DSE OSCE - 2024
Clinical Scenarios and Answers
1. 41-Year-Old Pregnant Woman with History of Infective Endocarditis:
- Need for pre-med? ✔️ Yes.
- Pre-med options for penicillin allergy:
- Amoxicillin - Not applicable.
- Cephalexin - Possible depending on the patient's allergy specifics.
- Clarithromycin - Correct choice due to allergy to penicillin.
- Ciprofloxacin - Contraindicated in pregnancy.
2. Procedure Without Consulting MD for Bisphosphonate Patient:
- Correct Procedure: ✔️ Occlusal restoration.
3. Pregnant Patient Afraid of Needles Stress Management:
- Best Position: ✔️ Place in Trendelenburg position.
4. 6 Months Pregnant with Bleeding Gums and Mobile Teeth:
- Treatment Approach: ✔️ Conservative debridement.
5. Pregnant Patient with Diastema Between #8 and #9:
- Cause of Diastema: ✔️ Chronic periodontitis.
6. Permanent Staining from Tetracycline:
- Age of Staining: ✔️ 0-5 years.
7. Pentobarbital (Nembutal) and Secobarbital (Seconal):
- Type of Drugs: ✔️ Barbiturates.
,8. Allergic Reaction to Barbiturate:
- Treatment: ✔️ Diphenhydramine (Benadryl).
9. Patient on Steroidal Medication:
- Information to Obtain: ✔️ Both dose and duration.
10. Most Important Factor for Child's Medication Dosage:
- Criteria: ✔️ Weight.
11. Trisomy 21 Patient Concerns:
- Initial Concern: ✔️ Congenital heart defects.
12. Recent Stroke Patient Initial Concern:
- Key Issue: ✔️ Are they on anticoagulants?
13. Differentiating Anaphylaxis from Syncope:
- Main Symptom: ✔️ Bronchoconstriction.
14. ELISA Test Negative for Needle Stick Incident:
- Interpretation: ✔️ Patient has no antibodies to HIV-1 present.
15. 14-Year-Old with Abnormal Bloodwork:
- Likely Diagnosis: ✔️ Leukemia.
16. Medication Likely Causing Rash:
- Answer: ✔️ Penicillin allergy.
,17. Drugs Inducing Gingival Hyperplasia:
- List: ✔️
- Calcium channel blockers (e.g., Amlodipine, Nifedipine)
- Dilantin (Phenytoin)
- Cyclosporines
18. Drugs Increasing Periodontal Destruction:
- Drug Type: ✔️ Amlodipine (Calcium channel blocker).
19. White Lesion on Tongue Due to Trauma:
- Diagnosis: ✔️ Fibroma (history of trauma).
20. Multiple Odontomas History:
- Suspected Syndrome: ✔️ Gardner's syndrome.
21. Mucocele Treatment:
- Correct Approach: ✔️ Excision with removal of local glands.
22. Shallow Ulcerated Lip Lesion in Farmer:
- Likely Diagnosis: ✔️ Squamous cell carcinoma.
23. Treatment Timing for Hepatitis A:
- Wait Duration: ✔️ 1 week.
24. Causes of Jaundice:
- Possible Causes: ✔️
- Liver Cirrhosis
- Hepatitis A
, - Hepatitis C
Pt presents with missing teeth and no hair. What is the likely medical condition?
- Gardner's disease
- Ectodermal dysplasia
- Trisomy 21
- Paget's syndrome
Ectodermal dysplasia
Pernicious anemia is associated with:
- autoimmune destruction of parietal cells in stomach
- acute, chronic blood loss
- both
autoimmune destruction of parietal cells in stomach
- pernicious anemia = associated with intrinsic factor from parietal cells, which is required to absorb B12
from food
What does intrinsic factor do?
- allows iron to bind to hemoglobin
- prevents destruction on RBCs
- required for absorption of vit B12 from food
Required for the absorption of vitamin B12 from food
Another version Pernicious anemia is caused by:
- Decrease in intrinsic factor (required for absorption of B12)
- Chronic use of aspirin, NSAIDs, corticosteroids
- A variant of hemoglobin A (called hemoglobin S)
- Destruction of RBCs
decrease in intrinsic factor
- Schilling's test to evaluate B12 absorption; most commonly used to eval pts w/pernicious anemia
What is hemolytic anemia?
- autoimmune destruction of parietal cells in stomach
- genetic defect, includes variant of hemoglobin A (called hemoglobin S)
- RBCs destroyed, removed from bloodstream before normal lifespan is over
- Folic acid is deficient, patient presents w/neurologic symptoms
Clinical Scenarios and Answers
1. 41-Year-Old Pregnant Woman with History of Infective Endocarditis:
- Need for pre-med? ✔️ Yes.
- Pre-med options for penicillin allergy:
- Amoxicillin - Not applicable.
- Cephalexin - Possible depending on the patient's allergy specifics.
- Clarithromycin - Correct choice due to allergy to penicillin.
- Ciprofloxacin - Contraindicated in pregnancy.
2. Procedure Without Consulting MD for Bisphosphonate Patient:
- Correct Procedure: ✔️ Occlusal restoration.
3. Pregnant Patient Afraid of Needles Stress Management:
- Best Position: ✔️ Place in Trendelenburg position.
4. 6 Months Pregnant with Bleeding Gums and Mobile Teeth:
- Treatment Approach: ✔️ Conservative debridement.
5. Pregnant Patient with Diastema Between #8 and #9:
- Cause of Diastema: ✔️ Chronic periodontitis.
6. Permanent Staining from Tetracycline:
- Age of Staining: ✔️ 0-5 years.
7. Pentobarbital (Nembutal) and Secobarbital (Seconal):
- Type of Drugs: ✔️ Barbiturates.
,8. Allergic Reaction to Barbiturate:
- Treatment: ✔️ Diphenhydramine (Benadryl).
9. Patient on Steroidal Medication:
- Information to Obtain: ✔️ Both dose and duration.
10. Most Important Factor for Child's Medication Dosage:
- Criteria: ✔️ Weight.
11. Trisomy 21 Patient Concerns:
- Initial Concern: ✔️ Congenital heart defects.
12. Recent Stroke Patient Initial Concern:
- Key Issue: ✔️ Are they on anticoagulants?
13. Differentiating Anaphylaxis from Syncope:
- Main Symptom: ✔️ Bronchoconstriction.
14. ELISA Test Negative for Needle Stick Incident:
- Interpretation: ✔️ Patient has no antibodies to HIV-1 present.
15. 14-Year-Old with Abnormal Bloodwork:
- Likely Diagnosis: ✔️ Leukemia.
16. Medication Likely Causing Rash:
- Answer: ✔️ Penicillin allergy.
,17. Drugs Inducing Gingival Hyperplasia:
- List: ✔️
- Calcium channel blockers (e.g., Amlodipine, Nifedipine)
- Dilantin (Phenytoin)
- Cyclosporines
18. Drugs Increasing Periodontal Destruction:
- Drug Type: ✔️ Amlodipine (Calcium channel blocker).
19. White Lesion on Tongue Due to Trauma:
- Diagnosis: ✔️ Fibroma (history of trauma).
20. Multiple Odontomas History:
- Suspected Syndrome: ✔️ Gardner's syndrome.
21. Mucocele Treatment:
- Correct Approach: ✔️ Excision with removal of local glands.
22. Shallow Ulcerated Lip Lesion in Farmer:
- Likely Diagnosis: ✔️ Squamous cell carcinoma.
23. Treatment Timing for Hepatitis A:
- Wait Duration: ✔️ 1 week.
24. Causes of Jaundice:
- Possible Causes: ✔️
- Liver Cirrhosis
- Hepatitis A
, - Hepatitis C
Pt presents with missing teeth and no hair. What is the likely medical condition?
- Gardner's disease
- Ectodermal dysplasia
- Trisomy 21
- Paget's syndrome
Ectodermal dysplasia
Pernicious anemia is associated with:
- autoimmune destruction of parietal cells in stomach
- acute, chronic blood loss
- both
autoimmune destruction of parietal cells in stomach
- pernicious anemia = associated with intrinsic factor from parietal cells, which is required to absorb B12
from food
What does intrinsic factor do?
- allows iron to bind to hemoglobin
- prevents destruction on RBCs
- required for absorption of vit B12 from food
Required for the absorption of vitamin B12 from food
Another version Pernicious anemia is caused by:
- Decrease in intrinsic factor (required for absorption of B12)
- Chronic use of aspirin, NSAIDs, corticosteroids
- A variant of hemoglobin A (called hemoglobin S)
- Destruction of RBCs
decrease in intrinsic factor
- Schilling's test to evaluate B12 absorption; most commonly used to eval pts w/pernicious anemia
What is hemolytic anemia?
- autoimmune destruction of parietal cells in stomach
- genetic defect, includes variant of hemoglobin A (called hemoglobin S)
- RBCs destroyed, removed from bloodstream before normal lifespan is over
- Folic acid is deficient, patient presents w/neurologic symptoms
