Surgery & perioperative · History + examination

Severe pain from a small lower-leg wound - Emergency Department

HardYear 5 · Curtin style · 10 min + 2 min reading · 5 tasks

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

Station - Instructions for candidate

You are an intern in the Emergency Department of a regional Western Australian hospital.

Carmela Bianchi is a 74-year-old retired library assistant in the Emergency Department with severe pain in her left lower leg after grazing it on a garden step 36 hours ago. She is distressed despite repeated analgesia.

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. State your most likely diagnosis and differential diagnoses to the examiner.
  5. Outline your initial management plan to the examiner.
  • You do NOT need to summarise your findings to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.
  • You do not need to write prescriptions or perform a procedure.

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?”

Examination

Say what you would examine and how; the examiner reports what you would find.