Mock OSCE

here's what i got for Mock OSCE. I hope you find these cases helpful.

please note, though, that i am writing this from memory. if you were from my group/stream, please help me correct it.

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P.E 1

-Patient has lymphatic Leukemia.

-examination of the cervical lymph nodes.

marking criteria

GIEP

refer to "general precautions"

inspection

note the following;

discoloration

swelling

surgical scars

-make sure you actually LOOK at the patient. look left, right, at the back of patient, and note any moles, little scars. it shows that you're actually inspecting for anything.

Palpation

make sure you;

1. warm hands
2. warn patient 'is this warm enough?'

recommended pathway-

submental

submandibular -

tonsillar

pre-auricular

post-auticular

occipital

posterior triangle - anterior to the trepezius muscle

jugular chain - medial to the SCM

supraclavivular

things to note in palpation of the lymph nodes;

• use the pulp of your finger to palpate, using circular motions, to feel a larger area of the lymphoid groups. do not jab.
• make sure you look at the patient's face while palpating. this is to see for any tenderness.
• when palpating for the submental and submandibullar lymph nodes, ask patient to look down slightly. this is to relax the muscle groups under the chin.
• when palpating for the jugular chain, first, ask the patient to push against your hand. locate the sternocleidomastoid, then ask the patient to look forward again. then palpate.
• when palpating for the posterior triangle group, a common mistake students make is to palpate on the trepezius muscle. posterior triangle is in FRONT of the trepezius.
• when palpating for the supraclavicular nodes, you may ask the patient to shrug, and palpate the fossa just posterior to the clavicles.
• when you're finished, report.

things to report upon palpation of lymph nodes.

• no palpable lymph nodes. there were no tenderness.
• OR, if there is a palpable lymph node, comment on; (scroll over)
  
  Site
  size
  surface
  mobility
  consistency
  tenderness
  temperature
  texture
  overlying skin

• According to the case scenario, which organ will you examine in this patient?
  SPleen and Liver. (scroll over)

to be continued...