UDM1 Task 2-D346 Objective Structured Clinical Examination (OSCE) Scenarios

UDM1 Task 2-D346 Objective Structured Clinical Examination (OSCE) Scenarios

UDM1 Task 2                           D346 Objective Structured Clinical Examination (OSCE) Scenarios

OSCE 3

You are evaluating Angela Tate, an 82-year-old female, who was brought in by her daughter due to concerns of subtle changes in behavior—progressive forgetfulness that started over the past year. She was referred by her primary care provider after receiving a thorough evaluation for medical causes of her symptoms. 

She has difficulty recalling recent events and started using a small pocketbook calendar to help her remember when to pay her bills. In the past, she loved attending family gatherings, but in recent months, she has declined multiple invitations. Per the daughter, her mother was an eloquent speaker and writer. She would present at conferences for her former career as a marketing executive and retired 20 years ago. In recent months, she has noticed that her mom sometimes pauses in mid speech, and her use of words has changed. Her daughter states that she would speak in more sophisticated terms and now uses more general terms to describe things. In addition, she has been misspelling words. 

Per the daughter, the changes are not apparent to people who are not close to the patient but have become noticeable to her children. Her daughter states that the patient has three adult children, two that live 20–30 minutes away from the patient, and one that lives in another state. She has a good relationship with her children and maintains frequent communication with them. The patient was married for 53 years, and her husband died seven years ago. The daughter is concerned about her mother’s state and believes that she should live with one of her daughters. The patient feels that the daughter is overreacting and agreed to an evaluation.

Vital Signs: 

Blood Pressure: 115/63

• Heart Rate: 63
• Respirations: 17 Height:  5’7″

Weight: 125 pounds

Medical History: Osteoporosis

Surgical History: Hysterectomy 40 years ago due to endometriosis

Medications: Multivitamins and calcium supplements

Social History: Drinks a glass of wine three to four days a week; exercises five days a week for 30 minutes per day; active in church and leads a women’s group weekly

Psychiatric History: History of postpartum depression 50 years ago; patient attended psychotherapy for six months and has not experienced depression since; family history of Alzheimer disease on maternal side; mother had Alzheimer disease and died at the age of 91; sister, who is four years older than patient, was diagnosed with Alzheimer disease

Labs/Diagnostics:

• Lab: Within acceptable limits 
• EKG: Within normal limits

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