Medicine · History + examination

Breathless with fluid in the chest - Respiratory ward

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 on the respiratory ward of a Perth teaching hospital.

Frank Bellamy, a 68-year-old retired boilermaker, was admitted yesterday with breathlessness. A diagnostic aspiration of fluid from the right side of his chest was done this morning and the results are back. The registrar has asked you to see him, work out what is going on, and then discuss it.

Your tasks are to:

  1. Take a focused history from Mr Bellamy.
  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 write prescriptions or medication orders.

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.