1
DIAGNOSTIC SKILLS EXAM OSCE 2025
– 170 REAL EXAM QUESTIONS AND
VERIFIED RATIONALES | A+ GRADED |
JUST RELEASED
Patient Assessment
1. A 45-year-old male presents with chest pain for 2 hours. What is the first step in
your assessment?
A. Order an ECG
B. Perform a physical exam
C. Take a detailed history
D. Administer aspirin
Correct Answer: C
Rationale: A detailed history is the first step to characterize chest pain (e.g., onset,
quality, radiation) and guide differential diagnosis, such as myocardial infarction, angina,
or non-cardiac causes.
2. Which finding during a cardiovascular exam suggests aortic stenosis?
A. Wide pulse pressure
B. Systolic murmur radiating to carotids
C. Mid-diastolic rumble
D. Fixed splitting of S2
Correct Answer: B
Rationale: Aortic stenosis causes a systolic murmur that radiates to the carotids due to
turbulent flow across a narrowed aortic valve.
3. A 30-year-old female reports shortness of breath. Which respiratory exam finding
indicates consolidation?
A. Decreased breath sounds
B. Wheezing
C. Bronchial breath sounds
D. Fine crackles
Correct Answer: C
Rationale: Bronchial breath sounds over a lung field suggest consolidation (e.g.,
pneumonia), as solid lung conducts sound better than air-filled lung.
4. During an abdominal exam, what does rebound tenderness suggest?
A. Gastritis
B. Appendicitis
C. Pancreatitis
D. Cholecystitis
Correct Answer: B
, 2
Rationale: Rebound tenderness indicates peritoneal irritation, commonly associated with
appendicitis due to inflammation of the peritoneal lining.
5. A 60-year-old male has unilateral leg swelling. What is the most concerning finding
to assess?
A. Pitting edema
B. Warmth and erythema
C. Varicose veins
D. Joint effusion
Correct Answer: B
Rationale: Warmth and erythema suggest deep vein thrombosis (DVT), a potentially
life-threatening condition requiring urgent evaluation.
6. What is the purpose of the Romberg test in a neurological exam?
A. Assess motor strength
B. Evaluate proprioception
C. Test cranial nerve function
D. Check for nystagmus
Correct Answer: B
Rationale: The Romberg test assesses proprioception and cerebellar function by
observing balance with eyes closed.
7. A 25-year-old female presents with a painful hand. Which exam finding suggests
carpal tunnel syndrome?
A. Thenar atrophy
B. Ulnar deviation
C. Joint effusion
D. Heberden’s nodes
Correct Answer: A
Rationale: Thenar atrophy indicates median nerve compression, a hallmark of carpal
tunnel syndrome.
8. Which physical exam technique is used to assess for ascites?
A. Murphy’s sign
B. Shifting dullness
C. McBurney’s point tenderness
D. Psoas sign
Correct Answer: B
Rationale: Shifting dullness detects fluid movement in the abdomen, confirming ascites.
9. A 50-year-old male reports neck stiffness. What finding suggests meningitis?
A. Brudzinski’s sign
B. Tinel’s sign
C. Phalen’s test
D. Spurling’s test
Correct Answer: A
Rationale: Brudzinski’s sign (involuntary hip flexion with neck flexion) indicates
meningeal irritation, suggestive of meningitis.
10. During a cranial nerve exam, what does inability to shrug shoulders indicate?
A. CN V dysfunction
B. CN XI dysfunction
, 3
C. CN VII dysfunction
D. CN XII dysfunction
Correct Answer: B
Rationale: The spinal accessory nerve (CN XI) innervates the trapezius, and weakness in
shoulder shrugging indicates its dysfunction.
11. A 35-year-old male has right-sided abdominal pain. What exam finding supports
cholecystitis?
A. Rovsing’s sign
B. Murphy’s sign
C. Obturator sign
D. Cullen’s sign
Correct Answer: B
Rationale: Murphy’s sign (pain on inspiration with gallbladder palpation) is specific for
cholecystitis.
12. What is the most appropriate initial exam for a patient with suspected thyroid
disease?
A. Palpate the thyroid gland
B. Auscultate for bruits
C. Check for exophthalmos
D. Test for Chvostek’s sign
Correct Answer: A
Rationale: Palpating the thyroid assesses for enlargement or nodules, a key step in
evaluating thyroid pathology.
13. A 40-year-old female reports joint pain. Which finding suggests rheumatoid
arthritis?
A. Bouchard’s nodes
B. Morning stiffness lasting >1 hour
C. Unilateral joint involvement
D. Crepitus on movement
Correct Answer: B
Rationale: Prolonged morning stiffness is characteristic of rheumatoid arthritis, an
inflammatory condition.
14. What does a positive straight leg raise test indicate?
A. Hip osteoarthritis
B. Sciatic nerve irritation
C. Knee ligament injury
D. Femoral artery occlusion
Correct Answer: B
Rationale: The straight leg raise test reproduces pain in sciatic nerve irritation, such as in
herniated discs.
15. A 55-year-old male has difficulty walking. What exam finding suggests Parkinson’s
disease?
A. Hyperreflexia
B. Cogwheel rigidity
C. Babinski sign
D. Clonus
, 4
Correct Answer: B
Rationale: Cogwheel rigidity, a combination of tremor and rigidity, is a hallmark of
Parkinson’s disease.
16. During an eye exam, what does papilledema suggest?
A. Glaucoma
B. Increased intracranial pressure
C. Diabetic retinopathy
D. Macular degeneration
Correct Answer: B
Rationale: Papilledema, or optic disc swelling, is caused by increased intracranial
pressure, often due to conditions like brain tumors.
17. A 28-year-old male reports ear pain. What finding on otoscopy suggests acute otitis
media?
A. Clear tympanic membrane
B. Bulging tympanic membrane
C. Retracted tympanic membrane
D. Cerumen impaction
Correct Answer: B
Rationale: A bulging tympanic membrane indicates fluid or pus in the middle ear,
typical of acute otitis media.
18. Which exam technique assesses for carpal tunnel syndrome?
A. Tinel’s sign
B. Lachman’s test
C. McMurray’s test
D. Drawer test
Correct Answer: A
Rationale: Tinel’s sign (tingling with percussion over the median nerve) is positive in
carpal tunnel syndrome.
19. A 65-year-old female has a productive cough. What finding suggests pneumonia?
A. Symmetrical chest expansion
B. Dullness to percussion
C. Vesicular breath sounds
D. Absent tactile fremitus
Correct Answer: B
Rationale: Dullness to percussion over a lung field indicates consolidation, as seen in
pneumonia.
20. What is the significance of a positive Kernig’s sign?
A. Spinal stenosis
B. Meningeal irritation
C. Peripheral neuropathy
D. Cauda equina syndrome
Correct Answer: B
Rationale: Kernig’s sign (pain on knee extension with hip flexed) suggests meningeal
irritation, as in meningitis.
21. A 50-year-old male reports chest tightness. What finding suggests pericarditis?
A. Friction rub on auscultation
DIAGNOSTIC SKILLS EXAM OSCE 2025
– 170 REAL EXAM QUESTIONS AND
VERIFIED RATIONALES | A+ GRADED |
JUST RELEASED
Patient Assessment
1. A 45-year-old male presents with chest pain for 2 hours. What is the first step in
your assessment?
A. Order an ECG
B. Perform a physical exam
C. Take a detailed history
D. Administer aspirin
Correct Answer: C
Rationale: A detailed history is the first step to characterize chest pain (e.g., onset,
quality, radiation) and guide differential diagnosis, such as myocardial infarction, angina,
or non-cardiac causes.
2. Which finding during a cardiovascular exam suggests aortic stenosis?
A. Wide pulse pressure
B. Systolic murmur radiating to carotids
C. Mid-diastolic rumble
D. Fixed splitting of S2
Correct Answer: B
Rationale: Aortic stenosis causes a systolic murmur that radiates to the carotids due to
turbulent flow across a narrowed aortic valve.
3. A 30-year-old female reports shortness of breath. Which respiratory exam finding
indicates consolidation?
A. Decreased breath sounds
B. Wheezing
C. Bronchial breath sounds
D. Fine crackles
Correct Answer: C
Rationale: Bronchial breath sounds over a lung field suggest consolidation (e.g.,
pneumonia), as solid lung conducts sound better than air-filled lung.
4. During an abdominal exam, what does rebound tenderness suggest?
A. Gastritis
B. Appendicitis
C. Pancreatitis
D. Cholecystitis
Correct Answer: B
, 2
Rationale: Rebound tenderness indicates peritoneal irritation, commonly associated with
appendicitis due to inflammation of the peritoneal lining.
5. A 60-year-old male has unilateral leg swelling. What is the most concerning finding
to assess?
A. Pitting edema
B. Warmth and erythema
C. Varicose veins
D. Joint effusion
Correct Answer: B
Rationale: Warmth and erythema suggest deep vein thrombosis (DVT), a potentially
life-threatening condition requiring urgent evaluation.
6. What is the purpose of the Romberg test in a neurological exam?
A. Assess motor strength
B. Evaluate proprioception
C. Test cranial nerve function
D. Check for nystagmus
Correct Answer: B
Rationale: The Romberg test assesses proprioception and cerebellar function by
observing balance with eyes closed.
7. A 25-year-old female presents with a painful hand. Which exam finding suggests
carpal tunnel syndrome?
A. Thenar atrophy
B. Ulnar deviation
C. Joint effusion
D. Heberden’s nodes
Correct Answer: A
Rationale: Thenar atrophy indicates median nerve compression, a hallmark of carpal
tunnel syndrome.
8. Which physical exam technique is used to assess for ascites?
A. Murphy’s sign
B. Shifting dullness
C. McBurney’s point tenderness
D. Psoas sign
Correct Answer: B
Rationale: Shifting dullness detects fluid movement in the abdomen, confirming ascites.
9. A 50-year-old male reports neck stiffness. What finding suggests meningitis?
A. Brudzinski’s sign
B. Tinel’s sign
C. Phalen’s test
D. Spurling’s test
Correct Answer: A
Rationale: Brudzinski’s sign (involuntary hip flexion with neck flexion) indicates
meningeal irritation, suggestive of meningitis.
10. During a cranial nerve exam, what does inability to shrug shoulders indicate?
A. CN V dysfunction
B. CN XI dysfunction
, 3
C. CN VII dysfunction
D. CN XII dysfunction
Correct Answer: B
Rationale: The spinal accessory nerve (CN XI) innervates the trapezius, and weakness in
shoulder shrugging indicates its dysfunction.
11. A 35-year-old male has right-sided abdominal pain. What exam finding supports
cholecystitis?
A. Rovsing’s sign
B. Murphy’s sign
C. Obturator sign
D. Cullen’s sign
Correct Answer: B
Rationale: Murphy’s sign (pain on inspiration with gallbladder palpation) is specific for
cholecystitis.
12. What is the most appropriate initial exam for a patient with suspected thyroid
disease?
A. Palpate the thyroid gland
B. Auscultate for bruits
C. Check for exophthalmos
D. Test for Chvostek’s sign
Correct Answer: A
Rationale: Palpating the thyroid assesses for enlargement or nodules, a key step in
evaluating thyroid pathology.
13. A 40-year-old female reports joint pain. Which finding suggests rheumatoid
arthritis?
A. Bouchard’s nodes
B. Morning stiffness lasting >1 hour
C. Unilateral joint involvement
D. Crepitus on movement
Correct Answer: B
Rationale: Prolonged morning stiffness is characteristic of rheumatoid arthritis, an
inflammatory condition.
14. What does a positive straight leg raise test indicate?
A. Hip osteoarthritis
B. Sciatic nerve irritation
C. Knee ligament injury
D. Femoral artery occlusion
Correct Answer: B
Rationale: The straight leg raise test reproduces pain in sciatic nerve irritation, such as in
herniated discs.
15. A 55-year-old male has difficulty walking. What exam finding suggests Parkinson’s
disease?
A. Hyperreflexia
B. Cogwheel rigidity
C. Babinski sign
D. Clonus
, 4
Correct Answer: B
Rationale: Cogwheel rigidity, a combination of tremor and rigidity, is a hallmark of
Parkinson’s disease.
16. During an eye exam, what does papilledema suggest?
A. Glaucoma
B. Increased intracranial pressure
C. Diabetic retinopathy
D. Macular degeneration
Correct Answer: B
Rationale: Papilledema, or optic disc swelling, is caused by increased intracranial
pressure, often due to conditions like brain tumors.
17. A 28-year-old male reports ear pain. What finding on otoscopy suggests acute otitis
media?
A. Clear tympanic membrane
B. Bulging tympanic membrane
C. Retracted tympanic membrane
D. Cerumen impaction
Correct Answer: B
Rationale: A bulging tympanic membrane indicates fluid or pus in the middle ear,
typical of acute otitis media.
18. Which exam technique assesses for carpal tunnel syndrome?
A. Tinel’s sign
B. Lachman’s test
C. McMurray’s test
D. Drawer test
Correct Answer: A
Rationale: Tinel’s sign (tingling with percussion over the median nerve) is positive in
carpal tunnel syndrome.
19. A 65-year-old female has a productive cough. What finding suggests pneumonia?
A. Symmetrical chest expansion
B. Dullness to percussion
C. Vesicular breath sounds
D. Absent tactile fremitus
Correct Answer: B
Rationale: Dullness to percussion over a lung field indicates consolidation, as seen in
pneumonia.
20. What is the significance of a positive Kernig’s sign?
A. Spinal stenosis
B. Meningeal irritation
C. Peripheral neuropathy
D. Cauda equina syndrome
Correct Answer: B
Rationale: Kernig’s sign (pain on knee extension with hip flexed) suggests meningeal
irritation, as in meningitis.
21. A 50-year-old male reports chest tightness. What finding suggests pericarditis?
A. Friction rub on auscultation
