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Index Page numbers in italics denote fi gures, anion gap 263 Baker’s cyst 100, 104 those in bold denote tables. ankle swelling 195–8 bamboo spine 189 ankle-brachial pressure index 70–1 basal cell carcinoma 77 abdominal aortic aneurysm 145 ankylosing spondylitis 179, 189 basic life support 282–5 abdominal distension 143–7, 145 antalgic gait 25, 42, 94 Behçet’s disease 181 abdominal examination 10–19 anti-tuberculosis drugs 223 benign paroxysmal positional vertigo abdominal masses 17–18, 17 antiepileptics 223 173 abdominal pain 137–42 antihypertensives 223 benign prostatic hypertrophy 57 acute 138 anxiety berry aneurysm 33 chronic 139 faintness 175 biceps tendonitis 81 investigations 139–40 palpitations 120 bleeding diathesis 149 origin of 140–1, 141 tremor 169 blood gas analysis see arterial blood gas abducens nerve 34 aortic dissection 116 analysis abscess 193 aortic regurgitation 3 Boerhaave’s syndrome 149 breast 54 aortic stenosis 3 Bouchard’s nodes 90 perianal 57 aorto-enteric fi stula 149 bowel cancer see colorectal cancer acidosis apex beat 4 bowel obstruction 144, 146 metabolic 263, 265 Apley’s test 102 brachial plexus 85 respiratory 264 apologising 237 brain natriuretic peptide 6 acoustic neuroma 34, 175 appendicectomy 218 breaking bad news 208–10 acquired immunodefi ciency syndrome apraxic gait 25 SPIKES framework 209 see HIV/AIDS arterial blood gas analysis 262–6, 264–5 breast abscess 54 acromioclavicular joint arterial examination 68–72 breast examination 53–5 arthritis 81 arterial ulcer 70 description of lumps 55, 55 Scarf test 84, 84 arthritis patient welfare and dignity 54 activities of daily living (ADLs) 77, 107 osteoarthritis see osteoarthritis techniques 54–5, 55 acute abdomen 140 psoriatic 89, 181 breast malignancy 54 acute coronary syndrome 116 reactive 181 breast screening 55 adhesive capsulitis 81 rheumatoid see rheumatoid arthritis breathlessness 125–7 adrenaline septic see septic arthritis Broca’s expressive dysphasia 45 advanced life support 289 seronegative 100 bronchiectasis 8, 129 intramuscular injection 255 arthroscopy, shoulder 82 bronchoscopy 216 in local anaesthetics 279 ascites 145, 146, 146 Brudzinski’s sign 36 advanced life support 286–90 asthma 8 Buerger’s test 70 age-related macular degeneration 38 medication 220–1 bulbar palsy 30, 45 alcohol abuse, and diarrhoea 134 ataxic gait 42 bulge test 102 alcoholic liver disease 13 atrial fi brillation 119 bupivacaine 279 alkalosis ECG 272 bursitis metabolic 265 atropine hip 94 respiratory 264 COPYRIGHTEDadvanced life support 289 MATERIALknee 101, 104 Allen’s test 263 intramuscular injection 255 amiodarone 289 autoimmune hepatitis 13 caffeine-induced palpitations 119 amputation 69 avascular necrosis of hip 94 calcifi c tendonitis 81 anaemia 175 calcium chloride 289 anaesthesia 203 back pain 183–90 cancer 240 anal fi ssure 57, 154 red fl ags 187 breaking bad news 209 analgesia overuse headache 163 yellow fl ags 189 breast 55, 55 angry patients 236–8 see also specifi c conditions colorectal 134, 147, 153 OSCEs for Medical Finals, First Edition. Hamed Khan, Iqbal Khan, Akhil Gupta, Nazmul Hussain, and Sathiji Nageshwaran. © 2013 John Wiley & Sons, Ltd. Published 2013 by John Wiley & Sons, Ltd. 293 294 Index cancer (cont’d) communication skills 205–7 diabetic foot 69 gastrointestinal 149, 153, 240 angry patients 236–8 diabetic neuropathy 135 lung 129, 240 breaking bad news 208–10 diabetic retinopathy 38 oesophageal 149 counselling for HIV test 225–7 diabetic ulcer 77 prostate 57 cues and emotions 205–6 dialysis 14, 16 testicular 65 do not resuscitate orders 230–2 diarrhoea 132–6 cannula ethics and law 206–7 overfl ow 135 care of 259 explaining medication 211–14 diastolic murmurs 3–4 fl ow rates 259 explaining procedures 215–19 diclofenac 255 intravenous 257–9 handovers 239–41 Dieulafoy lesion 149 carcinoid 135 ICE mnemonic 205 diplopia 34 cardiac arrest rhythms 288, 288 inhalers and asthma medication directly observed therapy 224 cardiac catheterisation 217 220–1 disc protrusion 185 cardiac tamponade 274 non-compliance 222–4 dizziness 172–6 cardiopulmonary resuscitation 282–5, non-verbal communication 206 do not resuscitate orders 230–2 289 post mortem consent 228–9 dorsal column 26 cardiovascular examination 2–6 post-myocardial infarction drug fever 194 carotid sinus hypersensitivity 174 medications 233–5 Dukes staging 147 carpal tunnel syndrome 88 signposting 206 Dupuytren’s contracture 89 cataract 38 complaints 237–8 dysarthria 45 catheters computed tomography dysphagia 158–60 cardiac 217 abdomen 136 dysphasia 45 urinary 245–7 bowel obstruction 144 dysphonia 46 cauda equina syndrome 57, 58, 185, chest 159, 196 187, 189 gastrointestinal cancer 153 Eaton-Lambert syndrome 25 cavernous sinus 30 head 163, 217 ECG see electrocardiogram cellulitis 197 pulmonary angiogram 126, 166 ectopic pregnancy 140 central lines 216 conduction aphasia 45 electrocardiogram (ECG) 271–5, central nervous system examination confusion 47, 47 272–4 28–36 congestive cardiac failure 196 cardiac arrest 288, 288 central retinal artery occlusion 38 consolidation 8 encephalitis 193 central retinal vein occlusion 38 corneal arcus 5 end-stage renal failure 11, 14, 16 cerebellar ataxia 94 coronary artery bypass graft 5 with chronic liver disease 16 cerebellar disease 45, 169, 175 Corrigan’s pulsation 3 endocarditis 193 cerebellar examination 40–3 corticobasal syndrome 170 endoscopic retrograde cerebellopontine angle tumour 30 corticosteroids see steroids choleopancreatography (ERCP) chaperones costochondritis 116 217 breast examination 54 cough 122–4 epididymal cyst 65 hernia 61 cranial nerves 31, 31, 32–3, 35 epigastric hernia 62 rectal examination 58 crepitations 9 epilepsy 174 testicular examination 65 Crohn’s disease see infl ammatory bowel ethics and law 206–7 Charcot’s joint 181 disease examinations 1 chest compression 285 cruciate ligament tear 101 abdominal 10–19 chest pain 115–17 CT see computed tomography breast 53–5 Child-Pugh grading system 150, 151 cyclizine 255 cardiovascular 2–6 chlorpheniramine 255 cysts central nervous system 28–36 chronic liver disease 11, 13, 13, 196 Baker’s 100, 104 cerebellar 40–3 with end-stage renal failure 16 epididymal 65 hand 87–92 chronic obstructive pulmonary disease thyroglossal 49 hernia 60–3 (COPD) 8 hip 93–7 chronic venous insuffi ciency 74, 75 De Musset’s sign 3 knee 98–104 Clostridium diffi cile 134 De Quervain’s tenosynovitis 89 ophthalmoscopy 37–9 cluster headaches 163 death, confi rmation of 105–6 peripheral nervous system 20–7 co-amoxiclav 255 death certifi cates 291–2 rectal 56–9 coeliac disease 134 deep vein thrombosis 197 respiratory 7–9 colonoscopy 216 defi brillation 288–9, 289 shoulder 80–6 colorectal cancer 134, 153 dextrocardia 274 speech 44–7 Dukes staging 147 diabetes mellitus 110, 111, 209 testicular 64–7 colostomy 19 hypoglycaemia 120, 174 thyroid 48–52 Index 295 ulcer 76–9 haemorrhoids 57, 153 hydrocele 65 vascular haloperidol 255 hyperkalaemia 273 arterial 68–72 hand 87–92 hypertensive retinopathy 38 venous 73–5 handovers 239–41 hyperthyroidism 49, 169 external (superfi cial) ring 61 Hawkins-Kennedy test 83, 83 and diarrhoea 135 head CT 217 treatment 50 FABER test 95 headache 161–4 hypertrophic obstructive facial nerve 35 hearing 32, 32 cardiomyopathy 119 palsy 30, 33 heart block 273 hypoglossal nerve palsy 30 faintness 174–5 heart failure 6, 13 hypoglycaemia 120, 174 FAIR test 95–6 heart murmurs 3–4, 3 hypokalaemia 273 fat necrosis of breast 54 Heberden’s nodes 90 hypothermia 273 fatty liver 13 HELP mnemonic 1 hypothyroidism 46, 49, 51, 196 femoral aneurysm 61 hemiplegic gait 25 post-thyroidectomy 49 femoral canal 61 hepatitis 13, 193 hysterectomy 209 femoral fractures 101 autoimmune 13 femoral hernia 61, 62 hepatomegaly 13–14, 15, 145 ICE mnemonic 205 festinant gait 25, 42 hereditary neuropathies 24 ileostomy 19 fever hernia 60–3, 144 immobilisation of spinal patients 188 palpitations 120 types of 61, 62 immunosuppressives 223 pyrexia of unknown origin 191–4 high-stepping gait 25, 42 impingement tests 83–4, 84 fi broadenoma 54 hip infl ammatory bowel disease 11, 134, fi broadenosis 54 anatomy 95 154, 194 fi nger clubbing 9, 16, 90 examination 93–7 infraspinatus test 83, 83 Finkelstein’s test 91 fractures 96–7 inguinal canal 61 foot drop 94 hip replacement 97 inguinal hernia 61, 62, 65 forced expiratory volume 269 histories 107–8 repair 218 forced vital capacity 269 abdominal distension 143–7 inguinal ligament 61 fractures abdominal pain 137–42 inhalers 220–1 femoral neck 101 ankle swelling 195–8 insulin 223 hip 96–7 back pain 183–90 intention tremor 43 Friedreich’s ataxia 24 breathlessness 125–7 intermittent claudication 69 Froment’s sign 90–1 chest pain 115–17 internal (deep) ring 61 frozen shoulder 81 cough 122–4 internuclear ophthalmoplegia 34 diarrhoea 132–6 intracerebral haemorrhage 163 gait 25–6, 41–2, 94, 102 dizziness 172–6 intracranial pressure, raised 163 see also specifi c types dysphagia 158–60 intramuscular injection 254–6 Gallavardin’s phenomenon 3 haematemesis 148–51 sites for 255 gastric cancer 149 haemoptysis 128–31 intravenous cannulation 257–9 gastritis 116, 149 headache 161–4 indications and contraindications gastroenteritis 134 jaundice 155–7 258 gastrointestinal cancer 149, 153, joint pain 177–82 sites for 258 240 lethargy and tiredness 109–11 intravenous drug administration generalised anxiety disorder 120 loss of consciousness 165–7 260–1 giant cell arteritis 193 needlestick injury 199–200 irritable bowel syndrome 135, 145 global aphasia 45 palpitations 118–21 ischaemia, critical 69 globus hystericus 159 pyrexia