General Medicine OSCE chart with details .pdf

Medicine exam and clinical practice oriented OSCE

10. OSCE

Time 3 mins

SCENERIO

35 year old female presented with digital ulcers with auto
amputation of fingers, she also noted difficulty in swallowing.

See the image and answer the questions.
IMAGE

11. Assessor check list

1. What is your probable diagnosis? — systemic sclerosis fish
mouth appearance, calcinosis. (1 mark)

2. Systemic sclerosis clinical features — skin tightening, salt and
pepper appearance, CREST syndrome ( calcinosis, raynauds,
esophageal dysmotility, sclerodactyly, telengectesia), ILD,
pulmonary hypertension, renal failure, (4marks)

3. Investigation to confirm your diagnosis- anti topoisomerase 1
(anti scl 70) , anti centromere antibody (2marks)

4. Respiratory complications

Respiratory — pleurisy, interstitial lung disease, pulmonary
hypertension - 2marks

12. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION 1: SCENARIO 1

QUESTIONS

1. What is your probable diagnosis?(2 marks)

2. Investigation of choice to confirm your diagnosis(2 marks)

3. Mention the hematological and respiratory system involvement
in your condition.(2+ 2 marks)

4. Mention the drugs used to treat this condition.(2 marks)

13. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION 1: SCENARIO 2

OSCE
Time: 3 mins
10 Marks

CANDIDATE INFORMATION

32 year oldmale presented to the medicine OPD.

‘See the image and answer the questions.

14. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION 1: SCENARIO 2

QUESTIONS

1. What is your probable diagnosis? (2 marks).
2. Which infection is associated with this condition.(2 marks)
3. Mention the complications in your condition. (2 marks)
4. Mention the drugs used to treat this condition.(2 marks)

5. Mention the syndrome associated with this condition. (2 marks)

15. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION 1: SCENARIO 2

Assessor check list

1.Bell's palsy (2 mark).

2. Herpes virus( 2 marks)

3. Exposure keratitis, Corneal ulcer (2 marks)

4. Steroids, acyclovir. (2 mark)

5. Ramsay hunt syndrome (2 mark)

16. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -1 SCENARIO -3
OSCE
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CANDIDATE INFORMATION

35 year old female presented fatiguability, postural giddiness and
weight loss. On examination she was thin built and
hyperpigmentation of the face and extremities is noted.

See the image and answer the questions.

17. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -1 SCENARIO -3 |

QUESTIONS

1. What is your probable diagnosis? (2 mark)

2. Mention the causes (2 marks )

3. Mention the appropriate investigations (2mark)

4. Mention the treatment( 2 mark)

5. Mention the metabolic derangements.( 2 Mark)

18. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -1 SCENARIO -3

Assessor check list

1. What is your probable diagnosis? — Addisonsdisease( 2marks)

2, Infections( tuberculosis), Autoimmune conditions, secondaries,
adrenal haemorrhage ( 2 Marks )

3. Serum cortisol, ACTH stimulation test (2marks)
| 4. Corticosteroid and fludricortisone supplementation( 2Marks)

5. Hyperkalemia, hyponatremia and metabolic acidosis (2 Marks)

19. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -2 SCENARIO - 2

OSCE
Time: 3 mins
10 Marks
CANDIDATE INFORMATION
Read the clinical scenario carefully and answer the questions

Clinical scenario

18 year old male is brought to the emergencyin unconscious state with
H/O multiple episodes of seizures for the past 20 min with no regain
of consciousness in between. He is a known case of seizure disorder
for the past 1 year and was on T. Eptoin 300mg/day which he
discontinued 1 day back. There was no other significant history.

His vitals were as follows:

Pulse- 108 bpm;Blood Pressure 110/80 mm of hg; SpO2 — 96%;
Temp - 98.2 F; CBG - 106 mg/dL

You are examining the patient and he starts to throw a fit. Venous
access is already established.

20. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -2 SCENARIO - 2

Answer the following:
1. What is yourprovisional diagnosis?
‘Write the prescription for the following Questions:
2. What will be your initial step (STEP 1)?
3. You repeat step 1 for one more time and still the seizure
continues. What will be your next step (STEP2)?
4. Seizure continues. What will be your next step (STEP 3)?

Answer the following:

5. The patient is shifted to ICU. Seizure continues. What will bethe
next step (STEP 4)?

21. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -2 SCENARIO - 2

Assessor check list
1 Diagnosis - Status epilepticus (2 Marks)

2.STEP 1
Inj, Lorazepam 4mg (or) 0.1 - 0.15 mg/kg IV over 1-2
min (or) stat (2 Marks)

3.STEP 2 (LOADING DOSE)
Inj. Phenytoin/Eptoin750-1000mg (or) 20 mg/kg IV

over 15-20 min (or) 50mg/min
(or)
Inj. Fosphenytoin 750-1000mg (or) 20 mg/kg IV over
5-10 min (or) 150mg/min (2 Marks)

4.STEP 3 (HALF-LOADING DOSE)

Inj. Phenytoin/Eptoin 350-500mg (or) 7-10 mg/kg IV
over 15-20 min (or) SOmg/min

(or)

Inj. Fosphenytoin 350-500mg (or) 7-10 mg/kg IV
over 5-10 min (or) 150mg/min (2 Marks)

5.STEP 4 (ICU)

Intubate the patient and give IV anaesthesia -
propofol/midazolam/pentobarbital (2 Marks)

22. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION - 2 SCENARIO - 3
OSCE
Time: 3 mins
10 Marks
CANDIDATE INFORMATION

Read the clinical scenario carefully and answer the questions
Clinical scenario

59 year male admitted with easy fatigability and loss of weightfor two
months duration with abdominal distension for one month. On
examination he is anemic and few petechial rash present. Pulse-
108bpm, Blood Pressure 100/80 mm of Hg. Systemic examination
reveals massive splenomegaly.

Laboratory investigations

Total leucocyte count — 28,000 cells/cubicmm
Platelets - 4,90,000 cells/cubicmm
Hemoglobin - Sgm/dl.

Peripheral smear study

+ normochromic and normocytic anemia with mildly increased
basophils and eosinophils, Platelet increased

+ Leukoerythroblastosis, with circulating immature cells from the
bone marrow and myeloblasts, myelocytes, metamyelocytes,
nucleated red blood cells

23. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION - 2 SCENARIO - 3

QUESTIONS

1. What is your probable diagnosis?

2. Investigations to confirm your diagnosis
3. Most common cytogenetic abnormality
4. Drug of choice of this condition

5. Treatment options availableto your clinical scene

24. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION - 2 SCENARIO - 3

Assessor check list

‘What is your probable diagnosis? - CML (2 mark)
Investigation to confirm your diagnosis- Bone marrow study
with immunohistochemistry. (2mark)

Most common cytogenetic abnormality - Philedelphia
chromosome (2mark)

Drug of choice to your clinical scene - Tyrosine kinase
inhibitors- IMATINIB, DASATINIB, SUNITINIB-(2 mark)

‘Treatment of choice for relapse - Hematopoetic stem cell
transplant- (2 mark)

25. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION - 4 SCENARIO - 1

OSCE

Time: 3 mins
10 Marks
CANDIDATE INFORMATION

A 55year old male diabetic presented to ER with complaints of pedal
edema and oliguria

U take an ECG.

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26. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL (MEDICINE
STATION - 4 SCENARIO - 1

QUESTIONS

1. Mention the ECG findings , and what is your diagnosis? ( 2 Marks)

2. What immediate blood investigations will you order for this
patient? ( 2 Marks)

3. Mention two drugs causing this condition. ( 2 Marks )

4. What is the management for the case? ( 4 Marks)

27. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION -4 SCENARIO - 1

‘ASSESSORS SHEET

1. Tall tented T waves and flattening of P waves. ( 2 Marks}
2. Renal functions and serum electrolytes ( 2 Marks )
3. ACE/ARB inhibitors , potassium sparing diuretics. ( 2 Marks )

4. Calcium gluconate, dextrose with insulin, beta2 agonist, potassium
binding resins. (4 Marks)

28. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION - 4 SCENARIOS - 3

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1. Mention the ECG findings ( 2 mark)

2. What is the diagnosis? ( 2 mark)

3. Mention some causes of this condition? ( 2 mark)
4. Mention the treatment of this condition? ( 2 mark)

5. What is the appropriate treatment for this patient? ( 2 mark)

29. SAVEETHA MEDICAL COLLEGE HOSPITAL
DEPARTMENT OF GENERAL MEDICINE
STATION - 4 SCENARIOS - 3

ASSESSOR CHECKLIST
a) ECG findings- regular narrow complex tachycardia,retrograde Pwaves ( 2
mark)
b) Diagnosis- PSVT (2 mark)

©) Ischemic heart disease, hyperthyroidism, COPD, caffeine overdose (2 mark)

lltiazem, cardiac

d) Vagal maneuvers, adenosine, — verapamil,
resynchronization, catheter ablation ( 2 mark)

e) cardiac resynchronization, Catheter ablation. ( 2 mark)