Course Content
🩺 OSCE Station 1 — Prescription Writing in Graves’ Disease
KMU clinical activity: Graves’ disease — formulation of an appropriate prescription. Learning Objectives The student should be able to: Formulate a prescription for a patient with Graves’ disease.
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Topic: 🩺 OSCE Station 1 — Prescription Writing in Graves’ Disease
🩸 OSCE Station 2 — Diabetes Mellitus: Glucose Testing and Prescription Writing
KMU clinical activities: Diabetes mellitus prescription + glucose estimation in urine and blood. Learning Objectives The student should be able to: Check glucose in urine. Check blood glucose in a given sample. Formulate an appropriate prescription for a patient with Type 1 diabetes mellitus. Formulate an appropriate prescription for a patient with Type 2 diabetes mellitus.
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Topic: 🩸 OSCE Station 2 — Diabetes Mellitus: Glucose Testing and Prescription Writing
🔬 OSCE Station 3 — Microscopic Identification of Multinodular Goitre
KMU clinical activity: Goitre — microscopic identification. Learning Objectives The student should be able to: Identify the important microscopic features of multinodular goitre. Recognize multinodular goitre when presented as a histopathology slide or image at the station.
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Topic: 🔬 OSCE Station 3 — Microscopic Identification of Multinodular Goitre
🔬 OSCE Station 4 — Gynecological Pathology: Pap Smear and Uterine Fibroid
KMU clinical activities: Pap smear interpretation + microscopic identification of uterine fibroids. Learning Objectives The student should be able to: Interpret a Pap smear slide. Identify the important microscopic features of uterine fibroids. Differentiate the two when presented as cytology/histopathology specimens or images at the station.
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Topic: 🔬 OSCE Station 4 — Gynecological Pathology: Pap Smear and Uterine Fibroid
🎗️ OSCE Station 5 — Microscopic Identification of Carcinoma of the Breast
KMU clinical activity: Carcinoma breast — microscopic identification. Learning Objectives The student should be able to: Identify the important microscopic features of carcinoma of the breast. Recognize carcinoma of the breast when presented as a histopathology slide or image at the station.
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Topic: 🎗️ OSCE Station 5 — Microscopic Identification of Carcinoma of the Breast
⚖️ OSCE Station 6 — Forensic Examination in Sexual Offences: Examination, Sampling and Preservation of Evidence
KMU clinical activities: Examination of a rape victim and assailant + examination of a sodomy victim and assailant. Learning Objectives The student should be able to: Take appropriate consent from a rape victim. Demonstrate or describe the examination of a rape victim/manikin. Describe the procedure for taking samples from the victim/manikin/item. Describe the correct sealing and preservation of specimens. Describe the procedure for examining a victim of sodomy. Describe the procedure for taking appropriate samples in such a case. Describe the correct sealing and preservation of specimens obtained during the examination.
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Topic: ⚖️ OSCE Station 6 — Forensic Examination in Sexual Offences: Examination, Sampling and Preservation of Evidence
💊 OSCE Station 7 — Contraceptive Identification and Counselling
KMU clinical activity: Contraception. Learning Objectives The student should be able to: Identify a given contraceptive device or drug. Explain its merits and demerits. Discuss the appropriate method of administration/use of the given contraceptive device or drug.
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Topic: 💊 OSCE Station 7 — Contraceptive Identification and Counselling
🤰 OSCE Station 8 — Antenatal Care: Maternal Health Chart and WHO Visit Schedule
KMU clinical activity: Mother and child health. Learning Objectives The student should be able to: Identify the relevant mother-and-child-health chart presented at the station. Devise an appropriate schedule for antenatal visits according to WHO criteria.
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Topic: 🤰 OSCE Station 8 — Antenatal Care: Maternal Health Chart and WHO Visit Schedule
💉 OSCE Station 9 — EPI Schedule, Vaccine Identification and Immunization Counselling
KMU clinical activities: EPI schedule + vaccination and immunization. Learning Objectives The student should be able to: Counsel a mother regarding the EPI schedule. Identify a given vaccine. Explain the uses of the vaccine. Discuss its schedule of administration. Interpret the VVM (vaccine vial monitor). Discuss the use of VVM in epidemics.
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Topic: 💉 OSCE Station 9 — EPI Schedule, Vaccine Identification and Immunization Counselling
👶 OSCE Station 10 — Child Growth Assessment: Anthropometry, Shakir’s Tape and Growth Chart
KMU clinical activities: IMCI anthropometric measures/Shakir’s tape + growth chart. Learning Objectives The student should be able to: Identify the relevant anthropometric model/instrument. Measure the mid-upper arm circumference using Shakir’s tape. Calculate or determine the weight and height of the child as required by the station. Interpret the anthropometric results. Identify a growth chart. Plot data on the growth chart using a given clinical scenario. Interpret the different parts and findings of the growth chart.
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Topic: 👶 OSCE Station 10 — Child Growth Assessment: Anthropometry, Shakir’s Tape and Growth Chart
📊 OSCE Station 11 — Interpretation of Demographic Indicators
KMU clinical activity: Demographic indicators. Learning Objectives The student should be able to interpret a given demographic indicator, including: Population pyramid Human Development Index (HDI) Physical Quality of Life Index (PQLI) Population growth rate Dependency ratio
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Topic: 📊 OSCE Station 11 — Interpretation of Demographic Indicators
AIM OSPE/OSCE Lab — Endocrine & Reproduction-II Module | 4th Year MBBS
AIM OSCE / OSPE • MBBS

Station 5 — Microscopic Identification of Carcinoma of the Breast

4th Year • GIT / Hepatobiliary • Rapid Revision • Practical Skills • Viva

🎯 Candidate Task

Examine the provided breast histopathology slide or image. Identify the lesion and state the important microscopic features supporting your diagnosis.

⚡ Model Station Answer

Identification: This histopathology slide shows carcinoma of the breast.

Key findings: Malignant epithelial cells are arranged in irregular nests, cords and poorly formed glandular or tubular structures infiltrating the surrounding breast stroma.

The tumour cells show nuclear pleomorphism, hyperchromasia and increased mitotic activity.

A surrounding desmoplastic fibrous stromal reaction may be prominent.

Exam shortcut: Atypical malignant epithelial cells infiltrating breast stroma + pleomorphic hyperchromatic nuclei + desmoplasia strongly support breast carcinoma.

🔎 How to Perform / Approach

  1. Step 1 — Identify the tissue: Recognize breast tissue by ducts, lobules and surrounding fibrofatty stroma where preserved.
  2. Step 2 — Assess architecture: Look for loss of normal breast architecture and irregular infiltration by abnormal epithelial cells.
  3. Step 3 — Examine cell arrangement: Look for malignant cells forming irregular nests, cords, sheets or poorly formed tubules.
  4. Step 4 — Assess cytology: Identify nuclear enlargement, pleomorphism, hyperchromasia and mitotic figures.
  5. Step 5 — Examine the stroma: Look for a desmoplastic fibrous reaction surrounding infiltrating tumour cells.
  6. Step 6 — State the diagnosis: Combine invasive malignant epithelial architecture and cytological atypia to identify carcinoma of the breast.

🖼️ Visual Learning

VISUAL 1

Histopathology of Breast Carcinoma

 

📝 Important Viva Questions

1. What is the key microscopic evidence of invasion in breast carcinoma?

Answer: Malignant epithelial cells infiltrate beyond normal ductal or lobular boundaries into the surrounding breast stroma.

2. What cytological features suggest malignancy?

Answer: Nuclear pleomorphism, hyperchromasia, an increased nuclear-to-cytoplasmic ratio and increased mitotic activity are important malignant features.

3. What is meant by a desmoplastic reaction?

Answer: It is a dense fibrous stromal response produced around infiltrating malignant tumour cells.

4. How may malignant epithelial cells be arranged microscopically?

Answer: They may form irregular nests, cords, sheets or poorly formed glandular and tubular structures.

5. What feature distinguishes invasive carcinoma from carcinoma in situ?

Answer: In invasive carcinoma, malignant cells breach their normal ductal or lobular boundaries and infiltrate the surrounding stroma; in situ disease remains confined within them.

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