OSCE Knowledge 2

Question 1

A patient presents with sudden-onset severe headache described as 'the worst headache of my life.' What is the most critical diagnosis to rule out?

Accepted Answer

Subarachnoid hemorrhage

Answer

A thunderclap headache reaching maximum intensity within seconds is the classic presentation of subarachnoid hemorrhage, a life-threatening emergency.

Question 2

During an OSCE station, you are asked to interpret a 12-lead ECG showing ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?

Accepted Answer

Right coronary artery

Answer

ST elevation in the inferior leads (II, III, aVF) indicates an inferior STEMI most commonly caused by right coronary artery occlusion.

Question 3

A 60-year-old patient has a serum potassium of 6.8 mEq/L. Which ECG finding would you expect to see first?

Accepted Answer

Peaked T waves

Answer

Tall, peaked (tented) T waves are the earliest ECG manifestation of hyperkalemia, appearing before P wave changes or QRS widening.

Question 4

Which spirometry pattern is consistent with obstructive lung disease such as COPD?

Accepted Answer

Reduced FEV1/FVC ratio below 0.70

Answer

Obstructive disease is defined by an FEV1/FVC ratio below 0.70 post-bronchodilator, reflecting impaired airflow due to airway narrowing.

Question 5

A 25-year-old female presents with unilateral lower quadrant pain, vaginal bleeding, and a positive pregnancy test. What is the most important diagnosis to exclude?

Accepted Answer

Ectopic pregnancy

Answer

Ectopic pregnancy is life-threatening and must be excluded first in any woman of reproductive age with pelvic pain and a positive pregnancy test.

OSCE Practice Test

OSCE Practice Test

OSCE Knowledge 2