OSCE Cardiovascular EXAM QUESTIONS AND ANSWERS
2024/2025 PROFESSOR VERIFIED
1. Increased work of breathing: This can be due to several cardiac pathologies
ranging from pericarditis to congestive heart failure.
2. Cyanosis: This suggests low tissue oxygen saturation and needs to be
promptly addressed. Cardiac causes of cyanosis are usually congenital in
nature (due to right-to-left cardiac shunting) or a result of abnormal
haemoglobin.
3. Pallor: This suggests anaemia or reduced perfusion, although it may just be the
natural complexion of the patient
4. Clubbing of hands: (convex curvature of the nails), which could be a sign of
congenital cyanotic heart disease, infective endocarditis or atrial myxoma (CIA).
5. Splinter haemorrhages: Tiny blood spots or splinters that occur under the nails
following microhaemorrhages. Causes include trauma, infection (such as in
infective endocarditis), psoriatic nail disease and vasculitis.
6. Janeway lesions: Painless macular lesions caused by septic emboli and are
only present on the palms.
7. Osler's nodes: Painful, raised lesions usually present on the fingers
8. long fingers (arachnodactyly): can be a sign of Marfan's syndrome, a risk
factor for aortic dissection.
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, 9. xanthomas (yellow cholesterol-rich deposits): which are indicative of familial
hypercholesterolaemia on joints and palm
10. infective endocarditis: The heart wall is made up of 3 layers. The epicardium
(outermost), myocardium and endocardium (inner most). Inflammation of the
endocardium secondary to infection is known as infective endocarditis.
Organisms form vegetations on cardiac valves results in fever, heart murmurs
and vascular phenomena (such as splinter haemorrhages).
11. radio-radial delay: Palpate the left radial pulse with right radial pulse to
compare and check for a radio-radial delay which could be a sign of aortic
coarctation or aortic dissection.
12. aortic coarctation: a congenital narrowing of the descending aorta. The
severity of the disease is dependant on the degree and location of the narrowing
-Preductal coarctation (narrowing proximal to the ductus arteriosus) can be very
serious as it can affect affects blood supply to the upper limbs and brain. Patients
will severe narrowing will present early on in childhood and survival is dependant
on a patent ductus arteriosus.
-Ductal and postductal coarctation may only present in adulthood. Signs include
hypertension in the upper limbs (with corresponding hypotension in the lower limbs),
a scapular murmur weak femoral pulses and radio-femoral delay.
13. aortic dissection: a condition in which there is a tear in the aortic intima
creating a false lumen for blood to flow through. Presenting features include
severe chest pain radiating to the back, syncope, arm blood pressure
discrepency, a wide pulse pressure
14. Collapsing pulse: With your left hand, hold their right elbow and feel for the
brachial pulse (medial to the distal tendon of the biceps brachii), and with your
right hand, feel for the radial pulse. Keep your hands in this position and lift the
patient's arm up briskly (but gently) above the level of their heart and hold it.
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2024/2025 PROFESSOR VERIFIED
1. Increased work of breathing: This can be due to several cardiac pathologies
ranging from pericarditis to congestive heart failure.
2. Cyanosis: This suggests low tissue oxygen saturation and needs to be
promptly addressed. Cardiac causes of cyanosis are usually congenital in
nature (due to right-to-left cardiac shunting) or a result of abnormal
haemoglobin.
3. Pallor: This suggests anaemia or reduced perfusion, although it may just be the
natural complexion of the patient
4. Clubbing of hands: (convex curvature of the nails), which could be a sign of
congenital cyanotic heart disease, infective endocarditis or atrial myxoma (CIA).
5. Splinter haemorrhages: Tiny blood spots or splinters that occur under the nails
following microhaemorrhages. Causes include trauma, infection (such as in
infective endocarditis), psoriatic nail disease and vasculitis.
6. Janeway lesions: Painless macular lesions caused by septic emboli and are
only present on the palms.
7. Osler's nodes: Painful, raised lesions usually present on the fingers
8. long fingers (arachnodactyly): can be a sign of Marfan's syndrome, a risk
factor for aortic dissection.
1/6
, 9. xanthomas (yellow cholesterol-rich deposits): which are indicative of familial
hypercholesterolaemia on joints and palm
10. infective endocarditis: The heart wall is made up of 3 layers. The epicardium
(outermost), myocardium and endocardium (inner most). Inflammation of the
endocardium secondary to infection is known as infective endocarditis.
Organisms form vegetations on cardiac valves results in fever, heart murmurs
and vascular phenomena (such as splinter haemorrhages).
11. radio-radial delay: Palpate the left radial pulse with right radial pulse to
compare and check for a radio-radial delay which could be a sign of aortic
coarctation or aortic dissection.
12. aortic coarctation: a congenital narrowing of the descending aorta. The
severity of the disease is dependant on the degree and location of the narrowing
-Preductal coarctation (narrowing proximal to the ductus arteriosus) can be very
serious as it can affect affects blood supply to the upper limbs and brain. Patients
will severe narrowing will present early on in childhood and survival is dependant
on a patent ductus arteriosus.
-Ductal and postductal coarctation may only present in adulthood. Signs include
hypertension in the upper limbs (with corresponding hypotension in the lower limbs),
a scapular murmur weak femoral pulses and radio-femoral delay.
13. aortic dissection: a condition in which there is a tear in the aortic intima
creating a false lumen for blood to flow through. Presenting features include
severe chest pain radiating to the back, syncope, arm blood pressure
discrepency, a wide pulse pressure
14. Collapsing pulse: With your left hand, hold their right elbow and feel for the
brachial pulse (medial to the distal tendon of the biceps brachii), and with your
right hand, feel for the radial pulse. Keep your hands in this position and lift the
patient's arm up briskly (but gently) above the level of their heart and hold it.
2/6
