Chapter 3 Practice OSCE questions for medical student exams
STUDENT OSCE A
A1
Q1
Mrs Brown is a 24-year-old nullipara with a 20-year history of type 1 diabetes (insulin-dependent diabetes mellitus). She wishes to have a baby. Please take a history and counsel.
A2
Q1
You are a rural GP obstetrician called by the midwives. “Mrs Wyatt delivered her baby 15 minutes ago, and is now bleeding very heavily. Could you please come to the labour ward as soon as possible.”
Q2
What are the risk factors for a post-partum haemorrhage? (In general – not specific to this patient.)
A3
Q1
You are attached to the Gynaecology Oncology Unit and have just assisted at a laparotomy on a 54-year-old woman with advanced ovarian cancer. She has had a total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy. Blood loss was estimated at 300 mL and 5 L of ascitic fluid was drained at the time of the surgery. Fluid replacement was 2.5 L crystalloid and urine output was 250 mL.
Please describe your post-operative orders for the first 24 hours. The patient is stable; there are no drains in situ. The patient has an indwelling urinary catheter and has patient-controlled analgesia (PCA) with morphine.
Q2
It is day 3 post-op. The patient has been stable and was commenced on clear fluids yesterday. You are asked to see her as she has vomited a large volume of bile-stained fluid and is complaining of abdominal pain.
A5
Q1
You are seeing Ms Veronica Hilton, a 23-year-old woman who wishes to try to have a baby in the next few months. She smokes 20 cigarettes a day and drinks 2–3 glasses of wine a night.
You are speaking to the patient. Please counsel her about the risks of smoking and alcohol, with particular reference to obstetric and gynaecological problems.
Q2
Ms Hilton is now 12 weeks pregnant, and has stopped drinking alcohol. However, she still smokes 10 cigarettes a day.
“Can I use nicotine patches to help me stop smoking, doctor?”
A6
Q1
You are seeing Mrs Prouse, a 70-year-old woman with three episodes of vaginal bleeding over the last 6 weeks.
A7
Q1
Miss Bertram is a 23-year-old woman who has come to see you following her routine Pap smear. The Pap smear has shown low-grade cervical dysplasia – CIN1/HPV.
Please explain this to her, as well as your management plan.
Q4
Miss Bertram returns in 12 months for her repeat Pap smear, which still shows CIN1/HPV. What is the next course of action?
A8
Q1
Ms H, a 24-year-old woman, presents to you complaining of pelvic pain. Please manage her problem.
Q2
Ms H’s abdominal and pelvic examination found a normal sized uterus which was fixed in a retroverted position. There was the impression of a mass on the right side of the pelvis.
Ms H has a laparoscopy at which endometriosis is seen and the areas of endometriosis are removed. Please explain endometriosis to Ms H and the management of her condition.
STUDENT OSCE B
B1
Q1
Ms V is presenting for the ‘morning-after pill’. She had unprotected sex last night with a long-standing male partner.
Q2
Please inform Ms V on the different types of emergency contraception currently available in Australia, their effectiveness and side effects.
B2
Q1
You are the obstetrics registrar, called to see Mrs Joan Grey in the labour ward. The midwife on duty tells you over the phone: “Mrs Grey has been pushing for two hours, and is getting tired. Please come and assess her.”
B3
You are seeing Ms T, who presents with irregular menstrual periods 6 to 12 weeks apart, and excessive hair growth. Please assess her and manage her problem.
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