MBBS OSCE · Gastroenterology
OSCE — Coeliac Disease
Eight-minute OSCE station on Coeliac 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 Coeliac Disease.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Coeliac disease is a chronic, immune-mediated small-intestinal enteropathy triggered by gluten (prolamins — gliadin in wheat, hordein in barley, secalin in rye) in genetically predisposed (HLA-DQ2/DQ8) individuals. Presents across a spectrum from classical malabsorption (diarrhoea, weight loss, bloating, steatorrhoea) to atypical/extraintestinal disease (iron-deficiency anaemia, osteoporosis, aphthous ulcers, short stature, dermatitis herpetiformis, transaminitis) and silent/latent forms found on screening. Diagnosis requires serology while on a gluten-containing diet — anti-tissue transglutaminase IgA (anti-tTG IgA, most sensitive ~90–95%) and anti-endomysial IgA (EMA, most specific ~99%) —
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 | Persistent iron-deficiency anaemia in any premenopausal woman, young man, or old |
| Safety | Chronic diarrhoea, weight loss, bloating and fatigue with iron/folate deficiency |
| Safety | Type 1 diabetes, autoimmune thyroid disease, Down syndrome, Turner syndrome, sel |
| 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.