MBBS OSCE · Paediatrics
OSCE — Urinary Tract Infection in Children
Eight-minute OSCE station on Urinary Tract Infection in Children: focused history, examination priorities, investigations, emergency and definitive management.
On this page
Study tools
Exam tags
Brief (to candidate)
You will assess a patient with a presentation consistent with Urinary Tract Infection in Children.
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Urinary tract infection (UTI) in children is common (8 percent of girls, 2 percent of boys by age 7), and in young infants the presentation is often non-specific (fever without source, poor feeding, vomiting, irritability, jaundice) — so a urine sample must be obtained in any unwell or febrile child under 3 months (and considered under 3 years). Causes: E. coli (75 to 85 percent), Klebsiella, Proteus, Enterococcus, Pseudomonas. Risk factors: female sex, uncircumcised boys, constipation, voiding dysfunction, vesicoureteric reflux (VUR), posterior urethral valves (boys), neurogenic bladder. Diagnosis rests on urine culture (SPA gold standard in infants; catheter 10^4 to 10^5; clean-catch over
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 | Febrile infant under 3 months without obvious source - urine sample (SPA/cathete |
| Safety | Ill-appearing child with flank pain, high fever, vomiting - pyelonephritis; IV a |
| Safety | Recurrent UTI (over 2 upper or over 3 lower) or atypical (over 7 days fever, non |
| 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.