MBBS OSCE · General Medicine
OSCE — Viral Hepatitis (Hepatitis A, B, C, D, E)
Eight-minute OSCE station on Viral Hepatitis (Hepatitis A, B, C, D, E): 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 Viral Hepatitis (Hepatitis A, B, C, D, E).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.
Clinical context
Viral hepatitis is inflammation of the liver caused by the five hepatotropic viruses — A (RNA, faecal-oral, never chronic), B (DNA, parenteral/vertical/sexual, chronic in 90 percent neonates), C (RNA, blood-borne, chronic in 75 percent, curable with DAAs), D (defective RNA requiring HBsAg), E (RNA, faecal-oral, fulminant in pregnancy). Acute infection presents with prodrome (anorexia, nausea, fatigue, arthralgia) then jaundice, dark urine, tender hepatomegaly; chronic infection is often asymptomatic until cirrhosis or HCC. Diagnosis by serology: HBsAg/anti-HBc (HBV), anti-HCV/HCV RNA (HCV), IgM anti-HAV/anti-HEV. Management: supportive for HAV/HEV; long-term nucleos(t)ide analogues (tenofovi
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 | Acute viral hepatitis with INR over 1.5 and encephalopathy — acute liver failure |
| Safety | HBsAg-positive patient starting rituximab, chemotherapy or high-dose steroids — |
| Safety | Pregnant woman with acute hepatitis and high ALT — test HEV; 20-25 percent mater |
| 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.