Patient Assessment and Evaluation Flashcards

In a geriatric OSCE station, which validated tool is most commonly used to assess cognitive impairment in a brief clinical encounter?

Answer: Mini-Mental State Examination (MMSE)

The MMSE is a widely used, validated 30-point screening tool for cognitive impairment covering orientation, memory, attention, and language.

A patient has decreased fremitus, stony dullness on percussion, and absent breath sounds at the right base. The most likely diagnosis is:

Answer: Right-sided pleural effusion

Pleural effusion classically presents with stony dullness, reduced or absent breath sounds, and decreased vocal fremitus due to fluid attenuating sound transmission.

When documenting a skin lesion in an OSCE, which term describes a raised, fluid-filled lesion greater than 1 cm in diameter?

Answer: Bulla

A bulla is a fluid-filled blister greater than 1 cm; vesicles are similar but smaller than 1 cm.

A 55-year-old male presents with polyuria, polydipsia, and a fasting blood glucose of 7.8 mmol/L (140 mg/dL). According to ADA criteria, this result most likely indicates:

Answer: Impaired fasting glucose (prediabetes)

A fasting plasma glucose of 5.6–6.9 mmol/L (100–125 mg/dL) meets ADA criteria for impaired fasting glucose (prediabetes); ≥7.0 mmol/L on two occasions diagnoses diabetes.

During an eye examination OSCE, the confrontation visual field test reveals the patient cannot see your hand in the right temporal field of both eyes. This pattern is called:

Answer: Bitemporal hemianopia

Bitemporal hemianopia (loss of both temporal fields) results from compression of the optic chiasm, classically by a pituitary adenoma.

In taking a drug history, which class of medication is most important to specifically ask about due to interactions and bleeding risk before any invasive procedure?

Answer: Anticoagulants and antiplatelets

Anticoagulants (e.g., warfarin, DOACs) and antiplatelet agents (e.g., aspirin, clopidogrel) significantly increase bleeding risk and must be identified before invasive procedures.

A patient with known heart failure presents with increasing breathlessness. On examination, you find bilateral basal crackles that do not clear with coughing. These are best described as:

Answer: Fine end-inspiratory crackles from pulmonary edema

Fine end-inspiratory crackles in the lung bases that persist after coughing are characteristic of pulmonary edema due to fluid in the alveoli.