MBBS OSCE · Obstetrics & Gynaecology
OSCE — Ovarian Cancer
Eight-minute OSCE station on Ovarian Cancer: 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 Ovarian Cancer.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Ovarian cancer is the leading cause of gynaecological cancer death in the UK and the sixth most common cancer in women (lifetime risk about 2 per cent, 1 in 50). The dominant subtype, high-grade serous carcinoma, arises from the fimbrial end of the fallopian tube (serous tubal intraepithelial carcinoma, STIC), not the ovarian surface — a paradigm shift that drives risk-reducing salpingo-oophorectomy in BRCA1/2 carriers. The classical presentation is late and non-specific — bloating, distension, early satiety — so most women are Stage III/IV at diagnosis. CA-125 plus transvaginal ultrasound triage via IOTA simple rules and the Risk of Malignancy Index (RMI), with RMI over 250 mandating specia
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 | Persistent bloating, early satiety or distension in a postmenopausal woman is ov |
| Safety | Ascites plus a pelvic mass in any woman = advanced ovarian cancer until proven o |
| Safety | BRCA1/2 carrier — risk-reducing salpingo-oophorectomy after family completion (3 |
| 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.