OSCE PART B Questions

1. CVS exam
Mitral valve replacement. Pt wore alert bracelet! Had to undress as was first candidate, then after examination, look at warfarin book.
Was told with a minute to go that I should ask a few questions as well about anticoagulation.

2. Patient with bile leak- reading station

3. Ditto. Discussion with consultant at St. Elsewhere. Reviewing patient so far, plan prior to transfer, what you want the centre to do for
you.

4. History- Progressive dysphagia. Describe/consent for upper GI endoscopy

5. Examination: Incisional hernia. Little on examination technique. Mainly questions on aetiology of incisional hernia and options of
repair.

6. Examination: OA Knee- Lateral compartment + valgus deformity. Mainly questions on why you do certain parts of the examination.
E.g. What extensor lag represents, why you measure circumference set distances above and below tibial tuberosity.

7. Information giving: Reading station

8. Information giving: Jehovah's witness. Describe what we can do to minimise bloos loss. Discuss options for replacement (what won't
be done, reassuring that we won't transfuse.)

9. History: Post op THR. DVT/PE. Piece of piss. (coughing blood, swollen calf, chest pain). Differentials and managment.

10. Physiology viva. Questions on management of fistula. then TPN complications.

11. Surgical Safety:

2 stations in this. I got a list with an amputation (MRSA infected) a simple hernia, diabetic patient and a child. Has to order the list and
discuss reasons for the order. Also others got diathermy- placement of pad, contraindications, types of diathermy.

12. Anatomy: Surface anatomy. Description of outline of pleura. Describe the locations of transverse and horizontal fissure of right lung.
Specimen of lung and heart- Pick them up and name the parts. I spoke for a while until the chap got bored and moved on.
Section of calf demonstrating DVT- what is it? describe the course of the clot from leg to lung.

13. Anatomy: Prosection. Describe aortic arch- branches, ligamentum arteriosum, recurrent laryngeal
Thyroid- location, arteries, veins, nerve relations- relevance of cutting them.
Parotid- Location, course of duct.

14. Data interpretation

ECG- Cant remember what it was- maybe AF or heart block.
CXR- bibasal atelectasis What does it show, what do you do.
CT- Pancreatitis

15. Rest

16.Data Interpretation
U&Es-
ABG- metabolic alkalosis. This one was an arse- ran out of time. You have to write fast for the written stations, although I think they're
changing them all to manned.
3rd part, cant remember

17. Patient with metallic heart valve on warfarin. Write a letter to GP explaining perioperative anticoagulation.

18. Anatomy- Abdomen with pins in- Nothing difficult in the naming anatomy. Few questions on relevance of watershed areas and
portosystemic anastamoses.

19. Excision of benign skin lesion and suturing. Was saved by pleasant model. You apparently get a point for suturing the shitty sponge
which CUTS OUT. Tried mattress sutures to no avail. More points gained by: checking consent, describing wound care instructions,
discussing when histolgy will be back, labelling the histology pot.