OSCE Knowledge 3

Question 1

During a clinical examination, you elicit Murphy's sign. Which condition does this finding suggest?

Accepted Answer

Acute cholecystitis

Answer

Murphy's sign — inspiratory arrest upon deep palpation of the right upper quadrant — is a classic sign of acute cholecystitis.

Question 2

Which cranial nerve is tested when asking a patient to shrug their shoulders against resistance?

Accepted Answer

CN XI (Spinal accessory)

Answer

The spinal accessory nerve (CN XI) innervates the trapezius and sternocleidomastoid muscles, tested by shoulder shrug and head rotation against resistance.

Question 3

A 70-year-old man has a blood pressure of 180/110 mmHg, and fundoscopy reveals arteriovenous nipping and flame-shaped hemorrhages. What grade of hypertensive retinopathy is this?

Accepted Answer

Grade 3

Answer

Grade 3 hypertensive retinopathy is characterized by flame-shaped hemorrhages, soft exudates, and AV nipping, without papilledema.

Question 4

In a patient with suspected meningitis, which finding would contraindicate performing a lumbar puncture before CT scan?

Accepted Answer

Papilledema on fundoscopy

Answer

Papilledema indicates raised intracranial pressure, and performing an LP before CT risks transtentorial herniation (coning).

Question 5

When interpreting an ABG showing pH 7.28, PaCO2 55 mmHg, and HCO3 24 mEq/L, what is the primary disorder?

Accepted Answer

Respiratory acidosis

Answer

A low pH with elevated PaCO2 and normal bicarbonate indicates primary respiratory acidosis due to hypoventilation.

OSCE Practice Test

OSCE Practice Test

OSCE Knowledge 3