OSCE — Endometriosis · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Endometriosis.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Endometriosis is the presence of functional endometrial glands and stroma outside the uterine cavity, producing a chronic, oestrogen-dependent, inflammatory condition. It classically presents with the triad of secondary dysmenorrhoea, deep dyspareunia and chronic pelvic pain, with infertility a frequent sole presentation. The ovary is the commonest site; the three phenotypes are superficial peritoneal, ovarian endometrioma ('chocolate cyst') and deep infiltrating endometriosis (DIE). Diagnosis is clinical plus transvaginal ultrasound; MRI maps DIE; laparoscopy with histology is the gold standard. Management is NSAIDs plus hormonal suppression (combined OCP, progestogens, GnRH analogues/antag

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	Secondary, progressive dysmenorrhoea plus deep dyspareunia plus chronic pelvic p
Safety	Cyclical dyschezia, cyclic dysuria or haematuria, or cyclic rectal bleeding - de
Safety	Adnexal mass with ground-glass echogenic content on transvaginal ultrasound in a
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.