Year 4 OSCE June 2018

DAY 1

Station 1 – Wound Care
– Take swab and fill out form
– Remove sutures
– Clean wound
– Dress
– Most found very difficult and unexpected- kits from each site were not exchanged

 

 

Station 2 – Placenta praevia history
– Take a history
– Differentials
– Investigation

 

 

Station 3 – RA history
– Take history
– Management plan: 2x DMARDs and steroids, OT and physio

 

 

Station 4 – Seizure history
– Sounded like a focal seizure with secondary generalisation (not that I said that in the OSCE!)
– Asked investigation and management
– Asked RE driving

 

 

Station 5 – Otitis media in a child
– Triadic interview with mum and child
– Raised temp other vitals normal, >3/7
– Asked management- most said amoxicillin, end sheet said was viral so delayed prescription
– Asked RE swimming

 

 

Station 6 – CV Exam
– I had AS, others had MR or a metallic valve
– Asked diagnosis and management options

 

 

Station 7 – Depression History
– Asked to perform “assessment”
– Recent suicidal thoughts, under crisis team
– Asked management

 

 

Station 8 – Respiratory examination
Asked diagnosis and why
I thought mine had bronchiectasis, others COPD, others thought IPF

 

 

DAY 2

 

Station 9 – Cannulation

 

 

Station 10 – Menopause history and counselling
– Hard station, lots of people weren’t sure
– Station said to take a history and discuss management, but many just took a brief history and counselled
– Woman was 45, perimenopausal and wanted to be amenorrhoeic

 

 

Station 11 – Woman presenting post ‘faint’ , GP setting
– Disclosed to some the hospital said she was hypokalaemic
– Had to ICE or specifically ask about eating that say to find out self induced vomiting
– Asked management of likely diagnosis

 

 

Station 12 – Preconceptual counselling
– Obese woman with DM2 and HT wanted to conceive
– Sister had shoulder dystocia
– Elevated HbA1c
– On gliclazide, metformin and ramipril
– I advised really push the weight loss and DM control for the next 3/12, then repeat HbA1c. If reduced stop gliclazide and ramipril (changed to labetalol) and start trying for baby
– Advised folic acid
– Some also advised vitamin D
– (Hard station)

 

 

Station 13 – PGALs
– Nice station
– Asked differentials for limp in a child

 

 

Station 14 – Cough
– Negative resp history
– Had recent health check and started on ramipril
– Asked management (changed immediately to losartan, check U+Es)

 

 

Station 15 – Renal colic history

– Barn door renal colic but now anuric for 12 hours ?AKI

– Asked investigations and management

 

 

Station 16 – Abdominal exam with stoma
– Mine had ileostomy and lap scars
– Larger scar in groin (asked to examine groin, was told no, and then asked where the bowel was removed and was told to check groin!)
– Asked reasoning on which stoma this was
– Others had colostomys, one patient had urostomy and colostomy