Year 3 OSCE July 2018

Station 1 – ECG
– Perform ECG
– Interpret = Supraventricular tachycardia

 

Station 2 – Thyroid exam
– Assess thyroid status
– Few questions on signs & symptoms of hyper/hypothyroidism

 

Station 3 – Cardiovascular exam
– Perform & present findings (normal)

 

Station 4 – Urine dipstick
– Take a brief Hx & perform urinalysis
– Pt worried it’s UTI and demands Abx
– Urine smelled very sugary, however nothing much came up on dipstick. From history (polyuria/polydipsia), you still need to investivate further to rule out diabetes. To be on the safe side, I explained to pt the colour change indicated a ‘trace’ rather than any clear positive presence of glucose (+)
– Send for blood test HbA1c.

 

Station 5 – Antibiotics counselling (sepsis 6)
– Take a short Hx and counsel patient
– Pt given broad sprectrum Abx after presenting with SOB
– Worried about Abx resistance, wondered why she needed to be given IV Abx
– Given results for blood culture, asked which Abx to change to
– Explain sepsis 6, hospital follow procedures. Now that we know the bacteria causing the pneumonia, we can remove the drug covering Gram – ve (result showed Gram + bacteria sensitive to penicillin).

 

Station 6 – Respiratory exam on a child
– Perform and present. Answer few questions.
– Chaperone/parent not present. Said that you’d expect a parent/guardian to be present.

 

Station 7 – Biliary colic counselling
– Take a brief Hx and explain USS report to pt.
– Explain the ultrasound report to pt (biliary colic).

 

Station 8 – Paeds Hx

 

Station 9 – Pulmonary Embolism Hx
– Take a Hx and present case i.e. investigations and management.

 

Station 10 – GI Hx
– Hx, Inx, and Mx
– Dx: Colorectal cancer

 

Station 11 – Depression Hx
– History, risk assessment
– Pt suicidal, had no immediate plans, but had means prepared. No protective factors.
– Ask the severity of depresssion and what the management plan was.
– Severe depression. Not comfortable sending her home due to the outcome of the risk assessment, therefore request RAID/psychiatric assessment.

 

Station 12 – Parkinson’s history
– Falls Hx, Differentias, Inx, and Management.