Clinical Skills OSCE Daniel Bryan

Question 1

Opening statement

Answer 1

I am here because my belly hurt last night and have been vomiting

Question 2

How much fluid have you been able to keep down since you started feeling sick

Answer 2

Not a lot

Question 3

Does anyone in your family have a history of similar symptoms (gastrointestinal issue or other related conditions)?

Answer 3

No

Question 4

Did you experienced a fever

Answer 4

I felt feverish but did not check the temperature

Question 5

Can you point where it hurt the abdomen.

Answer 5

Point toward the mid section of the abdomen

Question 6

Describe what the cramp feels like.

Answer 6

Sharp pain sensation

Question 7

Does the pain move anywhere from the central part of the abdomen

Answer 7

No

Question 8

Does the pain radiate toward your back or elsewhere

Answer 8

No

Question 9

On a scale from 1 to 10, with 10 being the worst pain you ever felt, how did you rate the pain

Answer 9

8 out of 10

Question 10

“Does anything make the pain worse or better? Have you noticed if certain positions or actions relieve the pain?

Answer 10

No

Question 11

How long do the cramps last when they occur?

Answer 11

They last for a couple minutes

Question 12

How often did the cramps occur in the middle of the night

Answer 12

Every few minutes

Question 13

What area did you felt the cramp

Answer 13

midsection of the abdomen

Question 14

Have you noticed the pain occurring at specific times

Answer 14

When the cramps occur throughout the night

Question 15

When was last bowel movement?

Answer 15

Last night

Question 16

(alleviating factors )for the pain

Answer 16

Vomiting and the bowel movement

Question 17

How many times did you vomit?

Answer 17

Around 6 to 7 times

Question 18

Have you noticed the pain occurring at specific times in relation to eating?”

Answer 18

No only when the cramps occur

Question 19

When did you started feeling the nausea?

Answer 19

After the second cramp occur

Question 20

Did anything made the pain worse

Answer 20

When you have no further bowel movement

Question 21

Did you try taking any over the counter medications or remedies

Answer 21

Pepto-Bismol and I end up vomiting out that liquid after a few minutes

Question 22

When was your last void (last time you urinated)

Answer 22

last night

Question 23

Anything you notice about when you voided that night?

Answer 23

I have noticed I was urinated less and the urine appear darker than usual

Question 24

Did you experience any similar cramping in the past?

Answer 24

A few month ago, I notice that I had a similar cramp after eating a large meal but it only lasted a few minutes and went away

Question 25

Did you experience any similar symptoms (nausea, vomiting etc.) in that specific event

Answer 25

No there was no vomiting, nausea or anything else severe in that episode

Question 26

Social History

Answer 26

Smoke cigarettes between 1-2 packs per day depending on the stress since college.
Dont drink alcohol
Married and have one year of college education
Work as a receptionist in a local attorney office

Question 27

Do you smoke

Answer 27

Yes I smoke 1 to 2 packs per day depending on the stress since college

Question 28

How long has it been since you were in college

Answer 28

About 20 years ago

Question 29

Family History

Answer 29

Father had a heart attack and the mother is healthy

Question 30

How is your dad health?

Answer 30

He had a history of a heart attack

Question 31

What about your mother health

Answer 31

She is healthy

Question 32

What medications you been taking

Answer 32

Tylenol

Question 33

Brief summary of the case

Answer 33

42-year-old female patient who presents with 24 hours of abdominal pain and nausea/vomiting

Question 34

Review of System

Answer 34

Cardiac- no chest pain: no history of arrythmia
Lung - no shortness of breath
Neuro- no history of seizure or stroke
Heme- no history of bleeding or bruising
Endocrine- no diabetes or thyroid issues: no frequent urination: no tiredness or fatigue

Question 35

In the days leading up to last night, did you engage in any activities, travel, or consume any food or drink that might have been out of the ordinary for you?”

Answer 35

Not that I am aware of