MBBS OSCE · General Medicine
OSCE — Anaemia of Chronic Disease (Anaemia of Inflammation)
Eight-minute OSCE station on Anaemia of Chronic Disease (Anaemia of Inflammation): 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 Anaemia of Chronic Disease (Anaemia of Inflammation).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Anaemia of chronic disease (anaemia of inflammation) is the commonest anaemia in hospitalised patients and the second commonest worldwide after iron deficiency. It arises from chronic immune activation (infection, autoimmune disease, malignancy, chronic kidney disease) driving hepcidin-mediated iron sequestration (iron trapped in macrophages, reduced gut absorption), suppressed erythropoiesis, and a moderately shortened red-cell lifespan. Classically a normocytic, normochromic anaemia (MCV 80 to 100), occasionally mild microcytic; iron profile shows low serum iron, LOW TIBC/transferrin (vs HIGH in iron deficiency), normal or raised ferritin (an acute-phase reactant) and low transferrin satur
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 | Normocytic anaemia with low iron and LOW TIBC and high ferritin — anaemia of chr |
| Safety | Anaemia disproportionate to iron studies in a patient with chronic inflammation, |
| Safety | Ferritin normal or high in an anaemic patient — not iron deficiency; consider an |
| 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.