Year 3 OSCE April 2018

Day 1



Station 1 – Abdomen Examination
– Pt had come in with weight loss, anorexia, deranged LFTs. Tasked to examine his abdomen.
– We were not asked to present our findings to the examiner.
– Examination was normal – no clinical signs.
– At 8 minutes we were asked:
– 2 causes of ascites in this male?
– How could you test for ascites?

Station 2 – Drugs Counselling
– There was a BNF to check drugs.

– This man has been recently diagnosed with AF. Explain the drugs he is on.
– He was on Ramipril, Apixaban, Bisoprolol.
– PMH: HTN, FH: father died of stroke.
– DH: none, apart from the new ones!
– SHx: could not complete in time.

Station 3 – NG tube
– Station was unexpected by some.
– Questions asked at 8 minutes:
– How would you check the placement of the tube?
– What would you do if you could not insert the tube?
– Some students had not been taught which tube to insert when so make sure to learn this.
– Should have inserted a Reyles tube.
– Everyone in our lane found that the NG tube was coiling at the back of the throat.

Station 4 – Paeds History
– Father has come to A&E with his child who was fitting at school.
– On questioning, no significant PMH, FHx, DHx (Calpol).
– Asked about immunisations and feeding.
– We were then shown results from a Lumbar Puncture and asked to interpret.
– What test we would perform to confirm the microorganism (hint: not LP as this showed no growth!).

Station 5 – Stroke History
– The woman’s husband had collapsed at Costa.
– SP was very confrontational. Wanting to know where her husband was. When asked if she was concerned: ‘what do you mean, of course I’m concerned, I want the doctors to do something’.
– No significant PMH, DH. He was adopted.

Station 6 – Peripheral Vascular Exam (Lower Limb)
– Usual stuff.
– We were not asked to present our findings by the examiner.
– We were then asked the following questions:
– How would you assess the severity at the bedside?
– Explain Beurger’s and ABPI. (normal, abnormal, what is classed as severe, ABPI > 1.2 etc.




Day 2



Station 1: Angina history
The following questions were asked:
– what is your diagnosis?
– what are your differentials?


Station 2: Respiratory exam
– patients with COPD
– Report your findings and your diagnosis


Station 3: diarrhoea history
– patient had recently finished 2 courses of antibiotics
– What is your diagnosis? (C. Diff)


Station 4: Abdominal pain history
– Short hx of RUQ pain and fever
– Exacerbated by eating fish and chips
– Likely diagnosis and why? Acute cholecystitis
– Asked differentials and tests (USS)


Station 5: ABG (suspected PE)
– what would you do with the sample now?
– How long do you have to take the sample to the analyser?
– What information would you take to the analyser?
– What would you do if you could not get there in time?
– What result would you expect if the Patient has a PE?
– Then we were asked questions based on acid-base balance, respiratory
failure and why we would have to take the sample so quickly.


Station 6: Dementia hx Triadic interview 
– Son/daughter was concerned that their mother was forgetting things
(particularly numbers)
– Make sure to ask about ADL, depression, psychosis etc
– ICE!