MBBS OSCE · Psychiatry
OSCE — Anxiety and Panic Disorder
Eight-minute OSCE station on Anxiety and Panic Disorder: 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 Anxiety and Panic Disorder.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Anxiety disorders are the most prevalent of all mental disorders. A panic attack is an abrupt surge of intense fear peaking within minutes with at least 4 of 13 autonomic/cognitive symptoms; it is a specifier, not a diagnosis. Panic disorder requires recurrent unexpected panic attacks followed by at least 1 month of persistent concern about further attacks, anticipatory anxiety, or maladaptive behaviour change. Generalised anxiety disorder (GAD) is excessive, difficult-to-control worry occurring more days than not for at least 6 months plus at least 3 of 6 somatic/cognitive symptoms (restlessness, fatigue, concentration, irritability, muscle tension, sleep). Lifetime prevalence: panic diso
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 | First panic attack with chest pain, dyspnoea, syncope, abnormal vitals, age over |
| Safety | Palpitations with chest pain, syncope or family history of sudden death — QT pro |
| Safety | Episodic severe hypertension, sweating and headache — phaeochromocytoma; check 2 |
| 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.