OSCE Diagnostic Skills 2

Question 1

A 55-year-old man presents with exertional chest pain radiating to the left arm. Which initial diagnostic test is most appropriate?

Accepted Answer

12-lead ECG

Answer

A 12-lead ECG is the first-line test in suspected acute coronary syndrome to detect ischemic changes rapidly.

Question 2

When percussing the chest, dullness over the lower lung fields bilaterally most likely indicates:

Accepted Answer

Pleural effusion

Answer

Bilateral basal dullness on percussion is a classic sign of pleural effusion due to fluid replacing air-filled lung.

Question 3

A patient has a positive Murphy's sign. Which condition does this most strongly suggest?

Accepted Answer

Acute cholecystitis

Answer

Murphy's sign (inspiratory arrest on RUQ palpation) is a specific indicator of acute cholecystitis.

Question 4

Which finding on fundoscopy is pathognomonic of hypertensive retinopathy grade IV?

Accepted Answer

Papilloedema

Answer

Grade IV hypertensive retinopathy is defined by papilloedema in addition to other hypertensive changes.

Question 5

A 70-year-old presents with sudden painless loss of vision in one eye described as 'a curtain falling.' The most likely diagnosis is:

Accepted Answer

Retinal detachment

Answer

Painless unilateral visual loss described as a descending curtain is the classic presentation of retinal detachment.

OSCE Practice Test