Practice OSCE questions for medical student exams

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.



Q2


Please counsel Mrs Brown with respect to pregnancy planning and care based on the history you have obtained.



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.”


Describe your assessment and management of the patient.



Q2


What are the risk factors for a post-partum haemorrhage? (In general – not specific to this patient.)



Q3


Would this episode change your management of Mrs Wyatt’s labour for her next baby? If so, how?



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.


Please assess the patient.



Q3


What investigations would you like to order?



Q4


The results of the investigations are as follows:


• CXR: mild atelectasis only

• AXR: air-fluid levels and distended loops of small bowel

• FBE: Hb 10.6 g/dl, WCC 18.0

• Urea/electrolytes: potassium 3.0, otherwise normal

What is your diagnosis and management?



A4


Mr and Mrs F are unable to become pregnant after trying for 3 years. Please advise.



Q1


Please take a history about the presenting problem.



Q2


Please ask for relevant examination findings.



Q3


What are the key investigations to be performed?



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?”



Q3


Ms Hilton has a friend who doesn’t smoke or drink, but uses cocaine at parties and is 20 weeks pregnant.


“Can cocaine harm her pregnancy, doctor?”



A6



Q1


You are seeing Mrs Prouse, a 70-year-old woman with three episodes of vaginal bleeding over the last 6 weeks.


Please take a history from Mrs Prouse.



Q2


What examination findings would you like to know?



Q3


What are the most appropriate investigations?



Q4


What features are you looking for in the ultrasound scan?



Q5


The curettings show a grade 1 endometrioid adenocarcinoma. What is the most appropriate treatment for Mrs Prouse’s cancer?



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.



Q2


Is there a role for the HPV vaccine in this woman?



Q3


Describe the HPV vaccines currently available.



Q4


Miss Bertram returns in 12 months for her repeat Pap smear, which still shows CIN1/HPV. What is the next course of action?



Q5


What does a colposcopy involve?



Q6


Miss Bertram has a biopsy that shows CIN3/HPV. The transformation zone is in full view, and the changes do not extend up the endocervical canal. What are the treatment options?



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.


Please take a history from Ms V.



Q2


Please inform Ms V on the different types of emergency contraception currently available in Australia, their effectiveness and side effects.



Q3


What should be advised for Ms V for the future?



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.”



Q2


What are the conditions that must be satisfied for you to safely perform a forceps delivery?



Q3


What are the potential complications of a forceps delivery?



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.



Q1


Please take a history of the presenting complaint from Ms T.



Q2


Please ask for relevant examination findings.



Q3


Are there any tests that you would order?



Q4


What are the treatment options for this woman?



B4

Related posts:

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  2. Specialist level OSCE answers and discussion
  3. How to approach an OSCE: clinical stations
  4. Medical student OSCE answers and discussion

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Jun 15, 2016 | Posted by in GYNECOLOGY | Comments Off on Practice OSCE questions for medical student exams

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