OSCE History Taking 4

Question 1

A 30-year-old woman presents with recurrent urinary tract infections. Which aspect of the sexual history is most relevant to elicit?

Accepted Answer

Frequency of intercourse and contraceptive method

Answer

Post-coital UTIs are common, and certain contraceptives like diaphragms or spermicides increase UTI risk, making sexual frequency and contraception key history points.

Question 2

When taking a travel history from a patient with fever, which combination of questions is most important?

Accepted Answer

Destination, duration, malaria prophylaxis, and vaccinations taken

Answer

Destination determines endemic diseases, duration affects exposure risk, and prophylaxis/vaccination status indicates degree of protection the patient had.

Question 3

In an OSCE station, a patient presents with haemoptysis. Which historical feature would most urgently point to lung cancer as the diagnosis?

Accepted Answer

40 pack-year smoking history with weight loss and hoarse voice

Answer

Heavy smoking history combined with constitutional weight loss and hoarseness (recurrent laryngeal nerve involvement) are classic red flag features for lung cancer.

Question 4

When taking a history of altered bowel habits, which change pattern would most urgently indicate a need to rule out colorectal cancer?

Accepted Answer

Persistent change to looser stools for more than 6 weeks in a patient over 50

Answer

NICE guidelines classify persistent change in bowel habit lasting over 6 weeks in patients over 50 as a red flag symptom requiring urgent colorectal cancer investigation.

Question 5

A patient with type 2 diabetes presents for a routine review. Which systems review question is most important to include in the history?

Accepted Answer

Any vision changes, foot numbness, or chest pain on exertion

Answer

Diabetes causes micro- and macrovascular complications affecting eyes (retinopathy), peripheral nerves (neuropathy), and coronary arteries (ischemic heart disease).

OSCE Practice Test

OSCE Practice Test

OSCE History Taking 4