OSCE MCQ 2 — Questions and Answers
Question 1: During an OSCE station on abdominal examination, which finding most specifically suggests peritoneal irritation?
- Voluntary guarding
- Rebound tenderness (Correct answer)
- Shifting dullness
- Absent bowel sounds
Correct answer: Rebound tenderness
Rebound tenderness (Blumberg's sign) specifically indicates peritoneal irritation when pain worsens upon sudden release of deep abdominal pressure.
Question 2: A patient presents with a unilateral, painless, hard, irregular breast lump in an OSCE breast exam station. What is the most appropriate next step in management?
- Reassure and review in 6 months
- Prescribe antibiotics
- Refer urgently for triple assessment (Correct answer)
- Advise the patient to monitor at home
Correct answer: Refer urgently for triple assessment
A hard, irregular, painless breast lump raises concern for malignancy and requires urgent triple assessment (clinical exam, imaging, biopsy).
Question 3: In an OSCE communication station, a patient refuses a blood transfusion on religious grounds despite life-threatening anemia. What is the most appropriate response?
- Proceed with the transfusion as it is life-saving
- Respect the decision and document it (Correct answer)
- Call security to enforce the transfusion
- Contact the patient's family for override consent
Correct answer: Respect the decision and document it
A competent adult has the right to refuse treatment, including blood transfusions, and this decision must be respected and documented.
Question 4: During a respiratory OSCE station, you note tracheal deviation to the right. Which condition most commonly causes this?
- Left-sided tension pneumothorax
- Right upper lobe collapse (Correct answer)
- Left pleural effusion
- Right-sided pneumothorax
Correct answer: Right upper lobe collapse
Right upper lobe collapse pulls the trachea toward the affected side (toward the right), whereas tension pneumothorax pushes it away.
Question 5: In an OSCE neurology station, a patient cannot perform rapid alternating movements smoothly. This finding is called:
- Asterixis
- Dysdiadochokinesia (Correct answer)
- Athetosis
- Myoclonus
Correct answer: Dysdiadochokinesia
Dysdiadochokinesia is the inability to perform rapid alternating movements smoothly and is a sign of cerebellar dysfunction.
Question 6: In an OSCE station on diabetic foot examination, which feature most indicates Charcot arthropathy rather than simple diabetic foot infection?
- Warm, swollen foot without open wound (Correct answer)
- Purulent discharge from a plantar ulcer
- Fever and elevated white cell count
- Black discoloration of the toes
Correct answer: Warm, swollen foot without open wound
Charcot arthropathy presents with a warm, swollen, erythematous foot without systemic signs of infection, often in neuropathic patients.
Question 7: A student performing a cranial nerve OSCE station tests the gag reflex. Which cranial nerves are assessed by this test?
- CN V and VII
- CN IX and X (Correct answer)
- CN X and XII
- CN VII and IX
Correct answer: CN IX and X
The gag reflex afferent limb is CN IX (glossopharyngeal) and the efferent limb is CN X (vagus).
OSCE MCQ 2
During an OSCE station on abdominal examination, which finding most specifically suggests peritoneal irritation?