MBBS OSCE · Paediatrics
OSCE — Henoch-Schonlein Purpura (IgA Vasculitis)
Eight-minute OSCE station on Henoch-Schonlein Purpura (IgA Vasculitis): 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 Henoch-Schonlein Purpura (IgA Vasculitis).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Henoch-Schonlein purpura (HSP), now officially renamed IgA vasculitis (IgAV) by the Chapel Hill Consensus Conference, is an immune-complex-mediated small-vessel (leukocytoclastic) vasculitis characterised by dominant IgA1 immune-complex deposition in the skin, gastrointestinal tract, joints and glomeruli. It is the most common vasculitis of childhood. Classically presents after a recent upper respiratory infection with the tetrad of palpable purpura (lower limbs/buttocks, mandatory), arthritis/arthralgia (knees, ankles), colicky abdominal pain, and renal involvement (haematuria/proteinuria). Platelets are NORMAL (key distinction from ITP). Diagnosis is clinical using EULAR/PRINTO/PRES 2010 o
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 | Palpable non-blanching purpura on lower limbs/buttocks + arthritis/abdominal pai |
| Safety | Rapidly progressive purpura with shock and fever = MENINGOCOCCAEMIA, not HSP; tr |
| Safety | Severe colicky abdominal pain with red-currant-jelly stool and a palpable mass i |
| 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.