MBBS OSCE · General Medicine
OSCE — Dengue & Dengue Haemorrhagic Fever
Eight-minute OSCE station on Dengue & Dengue Haemorrhagic Fever: 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 Dengue & Dengue Haemorrhagic Fever.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Dengue is an acute mosquito-borne flaviviral illness caused by four antigenically distinct serotypes (DENV-1 to DENV-4), transmitted mainly by the day-biting Aedes aegypti mosquito (also A. albopictus). It is the most important arboviral disease of humans, endemic across the tropics with ~96 million symptomatic cases a year (about 390 million infections). The clinical spectrum runs from undifferentiated fever through classic dengue fever (DF) to dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) — the latter driven by plasma leakage, thrombocytopenia and bleeding. A secondary infection with a different serotype is markedly more severe through antibody-dependent enhancement (ADE). The illness has three phas
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 | High fever, retro-orbital headache, severe myalgia, rash, thrombocytopenia in the monsoon - suspect dengue; NS1 (first 5 days), IgM after |
| Safety | Abdominal pain, persistent vomiting, mucosal bleeding, lethargy, rising haematocrit with falling platelets as fever settles - warning signs; admit, start IV fluids |
| Safety | Cold extremities, narrow pulse pressure (under 20 mmHg), tachycardia, oliguria as fever defervesces - DSS; crystalloid bolus 10-20 mL/kg over 15-20 min |
| 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.