OSCE — Childhood Leukaemia · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Childhood Leukaemia.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Childhood leukaemia is the most common childhood malignancy (30% of all childhood cancers). Acute lymphoblastic leukaemia (ALL) accounts for 75-80%; acute myeloid leukaemia (AML) 15-20%. Peak age: 2-5 years. Presentation: bone marrow failure (anaemia, infection, bleeding), organ infiltration (hepatosplenomegaly, lymphadenopathy, CNS). Diagnosis: FBC + blood film + bone marrow aspirate (morphology, flow cytometry, cytogenetics). Treatment: risk-stratified chemotherapy. 5-year survival ALL: 90%, AML: 65-70%.

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	id: 1
Safety	id: 2
Safety	id: 3
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.