OSCE — Bronchiectasis (non-CF)

Brief (to candidate)

You will assess a patient with a presentation consistent with Bronchiectasis (non-CF).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Bronchiectasis is the permanent, abnormal dilation of one or more bronchi caused by destruction of the muscular and elastic wall components. It is not a single disease but the end-result of a vicious cycle of impaired mucociliary clearance, chronic infection and neutrophilic inflammation (Cole's hypothesis). The classic presentation is a chronic productive cough with daily mucopurulent sputum, recurrent exacerbations, coarse crackles, finger clubbing and, in advanced disease, haemoptysis and cor pulmonale. Diagnosis is clinical plus high-resolution CT (the signet-ring sign — bronchus wider than its accompanying artery — is the radiological hallmark). Commonest organisms are *Haemophilus infl

Candidate tasks

1. Clarify onset, severity, associated features, and red-flag symptoms.
2. State focused examination priorities.
3. List first-line investigations and any named score/criteria.
4. Give immediate resuscitation steps.
5. Outline definitive management with doses/routes where standard.
6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

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.