MBBS OSCE · Psychiatry
OSCE — Post-Traumatic Stress Disorder (PTSD)
Eight-minute OSCE station on Post-Traumatic Stress Disorder (PTSD): 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 Post-Traumatic Stress Disorder (PTSD).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Post-traumatic stress disorder (PTSD) is a trauma- and stressor-related disorder that develops after exposure to actual or threatened death, serious injury, or sexual violence (directly experienced, witnessed, learned about when a violent/accidental event occurred to a close other, or through repeated extreme exposure to aversive details such as in first responders). Symptoms last more than 1 month and cluster in four domains: (1) intrusion (flashbacks, nightmares, intrusive memories, distress at reminders); (2) avoidance (of internal and external reminders); (3) negative alterations in cognition and mood (negative beliefs, blame, detachment, inability to recall key aspects); and (4) alterat
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 | Intrusion + avoidance + negative cognition/mood + hyperarousal more than 1 month |
| Safety | Acute stress disorder (3 days to 1 month after trauma) - many resolve; offer tra |
| Safety | PTSD with active suicidal ideation - 2-fold elevated lifetime suicide risk; asse |
| 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.