MBBS OSCE · General Medicine
OSCE — Haematuria (Evaluation)
Eight-minute OSCE station on Haematuria (Evaluation): focused history, examination priorities, investigations, emergency and definitive management.
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Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Haematuria (Evaluation).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Haematuria (red blood cells in the urine) is a sign, not a diagnosis. It is divided into visible (macroscopic/gross) and non-visible (microscopic, defined as more than 3 RBCs per high-power field on microscopy). The pivotal diagnostic distinction is glomerular vs urological source: glomerular bleeding shows dysmorphic red cells, red-cell casts and proteinuria and is managed by nephrology; urological bleeding shows isomorphic (intact) red cells and needs cystoscopy and CT urogram. Painless visible haematuria is cancer until proven otherwise and warrants an urgent suspected-cancer referral. Evaluation first excludes infection and transient causes, then uses urine microscopy to direct either a
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 | Painless visible haematuria in an adult — cancer (bladder/renal/urothelial) unti |
| Safety | Visible haematuria with clots and clot retention — heavy bleeding; three-way cat |
| Safety | Haematuria with RBC casts, dysmorphic cells and proteinuria — glomerular disease |
| 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.