MBBS OSCE · General Surgery
OSCE — Carotid Artery Disease
Eight-minute OSCE station on Carotid Artery Disease: focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Carotid Artery Disease.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Carotid artery disease is atherosclerotic narrowing of the extracranial carotid artery (commonest: bifurcation/internal carotid). Presents as TIA (focal deficit under 24 h), amaurosis fugax (transient monocular blindness from retinal embolus), or completed stroke. Or asymptomatic (incidental bruit). NASCET method measures stenosis: (normal ICA diameter − minimal lumen) / normal ICA diameter × 100. Symptomatic stenosis 70–99%: CEA within 2 weeks (NASCET, ARR 17%, NNT 6). Symptomatic 50–69%: CEA for selected (modest benefit). Asymptomatic over 60–70%: CEA if perioperative risk under 3% (ACAS/ACST). All patients receive best medical therapy (antiplatelet + high-intensity statin + BP control + 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 | Sudden focal neurological deficit (hemiparesis, aphasia, visual loss) — stroke o |
| Safety | Amaurosis fugax (curtain descending over one eye, transient) — retinal embolus f |
| Safety | Wound haematoma after CEA causing airway compromise — surgical emergency; evacua |
| 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.