ADEX Medical History Review OSCE – Red Flags & Modifications

1. What the medical history station is really about

In ADEX, the medical history OSCE is not a full internal medicine exam. It checks if you can gather essential information, recognise risk, and make a safe decision about dental treatment.

Examiners want to see that you are systematic, that you ask the right follow-up questions, and that you can clearly explain when you would continue, modify, or postpone treatment.

2. A simple structure for medical history in ADEX

Most examiners are satisfied if you think in a clear, repeatable pattern:

• Chief complaint and dental reason for visit.
• Past medical history – major diagnoses and hospitalisations.
• Current medications – dose, frequency, and indication.
• Allergies – especially to drugs and latex.
• Surgeries or recent procedures.
• Social history – smoking, alcohol, recreational drugs.
• Pregnancy status when relevant.

Always connect your questions back to dental care: “Does this condition affect your daily activities?” or “How well controlled is it?” are simple but High Yield.

3. High Yield red flags ADEX likes to test

Focus on the classic systems that change how you treat patients:

• Cardiovascular: history of MI, stroke, angina, heart failure, arrhythmias, valve disease.
• Anticoagulation: warfarin, DOACs, dual antiplatelet therapy – bleeding risk with extractions or surgery.
• Diabetes: control level, hypoglycaemia risk, healing issues, infection susceptibility.
• Respiratory: asthma, COPD, recent infections – ability to lie back, oxygen needs.
• Allergy: especially to local anesthetics, antibiotics, and latex.
• Pregnancy: trimester, radiograph precautions, positioning, and drug choices.
• Infectious risk: hepatitis, HIV, TB – standard precautions and when to delay elective care.

ADEX will often give you a brief description; your job is to identify why it matters for dentistry.

4. When to modify or postpone treatment

In OSCE questions, marks come from choosing safe and reasonable actions:

• Postpone: recent MI or stroke (within 6 months), unstable angina, uncontrolled BP, or active chest pain.
• Modify: adjust local anesthetic with vasoconstrictor, plan shorter appointments, or coordinate with the physician.
• Bleeding risk: follow current guidance for anticoagulants, use local haemostatic measures, avoid unnecessary surgical trauma.
• Diabetes: morning appointments, confirm food and medication intake, be prepared for hypoglycaemia management.

Examiners reward answers that show caution and willingness to seek medical clearance when unsure.

5. Common OSCE traps

• Ignoring a recent hospitalisation for cardiac or neurological events.
• Assuming “controlled” without asking about last check-up or readings.
• Forgetting to ask about blood thinners.
• Continuing with elective treatment despite clear red flags.
• Not documenting or summarising findings at the end.

A simple summary such as “This patient is medically complex and I would seek clearance before invasive treatment” can score points.

6. Fast memory points

• Always link medical conditions to dental risk.
• Cardiac, diabetes, and anticoagulation status are core topics.
• Unstable or recent serious events → delay elective care.
• When unsure, choose the safest conservative option.
• Summarise your assessment and proposed modification clearly.

References

• CDCA-WREB-CITA ADEX Candidate Manual – Medical History and Risk Assessment sections.
• Standard dental guidelines on treating medically complex patients.
• Common dental risk assessment frameworks used in clinical practice.