OSCE Mental Health Assessment 5

Question 1

In an OSCE focused on personality disorders, a patient repeatedly idealizes then devalues treatment team members, has chronic feelings of emptiness, and a history of self-harm. The most likely diagnosis is:

Accepted Answer

Borderline personality disorder

Answer

Splitting (idealization/devaluation), identity disturbance, self-harm, and chronic emptiness are hallmark features of borderline personality disorder.

Question 2

A patient presents with fear of eating in public, avoidance of social gatherings, and physiological symptoms (sweating, trembling) triggered by perceived scrutiny. The GAD-7 is 6 and the PHQ-9 is 5. The most appropriate primary diagnosis is:

Accepted Answer

Social anxiety disorder (social phobia)

Answer

Fear of negative evaluation in social/performance situations leading to avoidance is the defining feature of social anxiety disorder.

Question 3

During an OSCE psychiatric interview, the student asks, 'Do you ever feel that events on TV or radio have special meaning just for you?' This question screens for:

Accepted Answer

Ideas of reference

Answer

Ideas of reference are beliefs that neutral external events (TV, radio, strangers' behavior) carry a special personal message directed at the patient.

Question 4

In an OSCE focused on motivational interviewing for a patient with alcohol use disorder, which statement best exemplifies a 'change talk' response by the clinician?

Accepted Answer

'What are some reasons you might want to cut back on drinking?'

Answer

Evoking the patient's own reasons for change through open questions is the core technique of motivational interviewing.

Question 5

A patient taking lithium presents with coarse tremor, confusion, ataxia, and nausea. The serum lithium level is 2.4 mEq/L. The priority intervention is:

Accepted Answer

Discontinue lithium and initiate supportive care, consider hemodialysis

Answer

A lithium level >2.0 mEq/L with neurological toxicity (confusion, ataxia) constitutes severe toxicity requiring immediate discontinuation and possible hemodialysis.

OSCE Practice Test

OSCE Practice Test

OSCE Mental Health Assessment 5