OSCE Physical Examination 2 — Questions and Answers
Question 1: When assessing jugular venous pressure (JVP), at what angle should the patient be positioned?
- 15 degrees
- 30-45 degrees (Correct answer)
- 60 degrees
- 90 degrees
Correct answer: 30-45 degrees
JVP is assessed with the patient at 30-45 degrees so the meniscus of the internal jugular vein is visible in the neck.
Question 2: During abdominal examination, in which quadrant would you expect to find Murphy's sign positive?
- Left lower quadrant
- Right lower quadrant
- Left upper quadrant
- Right upper quadrant (Correct answer)
Correct answer: Right upper quadrant
Murphy's sign (inspiratory arrest on deep palpation) is elicited in the right upper quadrant over the gallbladder.
Question 3: Which finding on fundoscopy is most indicative of raised intracranial pressure?
- Arteriovenous nipping
- Papilledema (Correct answer)
- Flame hemorrhages
- Cotton wool spots
Correct answer: Papilledema
Papilledema (blurring and elevation of the optic disc margins) is the classic sign of raised intracranial pressure on fundoscopy.
Question 4: When testing the patellar reflex, which nerve root is primarily being assessed?
- L1-L2
- L2-L3
- L3-L4 (Correct answer)
- L5-S1
Correct answer: L3-L4
The patellar (knee jerk) reflex tests the L3-L4 nerve root via the femoral nerve.
Question 5: A patient has a positive Romberg test. This indicates impairment of which sensory modality?
- Cerebellar function
- Proprioception (Correct answer)
- Visual acuity
- Vestibular only
Correct answer: Proprioception
Romberg test becomes positive when proprioceptive input is impaired, as the patient relies on vision to compensate and falls when eyes are closed.
Question 6: On auscultation, a friction rub heard over the precordium that varies with position is most consistent with:
- Mitral stenosis
- Aortic regurgitation
- Pericarditis (Correct answer)
- Pulmonary embolism
Correct answer: Pericarditis
A pericardial friction rub is a leathery, scratching sound heard best with the patient leaning forward and is pathognomonic of pericarditis.
Question 7: When performing the straight leg raise test, at what angle of elevation does radicular pain that indicates lumbar disc herniation typically occur?
- 0-20 degrees
- 30-70 degrees (Correct answer)
- 80-90 degrees
- Only beyond 90 degrees
Correct answer: 30-70 degrees
Radicular pain reproducing sciatic symptoms at 30-70 degrees of hip flexion is a positive SLR indicating nerve root compression, typically L4-S1.
OSCE Physical Examination 2
When assessing jugular venous pressure (JVP), at what angle should the patient be positioned?