OSCE Knowledge 5

Question 1

A 28-year-old man presents with acute monoarthritis of the first metatarsophalangeal joint, erythema, and extreme tenderness. Serum uric acid is 9.2 mg/dL. What is the first-line treatment for the acute attack?

Accepted Answer

Colchicine or NSAIDs

Answer

Colchicine or NSAIDs are first-line for acute gout flares; allopurinol is for long-term urate lowering and should not be started during an acute attack.

Question 2

In a history-taking OSCE station, which question best assesses the severity of a patient's chest pain using the SOCRATES framework?

Accepted Answer

'On a scale of 1 to 10, how bad is the pain?'

Answer

A numeric pain scale directly assesses severity (S in SOCRATES), giving a standardized measure of pain intensity.

Question 3

A child presents with inspiratory stridor, a barking cough, and low-grade fever. What is the most likely diagnosis?

Accepted Answer

Croup (laryngotracheobronchitis)

Answer

Croup (viral laryngotracheobronchitis) classically presents with a barking 'seal-like' cough, inspiratory stridor, and low-grade fever, typically in children aged 6 months to 3 years.

Question 4

During fundoscopy, which finding is pathognomonic of diabetic retinopathy and not seen in hypertensive retinopathy?

Accepted Answer

Microaneurysms

Answer

Microaneurysms are the earliest finding in diabetic retinopathy and result from capillary wall weakness; they are not a feature of hypertensive retinopathy.

Question 5

A patient is prescribed warfarin and starts taking ibuprofen regularly. What is the most concerning drug interaction?

Accepted Answer

Increased bleeding risk due to CYP2C9 inhibition and antiplatelet effect

Answer

NSAIDs like ibuprofen inhibit CYP2C9 (reducing warfarin metabolism) and inhibit platelet aggregation, significantly increasing hemorrhagic risk.

OSCE Practice Test

OSCE Practice Test

OSCE Knowledge 5