NAC OSCE Cheat Sheet 2026

The 27 highest-yield NAC OSCE facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Under Canadian mandatory reporting laws, which situation REQUIRES a physician to report to authorities regardless of patient confidentiality? → Reasonable suspicion of child abuse or neglect
2. A newborn has persistent cyanosis that does not improve with supplemental oxygen. Which congenital cardiac lesion should be MOST suspected? → Transposition of the great arteries (TGA)
3. When performing a fundoscopic examination in a Canadian OSCE station, which finding is MOST associated with hypertensive emergency? → Papilloedema (disc swelling with blurred margins)
4. During a musculoskeletal examination, the Lachman test is performed and found to be positive. What does this indicate? → Anterior cruciate ligament (ACL) injury
5. A 70-year-old patient with non-valvular atrial fibrillation has a CHA₂DS₂-VASc score of 3. According to CCS guidelines, what anticoagulation is recommended? → A direct oral anticoagulant (DOAC), preferably over warfarin
6. According to the SOGC, at what gestational age is the combined first-trimester prenatal screening (nuchal translucency + PAPP-A + free β-hCG) performed? → 11+0 to 13+6 weeks gestation
7. A 55-year-old male presents in anaphylactic shock after a bee sting. What is the FIRST-line treatment according to Canadian Emergency Medicine guidelines? → IM epinephrine 0.3-0.5 mg (1:1000) into the anterolateral thigh
8. A 4-year-old child is brought in with a limp. On examination, the hip is held in flexion, abduction, and external rotation. What is the MOST likely diagnosis? → Septic arthritis of the hip
9. In a NAC OSCE station assessing cranial nerves, which test assesses the function of cranial nerve V (trigeminal)? → Corneal reflex (afferent V1) and facial sensation in three divisions
10. A 55-year-old man's ECG shows a PR interval of 240 ms with every P wave followed by a QRS complex and no dropped beats. What is the correct interpretation? → First-degree AV block
11. When taking a history from a patient with abdominal pain, which associated symptom is MOST suggestive of a surgical emergency? → Rigid abdomen with rebound tenderness and fever
12. When obtaining a family history, which pattern of disease is MOST suggestive of a hereditary condition requiring further investigation? → Multiple first-degree relatives with the same type of cancer diagnosed before age 50
13. During a breast examination in a Canadian NAC OSCE station, which feature of a palpable mass is MOST associated with malignancy? → Hard, irregular, non-tender, fixed mass with skin dimpling
14. In a NAC OSCE psychiatric history station, which Canadian screening tool is recommended for identifying major depressive disorder in primary care? → PHQ-9 (Patient Health Questionnaire-9)
15. During a NAC OSCE station, a patient presents with chest pain. Which mnemonic is most commonly used in Canada to structure a systematic pain history? → SOCRATES
16. When taking a medication history in a NAC OSCE station, which additional information is MOST important to elicit beyond drug name and dose? → Adherence, allergies with reaction type, and over-the-counter or herbal use
17. In a diabetic patient presenting with fever, flank pain, and costovertebral angle tenderness, what complication must be urgently ruled out? → Emphysematous pyelonephritis requiring urgent CT and possibly nephrectomy
18. A 22-year-old male university student presents with fever, neck stiffness, and a petechial rash. What is the MOST critical immediate action? → Administer IV ceftriaxone immediately without waiting for lumbar puncture results
19. A diabetic patient's ABG shows pH 7.28, pCO2 22 mmHg, HCO3 10 mEq/L; serum Na 138 mEq/L, Cl 98 mEq/L. What is the calculated anion gap? → 30 mEq/L
20. A 32-year-old woman at 10 weeks gestation has Hgb 92 g/L, MCV 73 fL, and serum ferritin 6 μg/L (normal >15). What is the most likely diagnosis? → Iron deficiency anemia
21. A patient mentions using cannabis recreationally. Under Canadian law since 2018, how should a physician address this in a non-judgemental history? → Acknowledge its legal status, ask about frequency and route, and assess for health impacts
22. A 6-year-old child weighing 20 kg presents to a Canadian emergency department with moderate croup (Westley score 3-5). What is the standard treatment? → Oral dexamethasone 0.6 mg/kg (single dose) with nebulised epinephrine for moderate cases
23. In the NAC OSCE, which communication technique is used to demonstrate active listening and encourage patients to elaborate on their concerns? → Facilitation (nodding, 'go on', open-ended follow-up)
24. When breaking bad news in a Canadian NAC OSCE station using the SPIKES protocol, what does the 'P' stand for? → Perception (assess what the patient already knows)
25. According to the Canadian Immunization Guide, which vaccine is recommended at 2, 4, and 6 months of age in the standard Ontario childhood immunization schedule? → DTaP-IPV-Hib-HB (hexavalent vaccine) plus PCV13 and Rotavirus
26. A 6-month-old infant presents with fever of 39°C. Which of the following findings would be MOST concerning? → The infant has a bulging fontanelle, is inconsolable, and has a non-blanching rash
27. When taking a medication history, which of the following is MOST important to document in addition to prescribed medications? → Over-the-counter medications, herbal supplements, vitamins, and any recreational drug use