MBBS OSCE · Gastroenterology
OSCE — Chronic Pancreatitis
Eight-minute OSCE station on Chronic Pancreatitis: 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 Chronic Pancreatitis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Chronic pancreatitis (CP) is a progressive, inflammatory, fibrotic disease of the pancreas producing irreversible morphological damage with permanent loss of exocrine (acinar) and endocrine (islet) function. Commonest cause worldwide is alcohol (60 to 70 percent); tobacco is an independent co-factor; tropical calcific pancreatitis dominates in southern India; hereditary (PRSS1), autoimmune (IgG4) and obstructive subtypes complete the spectrum (TIGAR-O classification). Presents with the classic triad of recurrent epigastric pain radiating to the back, steatorrhoea, and diabetes with weight loss; atypical painless CP presents with new diabetes and cachexia. Diagnosis rests on a combination of
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 | Chronic epigastric pain radiating to the back, with weight loss, steatorrhoea an |
| Safety | Painless obstructive jaundice with a 'sausage-shaped' pancreas on imaging and ra |
| Safety | Upper GI bleed in a patient with CP and splenic vein thrombosis - isolated gastr |
| 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.