Surgery & perioperative · History + examination

Severe constant upper abdominal pain - 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 a final-year medical student on placement in the Emergency Department at Bunbury Regional Hospital.

Rosanna Petrucci is a 54-year-old woman in the Emergency Department with 36 hours of severe constant pain in the upper abdomen, mainly in the epigastrium and right upper quadrant, with repeated vomiting. The triage nurse has handed over that she appears uncomfortable.

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. State your most likely diagnosis and differential diagnoses to the examiner.
  5. Outline your initial management plan.
  • You do NOT need to summarise your findings to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.
  • You do not need to prescribe, write medication orders or perform an internal examination.

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.