OSCE MCQ 4 — Questions and Answers
Question 1: In an OSCE gynecology station, a woman presents with heavy periods and an enlarged, irregular uterus. The most likely diagnosis is:
- Endometriosis
- Uterine fibroids (Correct answer)
- Endometrial carcinoma
- Polycystic ovarian syndrome
Correct answer: Uterine fibroids
Uterine fibroids (leiomyomas) classically present with heavy menstrual bleeding and an enlarged, irregular uterus on bimanual examination.
Question 2: During an OSCE station on ECG interpretation, you note ST elevation in leads II, III, and aVF. Which coronary artery is most likely occluded?
- Left anterior descending artery
- Left circumflex artery
- Right coronary artery (Correct answer)
- Left main stem
Correct answer: Right coronary artery
Inferior ST elevation in leads II, III, and aVF indicates right coronary artery (RCA) occlusion in the majority of patients.
Question 3: In an OSCE station on obtaining informed consent, which element is NOT required for valid consent?
- Patient capacity
- Disclosure of material risks
- Guarantee of a successful outcome (Correct answer)
- Voluntary decision
Correct answer: Guarantee of a successful outcome
Valid consent requires capacity, adequate information disclosure, and a voluntary decision — outcomes cannot be guaranteed and this is not a consent requirement.
Question 4: During a musculoskeletal OSCE station, Finkelstein's test is performed. Which condition does a positive result indicate?
- Trigger finger
- Dupuytren's contracture
- De Quervain's tenosynovitis (Correct answer)
- Carpal tunnel syndrome
Correct answer: De Quervain's tenosynovitis
Finkelstein's test (pain on ulnar deviation with thumb enclosed in fist) is positive in De Quervain's tenosynovitis affecting the first extensor compartment.
Question 5: A medical student in an OSCE station correctly identifies a patient with clinical features of myxedema. Which finding is most consistent with hypothyroidism on examination?
- Lid lag and exophthalmos
- Slow-relaxing reflexes and bradycardia (Correct answer)
- Fine tremor and heat intolerance
- Weight loss and diarrhea
Correct answer: Slow-relaxing reflexes and bradycardia
Hypothyroidism causes slow-relaxing deep tendon reflexes (hung-up reflexes) and bradycardia due to decreased metabolic rate.
Question 6: In an OSCE station on urinalysis, which finding is most specific for a urinary tract infection?
- Proteinuria
- Leukocyte esterase and nitrites (Correct answer)
- Hematuria alone
- Glycosuria
Correct answer: Leukocyte esterase and nitrites
Positive leukocyte esterase indicates white cells (pyuria) and positive nitrites indicate gram-negative bacteria, together highly specific for UTI.
Question 7: During a psychiatric OSCE station, a patient describes hearing a voice commenting on their actions throughout the day. This symptom is best described as:
- Second-person auditory hallucination
- Thought insertion
- Third-person auditory hallucination (Correct answer)
- Thought broadcast
Correct answer: Third-person auditory hallucination
Voices that comment on the patient's behavior refer to the patient in the third person ('he is doing X') and are a first-rank symptom of schizophrenia.
OSCE MCQ 4
In an OSCE gynecology station, a woman presents with heavy periods and an enlarged, irregular uterus.
The most likely diagnosis is: