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Clin Skills/OSCE II
Signs/Symptoms and what they may indicate
55
Medical
Undergraduate 2
10/10/2015

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Term
Dull chest percussion, bronchial breath sounds, crackles, no mediastinal displacement, may be reduced chest wall movement
Definition
Consolidation
Term
Ipsilateral shift in mediastinal displacement, reduced chest wall movement over affected side, dull chest percussion, reduced or absent breath sounds, no added sounds
Definition
Collapsed lung
Term
Reduced chest wall movement over affected area, stony dull chest percussion, absent breath sounds, sometimes a pleural rub
Definition
Pleural effusion
Term
Reduced chest wall movement over affected side, resonant chest percussion, reduced breath sounds, no added sounds
Definition
Pneumothorax
Term
Uniformly decreased chest wall movement, normal chest percussion, may be reduced breath sounds, wheeze
Definition
Asthma
Term
Uniformly decreased chest wall movement, normal chest percussion, normal breath sounds, fine late inspiratory crackles
Definition
Pulmonary fibrosis
Term
Fatigue, fever, sore throat, lymphadenopathy, lymphocytosis, palatine petechiae, splenomegaly, anorexia
Definition
Infectious mononucleosis (IM)
Term
Rapidly ill with high temperature, dry cough, pleuritic pain; 1-2 days later may be rusty-coloured sputum
Definition
Typical pneumonia
Term
Fever, malaise (flu-like illness), headache, minimal respiratory symptoms, non-productive cough, no consolidation
Definition
Atypical pneumonia
Term
Cough and sputum (main symptoms), wheeze and dyspnoea, wheezes or crackles on auscultation
Definition
Acute bronchitis
Term
Barrel chest, pursed lip breathing, use of accessory muscles; Palpation - reduced expansion, hyper-inflated chest and decreased vocal fremitus; Percussion - resonant percussion note with decreased liver dullness; Auscultation - decreased vocal resonance
Definition
Emphysema
Term
Loose cough and sputum (muco-purulent), cyanosis, signs of right ventricular failure (raised JVP); Palpation - hyperinflated chest with reduced expansion; Percussion - increased resonance;
Definition
Chronic bronchitis
Term
Dysuria, urgency, suprapubic pain, sometimes haematuria
Definition
UTI
Term
Reduced urinary stream, hesitancy of micturition, terminal dribbling, frequency with small volume, sometimes overflow incontinence
Definition
Bladder outlet obstruction (chronic)
Term
Facial oedema, proteinuria (>3g/day), hypoalbuminaemia, hyperlipidaemia
Definition
Nephrotic syndrome
Term
General oedema, haematuria, oliguria, hypertension
Definition
Nephritic syndrome
Term
Disturbance of vision, hearing, speech, or smell
Definition
Cranial nerve palsy or raised intracranial pressure
Term
Pallor (anaemia), fever (infection secondary to neutropenia), petechiae (thrombocytopenia), weight loss, muscle wasting and localised infections (e.g. tonsils)
Definition
Acute leukaemia
Term
Pallor (anaemia), fever (infection secondary to neutropenia), bony tenderness, lymphadenopathy, slight to moderate splenomegaly, slight to moderate hepatomegaly
Definition
Acute leukaemia that has infiltrated the haemopoeitic system
Term
Pallor (anaemia), secondary gout; massive splenomegaly, moderate hepatomegaly
Definition
CML
Term
Tiredness, pallor, recurrent acute infections; marked or moderate lymphadenopathy, moderate hepatosplenomegaly.
Definition
CLL
Term
Scratch marks (pruritis), injected sclera, plethoric face, signs of cyanotic congenital heart disease or chronic lung disease
Definition
Polycythaemia
Term
Scratch marks (pruritis), injected sclera, plethoric face, splenomegaly, peripheral vascular disease, gout, athropathy.
Definition
Polycythaemia rubra vera
Term
Lymph node enlargement (discrete, rubbery, painless, large, superficial and often confined to one site); weight loss and fever, splenomegaly, hepatomegaly
Definition
Hodgkin’s lymphoma
Term
Lymph node enlargement (often more than one site, Waldeyer’s ring commonly affected); hepatosplenomegaly
Definition
Non-Hodgkin’s lymphoma
Term
Signs of anaemia, purpura or infection, bony tenderness, weight loss, skin changes, spinal cord compression, mental changes
Definition
Multiple myeloma
Term
Oligomennorhea, palpitations, tachycardia, brisk tendon reflexes, warm moist skin
Definition
Thyrotoxicosis
Term
Weight loss and increased appetite, nervousness, goitre, diarrhoea
Definition
Thyrotoxicosis
Term
Diffuse goitre with audible bruits, pretibial myxoedema, oncholysis
Definition
Grave's disease
Term
Diffuse goitre with audible bruits, lid retraction, lid lag, conjunctival oedema
Definition
Grave's disease
Term
Low serum TSH, high serum T3/T4, pretibial myxoedema, lid lag
Definition
Grave's disease
Term
Hoarse voice, constipation, hair loss, angina pectoris, weight gain
Definition
Hypothyroidism
Term
Constipation, menorrhagia, cramping of muscles, weight gain, dry skin
Definition
Hypothyroidism
Term
Constipation, bradycardia, delayed relaxation phase tendon reflexes, xanthelasma
Definition
Hypothyroidism
Term
Menorrhagia, balding of eyebrows, pleural and pericardial effusions, goitre
Definition
Hypothyroidism
Term
High TSH, low T3/T4, menorrhagia
Definition
Hypothyroidism
Term
Nausea, lethargy, drowsiness, constipation, muscle weakness, polydipsia, polyuria and psychosis
Definition
Hyperparathyroidism
Term
Positive Chvostek's sign
Definition
Hypoparathyroidism
Term
Positive Trousseau's sign
Definition
Hypoparathyroidism
Term
Hirsutism, acne, hypertension, proximal muscle weakness
Definition
Cushing's syndrome
Term
Buffalo hump, central adiposity, ecchyoses
Definition
Cushing's syndrome
Term
Polyuria/polydipsia, amenorrhoea, oedema, hypertension, hirsutism, proximal muscle weakness
Definition
Cushing's syndrome
Term
Muscle weakness, malaise, postural hypertension, pigmentation and vitiligo, abdominal pain
Definition
Addison's disease (hypoadrenalism)
Term
Excessive sweating, greasy skin, hypertension, impaired glucose tolerance, bitemporal hemianopia
Definition
Acromegaly
Term
Spade-shaped hands, kyphosis
Definition
Acromegaly
Term
Epigastric and left hypochondrium pain (severe and constant) - may improve sitting forward, tachycardia, raised serum and urinary amylase, bruising in flanks
Definition
Acute pancreatitis
Term
Right hypochondrium and epigastric pain radiating to the right scapula and shoulder, positive Murphy's sign, nausea and vomiting
Definition
Acute cholecystitis
Term
Loin pain radiating to groin and scrotum - very intense colicky pain, microscopic or obvious haematuria, urinary frequency, nausea and vomiting
Definition
Renal colic (ureteric stones)
Term
Lower abdomen pain - colicky, made worse by food and drink, constipation then vomiting, abdominal distension
Definition
Large bowel obstruction
Term
Periumbilical pain - colicky, made worse by food and drink, vomiting then constipation, abdominal distension
Definition
Small bowel obstruction
Term
Periumbilical pain localising to right iliac fossa, made better by lying still, fever
Definition
Acute appendicitis
Term
Sudden onset of epigastric pain, may radiate to shoulder and extend to whole abdomen, made worse by movement, hypotension, rebound tenderness, rigid abdomen, fever
Definition
Perforated peptic ulcer
Term
Sudden onset of severe abdominal pain, made worse by movement, made better by lying still, tachycardia, hypotension, guarding and rebound tenderness, lower abdominal pain may become generalised
Definition
Ruptured ectopic pregnancy
Term
Pain radiating to back - moderate to severe, nausea, sweating, pulsative tender mass, hypotension, oliguria/anuria
Definition
Ruptured abdominal aortic aneurysm
Term
Weight loss, steatorrhea, epigastric pain radiating to back, jaundice
Definition
Pancreatic cancer
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