OSCE Cheat Sheets
Step-by-step examination checklists, organized the way examiners actually score them: inspection → palpation → percussion → auscultation. Use the standard opening and closing checklist for every station.
Before & After Every Examination
Examiners score this regardless of which system you're examining — don't skip it.
Cardiovascular Examination
Position at 45°, expose the chest.
Inspection
- General: breathlessness, cyanosis, scars (median sternotomy, clavicular pacemaker scar)
- Hands: clubbing, splinter hemorrhages, peripheral cyanosis
- Face: malar flush, conjunctival pallor, corneal arcus, xanthelasma
- Neck: raised JVP
- Legs: peripheral/sacral edema
Palpation
- Pulse: rate, rhythm, character, radio-radial & radio-femoral delay
- Apex beat: location (normally 5th ICS, midclavicular line), character
- Heaves and thrills over each valve area
Auscultation
- Four valve areas, then carotids and lung bases
- Repeat with bell at apex for mitral stenosis; sit forward + expiration for aortic regurgitation
Heart Murmurs — Quick Reference
| Murmur | Timing | Location | Radiation |
|---|---|---|---|
| Aortic Stenosis | Ejection systolic | Right 2nd ICS | Carotids |
| Aortic Regurgitation | Early diastolic | Left sternal edge | — |
| Mitral Regurgitation | Pansystolic | Apex | Axilla |
| Mitral Stenosis | Mid-diastolic | Apex | — |
Respiratory Examination
Position at 45°, expose the chest front and back.
Inspection
- Respiratory rate, pattern, use of accessory muscles
- Oxygen delivery devices, sputum pot, inhalers at bedside
- Scars, chest wall deformity (barrel chest, pectus)
Palpation
- Tracheal position (central vs. deviated)
- Chest expansion — symmetry, front and back
- Tactile vocal fremitus (optional)
Percussion
- Resonant — normal
- Dull — consolidation, collapse
- Stony dull — pleural effusion
- Hyper-resonant — pneumothorax
Auscultation
- Wheeze (asthma, COPD), crackles (fibrosis, pulmonary edema, infection)
- Bronchial breathing, reduced air entry
- Vocal resonance to confirm percussion findings
Cranial Nerves Examination
Test in numerical order to avoid missing one. Full nerve-by-nerve table and mnemonics are on the dedicated guide.
Abdominal Examination
Position flat, expose nipples to knees (preserve dignity).
Inspection
- Scars, distension, visible masses or peristalsis
- Striae, caput medusae, bruising (Cullen's / Grey Turner's)
- Stomas, hernias (ask patient to cough)
Palpation
- Light palpation, all 9 regions — tenderness, guarding
- Deep palpation — masses
- Organomegaly: liver edge, spleen (bimanual), kidneys (ballot)
Percussion
- Liver span, splenic dullness
- Shifting dullness (ascites)
- Bladder (suprapubic dullness)
Auscultation
- Bowel sounds (present/absent, tinkling in obstruction)
- Renal artery and aortic bruits
Thyroid Examination
Position seated, expose the neck and upper chest. Have a glass of water ready.
Inspection
- General: swelling, scars, visible nodules or asymmetry
- Ask the patient to swallow water — watch the swelling rise (thyroid moves with swallowing)
- Ask the patient to protrude their tongue — a thyroglossal cyst moves up; a goitre does not
- Eyes: exophthalmos, lid retraction, lid lag — signs of hyperthyroidism
Palpation
- Approach from behind the seated patient
- Isthmus and both lobes — size, consistency, tenderness, mobility, nodularity
- Repeat the swallow test while palpating
- Tracheal position; cervical lymph nodes
Percussion & Auscultation
- Percuss over the manubrium for retrosternal extension of a goitre
- Auscultate for a bruit over each lobe (suggests increased vascularity, e.g. Graves' disease)
Signs of Thyroid Status
- Hyperthyroid: tremor, sweating, tachycardia, warm skin, lid lag
- Hypothyroid: dry skin, bradycardia, slow-relaxing reflexes, periorbital puffiness
Peripheral Vascular Examination
Position supine, expose both legs (and arms if indicated).
Inspection
- Color: pallor, cyanosis, dependent rubor
- Hair loss, shiny skin, ulcers (note location — arterial ulcers are often distal/over pressure points; venous ulcers are often medial malleolus)
- Varicose veins, scars (previous bypass or harvest sites)
Palpation
- Temperature — compare side to side
- Capillary refill
- Pulses: radial, brachial, carotid, femoral, popliteal, posterior tibial, dorsalis pedis
- Pitting edema
Special Tests
- Buerger's test: elevate the leg for pallor, then dependency for rubor — suggests significant arterial insufficiency
- Ankle-brachial index (ABI) for objective assessment of arterial supply
Auscultation
- Bruits over carotid, femoral, and abdominal aortic regions
Frequently Asked Questions
Does this replace my school's official OSCE marking scheme?
No — always follow your institution's specific marking scheme for exams. This is a general reference to learn and practice the structure.
Why is there a 'before and after' checklist for every exam?
Examiners score these basics (introduction, consent, exposure, thanking the patient) regardless of which system you're examining, so it's worth memorizing once and applying to every station.
Can I print this for offline practice?
Yes — use your browser's print function. The page is formatted to print cleanly without the navigation bar or background colors.