OSCE Physical Examination 5

Question 1

A patient has an ulcer at the medial malleolus with surrounding lipodermatosclerosis and hemosiderin deposits. The most likely underlying cause is:

Accepted Answer

Venous insufficiency

Answer

Medial malleolus ulcers with lipodermatosclerosis and hemosiderin staining are classic features of chronic venous insufficiency.

Question 2

When performing Phalen's test for carpal tunnel syndrome, the test is positive if symptoms are reproduced within:

Accepted Answer

60 seconds

Answer

Phalen's test is considered positive if tingling or numbness in the median nerve distribution is reproduced within 60 seconds of maximal wrist flexion.

Question 3

During breast examination, which finding is most suggestive of malignancy rather than a benign cyst?

Accepted Answer

Hard, irregular, non-tender, fixed lump with skin tethering

Answer

Malignant breast lumps are characteristically hard, irregular, non-tender, and fixed to surrounding structures, with possible skin tethering or nipple inversion.

Question 4

When assessing peripheral arterial disease, an ankle-brachial pressure index (ABPI) of 0.6 indicates:

Accepted Answer

Moderate arterial disease with claudication

Answer

An ABPI of 0.5-0.8 indicates moderate peripheral arterial disease associated with intermittent claudication.

Question 5

When testing the Achilles tendon reflex, which nerve roots are being assessed?

Accepted Answer

L5-S1

Answer

The Achilles (ankle jerk) reflex tests the S1-L5 nerve roots primarily via the tibial nerve, with S1 being the dominant root.

OSCE Practice Test

OSCE Practice Test

OSCE Physical Examination 5