MBBS OSCE · Medicine
OSCE — Scurvy (vitamin C deficiency)
Eight-minute OSCE station on Scurvy (vitamin C deficiency): 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 Scurvy (vitamin C deficiency).
You have 8 minutes to take a focused history, outline examination, investigations, and management including red flags.[1][2]
Clinical context
Scurvy is caused by deficiency of vitamin C (ascorbic acid), an essential cofactor for collagen synthesis (hydroxylation of proline and lysine residues). Clinical features: follicular hyperkeratosis, corkscrew hairs, perifollicular purpura/petechiae (capillary fragility from defective collagen), bleeding and hypertrophied gums, poor wound healing, arthralgia, and anaemia. Risk factors: tea-and-toast diet in the elderly, alcoholism, anorexia nervosa, autism with selective eating, malabsorption, dialysis, smoking, and food insecurity. Treatment: oral ascorbic acid — published adult regimens use 500 mg to 1 g daily; children 1 g/day with symptom resolution within 48 to 96 hours; roughly 7 mg daily prevents scurvy.[1][2]
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.
- 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).
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 | Perifollicular purpura + corkscrew hairs + bleeding gums in a malnourished patie |
| Safety | Paediatric limp or refusal to walk with restricted diet — consider scurvy before |
| 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]Krečak I, Babić G, Skelin M. Scurvy Acta Dermatovenerol Croat, 2022.PMID 36153722
- [2]Ramirez IA, Moreno N, Chiaramonte S, Saure C. Scurvy in children with selectivity in foods: experience in a pediatric hospital Medicina (B Aires), 2026.PMID 42604498
- [3]Schleicher RL, Carroll MD, Ford ES, Lacher DA. Serum vitamin C and the prevalence of vitamin C deficiency in the United States: 2003-2004 National Health and Nutrition Examination Survey (NHANES) Am J Clin Nutr, 2009.PMID 19675106