GI OSCE

Question 1

preparation

Answer 1

Introduce
consent
wash hands
postion - lying flat, head propped on one pillow

Question 2

General Inspection

Answer 2

Comfortable breathing?
LOC?
Pain?
Colour?
Items?

Question 3

Hands

Answer 3

Nails:

• Leuconichia (milk spots)
• Koilonychia (Spoon nails)
• clubbing

Hands:

• palmar erythema (hepatic disease)
• palmar anaemia
• Dupuytrens contracture (bent fingers) (diabetes)

dorsum:
Pinch test (dehydration)
Spider naevi (liver) 
Hepatic flap

Question 4

Face

Answer 4

Jaundice (eyes)
Anaemia (conjunctiva)
Mouth ulcers
dentition
dehydration
tongue disorders (thrush)

Question 5

Lymph nodes

Answer 5

Occipital (occiput scalp)
post auricular (neck ear canal)
pre auricular (facial and temporal)
submandibular (lateral face)
submental (lower mouth)
Anterior cervical (anterior neck)
posterior cervical (scalp, thorax)
Supraclavicular:
- R (oesophagus)
- L (Virchows) (Abdomen)

Question 6

Abdomen Inspection

Answer 6

scars
Symmetry and shape (focal swelling)
Pulsation
peristalsis
venous distension (cirrhosis)
Discolouration (cullen and turners signs - pancreatitis)
stomas

Question 7

Abdomen Palpation

Answer 7

Light palpation - 9 areas
Deep palpation -  9 areas
rebound tenderness
Liver
Spleen
Kidneys
bladder
aorta

Question 8

Abdomen Percussion

Answer 8

Liver (Measure length)
Spleen 
Bladder
Shifting dullness
fluid thrill

Question 9

Abdomen Ausculatation

Answer 9

Bowel Sounds
Aorta bruits
Renal arteries bruits
Liver bruits

Question 10

Complete exam

Answer 10

Cover and thank pt
consider:
- BP
Temp
Dipstick