Osce

Front 1

What are Osler nodes? What do they mean?

Back 1

Painful red lesions on hands and feet
Occur in endocarditis, caused by immune complexes

Front 2

What are Janeway lesions? What do they mean?

Back 2

Non tender small erythematours or haemorrhagic nodules on hands or feet.
Occur in endocardits, caused by septic emboli

Front 3

What are Splinter Haemorrghages, what do they mean?

Back 3

Narrow red lines of blood beneath nails
Most often caused by trauma to nail, may occur in SLE or endocarditis

Front 4

What is Xanthelesmata? What does it mean?

Back 4

Yellow cholesterol deposits around the eye
Associated with hypercholesterolaemia, diabetes, biliary cirrhosis

Front 5

What is Corneal Arcus? What does it mean?

Back 5

A white/blue/grey ring in corneal margin
Bilateral is associated with hyperlipidemia,
hypercholesterolaemia
Unilateral is associated with poor blood flow eg carotid artery disease

Front 6

What are the cardiac causes of clubbing? (2)

Back 6

Endocarditis, Cyanotic congenital heart disease

Front 7

What are the respiratory causes of clubbing? (8)

Back 7

ABCDEF
Asbestosis/Abscess, Bronchiectasis/Bronchial Carcinoma, Cystic Fibrosis, Decreased O2 (hypoxia), Empyema, Fibrosing alveolitis

Front 8

What are the causes of an ejection systolic murmur? (3)

Back 8

Aortic Stenosis, Pulmonary Stenosis, Atrial Septal Defect

Front 9

What are the causes of a pansystolic murmur? (3)

Back 9

Mitral Regurg, Tricuspid Regurg, Ventricular Septal Defect

Front 10

What are the causes of an early diastolic murmur? (2)

Back 10

Aortic Regurg, Pulmonary Regurg

Front 11

What are the causes of a mid diastolic murmur? (2)

Back 11

Mitral Stenosis, Tricuspid Stenosis

Front 12

What the causes of a continuos cardiac murmur?

Back 12

Patent Ductus Arteriosus

Front 13

What are the causes of a dull lung percussion note? (4)

Back 13

Pleural Effusion (stony dull), Consilidation, Pulmonary Fibrosis, Lung Collapse

Front 14

What are the causes of a hyper-resonent lung percussion note? (2)

Back 14

Pneumothorax, Hyperinflation (COPD)

Front 15

What are the causes of a wheeze (rhonchi) on lung auscultation? (2)

Back 15

Asthma, Chronic Bronchitis

Front 16

What are the causes of crackes (crepitations) on lung auscultation? (5)

Back 16

Fine: Heart failure, fibrolising alveolitis
Coarse: Bronchiectasis, Pneumonia, Bronchitis

Front 17

What are the causes of a pleural rub? (2)

Back 17

Pneumonia, Pulmonary Embolism

Front 18

What are the causes of greyish white sputum? (3)

Back 18

COPD, Asthma, Smoker (Black Specks)

Front 19

What are the causes of black sputum? (1)

Back 19

Aspergillosis

Front 20

What are the causes of frothy pink specks in sputum? (1)

Back 20

Acute pulmonary oedema

Front 21

What are the causes of blood stained sputum (Haemopytysis) (5)

Back 21

TB, Bronchial Carcinoma, PE, Bronchiectasis, Pneumonia

Front 22

What are the causes of yellow/green sputum? (3)

Back 22

Bacterial Infection: Pneumonia, Bronchiectasis, Abscess

Front 23

What are the causes of rusty golden sputum? (1)

Back 23

Pneumococcal Pneumonia

Front 24

What are the abdo causes of clubbing? (3)

Back 24

Liver cirrhosis, Inflammatory Bowel Disease, Coeliac Disease

Front 25

What is leukonychia? What does it mean?

Back 25

Whitening of the nails
Caused by cirrhosis, hypoalbuminaemia

Front 26

What is Koilonychia? What does it mean?

Back 26

Spoon Shaped Neals
Iron Deficiency Anaemia

Front 27

What causes palmar erythema? (1)

Back 27

Chronic Liver Disease

Front 28

What is Duputyren's Contracture? What causes it?

Back 28

Fingers held flexed towars hand
Liver currhosis

Front 29

What causes Macroglossis? (2)

Back 29

Hypothyroidism, Acromegaly

Front 30

What causes atrophic glossitis? (3)

Back 30

Iron, Folate, B12 Deficiency

Front 31

What causes mouth ulcers? (2)

Back 31

Crohn's, Coeliac Disaese

Front 32

What are Campbell de Morgan spots?

Back 32

Cherry red papules on the skin containing abnormal proliferation of blood vessels

Front 33

What are spider naevi? What causes them?

Back 33

Red spot with red extensions which blanch when you compress the centre
May be caused by hepatic disease, or women with increased oestrogen levels

Front 34

What causes angular stomatitis?

Back 34

Infection, Iron Deficiencies, B vitamin deficiencies

Front 35

What does Virchows node suggest?

Back 35

Gastric carcinoma

Front 36

What can cause large, smooth and tender hepatomegaly? (5)

Back 36

Hepatitis, Chronic Heart Failure, Sarcoidosis, Early Alcoholic Hepatitis, Tricuspid incompetence with a pulsatile liver

Front 37

What can cause large, hard and craggy hepatomegaly?

Back 37

Primary hepatoma or secondary tumours

Front 38

What can cause large, smooth and non tender hepatomegaly?

Back 38

Cirrhosis and Lymphoma

Front 39

What can cause splenomegaly? (6)

Back 39

Chronic myeloid leukaemia, Myelofibrosis, Lymphoma, Infective (TB), Infective (Malaria), Glandular Fever

Front 40

What can cause hepatosplenomegaly?

Back 40

Infective - Viral Hepatitis, Infectious Mononucleosis, Cytomegalovirus
Haematological - Laukaemia, Myeloproliferative Disease, Lymphoma
Other - Amyloidosis, Acromegaly, SLE

Front 41

What can cause unilateral enlarged kidneys? (4)

Back 41

Polycystic kidney disease, Perinephric abscess, Hydronephrosis, Malignancy

Front 42

What can cause bilateral enlarged kidneys? (3)

Back 42

Polycystic kidney disease, Hydronephrosis, Nephroblastoma

Front 43

What causes Transudate Ascites? (4)

Back 43

Transudate = <30g/L protein
Liver Cirrhosis, Constrictive Pericarditis, Cardiac Failure, Nephrotic Syndrome

Front 44

What causes Exudate Ascites? (4)

Back 44

Malignancy, Acute Pancreatitis, Infective Causes (Pneumococcal, TB), Budd-Chiari syndrome