MBBS OSCE · General Medicine

OSCE — Multiple Endocrine Neoplasia (MEN) Syndromes

Eight-minute OSCE station on Multiple Endocrine Neoplasia (MEN) Syndromes: focused history, examination priorities, investigations, emergency and definitive management.

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NEET-PGINICETUSMLEPLAB

Brief (to candidate)

You will assess a patient with a presentation consistent with Multiple Endocrine Neoplasia (MEN) Syndromes.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Multiple endocrine neoplasia (MEN) syndromes are autosomal dominant disorders in which a single germline mutation predisposes to tumours of two or more endocrine glands throughout life. MEN 1 (Wermer syndrome) is caused by the MEN1 gene (menin) tumour suppressor on chromosome 11q13 and follows the 3 P's rule: Primary hyperparathyroidism (commonest, multi-gland hyperplasia), Pituitary adenoma (prolactinoma commonest) and Pancreatic neuroendocrine tumour (gastrinoma with Zollinger-Ellison commonest; insulinoma second). MEN 2A (Sipple syndrome) and MEN 2B are caused by the RET proto-oncogene on chromosome 10q11.2: MEN 2A features medullary thyroid carcinoma (near 100 percent), phaeochromocytoma

Candidate tasks

  1. Clarify onset, severity, associated features, and red-flag symptoms.
  2. State focused examination priorities.
  3. List first-line investigations and any named score/criteria.
  4. Give immediate resuscitation steps.
  5. Outline definitive management with doses/routes where standard.
  6. Name complications and disposition (ward / HDU / theatre / discharge safety-net).
  7. Mention one special-population modifier (pregnancy, child, elderly, CKD).

Examiner checklist

DomainPass behaviours
DefinitionCorrect working diagnosis language
AssessmentFocused, prioritised, red flags sought
InvestigationsAppropriate first-line + interpretation
Emergency careABC / time-critical actions first
Definitive careSpecific drugs/procedures, not generic phrases
SafetyMedullary thyroid cancer at any age - screen ALL MTC for RET (about 25 percent i
SafetyPhaeochromocytoma and thyroid cancer in the same patient or family - MEN 2A; gen
SafetyMarfanoid habitus with mucosal neuromas, chronic constipation and a neck mass -
CommunicationClear 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.

OSCE — Multiple Endocrine Neoplasia (MEN) Syndromes · MBBS OSCE · NeetVellum