OSCE — Peripheral Neuropathy · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Peripheral Neuropathy.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.

Clinical context

Peripheral neuropathy is any disorder of the peripheral nerves; clinically the term usually denotes polyneuropathy — a diffuse, usually symmetric process. The commonest pattern worldwide is a distal symmetric (length-dependent), sensorimotor, axonal polyneuropathy producing numbness, tingling and burning pain in a glove-and-stocking distribution, with loss of ankle reflexes. The commonest cause is diabetes mellitus (diabetic peripheral neuropathy, DPN); other leading causes are alcohol, vitamin B12 deficiency, drugs (chemotherapy, vincristine, isoniazid, metronidazole, amiodarone, phenytoin), uraemia, hereditary (Charcot-Marie-Tooth), vasculitic and CIDP. Diagnosis combines the clinical patt

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	Acute or rapidly progressive weakness with neuropathy — GBS or vasculitic; urgen
Safety	Asymmetric, painful, stepwise neuropathy — mononeuritis multiplex (vasculitis);
Safety	Progressive numbness in a glove-and-stocking distribution — screen for diabetes;
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.