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OSCE Review

The document outlines a systematic approach to evaluating chief complaints including cough, headache, chest pain, and abdominal pain, emphasizing the importance of thorough history-taking and physical examination. It suggests using the OLDCART method for constitutional symptoms and highlights relevant medical history and potential diseases related to each complaint. The document concludes with a recommendation for patient closure and communication with a preceptor for further assessment.

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pschnetzler
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2 views

OSCE Review

The document outlines a systematic approach to evaluating chief complaints including cough, headache, chest pain, and abdominal pain, emphasizing the importance of thorough history-taking and physical examination. It suggests using the OLDCART method for constitutional symptoms and highlights relevant medical history and potential diseases related to each complaint. The document concludes with a recommendation for patient closure and communication with a preceptor for further assessment.

Uploaded by

pschnetzler
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Chief Complaints

 Cough (egophony, tactile fremitus, whispered pectoriloquy)


o SOB, N/V, chest pain with exertion, sore throat fever, URI
o Look in ears (pull up and back), nose, mouth and lymph nodes
o Basic cardio exam and pulses/capillary refill
 Headache (vertigo – dicks Hallpike maneuver, Romberg for dizziness
o Include facial visual strength cranial nerves and reflexes)
o Include exam of neck to rule out something like meningitis
o Syncope, vertigo, vision changes, aura
 Chest pain (have them sit at 45 degrees)
o SOB, wheezing, fatigue, radiating and location of pain very important
o Check for swelling (CHF)
o Recent cough, associated with meals
o Previous hx of GERD, heart burn, HTN, cholesterol
o Apical, pulmonic, Erb’s point, tricuspid, and mitral with diaphragm and bell
 Abdominal pain (Murphey’s, McBurney, Rovsing)
o N/V/D, diet, children, weight changes, constipation
o Look in the mouth and at abdomen with a light source
o Include quick cardio exam too

- Begin with OLDCART with constitutional symptoms (fever, chills, night sweats, weight
loss, sleep changes, recent illness, sick contacts, recent travel, fatigue, malaise, trauma)
- Then ask history, family history (CVD, DM, Cancer), social history (smoke, drink, drugs,
work, exercise), allergies, medications, immunizations
- When asking about history, ask about basic cancer, DM, and CVD but then also ask about
diseases related to the system that you are covering – pick 3 other diseases
o Cough (COPD, asthma, PNA)
o Headache (stroke, vertigo, migraines)
o Cardiac (CHF, HTN, HLD, MI)
o Abdomen (IBD, ulcers, cholecystitis, appendicitis, pancreatitis)
- Then physical exam (review comprehensive physical exam video)
- Closure with patient – this is what I think you have so I am going to talk to my preceptor,
and we’ll come back

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