OSCE — Febrile Neutropenia · MBBS OSCE

Brief (to candidate)

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

Clinical context

Febrile neutropenia is an oncologic emergency defined as a single oral temperature at least 38.3 degrees Celsius, or 38.0 degrees sustained for one hour, in a patient with an absolute neutrophil count under 0.5 x10^9/L (or under 1.0 with predicted decline). Empiric broad-spectrum antipseudomonal beta-lactam therapy must be given within 60 minutes of recognition, after urgent blood cultures, with MASCC risk stratification guiding oral step-down versus inpatient IV care.

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	id: 1
Safety	id: 2
Safety	id: 3
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.