MBBS OSCE · haematology
OSCE — Aplastic Anaemia
Eight-minute OSCE station on Aplastic Anaemia: 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 Aplastic Anaemia.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Aplastic anaemia is a life-threatening bone marrow failure syndrome defined by pancytopenia (anaemia + neutropenia + thrombocytopenia) with a markedly hypocellular marrow and no abnormal infiltrate. Most cases are acquired and idiopathic (immune-mediated); recognised triggers include drugs (chloramphenicol, carbamazepine, NSAIDs), toxins (benzene, radiation), and viruses (seronegative hepatitis, EBV, parvovirus B19, HIV); inherited forms include Fanconi anaemia and dyskeratosis congenita. Presents with fatigue, bleeding and infection in a well-looking patient without organomegaly. Diagnose with full blood count, film, reticulocyte count and a trephine biopsy (cellularity under 25 percent). S
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 | Pancytopenia with hypocellular marrow and no blasts or organomegaly - aplastic a |
| Safety | Neutrophils under 0.5 (or under 0.2 very severe), platelets under 20, reticulocy |
| Safety | Fever in a neutropenic patient with aplastic anaemia - neutropenic sepsis; cultu |
| 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.