Emergency · History + examination

Near-faints and a slow pulse in a woman on a beta blocker - 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 an intern in the Emergency Department of a regional hospital in Mandurah.

Margaret Doyle, a 79-year-old retired bookkeeper, has been brought to the Emergency Department by her neighbour after two episodes this week of nearly fainting at the kitchen sink. She is lying on a monitored bed and says she feels perfectly well.

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. 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.