OSCE — Polycystic Kidney Disease · MBBS OSCE

Brief (to candidate)

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

Clinical context

Autosomal dominant polycystic kidney disease (ADPKD) is the commonest inherited kidney disease (prevalence 1 in 400 to 1 in 1000), caused in 95 percent of families by mutations in PKD1 (85 percent, chromosome 16, severe) or PKD2 (15 percent, chromosome 4, milder). It produces bilateral, progressively enlarging renal cysts arising from any nephron segment, leading to hypertension, grossly enlarged kidneys, and progression to end-stage kidney disease by the fifth or sixth decade (about 50 percent by age 60). Important extrarenal features include liver cysts (commonest, ~80 percent by age 60), intracranial berry aneurysms (~10 percent, with subarachnoid haemorrhage risk), mitral valve prolapse

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	Sudden severe or thunderclap headache in any ADPKD patient — subarachnoid haemor
Safety	Rapidly enlarging kidneys with falling eGFR in a young adult (Mayo class 1C-1E,
Safety	Fever, flank pain, and a tender kidney with positive blood cultures — infected c
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.