Peptic disease and Helicobacter pylori — OSCE

Station brief (candidate)

• Explain in plain language what H. pylori is and how it caused the ulcer.
• Outline the eradication plan, its 14-day duration, and why adherence matters.
• Explain how and when eradication will be confirmed.
• Address the family's questions about antibiotics, side effects, and recurrence.
• Avoid promising a breath test as the diagnosis or a short antibiotic course. [1] [5]

Role-player notes

You are the parent of a 10-year-old whose stomach camera test showed an ulcer caused by a germ called Helicobacter pylori. You are relieved there is an answer but anxious about giving your child two antibiotics for two weeks. You worry about side effects, whether the ulcer will come back, and whether other family members need testing. You cooperate when the doctor explains clearly and takes your concerns seriously. [1]

Expected candidate performance

1. Explain the diagnosis: "The camera test showed an ulcer in the first part of the bowel, caused by a common bacterium called Helicobacter pylori that lives in the stomach lining. Clearing it usually cures the ulcer and stops it coming back." [1] [2]
2. Explain the treatment: A 14-day course of acid-suppressing medicine plus two antibiotics, chosen to match the bacterium's susceptibility results, taken exactly as prescribed. Finishing the whole course matters because a partial course lets the bacterium survive and become resistant. [5]
3. Explain confirmation of cure: A breath or stool test at least four weeks after the antibiotics finish, with the acid medicine stopped for two weeks beforehand, to be sure the infection has gone. [1] [8]
4. Address side effects and acid medicine: Acknowledge that antibiotics can cause tummy upset or loose stools, and that acid-suppressing medicine is used purposefully and for a limited time. [9]
5. Address recurrence and family: Reassure that recurrence is uncommon after confirmed cure, and discuss that testing well family members is not routine but household transmission explains how it spreads. [1]
6. Communication: Use teach-back, check understanding, and offer written information and an interpreter if needed. [1]

Marking domains

• Clear, jargon-free explanation of H. pylori and the ulcer.
• Accurate eradication plan with 14-day duration and adherence emphasis.
• Correct timing and method of confirming cure.
• Honest handling of side effects and purposeful acid suppression.
• Respectful, concern-validating communication. [5] [8] [9]

Common fails

• Saying a breath test made the diagnosis or offering a 7-day course.
• Forgetting to stress adherence and the resistance risk of incomplete treatment.
• Confirming cure too early or while still on acid suppression.
• Dismissing the parent's worry about antibiotics.
• No plan to confirm eradication at all. [1] [5]