Station - Instructions for candidate
You are a medical student on placement in the Emergency Department at Royal Perth Hospital.
Enzo Rossi, a 54-year-old man, presents to the Royal Perth Hospital Emergency Department with two episodes of dark vomit and three days of black stools. He has had several months of upper abdominal discomfort.
Blood tests
| Item | Value | Reference range |
|---|---|---|
| Haemoglobin | 82 | 130-180 g/L |
| Haematocrit | 0.25 | 0.40-0.54 |
| White cell count | 6.8 | 4.0-11.0 x 10^9/L |
| Platelets | 286 | 150-400 x 10^9/L |
| Urea | 15.2 | 2.5-8.0 mmol/L |
| Creatinine | 92 | 60-110 umol/L |
| Sodium | 138 | 135-145 mmol/L |
| Potassium | 4.4 | 3.5-5.0 mmol/L |
| INR | 1.1 | 0.9-1.2 |
| ALT | 24 | 5-40 U/L |
| ALP | 28 | 30-110 U/L |
| Bilirubin | 14 | 3-20 umol/L |
| CRP | 4 | <5 mg/L |
Your tasks are to:
- Take a focused history.
- Perform a focused examination.
- Interpret the blood test results provided.
- Summarise your findings to the examiner with your most likely diagnosis and differential diagnoses.
- Outline your initial management plan to the examiner.
- You do NOT need to perform a rectal examination.
- Please verbalise your examination to the examiner; findings will be provided on request.
- You do not need to prescribe or write in the notes.
This is a 15-minute station, with 2 minutes of reading time.