MBBS OSCE · Psychiatry
OSCE — Eating Disorders
Eight-minute OSCE station on Eating Disorders: 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 Eating Disorders.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Eating disorders are persistent disturbances in eating or eating-related behaviour that impair physical health or psychosocial function and are not better explained by another disorder or a cultural practice. DSM-5-TR groups them under 'Feeding and Eating Disorders' and removed the amenorrhoea criterion for anorexia nervosa. The four examinable entities are anorexia nervosa (AN) — restriction leading to significantly low body weight with intense fear of weight gain and body-image distortion; bulimia nervosa (BN) — recurrent binge eating plus inappropriate compensatory behaviour (vomiting, laxatives, exercise, fasting) at normal weight; binge eating disorder (BED) — recurrent binges without r
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 | BMI under 13.5, or postural drop over 20 mmHg systolic, or HR under 40, or QTc o |
| Safety | Suspected refeeding syndrome on starting nutrition — hypophosphataemia, hypokala |
| Safety | Hypoglycaemia, severe electrolyte disturbance, or collapse after purging — high |
| 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.