://osce-stations.blogspot.co.uk 3
- 10. F&C – OSCE CHECKLIST – OBSTETRICS Revised Practiced Confident Task Case 1 History – Obstetric history Explanation – Antenatal care and screening (folate infectious disease, DS, scans, breastfeeding, checks) Explanation – Antenatal screening tests (infectious diseases, anomaly, and specific testing), and pre-natal genetic diagnosis Explanation – Folic acid supplementation and spina bifida Explanation – Infectious disease in pregnancy screening (rashes during pregnancy) Explanation – Group B Streptococcus Explanation – Physiological changes during pregnancy Explanation – Candidiasis in pregnancy Viva – Mechanisms of labour History/Explanation – Postpartum contraception History – Postpartum depression Explanation – Counselling for place of delivery (home, midwife-led, CDU) Explanation – Induction of labour (prolonged pregnancy) Explanation – Operative vaginal delivery Explanation – Analgesia during labour Explanation – VBAC Explanation – C-section Explanation – Breech presentation at term (CS, ECV) Case 2 Explanation – Smoking cessation during pregnancy Explanation – Diabetes pre-conceptual counselling Explanation – Gestational diabetes History/Explanation – Pre-eclampsia Explanation – Epilepsy pre-conceptual counselling Explanation – Obesity pre-conceptual counselling Explanation – Fetal growth restriction Explanation – Hypothyroidism pre-conceptual counselling Explanation – Thromboprophylaxis Case 3 Explanation – Placenta praevia, accreta, or percreta History – PV bleeding during early/late pregnancy Practical Examination – Antenatal Interpretation/Explanation – Partogram, CTG 4
- 11. F&C – OSCE CHECKLIST – GYNAECOLOGY Revised Practiced Confident Task Case 1 History – Amenorrhoea History – Menorrhagia History – Intermenstrual bleeding History – Postmenopausal bleeding History/Explanation – Menopause, Hormone replacement therapy History – Postcoital bleeding Explanation – IUCD (Mirena, copper coil) Explanation – Contraceptive methods (family planning); female sterilisation Explanation – Combined oral contraceptive, Progesterone-only pill counselling, implant Explanation – Diagnostic laparoscopy Explanation – Fibroids Explanation – Endometriosis Explanation – PCOS Case 2 History/Explanation – Abdominal pain/PV bleeding during pregnancy Explanation – Hyperemesis gravidarum Explanation – Termination of pregnancy Explanation – Cervical screening, Colposcopy, LLETZ Explanation – HPV vaccine Case 3 History – Pelvic pain History – PV discharge History/Explanation – Subfertility Explanation – Vasectomy Other History/Explanation – Incontinence, prolapse (urogynaecology) Practical Examination – Cervical smear Examination – Pelvic examination and swabs (HVS, ECS) 5
- 12. F&C – OSCE CHECKLIST – MISCELLANEOUS Revised Practiced Confident Task Breast Examination – Breast examination History – Breast symptoms; breast pain, lump, discharge (triple assessment) History – Back pain(?Breast metastasis, ovarian cancer) Explanation – Breast cancer screening Genetics History/Interpretation/Explanation – Genetics counselling (BRCA, Down Syndrome, Duchenne muscular dystrophy, CF, autosomal recessive disorders, MCADD, Turner’s, Klinefelter’s, Haemophilia, Fragile X, Huntington’s, Hypercholesterolaemia, PKD) Prescribing Prescribing – Trimethoprim (UTI), movicol (constipation), acne, eczema, otitis media, inhalers, meningitis, neonatal sepsis, cellulitis, gaviscon (GORD), fluids (gastroenteritis) Dermatology History – Acne, eczema, psoriasis Examination – Skin (actinic keratosis, seborrhoeic keratosis, BCC, melanoma, SCC) Explanation – Acne, eczema, psoriasis Infectious diseases History – Infection/travel history History – Sexual history Explanation – Consenting for HIV test Explanation – HIV diagnosis/implications Ethics History/Explanation – Consent ethics in a child (e.g. COCP for teenage girl) History/Explanation – Consent ethics for TOP Explanation – Viagra on the NHS 6
- 13. HLB – OSCE CHECKLIST – SKILLS Revised Practiced Confident Task Procedure – Venepuncture Procedure – Cannula Procedure – Blood culture Procedure – Measurement of vital signs Procedure – Collection and test of MSU Procedure – 12-lead ECG Procedure – Pulmonary function tests Procedure – Subcutaneous/intramuscular/intradermal injection Procedure – Intravenous injection Procedure – Intravenous infusion Procedure – Insert a urethral catheter (male) Procedure – Insert a urethral catheter (female) Procedure – Take nose, throat, skin and wound swabs Procedure – Suture and dress a wound Procedure – Measure capillary blood glucose Prescribing – Insert a urethral catheter (female) 7
- 14. FINALS–SPECIFIC/MISCELLANEOUS – OSCE CHECKLIST Revised Practiced Confident Task Discharge planning Acute station (Chest pain, SOB, Abdominal pain, Headache, Sepsis) Ethics – Capacity assessment, concerns about colleagues, disclosure about BBV, confidentiality (STIs) DVLA Requirements – Post-CVA/CVD, Epilepsy, T1DM without hypoglycaemic awareness Data interpretation Prescribing – Analgesia, Anti-emetics, Antibiotics, Morphine, Fluids Examination – Marfan Syndrome Death certification Key Station Types 1. History 2. Acute 3. Ethics 4. Examination 5. Skills 6. Prescribing 7. Explanation/Counselling 8. Data Interpretation 9. Handover 10.Discharge planning No more unique ‘Spotter’ stations 8