OSCE Diagnostic Skills 3

Question 1

A patient with diabetes presents with a foot ulcer, reduced vibration sense, and absent ankle reflexes. Which diagnostic tool best quantifies the degree of peripheral neuropathy?

Accepted Answer

10g monofilament test

Answer

The 10g Semmes-Weinstein monofilament test is the standard bedside tool to screen and quantify loss of protective sensation in diabetic neuropathy.

Question 2

When examining a patient with suspected Horner's syndrome, which triad of signs would you expect?

Accepted Answer

Ptosis, miosis, anhidrosis

Answer

Horner's syndrome results from sympathetic chain disruption and classically presents with ptosis, miosis, and anhidrosis on the affected side.

Question 3

Which auscultatory finding is most consistent with aortic stenosis?

Accepted Answer

Harsh ejection systolic murmur at the right second intercostal space radiating to the carotids

Answer

Aortic stenosis produces a harsh ejection systolic murmur heard best at the right second intercostal space with radiation to the carotids.

Question 4

A 30-year-old woman presents with weight gain, cold intolerance, and constipation. Which single blood test is most appropriate first?

Accepted Answer

TSH

Answer

TSH is the most sensitive screening test for thyroid dysfunction and is the recommended first-line investigation.

Question 5

Which sign, elicited by extending the knee with the hip flexed, suggests meningeal irritation?

Accepted Answer

Kernig's sign

Answer

Kernig's sign is positive when the patient resists or has pain on passive knee extension after hip flexion to 90°, indicating meningeal irritation.

OSCE Practice Test

OSCE Practice Test

OSCE Diagnostic Skills 3