Station - Instructions for candidate
You are a medical student on placement in a general practice in Midland.
Frank Costa, a 63-year-old retired mechanic, has come back to discuss the results of his exercise test, which has confirmed angina. The GP saw him briefly last week, started his tablets and prescribed a glyceryl trinitrate spray, and has asked you to explain the diagnosis, show him how to use the spray and go through the plan. The report and his medicines are on your sheet.
Exercise stress test (extract)
Stopped at 7 METs for typical chest tightness; 1 mm horizontal ST depression V4-V6 resolving within 3 minutes of recovery; no arrhythmia. Conclusion: positive test, intermediate risk. Cardiology referral sent.
Medicines started last week
Metoprolol 25 mg twice daily, aspirin 100 mg daily, atorvastatin 40 mg at night, glyceryl trinitrate 400 microgram spray as needed.
Your tasks are to:
- Take a focused history.
- Explain the diagnosis to Mr Costa.
- Counsel him on the glyceryl trinitrate spray and his other medicines.
- Discuss the plan with him.
- You do NOT need to examine the patient.
- You do NOT need to summarise your findings to the examiner.
- A demonstration spray is on the table.
This is a 10-minute station, with 2 minutes of reading time.