Nasal Congestion

I doubt that examination of the nose will be expected in an OSCE station (it is possible to ask you to inspect the external nose- for symmetry, masses, deformity etc- and to check air flow through each of the nostrils- simply close one and ask the patient to take a deep breath).  This is far more likely to be a history station.

  • Introduce yourself, wash hands, check name and DOB etc
  • HxPC
    • Any discharge blocking nose? (Check if watery, mucoid, purulent, bloody)
    • Chronic, recurrent, acute
    • Related to location, season, exposure
    • Foreign body?
    • Nose bleeds
  • Systemic review
    • fever, facial pain (sinusitis)
    • watery, itchy eyes (allergies)
    • sore throat, malaise, fever, cough (URTI)
    • Headaches (can occur with Headaches with autonomic features)
    • Also ask about other ENT conditions/infections
  • Red flags
    • Unilateral discharge, particularly if purulent or bloody
    • Facial pain, tenderness, or both
  • PMHx/RHx
    • Atopy
    • Diabetes
    • Immunocomprimise
    • Decongestant/antihistamine/cortisol spray use
    • Broken nose/other trauma
    • Surgery (Facial)

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