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How to describe a lump in an OSCE:

This is a pneumonic I made up in the 1990s - She Cuts The Fish(SCTF) PER

There are 3 each of the Ss, Cs, Ts and Fs namely:

Site - describe location briefly

Size - use your hand and fingers to estimate if you do not have a ruler with you(Know in advance how thick is one of your fingers and how wide are all your 4 fingers..it makes your presentation smoother and you do not have to stumble over the approximate diameter of the lump)

Surface/overlying skin

 

Colour

Contour - is the lump well-defined or irregular

Consistency - ?soft/firm/hard

 

Tenderness

Temperature - Is it hot/inflammed?

Transilluminable

 

Fluctuance - ?fluid-filled cyst

Fixity - ?is it fixed to the underlying tissue or to the overlying skin

Fields - draining lymph glands in the area

 

Finally, remember to check for whether the lump is:

PER - Pulsatile(Is it an aneurysm?), expansile , reducible(Is it a hernia?)

 

(This is also a useful way to remember to include all the neccessary details for documentation of a lump in the patient's medical records - it is best accompanied by a simple diagram showing the site and the lump)

Tip on how to improve your memory power :

1. It is easier to remember things in groups and subgroups of 3s and 4s rather than try to remember a whole long list! Try this for other lists you have to remember eg causes of Atrial fibrillation/Cardiac failure/pulmonary fibrosis/macrocytic anaemia; complications of surgery/medications. (I still can remember a lot of my medical stuff this way!)

2. Write/highlight each subgroup with the same colour

3. Use boxes/lines to group/link things together

Teaching - Melbourne Surgery

 

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