OSCE 2019(Based on Bonasso Notes note:
does not include the Ob Hx from Bonasso
History notes)
Vital signs - Answer Mr. Smith is a 76 year old well-appearing and fit male in no acute
distress. BP is 120/80 in *both arms*, HR is 72 bpm *and regular*, and RR is 17 breaths
per minute. *Height* is 65 inches, *weight* is 135lbs.
** do NOT forget to ask patient name and age!!
HEENT: *Head* - Answer Head is normocephalic, atraumatic. *Hair* is of normal
texture.
HEENT: *Eyes* - Answer - *Sclera* white, *conjunctiva* pink and moist.
- *Visual acuity* 20/20 bilaterally *with hand-held card*.
- *Visual fields* normal to confrontation.
- No contacts or corrective lenses used.
- *EOM* intact, with no nystagmus or ptosis.
- *Pupils* constrict 4mm to 2mm, PERRLA.
- Ophthalmic exam shows *sharp disc margins* with normal *disc to cup ratio*.
- Vasculature shows *no hemorrhages, exudates, AV nicking, cotton wools spots, or
arteriolar narrowing* (5).
HEENT: *Ears* - Answer - External ear is normal *with no masses or lesions*.
- *Acuity is good to whispered voice*.
- External *canal and tympanic membranes* normal with *good cone of light* and *no
discharge or injection*.
- Weber is *midline*. Rinne is normal (*air* > *bone* conduction)
HEENT: *Nose* - Answer Nasal mucosa pink. Nasal septum midline. *No sinus
tenderness, bleeding, discharge, or polyps present* (4).
HEENT: *Mouth/Throat* - Answer - *Lips* appear normal with *no masses or lesions*.
- *Oral mucosa* appears normal with *no masses or lesions or leukoplakia*.
- *Tongue* is midline *without deviation*.
- *Hard palate* appears normal with *no masses or leukoplakia*.
- *Dentitia* appears normal and healthy.
- *Tonsils* appear normal and without *exudates or inflammation*.
- *Pharynx* appears normal without *exudates, erythema, or swelling*.
- *Uvula* is not deviated and the *soft palate* is symmetrically *elevated*. Normal soft
palate *movement*.
HEENT: *Neck* - Answer - Neck supple w/ full ROM in lateral flexion, extension, flexion,
and rotation.
- *Thyroid* is nontender and not enlarged.
- *No carotid bruits* present bilaterally.
, OSCE 2019(Based on Bonasso Notes note:
does not include the Ob Hx from Bonasso
History notes)
HEENT: *LN* - Answer No lymphadenopathy in occipital, pre-auricular, post-auricular,
anterior cervical, posterior cervical, submental, submandibular, or supraclavicular
nodes.
Chest - Answer - *Chest* is normal to *appearance* with no visible masses, lesions, or
contusions.
- *Palpation* is normal and without *pain or tenderness*.
- *Good symmetric expansion*.
- Chest resonant to *percussion* with *symmetric diaphragmatic excursion (~4cm)*.
- *Breath sounds* vesicular and chest clear with no wheezes, rhonci, crackles, rales, or
rubs.
- No *whispered pectoriloquoy, egophony, or changes bilaterally in tactile fremitus*.
- No *cyanosis or clubbing* appreciated.
Cardiac - Answer - Regular heart rate and rhythm.
- *Normal* S1 and S2. No S3 or S4.
- No *murmurs*, gallops, rubs, heaves, or thrills appreciated.
- No *JVD* at 30 degrees.
- *PMI* is at midclavicular line in the 5th intercostal space.
- No *cyanosis or edema* appreciated.
- *Carotid upstrokes* are brisk and without bruits.
- *Radial and femoral pulses* were equal bilaterally.
- Heart sounds were listened to with the bell and diaphragm in the sitting, pt at 30
degrees, recumbent, and LLD positions.
Abdominal - Answer - Abdomen is flat (or protuberant) with *no visible masses, lesions,
or contusions*.
- *Bowel sounds* are present in all four quadrants and epigastric regions.
- *Liver span* measured 6cm on *percussion*.
- Abdomen is soft and nontender on *palpation* with *no masses* appreciated and *no
guarding or rebound tenderness* present.
- No *hepatomegaly or splenomegaly*
- *Spleen and kidneys were not palpable*
- No *CVA tenderness*
- *Aortic* pulsations were not palpable
MSK - Answer - Full ROM without pain or tenderness in fingers, wrists, elbows,
shoulders, neck, spine, hips, knees, ankles, and toes.
- Muscle strength is 5/5 throughout all noted joints.
- No evidence of swelling or deformity.
- Extremities are warm and without edema.
does not include the Ob Hx from Bonasso
History notes)
Vital signs - Answer Mr. Smith is a 76 year old well-appearing and fit male in no acute
distress. BP is 120/80 in *both arms*, HR is 72 bpm *and regular*, and RR is 17 breaths
per minute. *Height* is 65 inches, *weight* is 135lbs.
** do NOT forget to ask patient name and age!!
HEENT: *Head* - Answer Head is normocephalic, atraumatic. *Hair* is of normal
texture.
HEENT: *Eyes* - Answer - *Sclera* white, *conjunctiva* pink and moist.
- *Visual acuity* 20/20 bilaterally *with hand-held card*.
- *Visual fields* normal to confrontation.
- No contacts or corrective lenses used.
- *EOM* intact, with no nystagmus or ptosis.
- *Pupils* constrict 4mm to 2mm, PERRLA.
- Ophthalmic exam shows *sharp disc margins* with normal *disc to cup ratio*.
- Vasculature shows *no hemorrhages, exudates, AV nicking, cotton wools spots, or
arteriolar narrowing* (5).
HEENT: *Ears* - Answer - External ear is normal *with no masses or lesions*.
- *Acuity is good to whispered voice*.
- External *canal and tympanic membranes* normal with *good cone of light* and *no
discharge or injection*.
- Weber is *midline*. Rinne is normal (*air* > *bone* conduction)
HEENT: *Nose* - Answer Nasal mucosa pink. Nasal septum midline. *No sinus
tenderness, bleeding, discharge, or polyps present* (4).
HEENT: *Mouth/Throat* - Answer - *Lips* appear normal with *no masses or lesions*.
- *Oral mucosa* appears normal with *no masses or lesions or leukoplakia*.
- *Tongue* is midline *without deviation*.
- *Hard palate* appears normal with *no masses or leukoplakia*.
- *Dentitia* appears normal and healthy.
- *Tonsils* appear normal and without *exudates or inflammation*.
- *Pharynx* appears normal without *exudates, erythema, or swelling*.
- *Uvula* is not deviated and the *soft palate* is symmetrically *elevated*. Normal soft
palate *movement*.
HEENT: *Neck* - Answer - Neck supple w/ full ROM in lateral flexion, extension, flexion,
and rotation.
- *Thyroid* is nontender and not enlarged.
- *No carotid bruits* present bilaterally.
, OSCE 2019(Based on Bonasso Notes note:
does not include the Ob Hx from Bonasso
History notes)
HEENT: *LN* - Answer No lymphadenopathy in occipital, pre-auricular, post-auricular,
anterior cervical, posterior cervical, submental, submandibular, or supraclavicular
nodes.
Chest - Answer - *Chest* is normal to *appearance* with no visible masses, lesions, or
contusions.
- *Palpation* is normal and without *pain or tenderness*.
- *Good symmetric expansion*.
- Chest resonant to *percussion* with *symmetric diaphragmatic excursion (~4cm)*.
- *Breath sounds* vesicular and chest clear with no wheezes, rhonci, crackles, rales, or
rubs.
- No *whispered pectoriloquoy, egophony, or changes bilaterally in tactile fremitus*.
- No *cyanosis or clubbing* appreciated.
Cardiac - Answer - Regular heart rate and rhythm.
- *Normal* S1 and S2. No S3 or S4.
- No *murmurs*, gallops, rubs, heaves, or thrills appreciated.
- No *JVD* at 30 degrees.
- *PMI* is at midclavicular line in the 5th intercostal space.
- No *cyanosis or edema* appreciated.
- *Carotid upstrokes* are brisk and without bruits.
- *Radial and femoral pulses* were equal bilaterally.
- Heart sounds were listened to with the bell and diaphragm in the sitting, pt at 30
degrees, recumbent, and LLD positions.
Abdominal - Answer - Abdomen is flat (or protuberant) with *no visible masses, lesions,
or contusions*.
- *Bowel sounds* are present in all four quadrants and epigastric regions.
- *Liver span* measured 6cm on *percussion*.
- Abdomen is soft and nontender on *palpation* with *no masses* appreciated and *no
guarding or rebound tenderness* present.
- No *hepatomegaly or splenomegaly*
- *Spleen and kidneys were not palpable*
- No *CVA tenderness*
- *Aortic* pulsations were not palpable
MSK - Answer - Full ROM without pain or tenderness in fingers, wrists, elbows,
shoulders, neck, spine, hips, knees, ankles, and toes.
- Muscle strength is 5/5 throughout all noted joints.
- No evidence of swelling or deformity.
- Extremities are warm and without edema.
