MBBS OSCE · Psychiatry
OSCE — Attention Deficit Hyperactivity Disorder (ADHD)
Eight-minute OSCE station on Attention Deficit Hyperactivity Disorder (ADHD): 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 Attention Deficit Hyperactivity Disorder (ADHD).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
ADHD is a neurodevelopmental disorder characterised by persistent, pervasive, impairing inattention, hyperactivity, and impulsivity with onset before age 12 and symptoms present in two or more settings (home, school, work). Prevalence about 5 percent of children, 2.5 percent of adults; clinic male-to-female ratio 3:1 (community 2:1); heritability 74 to 88 percent — among the highest in psychiatry. DSM-5-TR: 6+ inattention and/or 6+ hyperactivity-impulsivity symptoms in children (5+ in adults 17+), for at least 6 months, several before age 12, in 2+ settings, causing impairment, not better explained. Three presentations: predominantly inattentive, predominantly hyperactive-impulsive, combined
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 | Child with persistent inattention, hyperactivity, impulsivity across home AND sc |
| Safety | Adult with lifelong inattention, disorganisation, time blindness, impulsivity an |
| Safety | Stimulant-treated child with poor growth or appetite loss - monitor height/weigh |
| 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.