MBBS OSCE · General Medicine
OSCE — Cor Pulmonale
Eight-minute OSCE station on Cor Pulmonale: 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 Cor Pulmonale.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Cor pulmonale is right ventricular hypertrophy, dilatation and failure caused by lung disease (NOT by a primary cardiac problem), via pulmonary hypertension driven by chronic hypoxia and loss of the pulmonary vascular bed. The commonest cause is COPD; others include interstitial lung disease, obstructive sleep apnoea/obesity hypoventilation, chronic thromboembolic disease and restrictive chest-wall disease. Patients show the features of the underlying lung disease plus right-heart failure — raised JVP, peripheral oedema, hepatomegaly, a loud pulmonary second sound (P2), a parasternal right-ventricular heave and tricuspid regurgitation. Echocardiography demonstrates RV hypertrophy/dilatation
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 | Right-heart failure with chronic lung disease — cor pulmonale; look for and trea |
| Safety | Severe hypoxaemia with peripheral oedema and raised JVP — assess for LTOT; chron |
| Safety | Chronic hypercapnia with cor pulmonale — optimise ventilation with NIV, not oxyg |
| 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.