MBBS OSCE · General Medicine
OSCE — Hypocalcaemia
Eight-minute OSCE station on Hypocalcaemia: 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 Hypocalcaemia.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Hypocalcaemia (corrected calcium under 2.20 mmol/L or under 8.5 mg/dL) presents with neuromuscular irritability — perioral numbness and paraesthesia, tetany, carpopedal spasm, Chvostek and Trousseau signs, and in severe cases generalised seizures, laryngeal stridor and a prolonged QT interval. Causes are split by PTH: low or inappropriately normal PTH (post-surgical hypoparathyroidism — the commonest hospital cause, autoimmune / APS-1, DiGeorge 22q11.2 deletion, infiltrative, hypomagnesaemia, activating CaSR mutations, pseudohypoparathyroidism with end-organ resistance) versus high PTH with appropriate secondary hyperparathyroidism (vitamin D deficiency, CKD-MBD, malabsorption, hungry bone s
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 | Hypocalcaemia with tetany, seizures, laryngeal stridor or a prolonged QT interva |
| Safety | Hypocalcaemia within hours to days of thyroid, parathyroid or central neck surge |
| Safety | Refractory hypocalcaemia not responding to IV calcium — check and correct magnes |
| 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.