Free medical quiz

Cardiovascular System OSCE Examination Quiz

Focused SBA-style practice, followed by the answer and explanation for every question.

Free now: 7 questions
Full bank: 45 questions
Answers: Explained

Free question

Try one with the answer

A question from this quiz. Answer it to see the explanation students get.

When examining a patient's back as part of a cardiovascular assessment, which actions best screen for fluid overload and pulmonary oedema?

A Listen for bronchial breath sounds at the lung bases and palpate the lower ribs for pitting oedema
B Listen to the lung bases for crackles and press over the sacrum to check for oedema ✓
C Auscultate over the mid-zones for wheeze and inspect the sacrum for erythema
D Percuss the posterior chest for dullness and check the abdomen for shifting dullness
E Percuss the upper posterior chest for hyper-resonance and listen over the lower chest for a pleural rub

The answer is B: Listen to the lung bases for crackles and press over the sacrum to check for oedema

Explanation

Why B is correct

See Neck Examination. Option B is correct. When the cardiovascular examination reaches the back, the aim is to look for signs of fluid overload, which means too much fluid in the body, as in heart failure. You listen to the lung bases, the lowest parts of the lungs, for crackles, which are short popping sounds that can be heard when the air spaces contain fluid. In heart failure, a weak left side of the heart lets pressure back up into the lungs, producing pulmonary oedema, which is fluid in the lungs. You also press over the sacrum, the flat bone at the base of the spine, to look for pitting oedema. A patient who is lying or sitting back has gravity pulling fluid into the lowest parts of the body, so in bed that includes the sacrum. Crackles can occur in non-cardiac disease as well, so they support but do not prove heart failure. A memory aid: heart failure shows at the bottom, with crackles in the lung bases and fluid over the sacrum.

Aim: look at the back for signs of fluid overload, as in heart failure.
Lung bases: listen for crackles from pulmonary oedema.
Sacrum: press for pitting oedema, because fluid collects in the lowest part of a patient in bed.

Why the other options are incorrect

A. Listen for bronchial breath sounds at the lung bases and palpate the lower ribs for pitting oedema: Bronchial breathing at the bases suggests consolidation rather than fluid in the alveoli, and the ribs are not the dependent site used to check for pitting oedema; the sacrum is.
C. Auscultate over the mid-zones for wheeze and inspect the sacrum for erythema: Wheeze suggests airway narrowing, and sacral erythema suggests inflammation or pressure damage, not the fine crackles of pulmonary oedema or the pitting oedema of fluid overload.
D. Percuss the posterior chest for dullness and check the abdomen for shifting dullness: Dullness over the posterior chest suggests a pleural effusion or consolidation, and shifting dullness detects ascites; these are not the targeted bedside signs for pulmonary oedema or dependent sacral oedema.
E. Percuss the upper posterior chest for hyper-resonance and listen over the lower chest for a pleural rub: Hyper-resonance and a pleural rub point to air trapping or pleural inflammation, not to alveolar fluid or dependent oedema, so they do not screen for the target findings.

Easy

With Premium, questions you miss become Revision Coach flashcards, scheduled for review.

Question preview

What you will practise

More questions from this set. Start the quiz to answer them and see each explanation.

1
A woman has a soft pansystolic murmur heard best at the cardiac apex. Which approach best helps you hear it and assess its expected radiation?
2
When inspecting the chest before a cardiovascular examination, which finding fits pectus carinatum?

Need wider coverage?

Explore every OSCE topic set, or build a tailored mixed session.

Browse subject quizzes