MBBS OSCE · Paediatrics
OSCE — Kawasaki Disease
Eight-minute OSCE station on Kawasaki Disease: 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 Kawasaki Disease.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Kawasaki disease is an acute, self-limited, medium-vessel vasculitis of childhood of unknown cause that preferentially involves the coronary arteries. It is the leading cause of acquired heart disease in children in developed nations. Diagnosis is clinical: fever for at least five days PLUS four of five principal features (bilateral non-purulent conjunctivitis, oral changes, polymorphous rash, extremity changes, cervical lymphadenopathy); an incomplete form (two to three features) is common in young infants and carries a higher coronary aneurysm risk. Cornerstone treatment is intravenous immunoglobulin 2 g/kg as a single infusion over 10 to 12 hours PLUS aspirin (high-dose anti-inflammatory
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 | Fever for at least five days unresponsive to antibiotics with any mucocutaneous |
| Safety | Coronary artery aneurysm in about 25 per cent untreated, reduced to 3 to 5 per c |
| Safety | Infants under six months often present with incomplete Kawasaki disease but have |
| 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.