MBBS OSCE · General Medicine
OSCE — Gonorrhoea & Chlamydia (Urogenital STIs)
Eight-minute OSCE station on Gonorrhoea & Chlamydia (Urogenital STIs): 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 Gonorrhoea & Chlamydia (Urogenital STIs).[1][3] You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.[1]
Clinical context
Gonorrhoea (Neisseria gonorrhoeae) and chlamydia (Chlamydia trachomatis serovars D-K) are the commonest bacterial sexually transmitted infections, causing urethritis, cervicitis, proctitis and pharyngitis, and — in women — ascending infection causing pelvic inflammatory disease (PID), ectopic pregnancy and tubal-factor infertility, plus neonatal conjunctivitis/pneumonia. Most infections are asymptomatic, so the clinical skill is screening high-risk, asymptomatic people and treating empirically + tracing partners. Disseminated gonococcal infection produces migratory polyarthralgia, tenosynovitis and a pustular rash. Diagnosis is NAAT on urine and genital, rectal and pharyngeal swabs. Gono[1][3]
Candidate tasks
- Clarify onset, severity, associated features, and red-flag symptoms.[1]
- State focused examination priorities.
- List first-line investigations and any named score/criteria.[1]
- Give immediate resuscitation steps.
- Outline definitive management with doses/routes where standard.[1]
- Name complications and disposition (ward / HDU / theatre / discharge safety-net).[1]
- Mention one special-population modifier (pregnancy, child, elderly, CKD).[1]
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 | Urethral or vaginal discharge with dysuria in a sexually active adult - gonorrho |
| Safety | Pelvic pain, cervical motion tenderness, fever and discharge in a woman - pelvic |
| Safety | Young adult with migratory polyarthralgia, tenosynovitis and pustular rash - dis |
| 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.[1]
References3ShowHide
- [1]Workowski KA, Bachmann LH, Chan PA, et al. Sexually Transmitted Infections Treatment Guidelines, 2021 MMWR Recomm Rep, 2021.PMID 34292926
- [2]Luckey A, Balasegaram M, Barbee LA, et al. Zoliflodacin versus ceftriaxone plus azithromycin for treatment of uncomplicated urogenital gonorrhoea: an international, randomised, controlled, open-label, phase 3, non-inferiority clinical trial Lancet, 2026.PMID 41391465
- [3]Peuchant O, Lhomme E, Martinet P, et al. Doxycycline versus azithromycin for the treatment of anorectal Chlamydia trachomatis infection in women concurrent with vaginal infection (CHLAZIDOXY study): a multicentre, open-label, randomised, controlled, superiority trial Lancet Infect Dis, 2022.PMID 35550262