Year 1 OSCE June 2016

Year 1 OSCE June 2016

Day 1

Station 1 – Anatomy (CNS)
– Identify various parts of the central nervous system:

– Pre-central gyrus, Primary visual gyrus, spinothalamic tract, dorsal column (and their functions), substantia nigra and it’s clinical relevance, dura mater, function and location of superior sagittal sinus, broca’s area, pons, two cranial nerves originating from the medulla, middle meningeal artery rupture (what kind of haemorrhage would this cause)

Station 2 – Patient interview (depression)
– Interview a patient with a mental health problem and explore how it affects their life.

(In our case, several bouts of post natal depression, one from her brother dying and most recently, her son in the army and haven’t heard from him in a while)

Station 3 – Drug dilutions
– 15mg/kg of 30 kg girl.
– Do the maths and make up the solution using correct equipment.

Station 4 – Cranial nerves
– Patient had been in a car crash.
– Test facial, trigeminal accessory and oculomotor cranial nerves.
– Explaining what you’re testing for at each point.

Station 5 – Vital signs
– Take blood pressure, radial pulse and breathing rate.
– Name two muscles of inspiration (used when exercising).

Station 6 – Histology (muscle)
– Set up the microscope and identify.
– Explain the muscle model and how muscle contraction is initiated.

Day 2

Station 1 – Anatomy (thorax)
– Articulate a rib and thoracic vertebrae.
– Order of structures in the costal groove.
– Motor innovation of the diaphragm.
– Azygous vein and what it drains.
– Identify the bronchus on the left lung.
– What vertebral level is at the sternal angle, name a structure lying directly behind it.
– Identify the oesophagus.
– Identify the anterior interventricular artery- what is it a branch of.
– What runs through the central tendon of the diaphragm.
– Layers of the pericardium.
– Identify the fossa ovalis, what is the purpose of the ductus arteriousus.
– Which lung is something ( e.g food) most likely to get lodged in and why.
– On the skeleton identify the apex of the heart.

Station 2 – Heart auscultation
– Auscultate the valves on a patient explaining to the examiner what you’re feeling for at all times.
– Name the valves on a model of a heart.
– Surface anatomy of the heart on a skeleton.

Station 3 – Ethical debate
– Woman has signed a birth plan stating she wanted a natural birth. Explore ethical issues regards to administering an epidural:

1 – law – lady screaming in pain- consent?

2 – capacity – what is capacity? And what happens when a patient can no longer give it.

3 – confidentiality (her friends waiting in the hall and asking you questions).

Station 4 – PCR (make up control and patient sample)
– Load 10 micro litres into 2 wells.

Station 5 – Pedigree diagram
– On placement at a GP and been asked to construct a pedigree diagram for a patient worried about a family history of tay Sachs disease.
– Draw the pedigree diagram and work out the chance she is a carrier.
– You are to use the genogram in a portfolio – obtain consent from the patient.