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 4 — Gynecological Pathology: Pap Smear and Uterine Fibroid

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

🎯 Candidate Task

Examine the provided cytology and histopathology slides or images. Interpret the Pap smear specimen, identify the second specimen and describe the important microscopic features supporting your identification.

⚡ Model Station Answer

  • Pap smear: This is a cervical cytology specimen. I would assess specimen adequacy and examine the squamous cells for nuclear and cytoplasmic abnormalities before giving the cytological interpretation.
  • Second specimen: This is a uterine leiomyoma (fibroid).
  • Microscopy: It shows intersecting or whorled fascicles of uniform spindle-shaped smooth-muscle cells with elongated blunt-ended nuclei and eosinophilic cytoplasm.
  • Key distinction: A Pap smear is a cytological preparation of exfoliated cervical cells, whereas a uterine fibroid is identified on tissue histology by organized smooth-muscle fascicles.

🔎 How to Perform / Approach

  1. Step 1 — Identify the preparation.
    Decide whether the specimen is a cytology smear containing individual exfoliated cells or a histological tissue section showing tissue architecture.
  2. Step 2 — Review the Pap smear systematically.
    Assess cellularity and adequacy, then examine squamous cells for changes in cell size, nuclear size, chromatin, nuclear-to-cytoplasmic ratio and cellular arrangement.
  3. Step 3 — Interpret the cervical cytology.
    State whether the smear shows no obvious epithelial abnormality or whether abnormal squamous-cell features are present, according to the provided specimen.
  4. Step 4 — Examine the tissue section.
    Look for bundles of spindle-shaped smooth-muscle cells arranged in intersecting fascicles.
  5. Step 5 — Identify the cellular features.
    Note uniform elongated cells with eosinophilic cytoplasm and blunt-ended, cigar-shaped nuclei with minimal atypia in a typical fibroid.
  6. Step 6 — State the diagnosis.
    Identify the smooth-muscle lesion as uterine leiomyoma and mention the characteristic fascicular or whorled microscopic pattern.
  7. Step 7 — Differentiate the specimens.
    Pap smear = exfoliative cervical cytology; uterine fibroid = histological smooth-muscle tissue with preserved architecture.
Exam point: First identify whether you are looking at cytology or histology. This immediately directs the rest of your description.

🖼️ Visual Learning

VISUAL 1

Pap Smear Cytology and Uterine Leiomyoma Microscopy

 

📝 Important Viva Question

1. What type of specimen is examined in a Pap smear?

Answer: It is an exfoliative cytology specimen containing cells collected from the cervix, particularly the transformation-zone region.

2. Which cytological features suggest an abnormal squamous cell?

Answer: Important features include nuclear enlargement, hyperchromasia, irregular nuclear contours and an increased nuclear-to-cytoplasmic ratio.

3. What is the characteristic microscopic arrangement of a uterine leiomyoma?

Answer: It consists of intersecting or whorled fascicles of uniform smooth-muscle cells.

4. What do the nuclei of typical leiomyoma cells look like?

Answer: They are elongated, uniform and blunt-ended or cigar-shaped, usually without significant atypia.

5. How can you rapidly distinguish a Pap smear from a leiomyoma slide?

Answer: A Pap smear shows dispersed exfoliated epithelial cells without tissue architecture, whereas leiomyoma histology shows organized bundles of spindle-shaped smooth-muscle cells.

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