The OSCE instructions may be non-specific, for example: ‘Examine this patient’s endocrine status.’ This could be Cushing’s syndrome, acromegaly or hypothyroidism. Approach this situation by asking a few generic questions (if allowed) and by doing a general inspection to determine which condition you think is present. Then proceed with the relevant focussed examination to elicit other signs.
Generic questions (may be required to differentiate between Cushing’s syndrome and hypothyroidism)
General
Work down body
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A patient presents to ED with chest pain and this trace. What would you do?
Interpretation management
Outline the physiological mechanism controlling cortisol release
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How does Cushing’s syndrome present?
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Please list some causes of Cushing’s syndrome
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What is the difference between Cushing’s syndrome and Cushing’s disease?
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What investigations are required to localise the cause of cortisol excess?
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Discuss the different management options available for Cushing’s syndrome
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There’s more learning on Cushing’s syndrome here!
Picture references
Cushing’s facial appearance: 2012. Ozlem Celik, Mutlu Niyazoglu, Hikmet Soylu and Pinar Kadioglu. Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs. Multidiscip Respir Med. 2012; 7(1): 26. Licenced under Creative Commons Attribution 2.0 Generic license (http://creativecommons.org/licenses/by/2.0). Sourced from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3436715/
A patient presents to ED with chest pain and this trace. What would you do?
Interpretation management