MBBS OSCE · General Medicine
OSCE — Acute Bronchitis
Eight-minute OSCE station on Acute Bronchitis: 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 Acute Bronchitis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Acute bronchitis is acute inflammation of the trachea and large bronchi producing a self-limiting cough of up to three weeks, nearly always viral (rhinovirus, influenza, RSV, coronavirus, parainfluenza, adenovirus) and without the radiographic consolidation of pneumonia. The cough often lasts one to three weeks (sometimes up to eight from post-viral airway hyper-reactivity). The pivotal clinical tasks are to exclude pneumonia (normal vital signs, no focal chest signs, normal oxygenation) and to avoid unnecessary antibiotics — they offer minimal benefit and real harm, because the cause is viral. Management is symptomatic (rest, fluids, analgesia, honey or an antitussive). Consider pertussis (
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 | High fever, tachypnoea, focal chest signs, or hypoxia — think pneumonia, not bro |
| Safety | Cough lasting beyond three weeks — chronic-cough pathway; consider pertussis (ma |
| Safety | Acute bronchitis with significant comorbidity (COPD, heart failure, immunocompro |
| 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.