For medical students

1. INTERNAL MEDICINE
OSCE
STATIONS

2. STATION 1
A 25 Year old male is referred from a Clinic to Hospital
with a 2 day history of cough with reddish sputum,
pleuritic Right sided chest pains, fever & episodic rigors
On examination, Temperature 39.4°C, Pulse Rate 110
Beats/min, Resp Rate 30 Breaths/min, Blood Pressure
110/78mmHg & Coarse crackles on the right side
posteriorly on Chest Auscultation.

3. STATION 1
a) What are the 4 possible organisms for this patient’s illness?
b) List 4 investigations that will aid in the diagnosis and
management of the patient? (2marks)
c) Mention 4 pathological stages of this patients illness?
(2marks)
d) Outline the 5 principles of management for the illness?
(2marks)
e) What 4 Clinical features are associated with an increased
risk of death in this patient? (2marks)

4. STATION 2
Mr. Tembo,a 42 year old Bar Man is brought to hospital
with a history of palpitations and swelling of feet for 4
days. He has been drinking over 12 units of alcohol per
day in the last 5 years.
On examination; Temperature 37.0°C, Pulse Rate 100
Bpm, Resp Rate 18 Bpm, Blood Pressure
130/80mmHg,Mild pedal oedema, Lowered apex beat
and a pan systolic apical murmur radiating to the left
axilla.

5. STATION 2
a) What are palpitations? (1mark)
b) What is the diagnosis for Mr. Tambo's current
illness? (1mark)
c) List at least 4 important investigations you would
request for to support your Diagnosis? (2marks)
d) Mention 4 other complications Mr. Tembo could
develop if he does continue with his lifestyle?
(3marks)
e) How are you going to manage this patient?(3marks)

6. STATION 3
A 26 year old man undergoing routine medical
examinations for employment had the following urine
results;
Urinalysis Urine Microscopy
protein ++++ Leucocytes -nil
pH 6 Epithelial cells-few
glucose-nil RBC Casts-nil
blood-nil granular casts-presents
ketones-nil
specific gravity 1020

7. STATION 3
a)What are the abnormalities on these results? (2marks)
b)What is your working diagnosis? (1mark)
c)What two clinical signs would you expect to
find in this condition? (2marks)
d)What investigation would you do to confirm
the diagnosis? (2marks)
e) What is the management of the condition(3marks)

8. STATION 4
A 42 year old woman presents to you with a 2 weeks
history of loosing weight, drinking too much water and
having excessive appetite.
She is a single mother of 2,who takes alcohol (Mosi
Larger) and smokes cigarettes.
On examination;Bwt:115kg, Height:155cm
Temperature:36.5°C,Pulse Rate:78 Bpm, Resp
Rate:20 Bpm, BloodPressure:160/110mmHg.

9. STATION 4
a) Identify the 3 risk factors to this patient’s current
condition? (2marks)
b) What are the differential diagnoses? (2marks)
c) What 2 important investigations would you do for
this patient? (2marks)
d) What things would you advise this woman to do
in order for her to be healthier? (2marks)
e) What class of antihypertensives would you avoid in
managing her Blood Pressure ? (2marks)

10. END