Summary
Summary OSCE Guidance - Mind and Movement Stations
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Comprehensive guidance notes for a range of common stations that could arise in the Mind and Movement OSCE.
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Tom SharpYear 4 Mind and Movement Explanation Stations Guidance
Sections in “quotes” are written in lay terms.
Sections in bold are important/key points.
In all conditions, start by checking the patient’s pre-existing conceptions of the condition, and end by asking them to repeat back to you, ask them if the
information.
Condition/ Explanation Causes Diagnosis/Treatment Mechanism/Expl
Procedure Treatment
Dementia “Dementia is a disease Most cases of dementia are AD, VD or Cognitive examination and imaging AChesterase inhibitor
(Alzheimer’s affecting the brain which DLB. (MRI). Difficult to detect early. increase levels of ACh
(AD)/Lewy causes problems with your “In AD, the brain shrinks and the Lifestyle changes in VD – stop smoking, brain to improve func
Body memory and understanding. It connections between brain cells drinking, exercise, lose weight, etc. Mechanism of mema
(LBD)/Vascula can also affect your mood, break down.” Acetylcholinesterase inhibitors – e.g. unclear – reduces glu
r (VD)) sleeping and appetite. This “In VD, the small blood vessels in the donepezil – “increases the level of the levels but not clear w
normally happens over a brain become blocked and cause chemical in the brain that allows brain helps in AD.
period of time.” brain cells to die.” cells to communicate with each other.”
“AD is NOT part of the normal “In LBD, proteins build up in the brain Memantine – “reduces a chemical in
age-related memory and interfere with the brain’s normal the brain called glutamate, which
impairment.” workings.” might slow down the damage caused
May also have mixed dementia, or a by AD.”
rarer cause. Antidepressants, sleeping tabs, social
Very common disease. care – district nurses, voluntary
organisations, orientation, etc.
Depression “Depression is where you have “Can be just for no reason, or might Diagnosed on symptoms. SSRIs – “increases the
a very low mood and other be due to situations in everyday life.” “A lot of people with depression can the chemical in the br
symptoms (e.g. tiredness, “If you have other problems with get better without us doing anything, think is responsible fo
appetite, etc.) every day for at your health, you might start to feel but it can take some time.” of happiness and wel
least two weeks.” down or anxious about things, which “If you’re really struggling, there are limits serotonin reabs
“Not the same as simply can get worse over time and lead to some things we can try to help.” into the presynaptic n
feeling sad. Some people even depression” (i.e. talking about Therapies e.g. CBT, cCBT, support CBT – “helps you dea
think about ending their lives” comorbidities here). groups, etc. problems in a more p
(good way to lead into asking Also think of other psychiatric Antidepressants – “medication to help based on the idea tha
about suicidality). conditions e.g. anxiety, or after improve your mood”, although make thoughts, feelings and
pregnancy. clear that this is not first-line. are all linked and that
“Some people find exercising helps to thoughts can cause a
boost their mood, but the evidence for cycle”.
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