Year 4 OSCE June 2012
Station 1 – Cardiovascular history / respiratory history
– Asked to give a differential, what investigations, etc.
Station 2 – Neurological exam (Day 1 Parkinson’s, Day 2 Stroke)
– What’s the most likely pathology, give differential, what investigations would you like to perform.
Station 3 – Skills – ABG / Cannulation
Station 4 – Pre-op assessment
– History for pre-op assessment, patient either IDDM or previous DVT, risk assessment and asked about DVT prophylaxis.
Station 5 – Neck examination (Day 1 Thyroid, Day 2 Lymphatics)
– Day 2 – Asked about possible causes of lymphadenopathy, investigations, staging of lymphoma, and investigation of possible DVT.
– REMEMBER TO ASK TO TAKE SHIRT OFF PATIENT.
Station 6 – Acute abdominal pain history (Day 1 LIF pain, Day 2 RUQ pain)
– History, then asked for differential and investigations, and likely management
Station 7 – Skill (Day 1 Urinalysis, Day 2 Nutritional assessment and BMI)
– Day 2 – Asked to assess nutritional status, and measure BMI for a patient with problems swallowing due to MND
Station 8 – Back pain history
– Patient very grumpy, previously had physiotherapy, had to come to a combined management plan for his pain
Station 9 – MSE (Manic patient)
– Taking history from SP simulating mania.
Station 10 – Sexual health history (Day 1 Male with discharge, Day 2 Female with lower pelvic pain)
– Sexual health history, asked about differential, investigations, and management.
Station 11 – Day 1 PR, Day 2 Testicular exam
– Performed on a mannequin with an SP holding the model. Day 2 – Testicular pain was likely epididymo-orchitis.
Station 12 – Suicide risk
– History from patient with recent overdose, had to present assessment of suicide risk and reasoning behind it.
Station 13 – Explain test result
– (Day 1 Mum had screening for possible Down’s baby, Day 2 Mum had just had ultrasound showing grade IV placenta praevia).
– Had to council the mother and explain options in terms of management to her.
Station 14 – Paediatric examination Knee pain
– GALS examination on a paediatric patient (7 years old) who had JIA with an acutely swollen left ankle.
Station 15 – Paediatric BLS
– On a mannequin, patient was known to have allergy to nuts, pollen, and suffer with asthma. Patient ‘breathing’ on arrival with circulation, but in ?anaphylactic shock.
– Had to talk about acute management (oxygen, IM adrenaline, hydrocortisone, etc), also put on 15L oxygen, ask for basic obs, ask for fluids, put out crash call, etc.
– Then patient ‘stops breathing’ and perform in-hospital BLS with 2 person CPR (as there’s a ‘nurse’ present) with bag valve mask. Fairly tough station overall.