Medicine · History + examination

Nausea and confusion with abnormal bloods on the ward - Hospital 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 general medical ward of a metropolitan hospital in Perth. It is 8 pm and you are covering the ward.

Kosta Papadopoulos, 68, was admitted three days ago with a right lower lobe pneumonia and has been improving on antibiotics. The nurse has called you because this evening he vomited once, has a headache, and is drowsy and confused. His wife Eleni is at the bedside.

Your tasks are to:

  1. Take a collateral history from his wife.
  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.