MBBS OSCE · General Medicine
OSCE — Transient Ischaemic Attack (TIA)
Eight-minute OSCE station on Transient Ischaemic Attack (TIA): 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 Transient Ischaemic Attack (TIA).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Transient ischaemic attack (TIA) is a transient episode of neurological dysfunction caused by focal brain, spinal cord or retinal ischaemia without acute infarction (tissue-based definition). It is a medical emergency, not a benign event — the risk of completed stroke is 5 to 10 percent within 48 hours and 10 to 20 percent within 90 days without treatment. The ABCD2 score (Age, Blood pressure, Clinical features, Duration, Diabetes) stratifies early stroke risk and drives triage urgency. Presentation is a sudden focal neurological deficit that resolves within 24 hours (usually under 1 hour) — unilateral weakness, aphasia, or monocular visual loss (amaurosis fugax). Urgent workup includes CT t
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 | Transient focal neurological deficit (weakness, speech disturbance, visual loss) |
| Safety | ABCD2 score of 4 or more — high early stroke risk; urgent imaging and secondary |
| Safety | Recurrent TIAs on antiplatelet therapy — treatment failure; escalate (dual antip |
| 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.