MBBS OSCE · General Surgery / Gastroenterology
OSCE — Charcot triad and cholangitis pathway
Station testing recognition of ascending cholangitis, resuscitation, antibiotic choice, and urgent ERCP versus cholecystectomy sequencing.
8 min stationVerification in progress
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Exam tags
NEET-PGINICETPLAB
Brief (to candidate)
A 70-year-old man has RUQ pain, fever, and jaundice. BP is 90/50 and he is drowsy. US shows CBD dilatation and gallbladder stones. Manage this station.
Candidate instructions
- Recognise Reynolds pentad / severe cholangitis.
- ABCDE resuscitation; blood cultures; IV piperacillin-tazobactam 4.5 g TDS (or local).
- Arrange urgent ERCP decompression — not cholecystectomy first.
- Plan later cholecystectomy once stable if GB stones remain.
- Consent themes for ERCP (pancreatitis, bleeding, perforation).
Examiner checklist
| Domain | Expected |
|---|---|
| Recognition | Charcot ± Reynolds |
| Resuscitation | Fluids, cultures, critical care |
| Source control | ERCP first |
| Sequencing | Chole after sepsis controlled |
| Safety | Names ERCP risks |
Common errors
- Booking only laparoscopic cholecystectomy for cholangitis.
- No blood cultures before antibiotics discussion.
- Missing shock as severity marker.