Summary of Common Conditions Seen in OSCEs
Hints and Tips for the Exam
Many of the causes of jaundice have been covered in the ‘abdominal examination’ station (Chapter 3), so we have not discussed them at any great length here.
Jaundice is yellow pigmentation of the skin and occurs when the serum bilirubin level exceeds 35 µmol/L. There are many causes of jaundice, so familiarise yourself with the common ones and know what questions to ask as well as the relevant investigations. The causes of jaundice can be divided into prehepatic, hepatic and obstructive.
Taking a thorough social history, including the use of recreational drugs and needle-sharing, as well as a sexual history, is fundamental to this station. Remember to signpost before you ask these questions, for example ‘I would now like to ask you some personal questions/questions of an intimate nature/questions about your personal life to find the cause of this problem. Is that all right?’
Questions You Could Be Asked
Q. Which type of jaundice would cause a raised urinary urobilinogen level?
A. Prehepatic jaundice.
Q. What is one of the most common non-fatal causes of jaundice and splenomegaly?
A. Hereditary spherocytosis.
Q. What are the most common hepatic causes of jaundice, and what investigations would you utilise to find a cause?
A. See Chapter 3 on abdominal examination.
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