OSCE Patient Assessment and Evaluation 3

Question 1

When performing the Romberg test, the examiner asks the patient to stand with feet together and eyes closed. A positive result indicates dysfunction of which system?

Accepted Answer

Proprioceptive/Vestibular

Answer

A positive Romberg test (increased sway with eyes closed) indicates impaired proprioception or vestibular function, as the patient loses compensatory visual input.

Question 2

A 45-year-old woman presents with heat intolerance, weight loss, palpitations, and a fine tremor. On inspection, her eyes appear to protrude. What is the most likely diagnosis?

Accepted Answer

Hyperthyroidism with Graves' disease

Answer

Exophthalmos (proptosis) combined with hypermetabolic symptoms is classic for Graves' disease, an autoimmune cause of hyperthyroidism.

Question 3

During a respiratory examination, you note that the trachea is deviated to the left. Which finding on the right side would most suggest a tension pneumothorax?

Accepted Answer

Resonance to percussion and absent breath sounds

Answer

Tension pneumothorax causes hyperresonance (resonance) and absent breath sounds on the affected side, with tracheal deviation away from the lesion.

Question 4

When assessing deep tendon reflexes, a grade of 2+ indicates:

Accepted Answer

Normal reflex

Answer

On the standard 0–4 scale, 2+ represents a normal reflex response.

Question 5

A patient with a history of peptic ulcer disease presents with sudden-onset severe epigastric pain radiating to the back. His abdomen is board-like rigid. What is the most likely diagnosis?

Accepted Answer

Perforated peptic ulcer

Answer

Sudden-onset severe epigastric pain with generalized peritonism (board-like rigidity) in a patient with PUD history is classic for a perforated peptic ulcer.

OSCE Practice Test

OSCE Practice Test

OSCE Patient Assessment and Evaluation 3