MBBS OSCE · General Medicine
OSCE — Allergic Bronchopulmonary Aspergillosis & Aspergillus Lung Disease
Eight-minute OSCE station on Allergic Bronchopulmonary Aspergillosis & Aspergillus Lung Disease: focused history, examination priorities, investigations, emergency and definitive management.
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Brief (to candidate)
You will assess a patient with a presentation consistent with Allergic Bronchopulmonary Aspergillosis & Aspergillus Lung Disease.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Aspergillus fumigatus causes a spectrum of lung disease whose form is set entirely by the host: Aspergillus sensitisation (skin/IgE positive, asthma may worsen, no structural change), allergic bronchopulmonary aspergillosis (ABPA) — a Th2 hypersensitivity reaction to Aspergillus colonising the airways of patients with asthma or cystic fibrosis, producing poorly controlled asthma, brownish sputum plugs, blood eosinophilia, a markedly raised total IgE (over 500 to 1000 IU/mL) and central (proximal) bronchiectasis with mucus plugging; aspergilloma — a saprophytic fungal ball in a pre-existing cavity causing haemoptysis (which can be massive); chronic pulmonary aspergillosis — slow cavitating di
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.
- State focused examination priorities.
- List first-line investigations and any named score/criteria.
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).
- Mention one special-population modifier (pregnancy, child, elderly, CKD).
Examiner checklist
| Domain | Pass behaviours |
|---|---|
| Definition | Correct working diagnosis language |
| Assessment | Focused, prioritised, red flags sought |
| Investigations | Appropriate first-line + interpretation |
| Emergency care | ABC / time-critical actions first |
| Definitive care | Specific drugs/procedures, not generic phrases |
| Safety | Poorly controlled asthma with eosinophilia and a raised total IgE — screen for A |
| Safety | Brownish sputum plugs plus central bronchiectasis and high-attenuation mucus on |
| Safety | Haemoptysis with an upper-lobe cavity containing a mobile intracavitary mass (ai |
| Communication | Clear plan and safety-netting |
Model outline
Lead with the working diagnosis and life threats. Resuscitate before definitive tests when unstable. Use guideline-standard therapy with named agents and doses. Document escalation criteria and follow-up. A safe candidate is specific, structured, and never delays critical care for non-urgent imaging.