Cardiology OSCE

02/09/2010 | Ward 125

Cluster A stations 5: Cognitive 2 | psychomotor 2 | affect 1
Cluster B stations 5: Cognitive 2 | psychomotor 2 | affect 1
Cluster C stations 5: Cognitive 2 | psychomotor 2 | affect 1
Cluster D stations 5: Cognitive 2 | psychomotor 2 | affect 1

Stations Type Case Examiner Patient
Station A1 Cognitive Case Scenario (Digitialis)
Station A2 Cognitive Chest X-Ray: Parts
Station A3 Skills History of Chest Pain
Station A4 Skills
Palpation of Cardiovascular
System

Station A5 Counseling Rheumatic Heart Disease
Station B1 Cognitive Match the following: AR signs
Station B2 Cognitive ECG: Atrial Fibrillation
Station B3 Skills
Examination of Mitral or
Aortic Area

Station B4 Skills Signs of Infective Endocarditis
Station B5 Counseling Coronary Artery Disease
Station C1 Cognitive Case Scenario: AS
Station C2 Cognitive
Chest X-Ray: Pulmonary
Edema

Station C3 Skills History of Chest Pain
Station C4 Skills
Palpation of Cardiovascular
System

Station C5 Counseling Rheumatic Heart Disease
Station D1 Cognitive
Match the following:
Anti-hypertensives

Station D2 Cognitive ECG: Normal Tracing
Station D3 Skills
Examination Of Mitral or
Aortic Area

Station D4 Skills Signs of Infective Endocarditis
Station D5 Counseling Coronary Artery Disease


Stations At A Glance - Cardiology OSCE (02/09/2010)



A3

C3

A4

A5

B1 B2

C4

C1 C2

A1 A2

C5

D1 D2

D3

D4

D5

B5

B4

B3
Stations Layout in Ward 125 - Cardiology OSCE

S.No. NAME
COGNITIVE PSYCHOMOTOR AFFECT
TOTAL
1 2 3 4 5
1 SHAKIRA YOOSUF
2 SHANMUGAM K
3 SHANMUGARAJA M
4 SHIKHA VIJAYAN
5 SHYAM KALYAN N
6 SHYAM SUNDAR S R
7 SHYAMALA GOWRI K
8 SIDDARTH M
9 SOUNDARYA K
10 SRINATH B
11 SRIPREETHIKA R
12 SUBASHNY B
13 SUBHASIS PRADHAN
14 SUGANYA M
15 SUJATHA N
16 SUKANYA S P
17 SUMATHI G
18 SURESH T
19 SURYA PRAKASH R
20 TERENCE JACKSON


Final Mark Sheet - Cardiology OSCE (02/09/2010)



S.No. NAME
COGNITIVE PSYCHOMOTOR AFFECT
TOTAL
1 2 3 4 5
21 THOOYAMANI P
22 VANMATHI C
23 VENKATARAM V
24 VENKATESH N R
25 VIGHNESH A
26 VIGNESH M
27 VIGNESWARI R
28 VIJAY THOMAS D
29 VIJAYARAGHAVACHARI T V
30 VIKRAM V
31 VIKRAM SINGH
32 VINITH C
33 VINITRA D
34 VINODH G KUMAR
35 VINOTH KUMAR K
36 VISHNU S
37 VIVEK P
38 VIVEKSANDEEP T C
39 VYSAKH C N
40 ARVIND NATARAJAN
41 MURALIDHARAN
Final Mark Sheet - Cardiology OSCE (02/09/2010)
Student-wise Mark Sheet: Cluster A
S.No. Name
Station
A1
Station
A2
Station
A3
Station
A4
Station
A5
Total
1 SHAKIRA YOOSUF
2 SHANMUGAM K
3 SHANMUGARAJA M
4 SHIKA VIJAYAN
5 SHYAM KALYAN N











Student-wise Mark Sheet: Cluster A
S.No. Name
Station
A1
Station
A2
Station
A3
Station
A4
Station
A5
Total
1 THOOYAMANI P
2 VANMATHI C
3 VENKATRAM R
4 VENKATESH NR
5 VIGNESH A

Student-wise Mark Sheet: Cluster B
S.No. Name
Station
B1
Station
B2
Station
B3
Station
B4
Station
B5
Total
1 SHYAM SUNDAR SR
2 SHYAMALA GOWRI K
3 SIDDARTH M
4 SOUNDARYA K
5 SRINATH B











Student-wise Mark Sheet: Cluster B
S.No. Name
Station
B1
Station
B2
Station
B3
Station
B4
Station
B5
Total
1 VIGNESH M
2 VIGNESHWARI R
3 VIJAY THOMAS D
4 VIJAYARAGHAVACHARI TV
5 VIKRAM V

Student-wise Mark Sheet: Cluster C
S.No. Name
Station
C1
Station
C2
Station
C3
Station
C4
Station
C5
Total
1 SRIPREETHIKA R
2 SUBASHYNY D
3 SUBHASIS PRADHAN
4 SUGANYA M
5 SUJATHA N











Student-wise Mark Sheet: Cluster C
S.No. Name
Station
C1
Station
C2
Station
C3
Station
C4
Station
C5
Total
1 VIKRAM SINGH
2 VINITHC
3 VINITHRA D
4 VINODH G KUMAR
5 VINOTH KUMAR K

Student-wise Mark Sheet: Cluster D
S.No. Name
Station
D1
Station
D2
Station
D3
Station
D4
Station
D5
Total
1 SUKANYA SP
2 SUMATHI G
3 SURESH T
4 SURYAPRAKASH R
5 TERENCE JACKSON











Student-wise Mark Sheet: Cluster D
S.No. Name
Station
D1
Station
D2
Station
D3
Station
D4
Station
D5
Total
1 VISHNU S
2 VIVEK P
3 VIVEK SANDEEP TC
4 VYSAKH CN
5 ARVIND NATARAJAN
6 MURALIDHARAN


Read the following case scenario and answer the questions.
A 78-year-old man with a long-standing history of CHF
presents with weakness, anorexia, nausea, and dizziness. He has
been receiving digoxin, 0.5 mg once daily orally, and furosemide,
120 mg twice daily orally.
1. What problem should you first suspect?
2. What is the mechanism of occurrence of nausea and vomiting
in digitalis toxicity?
3. What are the other causes of GI symptoms in patients with
CHF?
4. List other manifestations of digitalis toxicity.
5. Describe the cardiac complications of digitalis intoxication.
6. What laboratory test helps confirm the diagnosis of digitalis
toxicity?
7. Name two electrolyte disturbances which precipitate digoxin
toxicity.
8. What is the specific antidote for digoxin toxicity?

A1 Station

Identify the parts marked in the chest X-ray.
(Choose from the list given below)

Right Atrium Apex Carina
Aortic Arch Left Atrial Appendage Superior Vena Cava
Pulmonary Trunk Right Ventricle Trachea
Inferior Vena Cava Cardio-phrenic Angle Aortic Valve

A2 Station

History of Chest Pain.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
A
K
I
R
A

Y
O
O
S
U
F

2
.

S
H
A
N
M
U
G
A
M

K

3
.

S
H
A
N
M
U
G
A
R
A
J
A

M

4
.

S
H
I
K
A

V
I
J
A
Y
A
N

5
.

S
H
Y
A
M

K
A
L
Y
A
N

6
.

T
H
O
O
Y
A
M
A
N
I

7
.

V
A
N
M
A
T
H
I

C

8
.

V
E
N
K
A
T
R
A
M

V

9
.

V
E
N
K
A
T
E
S
H

N
R

1
0
.

V
I
G
N
E
S
H

A

1.
Self introduction, explanation of
procedure and seeking permission

2. Site of chest pain 1
3. Onset of pain 1
4. Character of chest pain 1
5.
Radiation to upper limb, neck, jaw,
epigastrium, back
1
6. Duration of pain 1
7.
Exacerbating factors- exertion,
respiration, coughing, movement
1
8.
Relieving factors- rest, nitrates,
NSAIDs
1
9.
Associated factors- breathlessness,
palpitation, sweating, dizziness,
vomiting, cough, trauma
1
10. Clinical impression 1
11. Thanking the patient
MARKS AT THIS STATION 10


A3 Station

Palpation of Cardiovascular System.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
A
K
I
R
A

Y
O
O
S
U
F

2
.

S
H
A
N
M
U
G
A
M

K

3
.

S
H
A
N
M
U
G
A
R
A
J
A

M

4
.

S
H
I
K
A

V
I
J
A
Y
A
N

5
.

S
H
Y
A
M

K
A
L
Y
A
N

6
.

T
H
O
O
Y
A
M
A
N
I

7
.

V
A
N
M
A
T
H
I

C

8
.

V
E
N
K
A
T
R
A
M

V

9
.

V
E
N
K
A
T
E
S
H

N
R

1
0
.

V
I
G
N
E
S
H

A

1.
Self introduction, explanation of
procedure and seeking permission

2.
Simultaneous palpation of both
hemi-thorax
1
3. Localisation of apex beat 1
4. Palpation in left lateral position 1
5. Palpation of para-sternal region 1
6. Palpation of pulmonary area 1
7. Palpation of aortic area 1
8. Palpation of carotids 1
9. Clinical impression 2
10. Thanking the patient
MARKS AT THIS STATION 10


A4 Station

Counseling of Patient with Rheumatic Heart Disease.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
A
K
I
R
A

Y
O
O
S
U
F

2
.

S
H
A
N
M
U
G
A
M

K

3
.

S
H
A
N
M
U
G
A
R
A
J
A

M

4
.

S
H
I
K
A

V
I
J
A
Y
A
N

5
.

S
H
Y
A
M

K
A
L
Y
A
N

6
.

T
H
O
O
Y
A
M
A
N
I

7
.

V
A
N
M
A
T
H
I

C

8
.

V
E
N
K
A
T
R
A
M

V

9
.

V
E
N
K
A
T
E
S
H

N
R

1
0
.

V
I
G
N
E
S
H

A

1 Self introduction, greetings
2 Listening, clearing doubts 1
3 Explaining nature of the disease 1
4 Dental hygiene 1
5 Avoidance of exertion 1
6
Education on drug compliance and
Rheumatic fever prophylaxis
1
7 Role of Surgery 1
8 Regular follow up 1
9 Possible complications 1
10
Education on when to seek
immediate medical attention
1
11 Thanking the patient
MARKS AT THIS STATION 10


A5 Station

Match the following.
1. Light house sign A. Head bobbing with each
heart beat
2. Quinkes sign B. Dancing carotids
3. Duroziezs sign C. Systolic murmur heard over
femoral artery
4. Gerhardts sign D. Pulsations of liver
5. de Mussets sign E. Change in pupillary size in
accordance with cardiac cycle
6. Landolfis sign F. Systolic pulsations of uvula
7. Hills sign G. Capillary pulsations
8. Rosenbachs sign H. Alternate flushing and blanching
of forehead
9. Mullers sign I. Popliteal pressure exceeds
brachial pressure by >20 mmHg
10. Corrigans sign J. Pulsations over enlarged spleen

B1 Station

Observe the ECG and answer the following questions.

1. Comment on the rhythm.
2. Describe the P waves.
3. What is the diagnosis?
4. Name two common causes associated with this abnormality.
5. Name one complication of this condition.

B2 Station

Examination of Mitral Area.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
Y
A
M

S
U
N
D
A
R

S
R

2
.

S
H
Y
A
M
A
L
A

G
O
W
R
I

K

3
.

S
I
D
D
H
A
R
T
H


M

4
.

S
O
U
N
D
A
R
Y
A

K

5
.

S
R
I
N
A
T
H

B

6
.

V
I
G
N
E
S
H

M

7
.

V
I
G
N
E
S
W
A
R
I

R

8
.

V
I
J
A
Y

T
H
O
M
A
S

D

9
.

V
I
J
A
Y
A
R
A
G
H
A
V
A
C
H
A
R
I

T
V

1
0
.

V
I
K
R
A
M

V

1.
Self introduction, explanation of
procedure, seeking permission

2. Inspection 1
3. Localization with finger 1
4. Palpation in left lateral position 1
5.
Auscultation with diaphragm and
bell
1
6. Auscultation in left lateral position 1
7.
Auscultation with breath held in
expiration
1
8. Auscultation of axilla and back 1
9. Dynamic auscultation 1
10. Clinical impression 1
11. Thanking
MARKS AT THIS STATION 10


B3 Station

Examination of Aortic Area.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
Y
A
M

S
U
N
D
A
R

S
R

2
.

S
H
Y
A
M
A
L
A

G
O
W
R
I

K

3
.

S
I
D
D
H
A
R
T
H


M

4
.

S
O
U
N
D
A
R
Y
A

K

5
.

S
R
I
N
A
T
H

B

6
.

V
I
G
N
E
S
H

M

7
.

V
I
G
N
E
S
W
A
R
I

R

8
.

V
I
J
A
Y

T
H
O
M
A
S

D

9
.

V
I
J
A
Y
A
R
A
G
H
A
V
A
C
H
A
R
I

T
V

1
0
.

V
I
K
R
A
M

V

1.
Self introduction, explanation of
procedure, seeking permission

2. Inspection 1
3. Palpation of Aortic Area 1
4. Palpation of Carotids 1
5. Auscultation with diaphragm 1
6.
Auscultation in leaning forward
position
1
7.
Auscultation with breath held in
expiration
1
8. Auscultation of carotids 1
9. Auscultation of Mitral Area
10. Auscultation of second aortic area
11. Clinical impression 1
12. Thanking
MARKS AT THIS STATION 10


B3 Station

Signs of Infective Endocarditis.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
Y
A
M

S
U
N
D
A
R

S
R

2
.

S
H
Y
A
M
A
L
A

G
O
W
R
I

K

3
.

S
I
D
D
H
A
R
T
H


M

4
.

S
O
U
N
D
A
R
Y
A

K

5
.

S
R
I
N
A
T
H

B

6
.

V
I
G
N
E
S
H

M

7
.

V
I
G
N
E
S
W
A
R
I

R

8
.

V
I
J
A
Y

T
H
O
M
A
S

D

9
.

V
I
J
A
Y
A
R
A
G
H
A
V
A
C
H
A
R
I

T
V

1
0
.

V
I
K
R
A
M

V

1.
Self introduction, explanation of
procedure, seeking permission

2. Recording temperature 1
3. Looking for pallor 1
4. Looking for icterus 1
5. Asking for ophthalmoscope
6. Oslers node, Janeway lesions 1
7. Clubbing, subungual hemorrhage 1
8. Joint examination for arthritis
9. Petechial rash in skin and mucosa 1
10.
Auscultation for new or changing
murmurs
1
11. Palpation for splenomegaly 1
12. Thanking the patient
MARKS AT THIS STATION 10


B4 Station

Counseling of Patient with Coronary Artery Disease.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
H
Y
A
M

S
U
N
D
A
R

S
R

2
.

S
H
Y
A
M
A
L
A

G
O
W
R
I

K

3
.

S
I
D
D
H
A
R
T
H


M

4
.

S
O
U
N
D
A
R
Y
A

K

5
.

S
R
I
N
A
T
H

B

6
.

V
I
G
N
E
S
H

M

7
.

V
I
G
N
E
S
W
A
R
I

R

8
.

V
I
J
A
Y

T
H
O
M
A
S

D

9
.

V
I
J
A
Y
A
R
A
G
H
A
V
A
C
H
A
R
I

T
V

1
0
.

V
I
K
R
A
M

V

1 Introduction, greetings 1
2
Listening and encouraging to get
patients doubts, concerns
1
3 Dietary modification 1
4 Adaptation of activity 1
5 Education on risk factors 1
6 Drug compliance 1
7 Role of surgery 1
8 Family Screening 1
9
Warning signs including angina
equivalents
1
10. Thanking the patient 1
MARKS AT THIS STATION 10


B5 Station

Read the following case scenario and answer the questions.
A 30 year old male, farmer, has been admitted with
complaints of chest pain and dyspnea on exertion with history of
one episode of sudden loss of consciousness. His BP was 110/80
mmHg. Pulse 80/min, regular. ECG shows evidence of LVH.
1. What is the probable diagnosis?
2. What type of LVH is expected in this patient?
3. What will be the nature of apical impulse in this patient?
4. What character do you expect in this patients pulse?
5. Describe the murmur.

C1 Station

Observe the Chest X-Ray and answer the following questions.

1. What are the two prominent findings?
2. What is the diagnosis?
3. What do you expect in auscultation of respiratory system?
4. Name two causes for this condition.
5. How will you manage?

C2 Station

History of Chest Pain.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
R
I
P
R
E
E
T
H
I
K
A

R

2
.

S
U
B
H
A
S
H
Y
N
Y

D

3
.

S
U
B
H
A
S
I
S

P
R
A
D
H
A
N

4
.

S
U
G
A
N
Y
A

M

5
.

S
U
J
A
T
H
A

N

6
.

V
I
K
R
A
M

S
I
N
G
H

7
.

V
I
N
I
T
H

C

8
.

V
I
N
I
T
H
R
A

D

9
.

V
I
N
O
D
H

G

K
U
M
A
R

1
0
.

V
I
N
O
T
H

K
U
M
A
R

K

1.
Self introduction, explanation of
procedure and seeking permission

2. Site of chest pain 1
3. Onset of pain 1
4. Character of chest pain 1
5.
Radiation to upper limb, neck, jaw,
epigastrium, back
1
6. Duration of pain 1
7.
Exacerbating factors- exertion,
respiration, coughing, movement
1
8.
Relieving factors- rest, nitrates,
NSAIDs
1
9.
Associated factors- breathlessness,
palpitation, sweating, dizziness,
vomiting, cough, trauma
1
10. Clinical impression 1
11. Thanking the patient
MARKS AT THIS STATION 10


C3 Station

Palpation of Cardiovascular System.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
R
I
P
R
E
E
T
H
I
K
A

R

2
.

S
U
B
H
A
S
H
Y
N
Y

D

3
.

S
U
B
H
A
S
I
S

P
R
A
D
H
A
N

4
.

S
U
G
A
N
Y
A

M

5
.

S
U
J
A
T
H
A

N

6
.

V
I
K
R
A
M

S
I
N
G
H

7
.

V
I
N
I
T
H

C

8
.

V
I
N
I
T
H
R
A

D

9
.

V
I
N
O
D
H

G

K
U
M
A
R

1
0
.

V
I
N
O
T
H

K
U
M
A
R

K

1.
Self introduction, explanation of
procedure and seeking permission

2.
Simultaneous palpation of both
hemi-thorax
1
3. Localisation of apex beat 1
4. Palpation in left lateral position 1
5. Palpation of para-sternal region 1
6. Palpation of pulmonary area 1
7. Palpation of aortic area 1
8. Palpation of carotids 1
9. Clinical impression 2
10. Thanking the patient
MARKS AT THIS STATION 10


C4 Station

Counseling of Patient with Rheumatic Heart Disease.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
R
I
P
R
E
E
T
H
I
K
A

R

2
.

S
U
B
H
A
S
H
Y
N
Y

D

3
.

S
U
B
H
A
S
I
S

P
R
A
D
H
A
N

4
.

S
U
G
A
N
Y
A

M

5
.

S
U
J
A
T
H
A

N

6
.

V
I
K
R
A
M

S
I
N
G
H

7
.

V
I
N
I
T
H

C

8
.

V
I
N
I
T
H
R
A

D

9
.

V
I
N
O
D
H

G

K
U
M
A
R

1
0
.

V
I
N
O
T
H

K
U
M
A
R

K

1 Self introduction, greetings
2 Listening, clearing doubts 1
3 Explaining nature of the disease 1
4 Dental hygiene 1
5 Avoidance of exertion 1
6
Education on drug compliance and
Rheumatic fever prophylaxis
1
7 Role of Surgery 1
8 Regular follow up 1
9 Possible complications 1
10
Education on when to seek
immediate medical attention
1
11 Thanking the patient
MARKS AT THIS STATION 10


C5 Station

Match the following.
1. Clonidine A. Calcium channel blocker
2. Prazosin B. Angiotensin receptor blocker
3. Indapamide C. K
+
channel opener
4. Amiloride D. +-adrenergic blocker
5. Carvedilol E. -adrenergic blocker
6. Minoxidil F. Central sympatholytic
7. Candesartan G. K
+
sparing diuretic
8. Ramipril H. ACE inhibitor
9. Nifedipine I. -adrenergic blocker
10. Atenolol J. Loop diuretic

D1 Station

Observe the ECG and answer the following questions.

1. What is the rhythm and rate in this ECG?
2. What is the standard speed at which ECG is recorded?
3. What is P wave due to?
4. Which wave in this ECG denotes ventricular repolarization?
5. What are the ECG findings of acute rheumatic fever?
6. Name any two causes for ST segment elevation.
7. What are the chest leads in a standard 12 lead ECG?

D2 Station

Examination of Mitral Area.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
U
K
A
N
Y
A

S
P

2
.

S
U
M
A
T
H
Y

G

3
.

S
U
R
E
S
H

T

4
.

S
U
R
Y
A
P
R
A
K
A
S
H

R

5
.

T
E
R
E
N
C
E

J
A
C
K
S
O
N

6
.

V
I
S
H
N
U

S

7
.

V
I
V
E
K

P

8
.

V
I
V
E
K

S
A
N
D
E
E
P

9
.

V
Y
S
A
K
H

C
N

1
0
.

A
R
V
I
N
D

N
A
T
A
R
A
J
A
N

1.
Self introduction, explanation of
procedure, seeking permission

2. Inspection 1
3. Localization with finger 1
4. Palpation in left lateral position 1
5.
Auscultation with diaphragm and
bell
1
6. Auscultation in left lateral position 1
7.
Auscultation with breath held in
expiration
1
8. Auscultation of axilla and back 1
9. Dynamic auscultation 1
10. Clinical impression 1
11. Thanking
MARKS AT THIS STATION 10


D3 Station

Examination of Aortic Area.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
U
K
A
N
Y
A

S
P

2
.

S
U
M
A
T
H
Y

G

3
.

S
U
R
E
S
H

T

4
.

S
U
R
Y
A
P
R
A
K
A
S
H

R

5
.

T
E
R
E
N
C
E

J
A
C
K
S
O
N

6
.

V
I
S
H
N
U

S

7
.

V
I
V
E
K

P

8
.

V
I
V
E
K

S
A
N
D
E
E
P

9
.

V
Y
S
A
K
H

C
N

1
0
.

A
R
V
I
N
D

N
A
T
A
R
A
J
A
N

1.
Self introduction, explanation of
procedure, seeking permission

2. Inspection 1
3. Palpation of Aortic Area 1
4. Palpation of Carotids 1
5. Auscultation with diaphragm 1
6.
Auscultation in leaning forward
position
1
7.
Auscultation with breath held in
expiration
1
8. Auscultation of carotids 1
9. Auscultation of Mitral Area
10. Auscultation of second aortic area
11. Clinical impression 1
12. Thanking
MARKS AT THIS STATION 10


D3 Station

Signs of Infective Endocarditis.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
U
K
A
N
Y
A

S
P

2
.

S
U
M
A
T
H
Y

G

3
.

S
U
R
E
S
H

T

4
.

S
U
R
Y
A
P
R
A
K
A
S
H

R

5
.

T
E
R
E
N
C
E

J
A
C
K
S
O
N

6
.

V
I
S
H
N
U

S

7
.

V
I
V
E
K

P

8
.

V
I
V
E
K

S
A
N
D
E
E
P

9
.

V
Y
S
A
K
H

C
N

1
0
.

A
R
V
I
N
D

N
A
T
A
R
A
J
A
N

1.
Self introduction, explanation of
procedure, seeking permission

2. Recording temperature 1
3. Looking for pallor 1
4. Looking for icterus 1
5. Asking for ophthalmoscope
6. Oslers node, Janeway lesions 1
7. Clubbing, subungual hemorrhage 1
8. Joint examination for arthritis
9. Petechial rash in skin and mucosa 1
10.
Auscultation for new or changing
murmurs
1
11. Palpation for splenomegaly 1
12. Thanking the patient
MARKS AT THIS STATION 10


D4 Station

Counseling of Patient with Coronary Artery Disease.
NAME OF STUDENT
M
a
r
k
s

f
o
r

e
a
c
h

s
t
e
p

1
.

S
U
K
A
N
Y
A

S
P

2
.

S
U
M
A
T
H
Y

G

3
.

S
U
R
E
S
H

T

4
.

S
U
R
Y
A
P
R
A
K
A
S
H

R

5
.

T
E
R
E
N
C
E

J
A
C
K
S
O
N

6
.

V
I
S
H
N
U

S

7
.

V
I
V
E
K

P

8
.

V
I
V
E
K

S
A
N
D
E
E
P

9
.

V
Y
S
A
K
H

C
N

1
0
.

A
R
V
I
N
D

N
A
T
A
R
A
J
A
N

1 Introduction, greetings 1
2
Listening and encouraging to get
patients doubts, concerns
1
3 Dietary modification 1
4 Adaptation of activity 1
5 Education on risk factors 1
6 Drug compliance 1
7 Role of surgery 1
8 Family Screening 1
9
Warning signs including angina
equivalents
1
10. Thanking the patient 1
MARKS AT THIS STATION 10


D5 Station
Station A1: Case Scenario (Digitalis)
1. Digitalis toxicity []
2. Stimulation of the area postrema in the medulla
oblongata of the brain stem []
3. Passive hepatic congestion, Ascites [1]
4. Neurologic symptoms: headache, neuralgia, [2]
confusion, delirium, seizures
Visual symptoms: scotoma, halos,
altered color perception
Cardiac toxicity: ventricular or junctional
tachyarrhythmias, AV block
Miscellaneous: gynecomastia, skin rash
5. Bradycardia, Multiple ventricular ectopics [2]
Ventricular bigeminy (alternate ventricular ectopics),
Atrial tachycardia (with variable block), Ventricular
tachycardia, Ventricular fibrillation
6. Serum Digoxin level [1]
7. Hypokalemia, Hypomagnesemia, Hypercalcemia [2]
8. Digibind (Digitalis antibodies) [1]

Station A2: Chest X-Ray: Parts
1. Apex [2]
2. Aortic Arch [1]
3. Right Atrium [2]
4. Trachea [2]
5. Pulmonary Trunk [1]
6. Superior Vena Cava [1]
7. Left Atrial Appendage [1]

Station B1: Match the following: AR signs
1. Light house sign H. Alternate flushing and blanching
of forehead
2. Quinkes sign G. Capillary pulsations
3. Duroziezs sign C. Systolic murmur heard over
femoral artery
4. Gerhardts sign J. Pulsations over enlarged spleen
5. de Mussets sign A. Head bobbing with each
heart beat
6. Landolfis sign E. Change in pupillary size in
accordance with cardiac cycle
7. Hills sign I. Popliteal pressure exceeds
brachial pressure by >20 mmHg
8. Rosenbachs sign D. Pulsations of liver
9. Mullers sign F. Systolic pulsations of uvula
10. Corrigans sign B. Dancing carotids

Station B2: ECG: Atrial Fibrillation
1. Irregular / Varying R-R intervals [2]
2. Absent P waves / Fibrillatory waves [2]
3. Atrial Fibrillation [2]
4. RHD (MS/MR), CAD, Thyrotoxicosis [2]
5. Thrombo-embolism, Cardiac failure [2]

Station C1: Case Scenario: AS
1. Aortic Stenosis [2]
2. Concentric LVH [2]
3. Heaving apical impulse [2]
4. Pulsus parvus et tardus [2]
5. Crescendo Decrescendo murmur [2]

Station C2: Chest X-Ray: Pulmonary Edema
1. Cardiomegaly, Alveolar opacities [2]
2. Pulmonary edema [2]
3. Bilateral fine crepitations [2]
4. Cardiac failure, Chronic Kidney Disease [2]
5. Back rest, Nasal oxygen, Diuretics [2]

Station D1: Match the following: Anti-hypertensives
1. Clonidine F. Central sympatholytic
2. Prazosin I. -adrenergic blocker
3. Indapamide J. Loop diuretic
4. Amiloride G. K
+
sparing diuretic
5. Carvedilol D. +-adrenergic blocker
6. Minoxidil C. K
+
channel opener
7. Candesartan B. Angiotensin receptor blocker
8. Ramipril H. ACE inhibitor
9. Nifedipine A. Calcium channel blocker
10. Atenolol E. -adrenergic blocker

Station D2: ECG: Normal Tracing
1. Normal sinus rhythm, Around 100/min [2]
2. 25 mm/s [1]
3. Atrial depolarization [1]
4. T wave [1]
5. Sinus tachycardia, Prolongation of PR interval [2]
6. Acute myocardial infarction, Acute pericarditis,
Early repolarisation, LV aneurysm [2]
7. V
1
-V
6
[1]