Year 3 OSCE April 2011

Year 3 OSCE April 2011

Station 1 – Venepuncture with order of draw 
– Remember to label bottles! – I didn’t …oops! Fairly straight forward, quite a lot of time to do it in,
– Just make sure not to do anything silly like re-sheath needles etc,
– Keep communicating with patient, fill in form properly and remember order of draw!

Station 2 – Mental state exam with woman from face to face DVD with bipolar and questions 
– DVD was put on straight away so not too long to write out the mental state, DVD watched for about 2 minute i think and then he gave a a bit of time to finish writing up on the mental state exam (you have to write out the headings yourself)
– Than was asked to present what you got and asked ethical questions ” when would you break confidentiality etc” Just make sure you know mental state headings well so you can go straight in there and write it out. Write it out as you would in patients’ notes so date, patients name ans sign at the bottom.

Station 3 – Abdo exam 
– Question after about what signs you would see with colon cancer (pre surgery, although i think the other group got post surgery).
– Questions about what signs you would find in someone with enlarged para-sternal lymph nodes and a diagnosis of lymphoma.

Station 4 – History from father about child with meningitis – CSF interpretation
– Signs of bacterial meningitis
– Shown results two days after child had been admitted and asked why there was no culture growth two days after but there was when he first came in – because he was given antibiotics.
– Asked what organism caused the meningitis.

Station 5 – Resp history – asthma
– Interpret PEFR results.

Station 6 – Cardio exam – blood pressure measurement
– Answering questions about blood pressure/heart failure/what signs would you find in a patient with aortic stenosis.
– Found this station really rushed to do all three in one station so have to be slick at this.

Station 7 – History from woman with post natal depression
– Triadic interview – couple kept arguing with each other. Think i made the mistake of letting them speak for ages, also thought this was a paed hx for ages cause of the baby so dont be fooled. Read the scenario before you go into station.
– Triadic interview, man with memory loss in denial and wife with concerns. Whst are your DD for memory loss/confusion.

Station 8 – Information giving to woman about drugs followed by ethical question
– Daughter calls and wants to know information
– Drugs were aspirin, metformin, ramipril and cant remember the last one! but nothing random
– Drugs for other group were asprin, simvastatin, dipyramidole
– Note which drug does not fit what conditions the patient has.

Station 9 – Abdo History and consent for PR
– Found this rushed too, they dont tell you to move on from taking hx to getting consent for pr so make sure you keep an eye on the time yourself or you wont get it done
– Diagnosis appendicitis, what are the other DD for RIF pain

Station 10 – Paediatric history with baby who had failure to thrive
– Ask for growth chart!!! Its not given to you, mum seemed depressed so asked her about how it’s affecting her….ICE!!!
– Ask parents heights both mother and father very short 5ft2.

Station 11 – Non occular cranial nerve exam
– With questions after about what happens in various lesions, group on first day got ocular exam
– Questions on UMN v LMN signs in face

Station 12 – Alcohol history from guy who had come into A&E previous night
– Remember to be sensitive with this one cause sp snapped at a few ppl apparently for being too confrontational about his drinking.
– CAGE questionnaire.