OSCE Knowledge 4

Question 1

During a respiratory examination, you find dull percussion, decreased breath sounds, and decreased vocal resonance over the left lower zone. What is the most likely finding?

Accepted Answer

Pleural effusion

Answer

Pleural effusion causes stony dullness on percussion, reduced breath sounds, and decreased vocal resonance due to fluid attenuating sound transmission.

Question 2

A patient with type 2 diabetes has an eGFR of 45 mL/min/1.73m². Which medication adjustment is most important?

Accepted Answer

Stop metformin use

Answer

Metformin is contraindicated when eGFR falls below 30 mL/min/1.73m² and should be used with caution below 45, often stopped to prevent lactic acidosis.

Question 3

In the OSCE consent station, which element is NOT a legal requirement for valid informed consent?

Accepted Answer

Patient signature on a consent form

Answer

A signed consent form is evidence of consent but is not legally required; verbal consent is valid if the other elements (capacity, voluntariness, information) are present.

Question 4

A 55-year-old man has a PSA of 12 ng/mL, and digital rectal examination reveals a hard irregular prostate. What is the next most appropriate step?

Accepted Answer

Transrectal ultrasound-guided prostate biopsy

Answer

An elevated PSA with a suspicious DRE finding requires histological confirmation via TRUS-guided biopsy to diagnose or exclude prostate cancer.

Question 5

Which physical sign, when positive, suggests ipsilateral cerebellar hemisphere disease?

Accepted Answer

Dysdiadochokinesia

Answer

Dysdiadochokinesia (inability to perform rapid alternating movements) indicates ipsilateral cerebellar hemisphere dysfunction.

OSCE Practice Test

OSCE Practice Test

OSCE Knowledge 4