MBBS OSCE · endocrinology
OSCE — Amenorrhoea (Primary & Secondary)
Eight-minute OSCE station on Amenorrhoea (Primary & Secondary): 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 Amenorrhoea (Primary & Secondary).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Amenorrhoea is the absence of menstruation — a symptom, never a diagnosis. Primary amenorrhoea (no menses by age 15 with secondary sex characteristics, or by age 13 with no thelarche) is caused by constitutional delay, Turner syndrome, Kallmann syndrome, Mullerian agenesis (MRKH), androgen insensitivity and outflow obstruction. Secondary amenorrhoea (cessation for 3 or more months) is caused by pregnancy (always exclude first), functional hypothalamic (low BMI, exercise, stress, eating disorder), polycystic ovary syndrome, hyperprolactinaemia, premature ovarian insufficiency, thyroid disease and Asherman syndrome. Evaluation uses the four compartments — uterus/outflow, ovary, pituitary, hypo
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 | Secondary amenorrhoea — ALWAYS do a pregnancy test first before any imaging or h |
| Safety | Primary amenorrhoea with short stature and absent puberty — Turner syndrome (45, |
| Safety | Amenorrhoea with anosmia — Kallmann syndrome (isolated GnRH deficiency) |
| 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.