OSCE Diagnostic Skills 4

Question 1

A child presents with a barking cough, stridor, and low-grade fever. The most likely diagnosis is:

Accepted Answer

Croup (laryngotracheobronchitis)

Answer

Croup typically presents in young children with a characteristic barking cough, inspiratory stridor, and mild fever due to viral subglottic oedema.

Question 2

Which investigation is most useful in differentiating prerenal from intrinsic renal acute kidney injury?

Accepted Answer

Urinary sodium concentration and fractional excretion of sodium (FENa)

Answer

FENa <1% suggests prerenal AKI (tubules conserving sodium), while FENa >2% suggests intrinsic renal disease with tubular dysfunction.

Question 3

A patient has a positive Trendelenburg test on the right side. What does this indicate?

Accepted Answer

Weakness of the right hip abductors (gluteus medius)

Answer

A positive Trendelenburg sign on the right means the pelvis drops on the left during single-leg stance on the right, indicating weak right gluteus medius.

Question 4

Which sign is used to detect a small knee effusion that would be missed by the patellar tap test?

Accepted Answer

Bulge (stroke) test

Answer

The bulge (stroke) test detects small effusions by milking fluid across the medial compartment and observing a bulge return medially.

Question 5

In a patient presenting with acute red eye and painful loss of vision, which diagnosis requires the most urgent intervention?

Accepted Answer

Acute angle-closure glaucoma

Answer

Acute angle-closure glaucoma causes rapid intraocular pressure elevation leading to permanent vision loss without emergency treatment.

OSCE Practice Test

OSCE Practice Test

OSCE Diagnostic Skills 4