Course Content
OSCE Station 1 — Urine Specimen Collection, Physical Examination and Microscopy
KMU clinical activity: Urine collection methods, physical examination of urine specimen and microscopic examination of centrifuged urine Learning Objectives The student should be able to: • Demonstrate the correct procedure for urine specimen collection. • Assess the volume, colour, appearance and pH of a urine specimen. • Recognize an abnormal urine specimen showing pyuria and hematuria. • Prepare an appropriate report from the physical examination of urine. • Identify important urinary microscopic constituents including pus cells, RBCs, epithelial cells, crystals and casts. • Prepare urinary sediment for microscopic examination. • Examine a prepared urinary-sediment slide under the microscope. • Detect relevant abnormalities in the urinary sediment. • Interpret the findings of physical and microscopic urine examination.
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Topic: OSCE Station 1 — Urine Specimen Collection, Physical Examination and Microscopy
OSCE Station 2 — Chemical Examination of Urine: Protein and Reducing Substances
KMU clinical activity: Chemical examination of non-centrifuged urine specimen Learning Objectives The student should be able to: • Identify substances commonly assessed during chemical examination of urine. • Describe different procedures used for detection of protein in urine. • Explain the principle of protein detection by the heat method. • Perform the heat and acetic acid test for urinary protein. • Demonstrate or interpret the test for Bence Jones protein. • Explain the principle of testing urine for reducing substances. • Explain the principle of Benedict's test. • Perform Benedict's test correctly. • Interpret the results of urinary protein and reducing-substance testing.
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Topic: OSCE Station 2 — Chemical Examination of Urine: Protein and Reducing Substances
OSCE Station 3 — Urinary Tract Infection: Staining, Culture, Sensitivity and Prescription
KMU clinical activity: Urine staining and culture; prescriptions for acute and chronic UTI Learning Objectives The student should be able to: • Describe the staining methods used for urine specimens in acute and chronic urinary tract infection. • Explain the basic principles underlying these staining methods. • Identify common uropathogens demonstrated on a prepared slide. • Demonstrate appropriate sterile methods for collection of urine for culture and sensitivity. • Describe or demonstrate culture of a urinary pathogen. • Perform or interpret antimicrobial susceptibility testing by the disc-diffusion method. • Relate culture and sensitivity findings to appropriate antimicrobial selection. • Formulate an appropriate prescription for acute UTI. • Formulate an appropriate prescription for chronic UTI.
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Topic: OSCE Station 3 — Urinary Tract Infection: Staining, Culture, Sensitivity and Prescription
OSCE Station 4 — Waste Disposal and Incinerator Model
KMU clinical activity: Incinerator / waste-disposal models Learning Objectives The student should be able to: • Identify an incinerator or waste-disposal model. • Recognize the purpose of the demonstrated waste-disposal system. • Explain the steps of waste disposal represented by the model. • Describe the sequence of waste handling demonstrated in the model.
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Topic: OSCE Station 4 — Waste Disposal and Incinerator Model
OSCE Station 5 — Water Sources and Sand Filtration
KMU clinical activity: Water-source models and sand filters Learning Objectives The student should be able to: • Identify a model representing a source of water. • Recognize the type of water source demonstrated. • Identify a sand-filter model. • Identify the different layers of the sand filter. • Explain the role of the different layers in water purification. • Explain the mechanism of purification by sand filtration.
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Topic: OSCE Station 5 — Water Sources and Sand Filtration
OSCE Station 6 — Water Disinfection and Water-Quality Assessment
KMU clinical activity: Bleaching-powder calculation; physical assessment of water; presumptive coliform test Learning Objectives The student should be able to: • Calculate the required dose of bleaching powder for disinfection of water in a domestic tank. • Assess a water sample according to relevant physical parameters. • Assess the colour of a water sample. • Assess turbidity and suspended particles. • Assess temperature and pH. • Interpret the bacteriological quality of water using the presumptive coliform test. • Integrate physical and bacteriological findings when assessing water quality.
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Topic: OSCE Station 6 — Water Disinfection and Water-Quality Assessment
OSCE Station 7 — Ethics and Legal Aspects of Organ Transplantation
KMU clinical activity: Ethics of Organ Transplantation Learning Objectives The student should be able to: • Describe important ethical principles related to organ transplantation. • Discuss ethical considerations surrounding organ donation and transplantation. • Describe the relevant provisions of the Human Organ Transplant Act (HOTA) as required by the KMU curriculum. • Apply transplantation ethics to a relevant clinical or forensic scenario. • Identify important loopholes in the existing system of human organ transplantation as stated in the KMU learning objectives
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Topic: OSCE Station 7 — Ethics and Legal Aspects of Organ Transplantation
AIM OSPE/OSCE Lab — Renal & Urology Module | 4th Year MBBS

AIM OSCE / OSPE • MBBS

Station 2 — Chemical Examination of Urine: Protein and Reducing Substances

4th Year • Rapid Revision • Practical Skills • Viva

🎯 Candidate Task

You are provided with a non-centrifuged urine specimen, appropriate reagents and laboratory apparatus. Demonstrate chemical examination for urinary protein and reducing substances using the heat and acetic acid test and Benedict’s test, and explain how Bence Jones protein is demonstrated and interpreted.

⚡ Model Station Answer

Chemical examination: Urine may be tested for substances including protein, glucose/reducing substances, ketones, blood and bile pigments.

Protein: I would heat the upper part of the urine and add acetic acid. Persistent turbidity indicates urinary protein; clearing suggests phosphates or carbonates.

Bence Jones protein: The classical heat test shows precipitation at about 40–60°C, disappearance on further heating toward boiling, and reappearance on cooling.

Reducing substances: Benedict’s test produces a colour change and precipitate when reducing substances reduce cupric ions to cuprous oxide on heating.

🔎 How to Perform / Approach

  1. Step 1 — Prepare safely.
    Check the urine specimen, arrange clean test tubes, test-tube holder, heat source or water bath, acetic acid, Benedict’s reagent and dropper/pipette.
  2. Step 2 — Perform the heat and acetic acid test.
    Fill about two-thirds of a test tube with clear urine. Hold it with a test-tube holder and gently heat only the upper portion, keeping the lower portion unheated for comparison.
  3. Step 3 — Add acetic acid and interpret.
    If turbidity develops, add a few drops of acetic acid. Persistence or increase of turbidity supports protein; disappearance suggests precipitation of phosphates/carbonates rather than protein.
  4. Step 4 — Demonstrate the Bence Jones heat pattern.
    With appropriately acidified urine, gradually warm the specimen. Classical Bence Jones protein precipitates at approximately 40–60°C, dissolves on further heating toward boiling and reappears as the specimen cools.
  5. Step 5 — Set up Benedict’s test.
    Place about 5 mL of Benedict’s reagent in a test tube, add approximately 8 drops of urine and heat carefully according to the laboratory setup.
  6. Step 6 — Observe after heating and cooling.
    Blue indicates a negative test. Increasing reducing substance produces progressive green, yellow, orange and finally brick-red colour/precipitate.
  7. Step 7 — State and record the result.
    Report protein and reducing-substance testing separately and correlate the observed turbidity or colour change with the appropriate interpretation.
Examination note: During direct heating, keep the mouth of the test tube pointed away from yourself and others.

🖼️ Visual Learning

VISUAL 1

Chemical Examination of Urine — Protein, Bence Jones Protein and Benedict’s Test

🎥 Practical Demonstration

Heat & Acetic Acid Test for Proteinuria — MBBS Practical

A practical demonstration of specimen handling, heating technique, addition of acetic acid and interpretation of urinary protein testing.

Source: Santiniketan Medical College & Hospital

Watch Practical Demonstration

📝 Important Viva Questions

1. What is the principle of the heat and acetic acid test for urinary protein?

Answer: Protein denatures and precipitates on heating. Acetic acid helps distinguish protein turbidity from heat-precipitated phosphates or carbonates.

2. How do you interpret turbidity after adding acetic acid?

Answer: Persistent or increased turbidity supports the presence of protein, whereas disappearance of turbidity suggests phosphates or carbonates.

3. What is the characteristic classical heat behaviour of Bence Jones protein?

Answer: It precipitates at approximately 40–60°C, dissolves on further heating toward boiling and reappears on cooling. Modern laboratory confirmation uses specific protein studies such as electrophoresis/immunofixation.

4. What is the principle of Benedict’s test?

Answer: In a hot alkaline medium, reducing substances reduce blue cupric ions to cuprous oxide, producing progressive colour change and precipitate.

5. Name other methods used to detect urinary protein.

Answer: Examples include reagent-strip testing, the sulfosalicylic acid test and Heller’s nitric-acid ring test.

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