MBBS OSCE EXAMINNATION

SET I
 RULES
• Total stations : 10
• Total time : 11min
• Time per each station : 1 min
• Marks per each question :( .5x2=1)
• No negative marking
1

• A 25-yr old was trapped in a collapsed

building, had his leg crushed by a slab
of concrete. It took 2 hours to release
him and take him to hospital.
Pt has extreme pain not relived by
pethidine . The clinical photograph of
the patient is given

• What is your diagnosis ?

Compartment syndrome

• List two possible complicatons

Volksmann ischemia, wet gangrene
• 2 yr old boys presented
with complains of
pain,fever , swelling over rt.
2
Proximal tibia & inability to
bear wt on affected limb.
a. Name earliest xray
change marked by arrow
b. List two common
complications of this
condition

Chronic osteomyelitis

Growth abnormalities, path#

• 65yr old man complains of
multiple bone pain , pallor . 3
Xray of the skull is shown
a. Name the most likely
condition
b. Mention most
confirmatory investigation

Multiple myeloma
Biopsy
a. name the condition
affecting marked 4
upper limb of child

b. Name the typical

deformity

Erb's palsy
Police man tip deformity
a. Name the congenital 5
deformity shown in
the figure.

b. Name the corrective

plaster technique used

Ctev

Denis brown splint, ponsetti method of serial casting

• 30yr old lady sustained cut 6
injury over lateral aspect
of proximal elbow
following which she was
able to extend her wrist
but developed finger drop
a. Name the most likely
structure injured
b. What happens if this
structure is injured more
proximally
Radial nerve

Wrist drop
Shown is deformity of
finger seen in RA
7

a. Name the deformity

b. List two DMARDs used

in this condition

Swan neck deformity

Methotrexate, sulfasalazine
8
A: What is the diagnosis?

B: What is the late

complication if this
condition is not managed
properly?
Lat condyle #

Cubitus valgus deformity

 9
a. Name the implant

b. Name its components

Dynamic hip screw

Lag screw, compression plate, barrel

 10
An 8 yr old boy is brought
by mother complaining
of gradually progressive
bowing deformity of
bilateral knee.
a. Name the deformity
b. Name one cause of
such deformity

Genu varus

Rickets
1 minute

Revise
OSCE

SET II
 RULES
• Total stations : 10
• Total time : 11min
• Time per each station : 1 min
• Marks per each question :( .5x2=1)
• No negative marking
 1
a. Identify the muscle marked
by arrow

b. What is its nerve supply

Pronator quadratus

Median nerve
 2
Xray of 19 yr old male
presented to ER with pain &
unable to use Rt arm.

a. Name the likely injury

b. Name two common

complications

Ant dislocation of shoulder

Imjury to axillary nerve, rotator cuff tear

 3
20 yr old labourer
complained progressive
back pain associted with
evening rise of temperature
& wt loss over the period of
5 months. His blood
examination showed
elevated ESR.

a. Name the likely diagnosis

b. Earliest radilogical sign Pott's spine

( as shown in xray)
Reduction in int vert space
• 8 yr old boy brought to
OPD with history of
discharging wound from 4
leg . Parents give history 1
month prior with pain ,
fever and inability to bear
wt on the affected limb.
a. Name the likely condition
b. Name the marked object
in the figure

Cr osteomyelitis

Involucrum
1 yr old girl brought by
mother complaining of
clicking of hip and difficulty
5
in applying diaper .

a. Name the likely condition

based on symptom
b. Name the provocative
test done in this condition

Developmental dysplasia of hip

Ortolani, barlow
Given is the image of
brachial plexus. 6
a. Name the structure
a
b. Name the structure

b
Musculocutaneous

Median
 55yr old lady sustained
injury to wrist following
fall on outstretched
7
hand.

a. Describe the
deformity
b. What is the
diagnosis

Dinner fork

Colle's #
• 25 yr old man with complain
of insidious onset back pain 8
and stiffness of back which is
recurring and increasing
severity of symptoms.

a. Give the most likely diagnosis

based on the X-ray feature
b. Name genetic marker
associated with the diasease

Ankylosing spondylitis

HLA B27
 a. Name the implant given
in figure
9

b. List two indications

External fixatur apparatus

Open fr, limb lengthening

 10
• 16 yr old male presents to opd with
history of rapidly progressing swelling
of the proximal leg over 6mth &
associated pain .Pt has significant wt
loss during this time.

a. Name the likely condition based on

history & xray
b. Name typical xray feature marked

Osteosarcoma

Sun burst appearance

1 minute

Revise
OSCE

SET V
 RULES
• Total stations : 10
• Total time : 11min
• Time per each station : 1 min
• Marks per each question :( .5x2=1)
• No negative marking
 1
5 yr old boy sustained fall on
outstretched hand following
which he developed
pain ,swelling around the
elbow.
XRAY taken in ER is shown

a. Name most common

mechanism of the injury

b. What is the treatment of Fall on out streched hand

choice ?
Closed red percutaneous k wire fixation
 Vastus intermedius

Articularis genu

Gastrocnemius

Sartorius
Gracilis
Ligamentum
Semitendinos
patallae
us
Shown is the internal 3
structure of knee.

a. Identify the
marked structure
b. List two functions

Meniscus

Reduce friction, provide stability

 4

a. What are the two

radiological changes

b. What is probable
diagnosis

Reduced joint space, osteophytes

Osteoarthritis
 5
a. Name the surgical
procedure

b. List two indications

for this procedure

Amputation

Malignant tumours, crush injury

 6
Shown is the anterior
anatomy of Elbow region

A: Identify the structure

marked by arrow

B: what are two branches of

this as evident distally

Radial nerve

Deep, superficial
• 40 yr old lady gives history of
multiple joint pain especially of small
joints of distal fingers with swelling .
Skin lesion on extensor aspect of joints
7
Rheumatoid factor negative

a. Based on these features give your

provisional diagnosis

b. Name a common genetic marker

associated with this condition

Psoriatic spondylo arthopathy

HLA B27
• A 7-yr boy told his parents
that he was experiencing 8
left hip pain referred to the
thigh for 4 wks
• There was no memory of
recent trauma or infection.

• Name the condition

• What is the cause for the

condition
Perthe disease

Thrombophilia, anti thrombotic factor

 9
• A 50-year-old woman working
as a medical secretary now
has developed progressive
pain in the dorsal/ radial
aspect of the base of her right
wrist and radial styloid.

• What is your diagnosis ?

• Name anatomical structures
involved
Dequervian disease

Tendenous sheath of abductor

pollicis longus and extensor
pollices brevis
a. Name the implant given
10
in figure

b. List two indications

Cancellous screw

Dynamic compression plate, # neck of

femur
1 minute

Revise
OSCE

SET VI
 RULES
• Total stations : 10
• Total time : 11min
• Time per each station : 1 min
• Marks per each question :( .5x2=1)
• No negative marking
 1

a. Identify the muscle

marked by arrow

b. Mention its nerve supply

Sartorius
 2
• 65 yr female presented to
OPD with pain , swelling of
multiple small joints of hand
and wrist for last 6 month .
She gives history of morning
stifness lasting for more than
30mins

a. Give a likely clinical

diagnosis
b. Mention two extraarticular
features RA

lymphadenopathy, vasculitis
• 25 year boy sustained
cut injury to forearm
following which he
3
developed following
deformity

a. Name the given sign

b. Name the muscle

involved
Claw hand

Flexor carpi ulnaris

a. Name the procedure 4
being done

b. Mention two
indications of this
procedure

Knee arthroscopic surgery

Ligament reconstruction, meniscal tear

 5
a. Mention the name of
the test
Tendenburg test

b. Mention two
Unilateral ddh, post dis of hip
conditions where it is
positive
 6

a. What is the test being

performed?
Thomas test

b. What is it done for? Lumbar lordosis testing

a. What is probable
7
diagnosis

b. Mention two surgical

modalities of
treatment

Osteoarthritis

Osteotomy, joint replacement

 8

a. Name the implant used

b. Mention one other

indication

K wire

Tension band wiring

A ten ten year old boy
complains of anterior knee 9
pain on after sports activity.
No history of significant
trauma or fever. X ray is
shown

a. What is the probable

diagnosis? Osgood schlatter disease

b. What is the pathology in

this condition ?
Inflammation of Patellar
ligament at tibial
Tuberosity
 10
An 8 yr old boy is brought by
mother complaining of
gradually progressive
bowing deformity of
bilateral knee.
a. Mention two radiological
changes
b. Name the serological
marker of this condition
A. Rickets
B. Serum ca-Normal or low
Serum po4 3-low
pTH -high
1 minute

Revise
• 25yr old lady had a self
inflicted cut over volar
aspect of wrist. Following 6
which patient was unable
to adduct the thumb and
loss of sensation over the
radial three and half digit
a. Name the nerve involved
b. Name the clinical sign Median nerve

shown
Pointing index
 7
• Name the anatomical
structures marked

a. Name the structure

marked in red

b. Name the structure

marked in blue
• 20 yr old labourer complained
progressive back pain&
weakness of bilateral limbs 4
associted with evening rise of
temperature & wt loss over
the period of 5 months. His
blood examination showed
eleveted count with
lymphocytic predominence /
low hemoglobin/ elevated ESR.
a. Name the likely diagnosis
b. Earliest radilogical sign ( as
shown in xray)

Pott's spine

Reduction of disc space

• An irritable infant is
brought by mother 8
complaining of bleeding
gums and tender joints.
a. Most likely metabolic
cause for the
complaints
b. Name the marked
radiological change
Scurvy

Epiphyseal hematoma
• 25yr old truck driver
was brought to ER .His 9
knee had collided in the
dash board. He had
complaint of hip pain
• Attitude of hip:
flexed ,adducted,intern
ally rotated
a. Name one most likely
daignosis
b. Post. Dislocation of hip
c. Nerve commonly
injured in such injury
d. Sciatic nerve
OSCE

SET III
 13
• 40 yr old lady gives history of
multiple joint pain especially of small
joints of distal fingers with swelling .
Skin lesion on extensor aspect of joints
Rheumatoid factor negative

a. Based on these features give your

provisional diagnosis-psoriatic
ankylosing apondysis

b. Name a common genetic marker

associated with this condition-HLA
B27
 RULES
• Total alloted stations : 12
• Total alloted time : 12min
• Time per each station : 2 min
• Marks per each question :( .25*2=.5)
• No negative marking
• 4yr old boy was brought by
mother with complains of
pain in rt proximal leg & 1
high grade fever with
asociated progressive
swelling over the same area
for 10 day
a. Name the likely diagnosis -
acute Osteomyelitis
b. Name the marked
radiological sign-periosteal
new bone formation
• 9yr old boy was brought by
mother with the complain
of rt leg for
2
2month,associated with
on/off low grade fever , wt
loss.

a. Give most likely diagnosis

based on give xray
b. Name the xray feature
marked

Ewing sarcoma

Onion peel appearance

 3
• 25 year boy sustained
cut injury to forearm
following which he
developed following
deformity

a. Name the nerve

involved(a)
b. Name the given sign
 4
a. Name the implant

b. Name one use

a. Name the marked
condition& muscle 5
involved

b. Name the nerve

involved in this
condition

Winging of scapula, serratus anterior

Long thoracic nerve

 6
25 yr old male sustained
injury to rt hip when he was
struck from behind the back
over hip.
He developed hip pain with
typical flexion, abduction &
ext rotation attitude of hip
a. Name the condition
b. Common complication
arising from this
condition
 7
• 45 yr female presented to
OPD with pain , swelling of
multiple small joints of hand
and wrist for last 6 month .
She gives history of morning
stifness lasting for more than
30mins
a. Give a likely clinical
diagnosis-RA
b. Name one hand deformity
occuring in that condition
(as given in figure)
8
a. Name the most likely
metabolic condition
given on xray

b. Name the marked

radiological change
 9
55yr old lady sustained
injury to lt wrist following
fall on outstretched hand.

a. Describe the typical

deformity
b. Name the likely
fracture sustained by
the patient
• 35 yr old male developed
acute swelling of 1st MTP
swelling. He gives history
10
of high protein diet
intake along with alcohol.
a. Name the most likely
condition
b. Name one xanthine
oxidase inhibitor

Gouty arthritis

Allopurinol
SET IV

OSCE
 RULES
• Total alloted stations : 12
• Total alloted time : 12min
• Time per each station : 2 min
• Marks per each question :( .25*2=.5)
• No negative marking
• 8 yr old boy brought to
OPD with history of
discharging wound from
1
leg . Parents give history 1
month prior with pain ,
fever and inability to bear
wt on the affected limb.
a. Name the likely condition
b. Name the marked object
in the figure

Cr osteomyelitis

Involucrum
 2
25 yr old boy came to OPD
with slowly enlarging mass
over distal thigh. This was
first noticed in the teenage.
On examination mass was
bony hard attached to
underlying bone.

a. Most likely diagnosis Osteochondroma

based on xray
Joint movement restrictions
b. Name one complication
 3
a. Name the implant

b. Name one indication

 4
• 25 yr old man sustained
cut injury to calf
following which he
developed high
stepping gait.
a. Name the likely nerve
injury
b. Name the nerve
supply of peroneal
compartment
 5
• 8yrs old boy progressive
weakness of thigh and
difficulty in getting up from
squatting position
• Raised
serumphosphokinase level
2-300 times

a. Name the likely diagnosis

b. Name the diagnostic sign
mentioned on the image
• 25 yr old boy has tall
habitus ,arm span 6
exceeding height,long
digits
a. Name likely connective
tissue disorder
b. Name one clinical sign
Marfan syndrome
associated with the
condition
• 70 yr old lady sustained
minor slip in the bathroom
following which she
7
developed severe hip pain
a. Mention two major
branches of profunda
femoris artery supplying
hip
b. most common
complication of fracture
neck of femur

Non union, avas necrosis

 8
• 20 yr old labourer complained
progressive back pain&
weakness of bilateral limbs
associted with evening rise of
temperature & wt loss over
the period of 5 months. His
blood examination showed
eleveted count with
lymphocytic predominence /
low hemoglobin/ elevated ESR.
a. Name the likely diagnosis
b. Earliest radilogical sign ( as
shown in xray)
• 19 yr old male presented
to ER with pain & unable
to use Rt arm. His arm was
10
supported by another a
hand & it was abducted
and externally rotated. He
had loss of sensation over
lateral aspect of deltoid
a. Name the likely injury
b. Name two clinical signs to
support your diagnosis

Ant shoulder dislocation

Dugas, Hamilton ruler test

2 minutes

Revise
MBBS OSCE

2072
 1
• 40 yr old lady comes with
complains of unexplained
pain in shoulder region
following episode of viral
illness On examination there
is weakness on lifting the
arm. Photo of the patient is
given.

• Name the likely nerve

involved
• Name the clinical sign
 2
• 40 yr old man comes with complaint of weakness of
shoulder since 1 month.He gives the history of
shoulder dislocation prior to onset of weakness.
• On examination there is wasting of
shoulder ,weakness of maintaining abduction & small
area of anaesthesia over the deltoid.

• Name the nerve involved

• This nerve arises from which chord of brachial plexus ?
 3
• 30 yr old drug addict came to Radial nerve at radial groove
OPD with complains of
weakness of elbow ,wrist , Deltoid
hand and finger extension.
• He gives history of falling
asleep in chair following bout
of alcohol

• What is the likely level of

injury of involved nerve
• Give the likely area of sensory
deficit
 4
• 30 yr old man came to OPD with complain of
difficulty in walking following history of knee
trauma.
• On examination : High stepping gait , foot drop
, sensory deficit at front & outer half of leg &
dorsum of foot
• Name the nerve affected
• Name principle evertor of foot
• 15 yr old boy was brought by
mother complainig of gradually
increasing mass over Rt. Knee
associated constitutinal
5
symptoms like wt loss & loss of
apetite .There is no history of
fever .
• On examination large mass over
distal femur,warm & tender
with bony consistency
• Give your provisional diagnosis
• Investigation to stage this
condition

Osteosarcoma

Biopsy
• 15 yr old boy was brought by
mother complainig of rapidly
increasing mass over Rt. Knee 6
associated constitutinal
symptoms like wt loss of apetite
.There is no history of fever .
• On examination large mass over
distal femur,warm & tender
with bony consistency
• Name XRAY feature
• Radiological investigation to
stage this condition

Osteosarcoma
Biopsy
• 10 yr old boy brought by mother at
orthopaedic OPD TUTH with 7
complains of pain over Lt leg since
last one month along with low grade
intermittent fever.
• On examination there is increased
local temperature ,tenderness, ill
defined bony mass over Lt shin.
• X-ray of the patient is given

• Most likely malignant condition

• Name the radiological feature
marked by the arrow

Osteosarcoma

Codman's triangle
• 18 yr old boy came to OPD
with complains of bony
lump over leg which is 8
discovered during cleaning
himself
• On examination bony hard ,
non tender mass arising
from distal femur

• Most likely lesion

• What is the tissue of origin
Osteochondroma

Cartilage
• 10 yr old boy was brought to
ER with history of acute onset
knee pain and fever for 1 wk .
9
• On examination patient had
Fever, inability to bear wt.
over Lt. leg ,localised
erythema and local bony
tenderness.
• Based on Xray give your
provisional diagnosis
• Name the marked radiological
feature

Ac osteomyelitis

Periosteal rxn
• 20 yr old boy came to opd
with complains of 10
discharging wound from Rt
proximal leg .He gives
history of ac onset of leg
pain ,fever, followed by
discharging wound with
recurrence of symptoms.
• Give your clinical diagnosis
• Name the marked
radiological feature

Cr osteomyelitis

Involucrum
 11
• 30 yr old lady complains of
insidious onset of joint
pain which is mainly
affecting hand ,associated
with morning stifness and
swelling of joints of
fingers.
• Give your provisional
diagnosis
• Name the deformity of
hand shown in diagram
• 25 yr old man with complain
of insidious onset back pain
and stiffness of back which is 12
recurring and increasing
severity of symptoms.

• Give the most likely diagnosis

based on the X-ray feature
• Name genetic marker
associated with the diasease

Ankylosing spondylitis

HLA-B27
• 25 yr old lady presents
with multiple joint pain
with systemic symptoms 14
such as malaise
anorexia ,wt loss and
intermittent low grade
fever
• Skin rash
• Name the likely condition
• Name the serological
marker associated

Psoriatic spondylo arthopathy

HLA B27
• A 4-year-old first-born girl
has hips clicking, although
they believe there is no
associated pain. Examination
• no obvious distress or pain.
• On inspection of her hips,
she has evidence of
asymmetrical skin creases.
• Movement of the right hip
leads to a reproducible
clunking

• Name the condition

• Clinical tests to diagnose the
condition
 8

• A 7-yr boy told his parents

that he was experiencing
left hip pain referred to the
thigh for 4 wks
• There was no memory of
recent trauma or infection.

• Name the condition

• What is the cause for the

condition