MBBS OSCE · Infectious Diseases
OSCE — COVID-19 (SARS-CoV-2)
Eight-minute OSCE station on COVID-19 (SARS-CoV-2): 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 COVID-19 (SARS-CoV-2).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
COVID-19 is the disease caused by the betacoronavirus SARS-CoV-2, declared a pandemic by the WHO in March 2020. The S1 subunit of the spike protein binds the ACE2 receptor (high density in type-II pneumocytes, nasal goblet cells, enterocytes, renal tubules, myocardium) and S2 is primed by TMPRSS2 and furin before membrane fusion. Spectrum runs from asymptomatic through mild upper-respiratory illness, pneumonia with hypoxaemia, ARDS and multi-organ failure. Hallmarks: anosmia/ageusia, silent hypoxaemia, bilateral peripheral ground-glass opacities on CT, and a lymphopenia/raised CRP/ferritin/D-dimer/IL-6 profile. Severe disease is driven by a cytokine storm with endothelialitis and microthromb
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 | Fever, cough, dyspnoea plus bilateral opacities on CXR/CT in a pandemic setting |
| Safety | SpO2 under 92 percent on room air, RR over 30, or rising inflammatory markers - |
| Safety | Silent hypoxaemia (SpO2 under 90 percent without breathlessness) - impending res |
| 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.