Year 4 - OSCE stations

Question 1

Day 1
- 4 Short
- 2 Long

Answer 1

Day 1

• 4 Short
  1. Obs Hx/Exp +(Ex + Exp)
  2. Neuro/Opthal Exam
  3. Capacity
  4. Derm/Ent Hx, S&S pic, Qs
• 2 Long
  5. Cancer complication
• Hx, Qs, Mx discussion
  6. Child
• Ix, Hx, Chart, Qs,
• Drug, Mx discussion

Question 2

Day 2
- Short Stations
- Long Stations

Answer 2

Day 2

• Short Stations
  —
  7. Gynae: Hx, Ix, Dx, Mx
  8. Y4 A-E: Ex, Ix, Dx, Mx
  9. Teen triadic: Hx, Mx
  10. Ethics: Results, concerns, Qs
  —
• Long Stations
  —
  11. OPIC
• collateral, Qs
• Exp Dx, Mx, Prog, Support
  12. Psych
• Hx, RA, MSE, DDx, S&S, Mx, MHA

Question 3

Station 3
- Capacity assessment
- Documentation
- Referral

Answer 3

Station 3
- Capacity assessment

1. Understand
   - Tell me why you in hospital
   - Do you know about your management options
   - Visual/hearing aides/ interpreter
2. Retain
   - Fatigue
   - Sedatives
   - Thought disorder
3. Weight up
   - Patient concerns
4. Communicate
   - Verbal/Written
   - BSL
   - Gestures

• Document
  1. Indication
  2. Decision being made
  3. Date and time
  4. Persons present
• Referral
  1. Senior clinicians
  2. Liaison psychiatry

Question 4

Station 3
- Lacking Capacity Steps

Answer 4

Station 3
- Lacking Capacity Steps

0. Check ADRT/LPA
1. Least restrictive option
   - Best interests
2. Safeguards
   - Depravation of Liberty

Question 5

Station 3 Capacity

Court of protection instances

Answer 5

Station 3 Court of protection

• Sterilisation
• Organ donation
• Withdrawal of nutrition in vegetative state

Question 6

Y4 Osce
- NSS Examinations

Answer 6

Y4 Osce
- NSS Examinations

1. Eye
2. Peripheral nerve
   - upper limb
   - lower limb
3. Cranial nerve

Question 7

Cranial nerve exam
1-6

Answer 7

Cranial nerve exam
1-6

1. Olfactory
   - Smell change
2. Optic
   - Pupil inspection, direct, accommodation
   - Acuity and colour
   - Fields, blind spot, neglect
   - Offer fundoscopy

3,4,6. Ophthalmic
- Ptosis
- Movements
- Strabismus (light reflex and cover)

5. Trigeminal
   - Facial sensation
   - Mastication
   - Jaw jerk and corneal reflex

Question 8

Cranial nerve exam
7-12

Answer 8

Cranial nerve exam
7-12

7. Facial
   - Taste and hearing change
   - Asymmetry at rest and movements
8. VC
   - Gross hearing
   - R&W
   - Turning test, VOR reflex

9&10.
- Uvula say ah
- Cough
- Swallow/offer gag

11. Accessory
    - SCM and Traps
12. Hypoglossal
    - Inspect
    - Protrude

Question 9

Eye exam
- Steps

Answer 9

Eye exam
- Steps

1. Acuity
   - Snellen, pinhole (6/9), fingers, hands, light
2. Colour
   - Ishihara
3. Fields, neglect, blind spot
4. Eyelids, pupils, and movements
   - Direct, consensual, accommodation
   - Swinging light
5. Fundoscopy
   - Offer mydriatic drops
   - Red reflex
   - Optic disc
   - Retina
   - Macula

Question 10

Peripheral nerve
- Five parameters

Answer 10

Peripheral nerve
- Five parameters

1. Tone
2. Power
3. Sensation
4. Reflex
5. Coordination

Question 11

Peripheral nerve
- Four sensations

Answer 11

Peripheral nerve
- Four sensations

1. Light touch
2. Pin point
3. Vibration
4. Proprioception

Question 12

Peripheral nerve exam
- Reflexes

1. Upper
2. Lower

Answer 12

Peripheral nerve exam
- Reflexes

1. Upper
   - Tri, Bi, Supinators
2. Lower
   - Knee, ankle, plantar

Question 13

Peripheral nerve exam
- Coordination

1. Upper
2. Lower

Answer 13

Peripheral nerve exam
- Coordination

1. Upper
   - Finger nose
   - Dysdiadochokinesia
2. Lower
   - Heel shin

Question 14

Cancer care
- Five emergencies

Answer 14

Cancer care
- Five emergencies

1. Hypercalcaemia
2. Tumor lysis
3. Neutropenic sepsis
4. Cord compression
5. SVCO