MBBS OSCE · General Medicine
OSCE — Guillain-Barré Syndrome
Eight-minute OSCE station on Guillain-Barré Syndrome: 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 Guillain-Barré Syndrome.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Guillain-Barré syndrome (GBS) is an acute, monophasic, immune-mediated polyradiculoneuropathy producing symmetric, ascending flaccid paralysis with areflexia, progressing to a nadir within four weeks and often preceded by an infection one to six weeks earlier. The commonest subtype is acute inflammatory demyelinating polyradiculoneuropathy (AIDP, 85 to 90 percent in Western countries), with axonal motor (AMAN) forms commoner in Asia. The antecedent trigger is classically Campylobacter jejuni gastroenteritis, but cytomegalovirus, Epstein-Barr virus, Mycoplasma pneumoniae, influenza and Zika are also recognised. Diagnosis is clinical, supported by CSF albuminocytological dissociation (high pro
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 | Ascending weakness with areflexia over days — GBS; admit for respiratory monitor |
| Safety | FVC under 20 mL/kg or falling rapidly — impending respiratory failure; ICU, prep |
| Safety | Autonomic instability (arrhythmia, blood pressure swings) — ICU monitoring; comm |
| 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.