Surgery & perioperative · History + examination

Vomiting and abdominal swelling - Emergency Department

HardYear 5 · Curtin style · 15 min + 2 min reading · 5 tasks

2 min reading · 15 min station · reminders at 2 min

Station - Instructions for candidate

You are a final-year medical student on placement in the Emergency Department at Royal Perth Hospital.

Nadia Haddad is an 83-year-old woman with moderate dementia and type 2 diabetes who has been brought to the Emergency Department by her daughter after two days of vomiting, abdominal swelling and reduced oral intake. She takes regular paracetamol and a slow-release pain medicine for knee arthritis. She had an appendicectomy many years ago.

Your tasks are to:

  1. Take a focused history from the patient and her daughter.
  2. Perform a focused examination.
  3. Request any relevant investigations and interpret the results provided.
  4. Summarise your findings to the examiner with your most likely diagnosis and differential diagnoses.
  5. Outline your initial management plan to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.
  • You do not need to prescribe, perform a procedure or complete a consent form.

This is a 15-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you would examine or request, the way you would in the station. Nothing is named until you ask for it.

Whatever the examiner recognises is revealed below. Or pick a numbered item to reveal it blind.

Investigations

Ask for a category the way you would in the station: “Can I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.

After treatment

Once you have acted, ask how the patient has responded.