MBBS OSCE · Infectious Diseases
OSCE — Malaria
Eight-minute OSCE station on Malaria: 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 Malaria.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Malaria is a mosquito-borne protozoan illness caused by the apicomplexan parasite Plasmodium and transmitted by the bite of an infected female Anopheles mosquito. Five species infect humans — P. falciparum (most lethal), P. vivax (commonest relapsing form), P. ovale, P. malariae and the zoonotic P. knowlesi. Classical presentation is a fever paroxysm (cold, hot and sweating stages) with chills, rigors, headache and splenomegaly, but in many endemic areas the periodicity is irregular and the illness is indistinguishable from other febrile syndromes. P. falciparum causes severe malaria — cerebral malaria, severe malarial anaemia, ARDS, acute kidney injury, hypoglycaemia and acido
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 in a returned traveller from an endemic area (tropics/subtropics, includin |
| Safety | Any degree of impaired consciousness, prostration, multiple seizures, deep breat |
| Safety | Parasitaemia over 2 per cent in a non-immune adult, or over 4 per cent in pregna |
| 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.