OSCE

Question 1

Symptoms of gallstones

Answer 1

Usually asymptomatic
Pain in upper right quadrant of the abdomen (colicky)
Referred pain to shoulder blade
Nausea and vomiting
Fever
Jaundice
Itchy skin
Confusion

Question 2

Complications of gallstones

Answer 2

Gallstone ileus (small bowel obstruction)
Biliary colic
Acute pancreatitis
Ascending cholangitis

Question 3

Signs on examination of gallstones

Answer 3

Rebound tenderness
Guarding
Murphy’s sign
(all only if there is acute cholecystitis)

Question 4

Risk factors for gallstones

Answer 4

Women
Over 40
Nutritional factors
Pregnancy

Question 5

Pathophysiology of gallstone formation

Answer 5

When bile contains too much cholesterol and not enough bile salts contribute to the formation of stones. Incomplete and infrequent emptying can also cause bile to become over-concentrated.

Question 6

Diagnosing gallstones

Answer 6

Ultrasound

Question 7

Symptoms of osteoarthritis

Answer 7

Pain
Reduced movement and stiffness (worst in the morning)
Crepitus

Question 8

Risk factors for osteoarthritis

Answer 8

Post-menopausal women
Men
Obesity
Previous joint injury

Question 9

Symptoms of ulcerative colitis

Answer 9

Diarrhoea with blood and mucus
Weight loss
Fatigue
Pale