Summary of Common Conditions Seen in OSCEs

Hints and Tips for the Exam

Weight loss should always ring alarm bells, so its vital – both for OSCEs and in clinical practice – to find the cause and deal with it swiftly.

Go Through the Systems

The weight loss station is fundamentally an extensive, thorough review of systems, with a specific focus on certain areas. So it is vital that you go through each of the systems and associated symptoms.

Energy In: Dietary History

Although most candidates will take a thorough history to rule out important organic causes, most do not appreciate delving into the details of the patient’s daily food intake. A change of job, house or other circumstances may result in a marked change in the patient’s eating habits. For example, if the patient used to have a regular high-calorie meal that they now miss out, it is likely that there would be a significant weight loss resulting from this. However, such a weight loss should not persist.

Energy Out: Exercise

Find out whether the patient has started a new exercise regime, or if their work or leisure pursuits now require much more physical activity than before.

Don’t Forget Possible Psychiatric Causes of Weight Loss

Many students will have had their psychiatry modules in the fourth year of their course, and finals will be largely based around medicine and surgery. However, the odd station might still have a psychiatric slant to it, and ‘weight loss’ is perfect for this. It is one of the key ‘biological symptoms’ of depression, and is naturally a result of eating disorders such as anorexia nervosa and bulimia. So make sure you ask about mood and anhedonia, and that you go through the ‘SCOFF’ questions listed in the checklist. The SCOFF questionnaire was published in the BMJ in 1999 after being devised by Dr John Morgan, a research fellow in psychiatry in the UK at the time it was published.

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