MBBS OSCE · General Surgery
OSCE — acute cholecystitis assessment and early surgery counselling
8-minute station: RUQ examination including Murphy sign, Tokyo severity thinking, initial bundle with antibiotic doses, and counselling for early laparoscopic cholecystectomy with critical view of safety and bail-out options.
8 min stationVerification in progress
On this page
Study tools
Exam tags
NEET-PGINICETPLAB
Brief (to candidate)
A 48-year-old woman has 30 hours of constant RUQ pain, fever 38.1°C, and vomiting. You have 8 minutes to examine her abdomen, state your working diagnosis and severity grade, outline immediate management with drug doses, and counsel her for definitive treatment.
Candidate instructions
- Wash hands, introduce, expose, examine the abdomen including Murphy sign.
- State diagnosis (acute calculous cholecystitis) and likely Tokyo grade.
- Prescribe NBM, IV fluids, analgesia, IV antibiotics with doses.
- Explain early laparoscopic cholecystectomy (timing within 72 h / index admission), conversion risk, and bile-duct injury prevention via critical view of safety.
- Mention cholecystostomy pathway if she were unfit or Grade III.
Examiner checklist
| Domain | Expected |
|---|---|
| Examination | Correct Murphy technique; compares sides |
| Diagnosis | Calculous cholecystitis vs colic vs cholangitis |
| Initial Rx | Co-amoxiclav 1.2 g IV TDS or cefuroxime + metronidazole; analgesia |
| Definitive | Early lap chole; CVS; bail-out options |
| Communication | Clear consent themes; safety-net for post-op bile leak |
Common errors
- Treating as simple biliary colic without antibiotics/admission.
- Offering only "interval cholecystectomy in 6 weeks" as default.
- Cannot define CVS or Calot anatomy.