FINAL OSCE

1. Medicine (3) • ID: Malaria

• CVS: murmurs(AR, MR, prosthetic valve, VSD) , Infective endocarditis, valvular diseases, Acute coronary syndrome.
• RS: cough & SOB (Lung cancer, asthma, COPD, bronchiectasis, pneumonia)
• Neurology: TIA, myasthenia graves (PC; dysphagia), Friedrich ataxia, MS, transverse myelitis
• ECG: supraventricular tachycardia (list 4 abnormalities, causes, ttt)
• Nephrology: PCKD, CKD, AKI, Nephrotic syndrome (Periorbital swelling) and nephritic, post-renal transplant.
• GI: ascites, jaundice, GI bleeding, IBD
• Endo: Cushing syndrome
• Hematology:
o ITP (PC: bleeding tendency).
o Thalassemia (PC; hepatosplenomegaly)
o DIC
o Sickle cell
o CBC result of 3 scenario:
▪ pt with epilepsy on phenytoin? Megaloblastic anemia (CBC show, high MCV)
▪ postnatal lady present with tiredness? Microcytic hypochromic anemia (CBC shows low Hbg,
low MCV & MCHC, high Retc. (20%))
▪ lady with h/o 3 wks SOB on excursion. CBC show pancytopenia (low Hbg, plt., WBC)
o Counsel for blood transfusion.
• Procedures:
o IV cannulation
o Insert NGT
o ECG leads placement.
o Pleural tab.
o Foley’s catheter
Pediatric (3) • Celiac
• Limping: Septic arthritis, IgA nephropathy, JIA, SLE
• Anaphylaxis
• Cystic fibrosis: genetic counselling and drawing of Pedigree.
• PC: dark urine, sore throats 3 weeks back.
• Croup
• 6 years old child presented with painful vesicular on the mouth and fever, he also have reduced feeding and liquid
intake
• Khadija brought her 2 month baby diagnosed as infantile colic, give advice to mother(medication, non medication
for the child).
• 2 Picture of white & red strawberry tongue:
o Describe the abnormality?
o What's the Dx? Scarlet fever.
o What's the causative organism?
o write 2 skin lesion characteristics of this disease?
o 2 complication?
• Developmental assessment/ assessment of growth.
• Rickets
• Counsel mother who refuses LP. Pt has meningitis (fever and headache).
• Assessment of weakness (Gower’s sign).
• Febrile sezuire.
Psychiatry (3) • Generalized anxiety disorder (anxiety over 6 months).
• ADHD (restlessness and hyperactivity)
• Demenia (forgetfulness & agitation)
• OCD
• Post-partum depression
• Schizophrenia; discharge on Olanzapine; give advice: tell him he is ready to go, advice on the drug side effects and
how to overcome these SE, advice on how to suppress his symptoms
• Depression
• Only mini mental state examination.
• Autism.
• Patient is a dependent alcohol drinker. Take history:
o Onset, type of alcohol, timing, frequency and with whom
o Craving
o Tolerance
o Withdrawal symptoms
o Forensic history
o Family support
o Focial life, drugs
o Occupation
• Delirium.
FAMCO (2) • UTI
• white coat HTN
 • Headache
• Counsel pt want to quint alcohol.
• Counsel pt want to quite smoking.
• Counsel pt regard high random blood sugar.
• Pt with rhinorrhea.
• Polycystic ovary syndrome (PCOS), infertility.
• Asthma: Give advice on how to use inhalers, show pt how to use MDI, management of severe asthma.
• Pt come for employment, has hepatitis B positive test, advise him. HsAg +ve/ HeAg +ve/ Ant IgG +ve/ Ant IgM -ve
• Counsel about IUCD.
• Pt has sleeping difficulties, want sleeping pills, assess her.
• Pt complain of obesity > Dx hypothyroidism.
• Back pain: do physical examination (gait, neurovascular of lower limbs, to end my examination, I would like to
perform PR examination to check anal sphincter tone). DX:
o Lower motor neuron lesion
o Sciatica (+ve SLR) – list causes
o Mechanical pain with paraspinal tenderness and no focal neurological findings.
• PC; palpitation and fatigue.
• Dehydration due to diarrhea; counsel on ORS.
• Child with paracetamol overuse. Counsel mother who refuses admission.
• Diabetic foot examination and care.
• Hx of vaginal discharge → Dx. trichomonas vaginalis → discuss management.
• Employment; HIV positive.
• Abnormal lipid profile, counsel.
Surgery (3) • Acute pancreatitis
Do examination • Right inguinal hernia
• Mastitis
• Fibroadenoma (breast pain for 1 year), must describe the mass.
• Thyroid (Graves); PC (neck swelling)
• Acute cholecystitis
• Urology: poor urine stream, PR examination on manikin
• Ulcers
• Acute limb aschemia
• Swelling: neck mass, lipoma, sebaceous cyst, ganglion
• Stoma ?
• Appendicitis.
• Pt was having a wound in his arm, perform a proper wound management fully.
Ortho (2) • Radial nerve injury , wrist drop.
Do examination • Examine knee (ACL tear, osteoarthritis). Must know about DEXA Scan.
• Car accident causing intraarticular fracture of tibia and fibula (Complication; compartment syndrome)
• Carpal tunnel syndrome.
• Shoulder examination.
• Ankle examination: tilt test.
• Rheumatoid arthritis.
Ophthalmology (1) • PC (headache and vision impairment): Pituitary adenoma causing bitemporal hemianopia, examine visual field only
• PC (Diplopia): use fundoscopy, DX (6th nerve palsy, stroke), advice pt whether he can drive or not.
Anesthesia (1) • Maintain airway (apply bag mask and connect it to IPPV), take hx of pt with chest pain & SOB
Do examination
Oral (1) • Drug induced xerostomia (amitriptyline)
• Aphthous ulcer with anemia. Counsell pt about management.
• Child with herpes gingivostomatitis (fever, malaise, difficulty in swallowing & cervical lymphadenopathy), advice
the mother;
o Causes? infectious? leukemia? follow up? Serious?
• Orthopantomography is showed, problems? Is valvular condition will be affected with dental exctrasion?
• known case of SLE, presented with disturbed taste & tooth pain; DX (xerostomia due to 2nd Sjogren Syndrome).
How to maintain oral hygiene.
Derma (1) • Lichen planus.
• Atopic dermatitis (redness and itchiness): There are three age-group stages of atopic dermatitis: infantile (from
infancy to 2 years old), childhood (from 2 years old to 12 years old) and the adult stage for those older than 12
years. adverse effects of applying a topical corticosteroid cream?
• Scabies
• Urticaria
• Allergic dermatitis.

Bayan Al-Harrasi
Collection of all OSCEs from previous links.