NAC OSCE Physical Examination 2

Question 1

In a NAC OSCE thyroid examination station, which technique is used to auscultate for a thyroid bruit and what does it indicate?

Accepted Answer

Use the bell of the stethoscope over the thyroid lobes; a bruit indicates increased vascularity, classically seen in Graves' disease

Answer

A thyroid bruit detected with the bell of the stethoscope indicates hypervascular thyroid tissue, classically associated with Graves' disease due to TSH receptor stimulation.

Question 2

When performing a fundoscopic examination in a Canadian OSCE station, which finding is MOST associated with hypertensive emergency?

Accepted Answer

Papilloedema (disc swelling with blurred margins)

Answer

Papilloedema on fundoscopy indicates raised intracranial pressure from hypertensive emergency and requires immediate blood pressure management per Canadian Hypertension Education Program (CHEP) guidelines.

Question 3

During a musculoskeletal examination, the Lachman test is performed and found to be positive. What does this indicate?

Accepted Answer

Anterior cruciate ligament (ACL) injury

Answer

The Lachman test (anterior tibial displacement on a flexed knee) is the most sensitive bedside test for ACL rupture, with sensitivity >80%, and is a key OSCE manoeuvre.

Question 4

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?

Accepted Answer

Septic arthritis of the hip

Answer

Septic arthritis presents with the hip held in the position of maximum capsular volume (flexion, abduction, external rotation) and is a surgical emergency; fever and elevated inflammatory markers distinguish it from transient synovitis.

Question 5

During a breast examination in a Canadian NAC OSCE station, which feature of a palpable mass is MOST associated with malignancy?

Accepted Answer

Hard, irregular, non-tender, fixed mass with skin dimpling

Answer

Malignant breast masses are typically hard, irregular, non-tender, and fixed to surrounding tissue, with skin dimpling (peau d'orange) from Cooper's ligament involvement.

NAC OSCE Practice Test

NAC OSCE Practice Test

NAC OSCE Physical Examination 2