MBBS OSCE · General Surgery
OSCE — Thyroid Carcinoma
Eight-minute OSCE station on Thyroid Carcinoma: 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 Thyroid Carcinoma.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Thyroid carcinoma arises from thyroid follicular cells (papillary 80%, follicular 10%) or parafollicular C cells (medullary 5%); anaplastic (1 to 2%) is undifferentiated and near-uniformly fatal. Presents as a thyroid nodule (palpable or incidental on ultrasound); risk factors: radiation exposure in childhood, female sex, family history, iodine deficiency (follicular), RET germline mutation / MEN-2 (medullary). Workup: TSH, ultrasound with TI-RADS risk stratification, FNA cytology using the Bethesda system, plus serum calcitonin when medullary is suspected. Papillary: best prognosis, BRAF V600E, lymphatic spread, psammoma bodies; treated with total thyroidectomy with or without prophylactic
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 | Rapidly enlarging thyroid nodule with hoarseness (recurrent laryngeal nerve invo |
| Safety | Thyroid nodule with cervical lymphadenopathy - papillary thyroid carcinoma with |
| Safety | Family history of thyroid cancer plus RET mutation - medullary carcinoma / MEN-2 |
| 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.