Station - Instructions for candidate
You are a general practice registrar in a Bunbury group practice.
Bao Nguyen, a 78-year-old retired orchardist, has been brought in by his daughter because he has been wetting the bed at night and dribbling during the day for a month. A set of blood results taken two days ago is on the screen for review.
Blood tests (two days ago, for review)
| Item | Value | Reference range |
|---|---|---|
| Sodium | 134 mmol/L | 135-145 mmol/L |
| Potassium | 5.6 mmol/L | 3.5-5.2 mmol/L |
| Urea | 18.4 mmol/L | 3.0-8.0 mmol/L |
| Creatinine | 214 umol/L | 60-110 umol/L |
| Baseline creatinine (last year's results) | 96 umol/L | 60-110 umol/L |
| Estimated glomerular filtration rate | 26 mL/min/1.73m2 | >90 mL/min/1.73m2 |
| Haemoglobin | 112 g/L | 130-180 g/L |
Your tasks are to:
- Take a focused history from the patient and his daughter.
- Perform a focused examination.
- Request any relevant investigations and interpret the results provided.
- State your most likely diagnosis and differential diagnoses to the examiner.
- 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 summarise your findings to the examiner.
- You do not need to consent the patient for a procedure today.
This is a 15-minute station, with 2 minutes of reading time.