Medicine · History

Three months of tiredness with abnormal bloods - GP

MediumYear 5 · Curtin style · 10 min + 2 min reading · 4 tasks

2 min reading · 10 min station · reminders at 2 min

Station - Instructions for candidate

You are a final-year medical student on placement in a general practice in Perth. Your supervising GP has asked you to see this patient first and to bring him a plan.

Graham Whitfield, 66, saw the practice nurse last week for tiredness and had blood tests taken. He has come back for the results, which are on the sheet below. He has not yet been told what they show.

Blood results (last week)
Haemoglobin 98 g/L (130-180), MCV 71 fL (80-100), MCH 22 pg (27-32), RDW 18% (11-15), WCC 7.2, platelets 410 (150-400). Ferritin 9 micrograms/L (30-300), transferrin saturation 8% (20-50), CRP 3 mg/L (under 5).

Your tasks are to:

  1. Take a focused history.
  2. Request any relevant investigations and interpret the results provided.
  3. Explain your provisional diagnosis to Mr Whitfield.
  4. Outline your initial management plan to Mr Whitfield.
  • You do NOT need to examine the patient; the nurse found no abnormal findings apart from pallor.

This is a 10-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?”

After treatment

Once you have acted, ask how the patient has responded.