OSCE Physical Examination 4

Question 1

A patient presents with a small, round, painless ulcer with indurated edges on the penis. The most appropriate next examination step is:

Accepted Answer

Examine the inguinal lymph nodes

Answer

A painless indurated penile ulcer (chancre) requires inguinal lymph node examination, which typically shows non-tender lymphadenopathy in primary syphilis.

Question 2

When assessing ankle clonus, how many beats of sustained clonus is considered pathological?

Accepted Answer

3 or more beats

Answer

Sustained clonus (3 or more rhythmic beats) is pathological and indicates an upper motor neuron lesion; 1-2 beats can be normal.

Question 3

During thyroid examination, which maneuver best confirms that a midline neck swelling is the thyroid gland?

Accepted Answer

Asking the patient to swallow

Answer

The thyroid gland moves upward on swallowing because it is enclosed in the pretracheal fascia, distinguishing it from other neck masses.

Question 4

On ophthalmoscopy, arteriovenous (AV) nipping at arteriovenous crossings is most associated with:

Accepted Answer

Hypertensive retinopathy

Answer

AV nipping occurs when hardened, thickened retinal arteries compress the veins at crossing points, a hallmark of hypertensive retinopathy.

Question 5

When performing the finger-nose test in a patient with cerebellar disease, the characteristic finding is:

Accepted Answer

Intention tremor increasing as finger approaches target

Answer

Intention tremor that worsens as the finger approaches the target (dysmetria) is the hallmark of cerebellar dysfunction on the finger-nose test.

OSCE Practice Test

OSCE Practice Test

OSCE Physical Examination 4