OSCE Test QUESTIONS AND ANSWERS

General Practice 1 - A 50 year old man has been sent along by his wife. He lost his license last month for the 3rd time for 'DUI' and she has insisted that he talk to you about his alcohol use. - Answer- 0 General Practice 1 - Leon 19 yo M mother insists poorly controlled asthma, Lots of ventolin, used to be on flixotide but lost it. - Answer- Hx: Age of onset[1]FHx[1]Triggers: exercise, cold air, hayfever, dust, smoke[3]Previous hospital admissions[1]Compliance with current meds[1]Attitude towards condition[1]Able to get Leon to demonstrate how he uses his accuhaler[2]Student can demonstrate correct use of Accuhaler[2]Empathy score: 2 General Practice 1 - Your next patient comes to see you about her/his asthma. It has been worse over the past few months, and s/he is needing to use a puffer a couple of times a day. - Answer- Communicate clearly, avoid jargon[0.5]Check patient's understanding of information and instructions[0.5]Choose preventer+reliever, ICS may be combined with LABA[1]Watch technique, recognise if poor.[1]Advise use of spacer[1]Demonstrate good MDI technique: Shake[0.5]Hold correctly[0.5]Exhale[0.5]Inhale and hold[0.5]Arange appropriate follow up (1-3/52)[1]Safety net including warning signs of severe asthma and action to take[1]Advice on care of delivery device[1]Appropriate dose[1]Possible side effects, wrinsing mouth to avoid thrush[1]Written action plan[1]Empathy score: 2 General Practice 1 - Your patient is 19 and tells you that s/he has recently started a triathlon-training course but finds s/he is still getting short of breath when training, and feels his/her fitness should have improved by now. - Answer- 0 General Practice 1 - Your next patient, a middle aged woman, has had a cough for the last 3 months. - Answer- 0 General Practice 1 - Country GP. Geoff is a 39 yo bank manager. He has been seen on a number of occasions in the practice over the last five years. His BP has been measured and recorded. The best reading was 140/98 and today it is 160/105. You note his BP is taken using the right arm and the correct sized cuff is always used with the patient sitting. When his blood pressure was taken supine last visit it was 155/100 at 5 and 10 minutes. Outline your Mx plan for this patient from the General Practice viewpoint. - Answer- Able to explain to Geoff that he has moderate hypertension and it is probably time to treat him with an antihypertensive medication. [3]Management: lifestyle modification eg low salt diet, weight loss, exercise, controlling stress[3]Ix: discussed Eg: fasting BSL, fasting lipids,UEC, MSU, ECG, CXR etc [3]Able to discuss phamacotherapy eg thiazide, ACE, beta blocker, calcium channel antagonist etc[3]Empathy score: 2