NUS Final MBBS Medicine OSCEs (2003 Main)
Last updated: 20 April 2003

Introduction

Note: The format of the written paper may change after 2003, so please check. But assuming that there's no change....

The OSCE segment of the Medicine paper contains 30 questions (15 adult, 15 paeds). You are given 2 minutes for each question for a total of 1 hour. The questions are MCQs with 5 options of which you are required to select one best answer. They may ask for the diagnosis, but frequently they ask for something else related to the diagnosis eg. cause, appropriate investigation, management or "select the correct/wrong statement".

The following questions are from the 2003 Main Paper. For obvious reasons most of the pictures aren't the actual ones used for the exams, but similar ones pulled off the net. Questions don't repeat... but no harm in practicing, right? So if you've benefited from this, remember your juniors too. :) For whoever's compiling the future OSCE papers, here are some useful sites:

  • Medical Digital Image Repository (user name: NUSSTU/medxxxxx; password: your NUSNET password)
  • Google Image Search

Update 17/2/04: If anyone's gonna compile something similar this year, please email the author and I'll gladly link to you. Best of luck for the coming exams!

Question 1: /
Patient complains of joint pain. What is the likely diagnosis?
a) Rheumatoid arthritis
b) Scleroderma
c) Gout
d) Osteoarthritis
e) Dermatomyositis
Question 2: / Lip - L side lower lip lesion, tense, erythematous ?abscess ?retention cyst
How do you manage this lip lesion?
a) Incision and drainage
b) Topical dexamethasone
c) Oral ampicillin
d) IV hydrocortisone
e) IV adrenaline
Question 3: /
27 y/o man complains of diarrhoea. Diagnosis?
a) Meckel's diverticulum
b) Crohn's disease
c) CA colon
Question 4: / Liver function test
Albumin / 4 g/L
Total bilirubin / 150 umol/L
Conjugated bilirubin / 145 umol/L
ALT / 1990 U/L
AST / 1550 U/L
GGT / 40 U/L
ALP / 70 U/L
What is the most likely cause of this LFT result?
a) Carcinoma of head of pancreas
b) Common bile duct stone
c) Acute hepatitis A
d) Hemolytic anemia
e) Gilbert's syndrome
Question 5: /
What is a likely cause of this patient's appearance?
a) Third nerve palsy
b) Horner's syndrome
c) Myasthenia gravis
d) Myotonia dystrophica
Question 6: /
28 year old patient complains of back pain. Diagnosis?
a) Prolapsed intervertebral disc
b) Spinal stenosis
c) Ankylosing spondylitis
d) Osteoarthritis
Question 7: /
How would you treat the patient whose ECG is shown above?
a) Adrenaline
b) Dopamine
c) Insulin + dextrose
d) Atropine
e) DC shock
Question 8: /
What is the diagnosis?
a) ventricular tachycardia
b) atrial flutter
c) acute myocardial ischemia
d) atrial fibrillation
e) ventricular fibrillation
Question 9: /
Which of the following is a likely cause of the above PBF appearance?
a) Sickle cell anemia
b) Thalassemia
c) B12 deficiency
d) CA colon
e) CLL
Question 10: /
2 y/o child, discovered to be pale few months ago. Abdominal exam showed palpable liver 2cm, palpable spleen 2cm. Diagnosis?
a) Iron deficiency anemia
b) Beta Thalassemia major
c) HbH disease
d) Leukemia
e) Alpha 1 thalassemia
Question 11: /
Patient complains of blurrness of vision. Most likely cause:
a) Diabetes mellitus
b) Multiple sclerosis
c) Retinitis pigmentosa
Question 12: /
What is the diagnostic test for this condition?
a) Synacthen test
b) Dexamethasone suppression test
c) Urine catecholamines
d) Oral glucose tolerance test
e) Thyroid function test
Question 13: /
Patient complains of gain of weight. Diagnosis:
a) Hashimoto's thyroiditis
b) Acromegaly
c) Polycystic ovarian syndrome
Question 14: / Face of middle aged lady - Loss of left nasolabial fold, drooping of right lip, weakness of right frontalis
Possible etiology:
a) CVA
b) Multiple sclerosis
c) Acoustic neuroma
d) Meniere's disease
e) Labyrinthitis
Question 15: /
Patient c/o chronic cough. Diagnosis:
a) Lung abscess
b) Hiatus hernia
c) Gastroesophageal reflux
d) Bronchiectasis
e) Tuberculosis
Question 16: /
Patient presents with unsteady gait. What investigation is indicated?
a) Full blood count
b) Liver function test
c) Coagulation panel
d) Lumbar puncture
e) Serum caeruloplasmin levels
Question 17: /
What is the diagnosis?
a) Glycogen storage disease
b) Nephrotic syndrome with cushingoid features
c) Mucopolysaccharoidosis
d) Congenital hypothyroidism
e) Liver cirrhosis
Question 18: /
Patient c/o intense pruritus. In a child, the likely diagnosis is:
a) Alagille's syndrome
b) Abetalipoproteinemia
c) Familial hypercholesterolemia
Question 19: /
Patient c/o fever, rash, abdominal pain, knee swelling. Diagnosis:
a) Henoch-Schonlein purpura
b) Rheumatic fever
c) Urticarial rash
Question 20: / CT abdomen: bilateral polycystic kidneys
Patient presents with lethargy. What investigation would help in the diagnosis?
a) Chromosomal culture for the patient
b) AFP levels in patient
c) U/S kidney for both parents
d) Tandem repeats for the patient
Question 21: /
This child can have the following features EXCEPT:
a) Left homonymous hemianopia
b) Central diabetes insipidus
c) Optic atrophy
d) Growth hormone deficiency
e) Secondary hypothyroidism
Question 22: /
2 year old child presents with first attack of fever, cough, wheeze. Auscultation shows decreased breath sounds on the right. Diagnosis:
a) Right pleural effusion
b) Allergic asthma
c) Foreign body aspiration
d) Atelactasis
e) Hyperventilation syndrome
Question 23: /
Patient fell, was conscious for an hour and later became unconscious. Diagnosis:
a) Brainstem herniation
b) Epidural hematoma
c) Subdural hematoma
d) Subarachnoid hemorrhage
Question 24: /
3 year old girl, fell down, c/o left elbow pain. Diagnosis:
a) Supracondylar fracture
b) Fracture of head of radius
c) Elbow contusion
d) Elbow dislocation
e) Pulled elbow
Question 25: /
What investigations are indicated?
a) Full blood count
b) Chromosomal culture
c) Albumin levels
Question 26: /
This patient has low serum thyroxine levels. Diagnosis:
a) Grave's disease
b) Thyroid dyshormogenesis
c) Lingual thyroid
d) Iodine excess
e) Atrophic thyroiditis
Question 27: / Infant - Bullae + peeling of skin over trunk, genitalia, thighs.
What is the MOST likely cause?
a) Epidermolysis bullosa
b) Steven Johnson's syndrome
c) Burn by hot liquid
d) Bullous impetigo
e) Infected chicken pox
Question 28: /
Patient presents with multiple bruises. Mother denies history of trauma. MOST likely cause?
a) Von Willebrand's disease
b) Neuroblastoma
c) Non-accidental injury
d) Hemophilia
Question 29: / IVU - bilateral shrunken kidneys
12 year old girl presents with tiredness and decreased urine output. Possible cause:
a) Renal stone
b) Renal cell carcinoma
c) Urinary tract infection
d) Pyelonephritis
e) NSAID nephropathy
Question 30: /
Patient presents with stridor and fever of 2 days duration. Diagnosis:
a) Croup
b) Acute epiglottitis
c) Retropharyngeal abscess
d) Adenoid lymphadenopathy
e) Laryngomalacia

Answers

  1. B - sclerodactyly
  2. A?
  3. B - string sign
  4. B
  5. B - left ptosis and miosis
  6. C - bamboo spine
  7. C - hyperkalemia: tall T waves
  8. B
  9. D - hypochromic, microcytic anemia with anisocytosis - iron deficiency anemia
  10. B - hypochromic, microcytic anemia, anisocytosis, poikilocytosis, target cells
  11. B - optic atrophy
  12. B - purple striae of Cushing's
  13. B - enlarged nose and lips
  14. B
  15. B - air-fluid level behind heart
  16. E - Kayser-Fleischer rings in Wilson's disease
  17. A - Gargoyle like facies, short stature, umbilical hernia
  18. A - xanthomata in hands
  19. A
  20. C - bilateral polycystic kidneys
  21. A - pituitary adenoma: bitemporal hemianopia
  22. C - unilateral (right) hyperinflation
  23. B - lens-shaped hematoma
  24. E
  25. B - lymphedema in Turner's syndrome
  26. B
  27. ?
  28. B
  29. E
  30. C - prevertebral space widening