OSCE History Taking 2 — Questions and Answers
Question 1: When taking a pain history in the OSCE, which mnemonic is most commonly used to ensure all key pain features are covered?
- SOCRATES (Correct answer)
- AMPLE
- OLDCARTS
- PQRST
Correct answer: SOCRATES
SOCRATES (Site, Onset, Character, Radiation, Associations, Time course, Exacerbating/relieving factors, Severity) is the standard mnemonic for comprehensive pain history.
Question 2: A 55-year-old male presents with chest pain. Which associated symptom would most increase your concern for acute coronary syndrome?
- Diaphoresis and nausea (Correct answer)
- Sharp pleuritic pain worsened by breathing
- Pain relieved by antacids
- Localised tenderness on palpation
Correct answer: Diaphoresis and nausea
Diaphoresis and nausea are classic autonomic symptoms associated with myocardial ischemia and significantly increase ACS concern.
Question 3: When asking about a patient's drug history, which class of medication is most important to specifically ask about due to its narrow therapeutic index and bleeding risk?
- Anticoagulants (Correct answer)
- Antihypertensives
- Antidepressants
- Antihistamines
Correct answer: Anticoagulants
Anticoagulants like warfarin have a narrow therapeutic index and significantly increase bleeding risk, making them critical to document in any history.
Question 4: A patient presents with shortness of breath. Which question best differentiates cardiac from respiratory causes?
- Does the breathlessness wake you from sleep? (Correct answer)
- Does it occur at a specific time of day?
- Is it associated with a productive cough?
- Does it occur in cold weather?
Correct answer: Does the breathlessness wake you from sleep?
Paroxysmal nocturnal dyspnea (waking from sleep breathless) is a hallmark of left heart failure due to fluid redistribution when supine.
Question 5: In a paediatric history taken from a parent, what additional component is mandatory compared to an adult history?
- Birth and developmental history (Correct answer)
- Sexual history
- Travel history
- Occupational history
Correct answer: Birth and developmental history
Birth history, developmental milestones, and immunization status are essential additional components when taking a paediatric history from a caregiver.
Question 6: When exploring a patient's alcohol history, which validated screening tool asks four specific questions including about guilt and need to cut down?
- CAGE questionnaire (Correct answer)
- AUDIT-C
- FAST tool
- TWEAK questionnaire
Correct answer: CAGE questionnaire
The CAGE questionnaire asks about Cut down, Annoyed, Guilty, and Eye-opener, and is a widely used brief alcohol screening tool.
Question 7: A patient reports dizziness. Which question best differentiates true vertigo from pre-syncope?
- Does the room spin around you? (Correct answer)
- Does it occur when you stand up quickly?
- How long does each episode last?
- Do you have associated tinnitus?
Correct answer: Does the room spin around you?
A sensation of spinning (vertigo) indicates vestibular pathology, while lightheadedness without spinning suggests pre-syncope or cardiovascular causes.
OSCE History Taking 2
When taking a pain history in the OSCE, which mnemonic is most commonly used to ensure all key pain features are covered?