OSCE Board 84

ECG 1:
Rate 75 - 80 1 point
Rhythm: Normal Sinus Rhythm 1 point
Delta Wave 1 point
Short PR 1 point
QRS morphology: LBBB 1 point
Axis: Left Axis Deviation 1 point
Secondary ST Changes 1 point
WPW 1 point
Right Postero Septal Accessory Pathway 2 point
Sum: 10 Points

ECG 2:
Rhythm: SVT (Narrow Complex Tachycardia) 1 point
Atrial Rate 180 – 200 / min 2 points
Variable Ventricular Rate, 2:1 – 3:1 Block 2 points
Atrial Tachycardia 3 points
Variable Block 2 points
Sum: 10 Points

ECG 3:
Rate 65 - 70 1 point
Rhythm: Non Sinus Rhythm
PR: 0.12 sec 1 point
QRS morphology: RBBB 2 point
Axis: Left Anterior Hemiblock 2 point
Secondary ST - T Changes 1 point
Low Atrial Rhythm (Junctional Rhythm) 3 point
Sum: 10 Points

Echo 1:
Large Pericardial Effusion 2 points
RV Early Diastolic Collaps 2 points
RA End Diastolic Collaps 1 points
RA Early Systolic Collaps 1 point
Significant Respiratory Variation 2 point
Regional Wall Motion Abnormality 2 points
Apical Akinesia 2 points
Tamponade 3 points
Sum: 15 Points
Echo 2:
Aneurysm of Right Sinus of Valsalva 3 points
Fistula or Rupture of Sinus of Valsalva 2 points
Between Aorta or RV 2 points
RV Enlargement 1 point
LV Enlargement 1 point
Left to Right Shunt in Color Doppler Flow 2 points
Continous Flow in Doppler 2 points
No right to left shunt in contrast echo 2 points
Sum: 15 Points

Chest X ray 1:
Increased CT ratio 2 points
Dilation or Aneurysm of Ascending Aorta 4 points
Prominent Aortic Knob 1 points
Calcified Aortic Knob 1 points
Mild Cephalization or Congestion 2 points
Sum: 10 Points

Chest X ray 2:
Suture Line 2 points
Chest Tube 2 points
Pneumopericardium 2 points
Increased CT ratio 2 points
Normal Pulmonary Flow 1 points
Pneumothorax 1 points
Sum: 10 Points

EP Tracing:
Narrow Complex Tachycardia 1 points
Negative P in I & II 1 points
Normal Antegrade Conduction (His) 2 points
Retrograde Earliest CSp or CS 7-8 2 points
PJRT 3 points
AT, Atypical AVNRT 1 points
Sum: 10 Points
Cardiac Catheterization:
RV Injection 2 points
Mild to Moderate RV Enlargement 1 points
Simultaneous Visualization of Aorta and PA 3 points
RVOT Obstruction 3 points
Overriding of Aorta 2 points
Large VSD 3 points
Aortic Root Injection 1 points
(Catheter through VSD) 2 points
Diagnosis: Tetralogy of Fallot 3 points

Sum: 20 Points

Pressure Tracing:

Dip and Platu Pattern (Square Root Sign) 2 points

Equalization of Diastolic Pressures 2 points
LV Pressure 110/0-20 1 points
PA Pressure 35/15-20 1 points
RV Pressure 35/0-20 (15) 1 points
Mean RA Pressure: 15 – 20 1 points
Diagnosis: CP 2 points

Sum: 10 Points