Revised 7/4/15

Appendix A : OSCE ( Objective Structural Clinical Examination )

_________ (5% )General survey : conscious , coherent. Afebrile, ambulatory with the ff. vs
: BP= ? mm Hg ; CR = ? / min RR== ? / min Temp = ? oC ; WC = ? inches ; Ht = ?
meters ; Weight = ? kg ; BMI = ?
_________(5% )HEENT : pinkish palpebral conjunctivae ; anicteric sclerae ; (-) circus senilis ;
(-) xanthelasma ; (-) alopecia ; (-) Tonsillopharyngeal congestion ;
________(10% )Neck : supple ; JVP = 5 cm at 45 degrees ; (-) thyromegaly ; (-) cervical
lymphadenopathy ; (-) carotid bruit
________(15% ) Chest/ Lungs : symmetrical ; (-) retractions ;(-) lag; (-) spider angiomas; equal
vocal and tactile fremiti ; equally resonant on both lung fields; equal breath sounds ; (-)rales ; (-)
wheezes
_________(20% ) Heart : Adynamic precordium ; Apex beat at the 4th or 5th intercostal space left
midclavicular line ; (-) thrills/ heaves ; (-)loud and palpable P2 ; normally split S2 ; S1 > S2 at
apex ; S2 > S1 base ; (-) S3 ; (-) S4 ; normal rate regular rhythm ; (-) murmurs
_________(20% ) Abdomen : Abdominal girth = cm ; flat ; (-) caput medusae ; normoactive
bowel sounds ; soft; nontender ; tymphanitic ; (-) splenomegaly ; liver span = __ cm at the
midclavicular line ; liver edge non palpable ( if palpable cms below the ribs ;
smooth/nodular edge ; nodular / smooth surface of the liver )
________ (5% ) Extremities : (-) deformities ; ( -) clubbing ; (-) cyanosis ; with the ff. pulses :
DP PT P F B R
R ++ ++ ++ ++ ++ ++
L ++ ++ ++ ++ ++ ++
_________ (5% )Rectal exam : ( -) anal tags good sphincteric tone ;rectal vault not collapse ;(-)
hemorrhoids nor mass noted; brownish stools in the tactating finger
_________ (15% ) Neurologic exam :
Cerebrum : conscious ; oriented to 3 spheres
Cerebellum : (-) nystagmus ; can do heel to shin test ; intact Rombergs test ; can do rapid
alternating movements ; can do finger to nose test
Cranial nerves :
I can smell coffee
II, III pupils equally reactive to light
III, IV, VI intact extraoccular muscles
V intact corneal reflex , bilateral ; intact masseter muscle contraction
VII (-) facial asymmetry
VIII can hear, bilateral
IX, X intact gag reflex
XI can shrug shoulders , bilateral
XII - tongue midline on protrusion
(-) Babinski ; (-) nuchal rigidity ( -) Brudzinski (-) Kernigs sign
Dermatomal test : equal and intact on all levels
Motor Sensory DTR

Total Score : _______________

Preceptor ( Name and Sign) : ________________________________

Student ( Name and Sign ) : __________________________________
REVIEW OF SYSTEM

Constitutional : fatigue; weakness; weight loss. No fever ; chills

Neurologic : No headache ;No syncope ; no seizures ; no areas of focal

weakness ; no sensory problems / numbness ; tingling or pins and needles ;
no history of seizures ; no dizziness; no scotoma ; no vertigo ; no tremors or
other involuntary movements

Eyes: No significant visual difficulties; blurred vision ; No diplopia ; no eye pain

ENT : No problems in hearing; no sore throat no sinus drainage ; no epistaxis ;

no tinnitus

Cardiovascular / PVS : no chest pain or discomfort ; no PND, no orthopnea ;

no palpitation ;Rheumatic fever manifestations ( sore throat , fever and joint
pains); no claudication ; pedal edema; no leg cramps

Respiratory : no cough ; no difficulty of breathing ; no hemoptysis ; ( GINA

guidelines if asthma)

Gastroenterology: Dysphagia ; odynophagia ; change in appetite ; celching or

bloatedness; flatulence ; burping No nausea ; no vomiting ; no abdominal pain ;
no diarrhea/ constipation ; no change in bowel movement ; no melena ; no
hematochezia

GUT : dysuria or burning pain on urination ; incontinence ; hematuria; nocturia ;

frequency ; polyuria/ oliguria ; urgency ; hesitation; dribbling ; loss of parabolic
curve

Musculoskeletal : No joint pain ; swelling or redness ; no decreased range of

motion ; no myalgia

Endocrine : No diabetes ( 3 Ps ) ; no thyroid disease ( heat or cold intolerance ;

Waynes index ) or hormone replacement ; no hot flashes or night sweats

Immunologic /Hematologic : no easy bruising or bleeding ; No urticarial/

allergy

Psychiatric : No insomnia ; depression ; mania or mood swings ; no

psychotropic drugs

* All types of pain = LPPQRST ( location, provocative and palliative factors , quality ,
radiation ; severity and timing or temporal profile )