Surgery & perioperative · History + examination

Massive abdominal distension and vomiting - Emergency Department

MediumYear 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 an intern in the Emergency Department of a Perth metropolitan hospital.

Dimitri Georgiou is a 78-year-old man from a Perth residential aged care facility who has been brought to the Emergency Department with three days of marked abdominal distension and vomiting that began today. The ambulance handover reports that he has passed no flatus for two days.

Your tasks are to:

  1. Take a focused history.
  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 perform a procedure or prescribe on a medication chart.
  • A nurse from his aged care facility is with him and can answer questions about his medicines and his usual function.

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.