OSCE — Intestinal & Tissue Helminth Infections (STH, Tapeworms, Schistosomiasis, Strongyloides, Filariasis) · MBBS OSCE

Brief (to candidate)

You will assess a patient with a presentation consistent with Intestinal & Tissue Helminth Infections (STH, Tapeworms, Schistosomiasis, Strongyloides, Filariasis).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.^[1]

Clinical context

Helminth infections are parasitic worm infestations caused by nematodes (roundworms), cestodes (tapeworms), and trematodes (flukes). STH infect over 1.5 billion people globally and are associated with anaemia and stunting. The soil-transmitted helminths (STH) - Ascaris lumbricoides, hookworm (Necator americanus / Ancylostoma duodenale), and Trichuris trichiura - are acquired by egg ingestion or larval skin penetration from contaminated soil; tapeworms (Taenia solium/saginata) by undercooked meat; schistosomes by freshwater cercariae; filarial worms by insect vectors.^[27]^[1]

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).^[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	Eosinophilia with or without iron-deficiency anaemia in an endemic or returned-t
Safety	Acute small-bowel obstruction or biliary colic with a worm passed per mouth or r
Safety	New-onset seizures in a patient from a pork-endemic region - neurocysticercosis;
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]

References2Show

[1]Jourdan PM, Lamberton PHL, Fenwick A, et al. Soil-transmitted helminth infections Lancet, 2018.PMID 28882382
[27]Sheahan W, Anderson R, Aruldas K, et al. Overestimation of school-based deworming coverage resulting from school-based reporting PLoS Negl Trop Dis, 2023.PMID 37036890

Clinical context

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).^[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	Eosinophilia with or without iron-deficiency anaemia in an endemic or returned-t
Safety	Acute small-bowel obstruction or biliary colic with a worm passed per mouth or r
Safety	New-onset seizures in a patient from a pork-endemic region - neurocysticercosis;
Communication	Clear plan and safety-netting

Model outline

References2Show

[1]Jourdan PM, Lamberton PHL, Fenwick A, et al. Soil-transmitted helminth infections Lancet, 2018.PMID 28882382
[27]Sheahan W, Anderson R, Aruldas K, et al. Overestimation of school-based deworming coverage resulting from school-based reporting PLoS Negl Trop Dis, 2023.PMID 37036890