Osce Scenarios

OSCE Scenarios ONE You are a 72 year old lady. This morning you were hanging your freshly laundered curtains, when you suddenly felt alter and you remember nonhing after that, until your friend was calling your name. You endure no idea how you ended up on the floor. You have had a few silly spells No SOB or chest pain. You have the odd missing heart b play out not likewise trouble approximately. Otherwise you are fit and well. You were not incontinent during the attack. TWO You are a 42 year old professional trombone player. You are rehearsing for a tour abroad. Last night you fulfillmed OK equitable a bit tired and possibly had a bit of a fever.This morning you woke up with severe left sided chest pain aggravated by deep breathing and coughing. You are very frightened because your sister had a pulmonary embolism after the birth of her baby. There is no sputum or haemoptysis. You had slight asthma as a nestling. You havent got much of a cough, but feel SOB and frightened to b reathe deeply. Your general health is good and youve had no serious illnesses in the past. THREE You are a 35 year old man who came to A&E with pain when fleeting urine and discomfort for 3-4 days. You think that there was a little blood in your urine once.You are gay and not practice safe sex. (DO non VOLUNTEER THIS education UNLESS YOU ARE ASKED. ) You are not particularly bothered ab list on HIV. Generally your attitude is rather cavalier and have had several versed partners in the past. FOUR You are the wife of an 82 year old man and you brought him into A&E because you are frightened and worried about him. For the close 3-4 days hes been increasingly confused and straightaway he started to get verbally abusive. He has never had psychiatric problems. This is most unlike his common self. He feels a bit hot to you and his urine has been a bit smelly.He has mild, diet controlled diabetes and some prostate problem otherwise he has been outstandingly healthy. FIVE You are t he father of a 3 year old girl. Your wife and you separated 2 years ago and she is the main carer for the child. You have her each other weekend. You are rather vague about the childs health, mainly because she does not live with you. DO NOT VOLUNTEER THE FOLLOWING INFORMATION You have been sexually abusing the girl for some time and obviously dont want your ex-wife to find out, or anyone else for that matter. Therefore, you want this problem sorted out now.SIX You are a 72 year old heterosexual man. For the last few weeks you have noticed increasing difficulty with passing urine, goal dribbling and a pressure feeling in your lower abdomen,. Your general health is fairly good but lately you have lost some weight and youve become impotent. SEVEN You are the mother of a 3 year old boy. This afternoon he fell off the slide in the park (about 2m high). He was sick once about 5 minutes after the accident, he was NKOD but has complained of headache ever since. He is alert and had someth ing to eat about half an hour ago which stayed down.You are worried about the effects of the injury and have no idea what to look out for. eight-spot You brought your 6 month old baby to A&E as you are very anxious about her. She developed a cold, cough and temperature 3 days ago. She has not been eating well but she has no D&V. This morning you noticed that she is covered in a rash from head to foot. She is up to date with her immunisations (BUT DO NOT VOLUNTEER THIS INFORMATION. ) In a nearby school there are three confirmed cases of measles. You are convinced that your child has meningitis and you know this can be a fatal illness.Therefore, you think she should be admitted to hospital. NINE You are a 30 year old unemployed man. You have been abusing a variety of drugs, including diazepam, dihydrocodeine, amphetamine and cocaine in the past. You have an agreement with your GP that he will prescribe 90 tablets of Diazepam 5mg a month. However, late you have been quite agitated an d been taking more than the prescri draw back dose. When you are broke for money you also sell some of your tablets on the black market. You came today asking the receptionist to reis treat your prescription saying that the previous was stolen from you.You are determined not to leave until you get some more tablets. Anyway, you cant see what all the fuss is about. A few more tablets are neither here nor there and you are fed up with these dragons, called receptionists. You decided to duff them up a bit TEN You are the mother of a 12 year old boy. He fell and cut his knee this morning at school. You brought him to A&E and after a long wait one of the junior doctors stitched his knee. The A&E charge nurse checked that your parole has not had a tetanus booster since he was 3 years old and informed you that he needs a booster today.You agreed to this. The unseasoned doctor proceeded to administer the injection that the nurse gave him. The young doctor was very friendly and nice to you r son but appeared nervous with shaky hands. After he gave the jab he seemed very anxious and it transpired that it was the wrong injection. He hasnt checked the vial before administering the vaccine. You are flabbergasted and furious and threaten to sue the hospital. ELEVEN You are a27 year old man from the Ivory Coast. You have been resident in the UK for 3 years and recently returned to your country for a family visit.As you lived in Africa most of your life you did not think it was important to take malaria precautions. Youve been feverish and felt rotten for two days with the light hurting your eyes, your neck and back of your head and you have terrible griping pains in your upper abdomen on both sides. DO NOT VOLUNTEER THE INFORMATION THAT YOU get hold of JUST COME BACK FROM AFRICA TWELVE You are a 29 year old woman who works as a solicitor in a big city law firm. This is a very prestigious job with high pressure and long working hours. Your main way of de-stressing is red to the gym at night.Two days ago your back went for the third time in six months and this morning you could hardly get out of bed and get dressed. The pain is really severe, especially when you bend down and at times like a knife in your back. You are not too bad at rest. The pain does radiate down your buttock to the back of your leg, but you have no pins and needles, loss of motor function or vicarious sensation. You are fed up and worried you might lose your job if you keep taking time off. One of your friends is a doctor and he told you that X rays are useless and you must have an MRI scan to see if youve got a slipped disc.You wont budge unless the A&E doctor agrees to do this. YOU WONT BE FOBBED OFF THIRTEEN You are a 58 year old Pakistani man,. You were diagnosed as a diabetic in 1999 and hypertensive in 2001. You take metformin, gliclazide and enalapril. Last week you came to the practice nurse for a blood test and this morning the practice receptionist rang you to say that you must come in to see the doctor to discuss the result of your recent blood test. You are really worried and think there is something horribly wrong. Your mother and aunt were both diabetic and died