MBBS OSCE · General Medicine
OSCE — Lead Poisoning (Plumbism)
Eight-minute OSCE station on Lead Poisoning (Plumbism): focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Lead Poisoning (Plumbism).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Lead poisoning (plumbism/saturnism) is toxic accumulation of lead (Pb), a heavy metal with NO biological role and NO safe blood level, causing multisystem harm — neurotoxic (especially irreversible IQ loss in children), microcytic sideroblastic anaemia with basophilic stippling, lead colic, motor peripheral neuropathy (wrist drop), nephropathy, saturnine gout, hypertension, and reproductive damage. Sources: lead-based paint (pre-1970s housing, children ingest flakes/dust), contaminated water (lead pipes/solder), industrial exposure (smelting, battery recycling, ammunition, soldering, foundry, demolition), traditional cosmetics (surma/kohl, sindoor), Ayurvedic/herbal medicines, ceramic glazes
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 | Child with developmental regression, behavioural change, seizures or encephalopa |
| Safety | Cramping abdominal pain (lead colic) + constipation + microcytic anaemia with ba |
| Safety | Adult with wrist drop/foot drop (motor peripheral neuropathy, sensory spared) + |
| 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.