OSCE "Examination of a patient with shortness of breath in the practice of a
family doctor"
STATION 1
You are the doctor on call in the outpatient department and a 23 year old male
comes to your clinic complaining of shortness of breath,, please perform history
taking for this scenario
"Fishing rod" - Preparation/Introduction
"Meet"
Smile, getting up, shaking hands, makes gesture towards the chair
""
Hello D: Good afternoon, I'm your doctor…. (PIP). What is your name?
P: Good afternoon! I'm Albert Chunga.
Age
D: How old are you?
P: I’m 23 years old
Occupation
D: What is your current occupation?
P: I’m a store assistant
"FISH HEAD" - History taking
Open question - "Golden Minute" - the main symptom
D: Hi, how can i help you today?
P: I have been having difficulty breathing lately, and I have also been feeling exhausted for the past 5 days,
this started a few days ago because of a cold, I’m asthmatic and I haven’t been taking my medication at all.
Now I’m really worried because this happened to me twice already
History of the complaint (OATES)
O (Onset)
D: How long have you had your shortness of breath?
P: for 5 day now
D: Oh I see it’s been bothering you for a few days now. (R)
A(Associated symptoms)
D: Do you have any other symptoms associated with the shortness of breath?
P: Yes, I have been coughing as well,
D: is you cough productive of any sputum or not?
P:yes I cough out green sputum
D Is there any blood
P:No
T(Timing)
D: Does your shortness of breath occur at a specific time?
P: Yes, If I spend the day around Lilly flowers, then it occurs, or if I exercise I sometimes feel it?
, E (Exacerbating and alleviating symptoms)
D: Have you noticed anything that makes it worse?
P: No at the moment I haven’t taken note of it
D:Oh I understand, your chest pin episodes are really affecting your daily routines
D: What can relieve it?
P: well if I my salbutamol it seems to help but not today.
S (Severity) we use MMRC scale
D: So in terms of severity, do you get short of breath only on exercise, or when hurrying on a flat level, or
you can walk a long distance but sometimes you have to stop to breath, or when you walk less than 100m , or
when you are dressing? Which one is it from the five?
P: Usually I only get short of breath when I exercise but now I can’t even walk more than 100m without
getting short of breath
FOCUSED HISTORY TAKING
1.1.PAST MEDICAL HISTORY
D: Have you any episodes of chest in the past or been admitted for any illness?
P: As a matter of fact, yes, I was diagnosed of asthma at the age of 15, and ever since then I have at least 1 or
2 admissions per year due to worsening of my symptoms. My last admission was 8 months ago and I was
admitted in the intensive care ward where I was ventilated.
D: Have you ever had a surgical procedure performed on you?
P: No
1.2.DRUG HISTORY
D: Are you currently taking any medications?
P: I’m current taking salbutamol inhaler
1.3.FAMILY HISTORY
D: Is there anyone in your family who had eczema, asthma, or hay fever?
P: Yes my mother had asthma
1.4.SOCIAL HISTORY AND RISK FACTORS(SAAD)
S(Smoking)
D: Do you smoke?
P: Yes I have been smoking 10 cigarettes a day for the past 4 years.
A(Alcohol)
D: Do you drink alcohol?
P: no I don’t
family doctor"
STATION 1
You are the doctor on call in the outpatient department and a 23 year old male
comes to your clinic complaining of shortness of breath,, please perform history
taking for this scenario
"Fishing rod" - Preparation/Introduction
"Meet"
Smile, getting up, shaking hands, makes gesture towards the chair
""
Hello D: Good afternoon, I'm your doctor…. (PIP). What is your name?
P: Good afternoon! I'm Albert Chunga.
Age
D: How old are you?
P: I’m 23 years old
Occupation
D: What is your current occupation?
P: I’m a store assistant
"FISH HEAD" - History taking
Open question - "Golden Minute" - the main symptom
D: Hi, how can i help you today?
P: I have been having difficulty breathing lately, and I have also been feeling exhausted for the past 5 days,
this started a few days ago because of a cold, I’m asthmatic and I haven’t been taking my medication at all.
Now I’m really worried because this happened to me twice already
History of the complaint (OATES)
O (Onset)
D: How long have you had your shortness of breath?
P: for 5 day now
D: Oh I see it’s been bothering you for a few days now. (R)
A(Associated symptoms)
D: Do you have any other symptoms associated with the shortness of breath?
P: Yes, I have been coughing as well,
D: is you cough productive of any sputum or not?
P:yes I cough out green sputum
D Is there any blood
P:No
T(Timing)
D: Does your shortness of breath occur at a specific time?
P: Yes, If I spend the day around Lilly flowers, then it occurs, or if I exercise I sometimes feel it?
, E (Exacerbating and alleviating symptoms)
D: Have you noticed anything that makes it worse?
P: No at the moment I haven’t taken note of it
D:Oh I understand, your chest pin episodes are really affecting your daily routines
D: What can relieve it?
P: well if I my salbutamol it seems to help but not today.
S (Severity) we use MMRC scale
D: So in terms of severity, do you get short of breath only on exercise, or when hurrying on a flat level, or
you can walk a long distance but sometimes you have to stop to breath, or when you walk less than 100m , or
when you are dressing? Which one is it from the five?
P: Usually I only get short of breath when I exercise but now I can’t even walk more than 100m without
getting short of breath
FOCUSED HISTORY TAKING
1.1.PAST MEDICAL HISTORY
D: Have you any episodes of chest in the past or been admitted for any illness?
P: As a matter of fact, yes, I was diagnosed of asthma at the age of 15, and ever since then I have at least 1 or
2 admissions per year due to worsening of my symptoms. My last admission was 8 months ago and I was
admitted in the intensive care ward where I was ventilated.
D: Have you ever had a surgical procedure performed on you?
P: No
1.2.DRUG HISTORY
D: Are you currently taking any medications?
P: I’m current taking salbutamol inhaler
1.3.FAMILY HISTORY
D: Is there anyone in your family who had eczema, asthma, or hay fever?
P: Yes my mother had asthma
1.4.SOCIAL HISTORY AND RISK FACTORS(SAAD)
S(Smoking)
D: Do you smoke?
P: Yes I have been smoking 10 cigarettes a day for the past 4 years.
A(Alcohol)
D: Do you drink alcohol?
P: no I don’t
