March 2018
1.3.18
1.Gp setting, Guy who took tt for tonsillitis: amox
and clavulanic, presented with dark urine. When
asked only gave h/o peripheral itching. Vitals
normal. No proteinuria, urine billirubin positive,
neg urobilliongen, no proteiburia. Looks like a
case of drug induced hepatitis secondary to
amoxycillin. Task was take hx, diagnose and mx.
2. Ed setting, 32 yr old women presented with
epigastric pain, blood results showed raised
lipase, pancreatitis and raised ggt abd ast. H/o
intake of 5-6 sd daily, murphy sign negative.
Taskhx, explain diagnosis and dd, treatment .
3. Examination of hip, 62 yrs old with trochanteric
bursitis , diagnose and mx.
4. Thyroid exam and explain blood test, typical
raised free t4 and drop in tsh.
5. Eye and vision test for 60 yr old with diplopia,
gave fundus findong?? Papiloedema.
6. 3 yr old child with diarrhea 6-7 episaides× 6-7
times, foul smelling. No food relationship. Task,
hx, exam finding from examiner, inv , diagnosis
and tt.?? Giradiasis
7. 30 weeks preg women with mchc anaemia,
vegetarian diet, last delivery 1 yr ago. Looked like
ida, task hx, exam findings, inv and tt.
8. 3 yrs old with runny nose, hx, exam , diagonosis
and tt: allergic rhinitis.
9. 32 yr old female with hpv +, hsil: take hx,
explain result and tt
10. 30 yrs old women who presented to ed with
superficial cuts on her thigh, cleared by psych
team. U r ed doc, take hx, assess risk and advise
mx plan. She was diagnosed witb borderline
personality disorder.
11. 40 yr old came for health assessmrnt, cvs
exam. Explain it to pt.
12. Gp setting, Daughter of 82 yr old man came to
get blood test results which were organized in
view of sudden confusion. He lives in nursing
home, on hydrochlorthiazide : bloods showing
hyponatremia, hypochlorides , increased anion
gap, and urea,. Task, explain result, diagnosis ,
ddand mx. Looks like hyponatremia sec to
hydrochlorthiazide.
13. Gp setting, 62 yrs old women with right calf
pain. Task hx, exam diagnosis, inv, mx. She did not
give any h/o dvt, pe. Classic h/o intermittent
claudication. Abi was not availab
14. Ed setting, 9 mnth old, presented with
vomiting x 2 days. Already known cystic fibrosis.x
ray of clasic intestinal obstruction given, Hx,
exam, explain x ray,diagnosis tt ,
15.gp setting First time preg, says she is 20 weeks
but sfh : 30 cm. No antenatal check up. Came
recently from overseas. No folic acid intake. Task
hx, exam findings, most probable diagnosis , dd
and mx.
16. Hospital, post colonoscopy. Experienced ptsd
of childhood sexual abuse. Task hx and mx.
1/3/18
Chronic nasal discharge
IdA
Thyroid PE
HIP PE
cvs assessment PE
Diplopia PE
Delirium
PtSD
Borderline personality
Chronic diarrhea in 3yr old
PaD
Pancreatitis
Large for dates
HsIL
1/3/18
FROM ONE FRIEND,,,,,,,,,,,,,,
1.Drug induced hepatitis
Gp setting, Guy who took tt for tonsillitis: amox
and clavulanic, presented with dark urine. When
asked only gave h/o peripheral itching. Vitals
normal. No proteinuria, urine bilirubin positive,
neg urobilliongen, no proteiburia. Looks like a
case of drug induced hepatitis secondary to
amoxycillin. Task was take hx, diagnose and mx.
It was female with dark urine. Hx, pefe from exam
and ddx
Page 1 of 16
March 2018
Rest u have to get in hx
Pale stool, took augmentin for sorethroat as when
i asked for drug she got a piece of paper from
under her seat
Pefe : jaundice, liver span 3cm enlarged, urine
dipstick bilirubin +
dark urine post amox for tonsillitis.
PASS
i dont know how i passed this as i spent 4 min
thinking its post strep glomerulonephritis lol
i read the stem it said guy had sore throat n took
amox now developed dark urine and i went in
with tunnel vision !!!worst thing that can happen
to you!!
after wasting time i finally realised my mistake
and then made up for it quickly ruled out all
causes of conj hyperbilirubinemia
in pefe there were scratch marks , and dipstick
had bilirubin 
i explained the diagnosis sayin its hepatitis which
can cause this picture or it could be duct blockade
too but you dont have pain so its unlikely .  levels and blood pressure on few med a diuretic
i did not say drug induced hepatitis but i did say
hepatitis
2. Ed setting, 32 yr old women presented with
epigastric pain, blood results showed raised
lipase, pancreatitis and raised ggt abd ast. H/o
intake of 5-6 sd daily, murphy sign negative.
Task hx, explain diagnosis and dd, treatment .
LFT was all high, including GGT and lipase, most
likely pancreatitis
abdominal pain PASS
ed woman with epigastric pain,.lipase increased,
ggt and ast increased
murphy neg
hx, explain diagnosis,mx
vitally stable??
took complete hx for epigastric pain using
socrates and ruling out other ddx, sadma. hx of
chronic alcohol abuse .
explained diagnosis as pancreatitis ,drew it,
explained to her .
mx short term to treat her pain and inflammation
so admit ,told her we will admit you and correct
your electrolytes ie suportive treatment and long
term would be alcohol abstinence so explained
that to her that we will help you quit alcohol ,and
make a plan for you ,might require rehabilitation
but it will be MDT approach and involve family etc
3. Examination of hip, 62 yrs old with trochanteric
bursitis , diagnose and mx.
UNSCORED
hip examination
4. Thyroid exam and explain blood test, typical
raised free t4 and drop in tsh.
neck examination PASS
stem had hyperthyroid inx results given
examine and explain diagnosis
i did thyroid examination all was normal
explained the diagnosis and inv to the patient
5. Eye and vision test for 60 yr old with diplopia,
gave fundus findong?? Papiloedema.
eye examination
old man with no trauma,ix given of high sugar
and ascard i think
i went in did complete eye examination, only
finding was diplopia , examiner gave me a
fundoscopy picture which was normal (people
said it was papilledema but i think it was normal)
i explained the diagnosis to the rolplayer i said its
diplopia , explained what that is, said its because
of hus diabetes so il refer to eye specialist and
also to diabetes specialist for sugar control and
mx of comorbidities
had 1 min left, the exmainer asked me . are you
satisfied with your performance.
i said yeah, she said you may leave then
i did 😛
Eye Examination(diplopia) 
A 65 yr old man presented with vision problem
(double vision),hypertensive and diabetic,
task,perform PE of eyes only and counsel pt
*pt had diplopia of left eye only ,not on regular
medication for dm and htn
Page 2 of 16
March 2018
Physical Examination
Good Morning Mr.x ,my name is Dr.X,today i will
be examining ur eyes to find the cause of having
double vision,this Ex will involve having a look and
feel ur eyes and doing some eye movements,does
this sound ok to u?before we begin with Ex dou
have any discomfort in ur eyes,during the EX i will
be v gentle but if u feel pain at any moment plz
stop me,wash hands
General Appearance,
My pt Mr.x is amiddle aged man of average height
and built sitting comfortably on chair ,he doesnot
appear to be anxious/agitated,not wearing
spectacles ,and there are no signs of trauma to his
head and around his eyes,no eye drops or any
other medication near bed.
BMI, Vital signs,,,check BP and pulse
Now starting with close inspection of eyes,
1,from behind...ptosis,colour of sclera (yellow for
jaundice,red for
iritis/scleritis/conjunctivitis/subconjunctival
hemorrhage,blue for osteogenesis
imperfecta),,,would u plz pull down ur lower lid
and notice for pallor.
from above,,,proptosis
from behind and above ...exophthalmos
from front for any discharge/secretions, corneal
ulcerations(ask for strip coated with
flourescene),arcus senilis,white opacities(cataract)
check for lid lag
cranial nerve examination including,,visual
acuity,visual fields,and pupillary responses to light
and accomodation.if visual acuity is not poor
check for colour vision using ishihara chart.
test for eye movements by making h shape,,plz let
me know if u get double vision at any point.
***find whether it is moncular
/binocular,,monocular diplopia persists when one
eye is covered and it disappears when pt looks
through a pinhole
look for fatigability of eye muscles by asking the pt
to look at hat pin for about half aminute(in
myesthenia gravis the eye muscles tired and the
eyelids begin to drop)
corneal reflex
fundoscopy(comment on hypertensive changes
,look for diabetic retinopathy,CRAO,CRVO,RD)
palpate orbits for any
tenderness,hardness**,auscultate the eyes with
bell (for any bruit indicative of av malformation or
vascular tumour)
feel for pre auricular node(adenoviral
conjunctivitis)
*I would like to finish by doing slit lamp
examination.
thanks patient
common causes for monocular diplopia include
astigmatism,dislocated lens,uneven contact lens
surface/thick spectacles,cataract
binocular diplopia causes include;
cranial nerve palsy,eye muscle
disease(myesthenia gravis),thyroid
ophthalmopathy,trauma to orbit,internuclear
ophthalmoplegia
6. 3 yr old child with diarrhea 6-7 episaides× 6-7
times, foul smelling. No food relationship. Task,
hx, exam finding from examiner, inv , diagnosis
and tt.?? Giradiasis
chronic diarrhoea FAIL
i didnt do well here for some reason got confused
as there was no weightloss and no other finding
on pefe
it was giardiasis i think
7. 30 weeks preg women with mchc anaemia,
vegetarian diet, last delivery 1 yr ago. Looked like
ida, task hx, exam
findings, inv and tt.
Antenatal exam PASS
hx,pefe,inv,tx
in the stem they had given microcytic anemia so
my approach was to rule out all causes of anemia
in hx in the preg lady. she gave a hx of vegetarian
diet and short gap btw kids, IDA handbook case
inv i did iron profile
tx i said depending on result of iron studies il start
iron therapy
8. 3 yrs old with runny nose, hx, exam ,
diagonosis and tt: allergic rhinitis.
nasal discharge PASS
3 yr old with runny nose
hx pefe diagnosis mx
took complete hx of chronic dischrge, no smoker
at home no family hx of allergies or atopy or
asthma, child care hx positive . no ear prob or
speech issue
no other prob all growth chart normal
in pefe mouth breathing was there
other ent was normal
Page 3 of 16
March 2018
i said i think its post viral dischrge and it gets
better on its own children can get upto 5 6 viral inf
a year , she can get flu shots and try to keep child
at home n not send to child care until hes better ,
she got offended and said i work 2 jobs who will
keep the child at home . so i smiled and said i can
only imagine how tough it must be for you , i can
arrage a social worker to help you out .
she said thanks
i said one thing that concerns me is mouth
breathing so he may have enlarged adenoids so
just to be safe il refer him to ent to check it out .
bell rang
9. 32 yr old female with hpv +, hsil: take hx,
explain result and tt
HPV PASS
32 year old female with pap showing HSIL and
HPV
hx explain result tx
frankly i hadnt done pap smear as i tought its
obsolete now so they wont give it but its AMC you
should expect anything !!
as soon as i read the task i knew im screwed and
was cursing myself for leaving it anyway i went in
i took 5p and sexual hx and gardasil vacc hx
,previous pap,fam hx of gynaecological cancers
explained the result by drawing the epithelium
and explaining that some cells are growing and
dividing abnormally however is not cancer but can
convert into it so needs to be treated
tx i said il refer her for colposcopy (explained what
it is) and then i said they might excise the area if
needed or treat by cautery...vell rang i thanked
the roleplayr and examiner
10. 30 yrs old women who presented to ed with
superficial cuts on her thigh, cleared by psych
team. U r ed doc, take hx, assess risk and advise
mx plan. She was diagnosed witb borderline
personality disorder.
borderline personality
hx risk assessment mx
old recall did exactly that  on pefe abi wasnt given , pulse of DP and popliteal
complete psychosocial hx  was absent and weak femoral pulse was palpable
sad persons approach  on right side however no ulcers or discoloration
mx i said we will not keep you here and my senior
will come and have a look at you and will dischgre
you arranged for some1 to oick her up.
cbt and family meeting
11. 40 yr old came for health assessmrnt, cvs
exam. Explain it to pt.
health assessmnt CVS exam PASS
old recall where a guy came for insurance
checkup, do complete cvs examination exluding
abdomen and leg
i did complete examination with the dynamic
maneuvers . everything was normal
which i then explained to the roleplayer
12. Gp setting, Daughter of 82 yr old man came
to get blood test results which were organized in
view of sudden confusion. He lives in nursing
home, on hydrochlorthiazide : bloods showing
hyponatremia, hypochlorides , increased anion
gap, and urea,. Task, explain result, diagnosis ,
ddand mx. Looks like hyponatremia sec to
hydrochlorthiazide.
confusion FAIL
2 page long stem with low sodium and chloride,
high anion gap and urea he was on a million med
explain result to daughter dx mx
i failed so i cant say what this was 
my diagnosis was delirium due to hyponatremia ,
explained that and said il admit the patient
13. Gp setting, 62 yrs old women with right calf
pain. Task hx, exam diagnosis, inv, mx. She did
not give any h/o dvt, pe. Classic h/o intermittent
claudication. Abi was not availab
calf pain PASS
60 yr old with pain in leg
hx pefe inx mx
in hx she gave a v clear hx of intermittent
claudication, no rest pain no swelling or tortuous
veins ,she didnt know if she had bp or dm etc i
took a thorough hx she was a nice old lady.
,buerger was neg
inx i said color doppler, my diagnosis was PAD. i
explained it to her .
Page 4 of 16
March 2018
i asked if she was a smoker or on any med , she
wasnt .
in mx i said il refer to the specialist and before
that run some blood tests to look for
comorbidities like cholesterol ,blood sugars etc
14. Ed setting, 9 mnth old, presented with
vomiting x 2 days. Already known cystic fibrosis.x
ray of clasic intestinal obstruction given, Hx,
exam, explain x ray,diagnosis tt ,
int obst cystic fibrosis UNSCORED
15.gp setting First time preg, says she is 20
weeks but sfh : 30 cm. No antenatal check up.
Came recently from overseas. No folic acid
intake. Task hx, exam findings, most probable
diagnosis , dd and mx.
large for dates PASS
5 month preg 30 cm fundal height ,was traveling
no antenatal checkup done
Hx dx ivx
took hx to tule out all causes of large for dates
she didnt remember lmp, wasnt taking folate, had
no scans done
didnt eat raw meat or dairy though
no fever
no fam hx of twins
sugars were normal no hx of gdm or DM or large
babies
the distension wasnt affecting her life
i was telling her ddx when the examiner asked me
what is your likely diagnosis i sai wrong dates.
ivx i said il do US  boyfriend, poor sleep, good mood, appetite. Task
tx i axplained high risk preg and refer to high risk
clinic 
16. Hospital, post colonoscopy. Experienced ptsd
of childhood sexual abuse. Task hx and mx.
Abdominal pain PASS
recurrent abd pain for which colonoscopy was
done, and she rememebered something wants to
talk
old recall
i did complete psychosocial hx,asked about
hyperarousal, nightmares,flashbacks etc and
avoidind situations that remind her of
that......made sure she was safe and felt safe now
and the abuser wasnt around,asked if she wants
to involve police she said no, offered continuing
support in case she changed her mind, 
mx> CBT as i said its delayed PTSD
explained that recurrent abd pain could be due to
the same stress and cbt will help with that too as
colonoscopy was normal
2/3/18
1. Female child who has vaginal rash suspected
abuse by dad
Vulvovaginitis) mom insists sexual abuse. Take
history, explain to mother possible cause
2. Pe of pt with signs of HYPOTHYROID i think it
was actual pt with pretibial myxoedema
Thyroid pe (stem- patient had been having
symptoms of hypothyroidism.. diff concentration,
constipation, with family hx of hypothyroidism)
perform thyroid examination, and explain to px
the findings you have. 
3. Ill 17yld with bsl of 34 and ketones of +4
 case of young boy who was unable to go to work/
school due to tiredness, BSL and Ketone on PEFE
Dm 17yo complains of unwell. not able to work in
farm. Thirsty, freq urinating. Hx pefe, ddx
4. Ocd girl with thoughts of taking pictures of ex
and his new partner together, relived if she
counts to 7
repetitive thoughts of seeing ex having sex with
take psychiatric history, give ddx
5. Drug chart morphine sub q prn normal gfr
drug chart for morphine that an intern has to fill
patient was having pyelonephritis and want it for
pain relief gfr 100 serium creatinine 60
Medication chart - subcutaneous morphine, with
medication book on table, theres a tab on the
page, no need to look at index
6. Gcs of unconcious guy with + neck stiffness
ddx(case of maria)
7. Atrophic vaginitis in 62yld
63 woman, noted recent profuse vaginal
discharge yellowish brown. Hx pefe dx mx
8. Psychogenic cough of 12yld
Page 5 of 16
March 2018
17 yo girl, bouts of coughing, triggered by reciting Subfertility - woman comes back after 12mos of
in class, ordering in front. Asthma medications no trying to conceive. Partner and wife pe normal.
effect, bronchodilator challenge test no change.  Husband not here today. Hx mx 

9. Greenstick fracture of child who fel with 15. Hoarsness in a teacher with strong smoking
outstrech arm hx and +dullness in chest
Fracture 3 yo boy swelling of forearm. Fall in Hoarseness cancer vs overuse (30 to 40 yo man
outstretched arm. With radiology given.  recent hoarseness, teacher, smoker, pefe showed
decreased breath sounds dullness in the left lower
10. Vag discharge from 10 day post partum lobe) hx pefe dx mx 
Endometritis abd pe (vsd endometritis stem..
mom had vsd 10 days ago, placenta seemed 16. Gastro in a 6month child with no
complete. Today comes with bleeding of bright immunizations
red blood, temp 38.7) take hx as you require, 6 month old fully breastfed baby acute diarrhea
relevant pe, explain to mother and vomiting last 24hrs. Brother had diarhea 1
week ago. Ketones in urine. Gastroenteritis, no
11. Pe of testis, i think it was hydrocele immunization. History, pe, dx, management
+transilum 7/3/18
Guy concerned that he may have contracted STI.
Take consent, do genital exam, further inv. Male 1.pulmonary Atelactasis same book case
pelvis dummy. (?) Scrotal mass, +transillumination Fever:38.5
test (?) Task:take short history
Management.(patient wants to go home today so
12. Lymphedema of lady who had mastectomy council)
Lymphedema post mastectomy (woman
diagnosed breast cancer underwent total 2.slpeen rupture(2 grade)
mastectomy 4 yrs back with chemotherapy and After trauma all investigation s normal.bp going
tamoxifen, 1 month ago noticed swelling of arm down
and forearm, not including hands) hx, explain pulse going up.
possible causes, mx)  Task : explain pt abt suituation and what you
going to do.
13. History of headache with Ct scann of brain
tumor if asked 3. 8 year boy ab pain on and off no associated
This patient had a past history of MELANOMA .. features
which he gives on asking. and when u say you Task:History (grand mother CA)
would like a imaging done. CT BRAIN... you wiil Pete
have a CT with a lesion. Inv
there was only history investigation choice and Management.
prov dx
Took all the history in detail.. with past history etc. 4.sob(bronchogenic CA)
excluded all DDX.. and when I got to past history Rt lower lobe dullness)
he told me about the Melanoma. Also in the
beginning of any pain station I asked if they 5.tia pe lower limb
needed any pain killers.
6.breast CA PE lump in upper quadrant.
headache x 3 months. Throbbing, sometimes one
side, or both. Usually in morning, with 7.eye examination (after trauma)sub conjunctival
nausea/vomiting. Wife notices husband has beam orbital fracture.
twitches or jerks when sleeping. hx of skin cancer
and vasectomy. Hx, ask for spec inv, ddx 8.gout book case

14. Infertility 12mos sex 1/wk 9.serotonin syndrome moderate so admit.

History and manage.

Page 6 of 16
March 2018
1-Breast lump
10.taddlors diahorrea.
2-Cp child 
11.mse video major depression. 3-Haematology exam- leg rash
4-Atrophic vaginitis 
12. pprom 200kms away 30 weeks pregnant.
Task: all.  atropic vaginitis in 25 year old girl.. delivered 3
months ago..dyspareuniau
13.primary infertility 32 years only on speculum wen asked for they tell its
Task:all. atropic

14.diabetic neuropathy PE.

5-Schizophrenia mse 
15.ocd king.task:all. 6-Right lower abd pain US gall stones no
obstruction and ruptured graphian follicle 
16.loss of app and tiredness
Task:all. gall stones presrnt on us
History:fever, dental procedure and past cardiac but pain in right lower quadrant
murmur present. fluid in pouch of doghlous
Infective endocarditis. Pain every month... so u tell her about
mittelschenrz n u also tell her that if the gall
stones become symptomatic they 2 wil need
treatment
7th of March 2018 recalls
Copied from the group :

1 Hypoglycaemia 7-SVT
2 PROM 8-Domestic violence 
3 OCD >>>>> king 9-Femoral hernia (child)
4 Mse >> Major depression ( video )
5 PVD + DM >>> PE pic was given wen asked about hernia orifices
6 Breast for Ca >>> PE came with vomiting only 6 year old girl
7 Psychogenic abd. Pain in 8 yrs boy with Ca femoral in the thigh
grandma ?? she said she see redness so told her its
strangulated n will call the surgical team
8 Infective endocarditis From other candidate-Same recall of incarcerated
9 TIA >>> PE inguinal hernia looks like femoral but still would
10 post op. Cholecystectomy with atelectasis go with the obvious and say inguinal hernia and
11 Splenic injury paed ( fast US of abdomen it’s irreducible.
provided )
12 SOB working in Timber industry
13 acute gout 10-Old person with Sob lt lung opacity with steel
14 primary infertility industry exposure 
15 secondary survey of MVA :
Picture given , raccon eyes , painful eye opacity in the left lung so it cant be ild..
movement nasty growth but need to confirm on ct

No idea about any case, Thank you

11-Threaten abortion 
12-Facial nerve palsy PE+ cholesteatoma
8/3/2018 13-Detrosor instability 

u had to tell inx then

Page 7 of 16
March 2018
urodynamic study was available,,, Care giver talking about a DM patient having self
isolation.
History and ddx.
14-Thyroid carcinoma Typical depression manifestations with trigger of
departure from friend.
15-Dvt
16-bacterial lymphadenitis with pain and fever Counseling to a upset family of whom underwent
has injected tonsils and tympanic membrane and laparoscopy for acute cholecystitis . Bleeding
tender lymph nodes ( main complaint from a occurred few hours after surgery.
stressed parent was tender lymph nodes that Task : counseling and answer questions.
prevent him from sleep) Role player was standing at beginning, but
actually nice and helping.
08.3.18
Pneumothorax, sudden onset of dypnoea and left
Breast lump upper chest pain. x ray available upon request.
Cp child Task : history, PE from examiner and explain
Haematology exam differential diagnoses to patient.
Atrophic vaginitis
Schizophrenia mse Asking for check of STD. Condom rupture last day
Right lower abd pain US gall stones no obstruction and traveling to Philippine are mentioned in stem.
and ruptured graphian follicle Task : history taking and explain relevant
SVT investigation to patient.
Domestic violence Role player was reluctant to talk even with
Femoral hernia (child) confidential provided twice. Maybe didn't ask in
Old person with Sob lt lung opacity with steel right way. Every kind of unsafe sex and IV drug
industry exposure abuse present in history.
Threaten abortion Retest 9.03.18
Facial nerve palsy PE
Detrusor instability 1. Pheumothorax sudden SOB. Task history, pefe,
Thyroid carcinoma investigations from examiner, tell ds and Dd with
reasons.
9/3/2018 The guy was jogging and felt sob. 3 hours ago. On
history nothing like this before, no smoking, pain
Acute abdomen examinations. Task : do PE and on the chest but not too strong on the left upper
explain possible causes to patient. Note: examiner part. I did history for Dd pheumothorax,
and patient didn't stop me . Therefore, need to to pulmonary embolism, panic attacks, copd,
complete abdomen examination. asthma. Asked pefe, o2 saturation was 92, so I
gave oxygen, on auscultation no breath sounds in
Tingling in right hand. left upper zone, all the rest normal. I asked blood
Task : do PE and ddx to patient. Ask patient which tests and d-dimer - not available. Xray available -
fingers are affected but he dodged that question. pheumothorax on left upper. I've explained with
Only vibration is skipped by examiner due to lack picture. Key steps 5 out of 5. Score 5-6. Pass.
of tuning fork.
2. PE cholecistitis. PE, explain Dd with reasons. I've
Secondary amaenorrhia for 12 months. ensured stability first, did abdominal exam like in
Task : history and ddx to patient. Use of OCP and Talley, forgot hernia orifices and per rectum.
being a athlete training for triathlon. Murphy was positive plus pain on deep palpation
in right hypochondrial area. I said cholecystatis,
3 year old child with breath holding spell. explained with picture, run out of time for
Task : history, provisional diagnosis, immediate differentials. Key steps 3 out of 4. Score 4-5. Pass
treatment and further advice.
3. Rest

Page 8 of 16
March 2018
4. PE tingling on right hand. Task PE, tell ds and
Dd. Machinery worker. I started with vitals, then
inspection, palpation. Tested sensation: impared
on ulcer nerve distribution for needle and light
touch, proprioception and vibration sence normal.
Power normal. Carpal tunnell tests - normal. Run
out of time to do De quervan test. I did test for
cubital tunnel syndrome incorrectly - that's why it
was negative. I said Carpal tunnel, De quervan,
injury to ulner nerve. Key steps: 4 out of 5. Score
4-5 but Ds/dds 2. Fail.
5. Breath holding spell child. History, explain
condition to parent. In the stem: child gone
unconscious and fingers injured. I took history,
binds, excluded epilepsy and fever fits. Explained
breath holding attack with a picture. Key steps 2
out of 3. Score 4-5. Pass.
6. Adjustment disorder on Down syndrome. Task
history, ds. I asked Massas. Said adjustment
disorder because of stressor present. Key steps 3
out of 5. Score 3. Fail.
7. Post cholecystectomy, clip came off,
counselling. I ensured privacy, said of anyone else
need to be present, asked about what does she
know about her husband condition, does she
want to know all into or just the main points. Then
explained operation with picture. Said no surgeon
fault. Can organise meeting with him. Empathy.
Offered counsellor and water. Key steps 4 out of
5. Score 3-4. Pass.
8. Rest
9. Secondary amenorrhoea due to exercise. Task
history, ds, dds. I did 5 P, excluded asherman
syndrome, due to diet, pregnancy, OCT,
premature ovarian failure and pops. Explained
with the picture. Key steps 2 out of 3. Score 4-5.
Pass.
10. Man screening for STI. Confidentiality. Asked
about what sex, previous sti. Explain HIV testing,
forgot informed consent. Hepatitis, urine and
swabs for gonorrhoea, chlamydia, trichomoniasis.
Notify, safe sex, contact tracing. Empathy. Key
steps 3 out of 5. Score 2-6. Pass.
14/03/2018 recalls
[[[[FROM FRIEND]]]]]]
1.common peroneal nerve entrapment PE
2.ear pain with reccurent attacks with discharge
Hx, PE,DX
3.linear rash take HX,PE,DX & DDX
4. 3.5yrs old child with cough all the night
HX,PE,DX and DDX
5. 7 month old infant with inguinal, umblical
hernia and undescended testis counsel
6. 47 yrs old lady with irregular menstrual cycle
and hot flush HX and counsel, send investigation
7. 32 wks pregnant lady with head ache HX, PEFE,
DX it was pre-eclampsia
8.polyhydramnios
9.ceftriaxone medication chart
10.post op fluid overload
11. Post MVA with blurred vision do eye
examination everything normal tell DX and DDX
12.neck and shoulder pain
HX, PEFE,DX and investigation( cervical
radiculopathy)
13.patient prevously diagnosed with
schizophrenia now brought by police homeless
wondering and having grandiose delusion take HX
and tell patient the findings
14. Bullemia nervosa with irregular cycle and
priveous history of dizziness due to laxative use
15. Old age female wondering and itritable having
delrium counsel the daughter
16. Chest pain with ECG interpretation to
examiner and diagnosis to ptient (pericarditis)
14/03/2018 recalls
[[[[FROM FRIEND]]]]]]
1.common peroneal nerve entrapment PE
1.inspection: check the leg and ask patient to
walk,comment on leg ,ankle and foot.
2.feel ankle and foot for any pain 
3.move: dorsi flex,plantar flex,inversion and
eversion,check resistance as well
4.sensory according to dermatomes
5.special test: slr,tap at knee
2.ear pain with reccurent attacks with discharge
Hx, PE,DX
Acute otitis media with conductive hearing loss on
the same ear
patient was stupid, when I applied the rinee and
weber test,the patient was confused and gave me
signs of CHL on the left ear and SNHL in the right
ear!
3.linear rash take HX,PE,DX & DDX
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Simply it is acute thrombophelebitis
Rash was on the photo and was drawn over the
patient arm
RASH EXAMINATION
1,GENERAL APPEARANCE;patient in pain/not in
pain,pallor,no iv cannulas in hands.
2,vital signs;temp/pulse/R-R/so2
3,Inspection;swelling in forearm?injection
markks?insect bites?signs of trauma?
Site/symmetrical or asymmetrical/flexor or
extensor surface/single or multiple?/note
morphology(macular/papular/vesicular/crusty/ur
ticarial?)
note color/shape/regular/irregular/areas of
inflammation around?/edges sharply demarcated
or poorly defined.any discharge visible??
measure the rash for accuracy**
4,palpation;temp/tenderness/consistency(hard/so
ft/firm/fluctuant?)blanching or non-blanching on
pressure/hairs in the local skin/nail changes?
5,regional lymph nodes.
i would like to examine skin of whole body for
rash @ any other place.
Dds;superficial
thrombophlebitis/cellulitis/cutaneous larva
migrans/allergic dermatitis.
4. 3.5yrs old child with cough all the night
HX,PE,DX and DDX
3.5 yo boy with cough
all home is sick with runny nose
mother heard wheezes
any before he got sick, he used to wheeze when
run with his mates
on examination: no respiratory distress - expiatory
wheezes bilaterally
DD Asthma - Allergy - Post nasal drip -
Gastroesophageal reflux disease
5. 7 month old infant with inguinal, umbilical
hernia and undescended testis counsel
6. 47 yrs old lady with irregular menstrual cycle
and hot flush HX and counsel, send investigation
7. 32 wks pregnant lady with head ache HX, PEFE,
DX it was pre-eclampsia
8.polyhydramnios
9.ceftriaxone medication chart
The patient was feverish
We should write down paracetamol QID for the
patient
There was no allergies
Ceftiraxone 1 gm BD 0800 / 2000
Paracetamol 1 gm 6Hrly 0600 / 1200 / 1800 /
2400
10.post op fluid overload
Acute pulmonary odema
I can't remember the stem because the whole
stem and charts outside you will know from the
fluid chart that the pt intake more than the output
The patient didn't take his frusemide for 2 days
1.Ask exam findings from the examiner
2.interpret findings to the examiner
Explain the cond to the pt
7/10/2016 recall case: Post op patient. 2 days ago
had sigmoid colon surgery. now has complain of
SOB. He was on different meds including
furosemide which were stopped before surgery.
His intake output charts and observation charts
were given. He was on self-control pain relief.
Vitals were normal but input was 6000 ml and out
put was 1240 ml. PE from examiner- S4 heart
sound on CVS exam, resp exam -bilateral basal
crackels. GIT exam - wound dressing on abdomen
and slightly painful, no drains present. Task: PE,
explaination of chart, tell patient the diagnosis
and differential and management
It was my exam question. So it's a 50 year old post
Op Day2. I don't remember what surgery he had,
but certainly it was an abdominal surgery. He has
been having SOB for the last 3 hours. You have
been called to have a look. A big stem on the front
plus a big drug and nursing vitals chart. Drug chart
mostly had fluids. He got around 9 litres of fluid
over 2 days post operatively and 2 litre was
output. So he was positive by 7 litres.
In the room you have to discuss the drug chart
with the examiner and ask examination finding
from him. And explain the causes and
management to the patient.Regarding him being
of Loop diuretics I don't remember reading that
anywhere. May be I was poor at skimming
through the history.
So I entered the room and greeted the examiner
and the role player who was lying on the bed and
was having Dyspnea. I introduced and
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acknowledged his discomfort, told him I'll talk to
the examiner and then come back to him.
I told the examiner that I have read his charts and
I see he has got 9 litres fluid and output is only 2
litres. So he is positive by almost 7 litres. Then I
asked about any pedal edema +, CVS- S3 heard
rest normal, R/s Bibasal crepitations, increased
work of breathing.P/A- any ascitis. Wound site
status-no discharge or bleeding.No drains, No
Nasogastric tube, foley's in place. No
hematuria.VS- I don't remember. Forgot to ask
JVP!!!
Told the patient that he has got a lot of fluid over
two days and his urine output is less. Can be a lot
of reasons- heart problem, kidney problem,
infection etc. not sure will discuss with my
registrar and we will give you water
injection( diuretic) to increase urine output. Strict
monitoring from now on. Also will do some tests.
FBE,UEC,Urine R/m, CXR, ECG, ECHO. Asked him if
he had adequate pain relief. Reassured he will be
alright. Still time was left. Checked my tasks again.
Stated all the things again to the role player. Bell
rang---- TaDA!!!!!!
11. Post MVA with blurred vision do eye
examination everything normal tell DX and DDX
12.neck and shoulder pain
HX, PEFE,DX and investigation( cervical
radiculopathy)
computer guy
with left shoulder pain and neck pain
No trauma / No family history
on examination: numbness in fingers index and
thumb and outer side of the arm (C7, C8, C6)  HR/BP/Temp/RR/SPO2/URNALYSIS/ECG/Blood
DD: cervical radiculopathy - RA - Ankylosing
spondyolitis - Muscle straim
Invest: MRI - Nerve conduction study - HLA B27 -
basic blood
13.patient previously diagnosed with
schizophrenia now brought by police homeless
wondering and having grandiose delusion take
HX and tell patient the findings
Marijuana smoker
God speaks to him, and asks him to save world
Retired
avoid eye contact
Restless, agitated
14. Bullemia nervosa with irregular cycle and
previous history of dizziness due to laxative use
15. Old age female wondering and irritable
having delrium counsel the daughter
one of the most stupid cases you will ever seen in
any exam
Relative was stupid and rude
patient was in ward / greek / she started to shout
and speak in greek
her saturation is 93% while on oxygen
Causes of Delirium: hypoxeia / infection ..etc.
Task: council the relative / who won't understand
whatever you tell
no interpreter
obvious case of delirium
discuss possible cases of delirium
It was a case of pneumonia- sepsis
16. Chest pain with ECG interpretation to
examiner and diagnosis to patient (pericarditis)
I feel so frustrated from this case as I was
confused
Chest pain go to shoulder increase by breathing
and relief by pending forward but the ECG it was
anterolateral MI ECG even I saw the waves not
concave so I said anterolat MI,pericarditis,pleuritis
It was most likely dx and other ddx
Ammar Alani - AMC Clinical - 14.3.2018 Cases - My
Approach
***CONSENT and WASH Hands before any PE***
** Always ask if the patient was in pain and offer
pain killers **
** Do not forget to ask about
Sugar **
Hx-History
PE Physical Examination
PEFE-Physical Examination From Examiner
IX Investigations
1-Common Peroneal Nerve Entrapment - PE then
Counsel
Young lady with difficulty walking - introduced my
self - consented for PE - asked her to walk - there
was obvious Rt foot drop - asked her to squat then
did Trendlenberg Test. Then asked her to lie
down, inspected both LLs for wassting, skin,
scars..etc – then told him I needed to measure the
length of the legs and the thigh circumference –
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examiner said we don’t have a tape measure ! I
was talking to examiner while performing PE -
then palpation for tenderness - temperature -
masses - then did motor and sensory examination
( Power - Tone - Reflexes - Touch - Pain Prick -
Proprioception ) - was about to do vibration then
examiner told me it was normal - there was power
and sensory issues - then talked to patient - told
her that ONE of the nerves in her Rt Leg is
damaged - may be due to trauma-infection-
pressure from LN - tumour - I do not remember
saying the work Peroneal Nerve- I was asking her
general quick questions while doing PE to exclude
other central issues like
headache/vision/unsteady gait..etc.
Bell rang!
2-Ear Pain for months with discharge- PE and Dx
There was a head model in the room with a table
on which there were 2 tuning forks – Otoscope
There was a young pain – apparently in pain – not
very cooperative – said he had pain with discharge
for months – then took brief history – asked him
about loud noises/trauma/infection/ tonsillitis /
said no – then he said he has been having this
since childhood !
The consented for PE – inspected external ears on
both sides – scars – discharge – trauma - palpated
for LN – wanted to examine throat then examiner
said no tongue depressor – then used the
otoscope and examined the ear on the model –
there was obvious TM rupture with discharge and
visible ossicles. – I told him that he had ruptured
TM may be du to trauma – infection-loud noises
and I need to refer you to ENT for management – I
told him about TM grafting then examiner said no
management then bell rang !
I DID NOT perform HEARING TESTS with TUNING
FORK.
3-Liner Rash on Left Arm – Hx Ex Dx DDx
Young man with a red line from his left cubital
fossa towards his shoulder – asked him whether
he was bitten/trauma/thorn/IVDU/clotting then
general health/ SADMA/ then PE inspection
Then palpated for tenderness/pulses/ then
Axillary LN then told him this might be
thrombophlebitis – DDx
Thrombophlebitis/allergy/skin infection then bell
rang
4-Father asking about his 4 yr old daughter with
cough – no child in room only father.
Took history about the
cough/nature/when/daily/fever/SOB/cyanosis/ch
est indrawing/general health/immunization/birth
history/family history ( NOW HE SAID THAT HE
HAD ASTHMA ) – then told him this was asthma as
well but might be URTI/allergy/pneumonia – told
him that I would give him reading material about
asthma and what to do in case of emergency -
then bell rang
5-Mother asking about her 7months old with
Inguinal Hernia – Umbilical Hernia – and
undescended testis – she said she was really
worried - Counsel.
My first question was when did you know he had
these issues – she said since birth – then I said
where have you been for 7 months !!? why did
you come only now ? she did not know what to
say. Then explained to her about Umbilical hernia
no need to worry but we need to follow up as
most of the get closed – then told her about
inguinal hernia that needs to be fixed then
arrived at the most important think – the
undescended testis and told her this is the most
important thing to be managed as it might lead to
sinister tumours if left – then explained to her
with a drawing about how testes descend from
the abdomen and that how sometimes the do not
descend completely and cause the hernia then
told her that I was to refer her to a surgeon for
management then asked her if she had any
questions – she said no Dr – Thank you then I told
her that I would give her reading material - then
bell rang.
6- Amenorhoea in 47 years lady – with flushing –
counsel and send investigations.
Started with history – 5 Ps – mood changes –
regularity – medications..etc – it was an obvious
premenopausal symptoms – explained that to her
and offered her HRT to minimize her symptoms
and told her that I would give her reading material
( was an easy straight forward case ) . told her
that we might need to send for
FSH/LH/Prolactin/U/S.
7-Pregnant with headache – Hx and PEFE
Took history – 5 Ps – headache – tired – no visual
symptoms – leg swelling – asked examiner about
PE – had HTN – protein in urine – told her that this
is Pre Eclampsia – she asked about cause – I told
her unknown but some think it is related to some
materials produced by placenta – I told her that I
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need to send you to hospital then examiner said –
NO MANAGEMENT in tasks !! then told her that I
would give her some reading material then I
remained silent until the bell rang after about a
minute !
8-Primaegravida in 32 weeks – came for check up
– examination given outside the room as ( LATEST
FUNDAL HEIGHT 4 weeks ago was correspondent
with 28 weeks )  TRICJK
Took history – 5Ps – previous US..etc ALL NORMAL
then asked examiner about vitals normal – asked
for FUNDAL HEIGHT he said 36 now !! – then
asked for LIE/Presentation/PV/Speculum .all
normal.then asked about urine/Blood sugar -
Then told her this is mostly polyhydraminious –
then explained to her the meaning of that and
complications of it and need for hospitalization to
know the cause and will give you reading material
then bell rang.
9-You registrar asked you to chart ceftriaxone for
a patient with pneumonia
There is an examiner and a table on which there
was a medication chart and a pen.
CHECK FOR ALLERGIES FIRST
Write the medication name /dose / iv or im / your
name / signature / timing.
( easy case if you have done this before / if you
are working somewhere )
10-Post operative man with history of CHF –
developed SOB
In the room there was a patient lying on the couch
– looked tired and there was the fluid input
output chart – I started calculating the input and
output – then examiner asked me to explain the
chart for him – there was an obvious FLUID
OVERLOAD – I spoke to patient and told him that
he had extra fluid through the drip and with his
weak heart , this caused some fluid to accumulate
in his lungs and that we need to give him some O2
and fluid tablets/injections – he thanked me then
bell rang.
11-MVA – Blurred vision – PE and DDx – the wrote
Do not perform Corneal Reflex as it was normal.
Young man –said had MVA 4 hrs ago – had blurred
vision – now better- asked him quickly about his
general health/past medical/SADMA – all Normal.
Then inspection (was talking to examiner while
performing PE ) – then palpation for tenderness –
then VA/VF/then Ocular movement/ Light reflex –
grabbed the fundoscope then examiner said no
need then handed me a big photo showing normal
retina/optic disc/macula told him that the inside
of the eye was normal ( then said some medical
terms to examiner like normal
fundus/macula/disc/no flame hameorrhage..etc )
Then said ideally I need to do slit lamp to check
anterior chamber – examiner said we do not have
one !
Then for DDx – told patient that everything is ok –
nothing to worry about – might be due to some
concussion – need to refer you to specialist and
follow up again – will give you reading material
then bell rang.
12-45F with left UL pain. Hx PEFE – Ix Counsel
(easy case )
She had pain – from neck down – secretary – took
brief history – it was obviously a neck issue as she
said in history she usually had neck pain –
examination was normal – told her we need to do
cervical xray and MRI – DDx - might be
OA/spondylosis/trauma/infection .
ManagementReading material / Physio therapy /
specialist / follow up
13-Woman brought by police – Background of
Schizophrenia – take history and TELL PATIENT
ABOUT MANAGEMENT !! PATIENT HAD NO
INSIGHT BUT ACCPETED ADMISSION.
Patient was constantly talking to herself – looked
unkempt – dirty clothes – I took history from her
as below
MSE
ASEPTIC
Appearance-behavior-proper dressing-agitation-
smell-calm-dirty
Speech-low tone-monotonous-pressure
Emotions-Mood-angry-happy
Perception-hallucination-I hear them
Though-delusions—Im special-talking to angels
Insight-do you think you need help
Cognition-where are you now ( ORIENTATION)
DEPRESSION
S leep
I nterest
G uilt-Grief
E nergy
M ood
C oncentration
A ppetite
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P sychomotor agitation-Do you remain on the
edge all the time ?
S uicifdality – life is not worth living – thought of
ending it all for once – plans-any notes left
Then wanted to talk to examiner about
management – he said TALK TO YOUR PATIENT
then I spoke to patient that she needs admission
as she had not taken her medications for 3
months.
14-Young woman with irregular menses then
Secondary Amenorrheoa
Took history – hypothalamus ( eating disorder )
patient had eating disorder – bulimia
Pituitary ( visual disturbances ) – Thyroid
symptoms – PCOS symptoms – Uterine issues
( previous D&C/Asherman/congenital )
then told her that the cause is her eating habit
and that she needs to be referred to psychiatrist
for that. – reading material – she was happy to
know the casue.
15-middle aged man wanted to know why his
inpatient mother started to shout in the ward and
did not recognize him – she was a post operative.
Son was very angry – I calmed him and told him
that I was there to help him – I asked him quickly
about his mother – he described the situation to
me as she suddenly started to shout…etc
I told him this is called Delirium / there is now
specific cause for it – we need to do some blood
tests to check blood salts 9 electrolytes ) / CXR if
pneumonia – have her relatives stay with her…etc.
he became very calm and happy and thanked me.
16-Young woman with chest pain – ECG shown
outside room. Hx-no PE – Counsel
Young woman – hx of flu like illiness 2 weeks ago
– chest pain – related to movement – better when
leans forward – radiates to left shoulder – ECG – T
inversion in some leads only – told her this is
mostly Pericarditis – DDx ACS – MI – Trauma –
Pneumonia. We need a CXR – FBC/CRP and
referral to ED for admission. Reading Material
handed to patient – She thanked me.
Best of Luck Guys and All the Best for You All.
15.3.2018
1) ED, 10 days post partum bleeding and fever
Task: perform PE, findings to examiner, explain
pdx and ddx to patient (Endometritis dt rpoc, i
examined the tumny with palpation without
asking for any painful area, damn. Good thing that
i pressed softly the tummy. Os is open. Pelvic and
breast examination results given by examiner.
Uterus 2cm above the pelvic brim)
2) doctor at primary care center. Talk to the care
giver at some centre because one of the residents
he is taking care of acting strange. Has been dxed
with schiz for 5 yrs. Now auditory hallucination +,
delusion of grandiosity +, delusion of persecution
+, no idea of harming himself or others.
Tasks: take further focused history, explain the
condition, explain the necessary Mx (relapse
schiz, care giver asking is it safe for him to stay at
the care centre)
3) ED, CT scan of haemorrhagic stroke. Pt taking
perindopril for high blood pressure and aspirin.
No injury or trauma history. Been living together
happily with husband
Tasks: explain the findings to the husband, dx and
possible risk factors in the patient including the
prognosis with reasons. (Pt complained that his
wife has told him to make her dead if she ends up
in vegetation)
4) GP, complaining of lump in front of the neck
which moves with deglutition. Having that for
6mths. Initially tender but not now.
Tasks: explain the dx and ddx, mention invx u
would like to do to ur patient and possible
management
This was thyroid lump. He had hx of wt loss too.
Investigate as for thyroid Ca...CBC, KFT, lft, ECG,
coagulation profile, USG+fnac and then proceed
5) GP, pt having night sweats, 2LNs palpable at
groin, and some features of lymphoma. Very long
stem. I forgot because there are 2 lymphoma
cases.
Tasks: perform haenatological examination, give
pdx and ddx (no positive findings except groin
nodes)
6) yes another case of lymphoma. I forgot most of
the case. History is given. pt 27 yr ol male came
with night sweats and fever, do pe from examiner
and say ur initial investigations to pt with reasons
Tasks: ask pefe, dx and ddx, invx??
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7) low back pain examination. Dx and ddx. Disc
prolapse (slump test cannot be done, schober not
given, slr +, sensation loss at L5, loss of ankle jerk,
power normal)
pt lifted something heavy, do pe and state ur dx
Regarding the back exam I heard from friend, he
was not cooperative and just wanted to sleep.
He did stand up...antalgic gait with wt bearing on
rt. Left l2,3,4 neurology + motor gone. Lumbar
area tenderness
Ankle reflex absent
8) ED, 8 mths old crying child, father is very
worried.
Tasks: history, NO PEFE, give dx and ddx. I
struggled this case because there is no PE. Extra
time in history so a little bit awkward.
(Intussusception- might be wrong. Pain started 4
hrs ago, no poo since then, no more feeding as
well, no pee changes, i didnt exclude irritable
baby)
irritable baby for last 6 hrs, ask hx for 6 hrs and
state dx and ddx
9) GP, pt complaining of lack of sleep and
irritable.
Tasks: history, give dx and ddx (ptsd. Have been as
a strategist in parkiston and experienced very bad,
now avoiding all things concerning abt war, flash
backs and vivd dreams, lack of sleep for 6 months,
as a result very edgy and quarrel with husband,
now working as a financial analyst, also some
problems at work too, no depression, no thyroid,
no pheochromocytoma, lmp last week)
pt delayed ptsd, came after a trip and started
exhibiting symptoms
10) ED, pt having chest pain from time to time.
Long stem given. Getting pain with exercise,
walking uphills and not relieved with omeprazole.
Pt. taking omeprazole and ibuprofen for back
pain. Family history of heart attack in dad and
stroke in mum.
Tasks: ask pefe, dx and ddx, give management
pt with chest pain and Malena, do pefe and tell
initial inv and management
Mesenteric ischemia + mi
Pulse 92, regular
But h/o Malena...And had been taking ibuprofen
Om history...1 pack a day smoker, 6pack/day beer
11) GP, pt coming to you because his frds are
telling him he is hving parkisonism
Tasks: perform examination (yes no specific
mentioned), give dx and ddx to patient (no resting
tremor,no head tremor, no intentional tremor,
fine tremor +, mask like facies +, walking well,
finger nose good, no micrographia, no slow
movement, slow speech +, tone a little bit
increased, glabellar +)
pt suspected parkinsonism, do pe and state dx
Perhaps a real patient..Mask like facies, no rest
tremors but tremors + on outstretching. Shuffling
gait was +, and he had some fasciculation in upper
arms on movements. Cogwheel rigidity(not
classical) in left upper limp
12) 30 weeks pregnant, GP, 4th pregnancy. Tests
show hypochromic microcytic anaemia.
Tasks: take further focused history, ask pefe, give
dx, mx (vegetarian, children 5, 3, 1 respectively)
13) GP, 42 yrs old lady complaining of indigestion.
Tasks: history, dx and ddx, explain invx u would
like to do (CA oesophagus, history of long standing
heart burn, 5kg loss in last mth, now indigestion is
persistent, no more time to ask abt any problem
with swallowing, smoking +, alcohol +, no spicy
food, no coffee, no family history)
man with indigestion, ask hx, examiner will give u
findings card, and say investigations with reasons
14) ED, seeing a patient with rash, has urti 10 days
ago, started limping 3 days ago and now joint pain
and tummy pain.
Tasks: explain the dx and ddx,arrange invx,
possible mnx. (HSP. I forgot to mention abt
possible dialysis. Pt is worried abt meningo and
leukemia, only get fbe from examiner, no renal
function or electrolytes)
picture of HSP, state ur dx to mother and tell her
ur initial investigations and examiner will give you
results, tell her ur management
15) GP, going to see a patient 1yr 6 mths brought
in by mum. Mum no concern. Local nurse worried
abt weight gain. Wt chart and height chart given.
Height is good. Wt grows well till 6 mths, become
stuck from 6 mths and now below 3rd centile.
Tasks: history, explain the condition (mum broke
up 6 mths ago, fuzzy eater starting to drink milk 3
times a day from 6 mths of age, no concern at all,
Page 15 of 16
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currently no job and receiving funds for being
single mother, looking after the child)

18 month old baby with ftt( fussy eater and single

mom) ask hx and dx and management

16) female young pt came for sti screening, ask

hx , pefe, counsel

Goodluck to all candidates!!!

16/3/18
1.sore eyes
Fever+, rash, gen rash, travel hx, retro orbital
pain, small joint pain, travel to brazil, its mosquito
bite.
Can be zaka virus or dengue.
2. HTN patient not complient to medication
because of heavy drinking (dementia)

3. Hypoglycemia in diabetic patient due to

gliclacide

4. Head ache examination(temporal artritis)

5.ear examination(chlesteatoma)
Wax

6.acute abdomen examination(cholysistitis)

7.psychogenic cough

8. Testicular torsion

9. Lichen sclerosus

10.transverse lie

11. Orbital cellulitis

12. IDA due to excessive cow milk intake

13.Gynecomastia (hx, ddx and dx)

14.OCD (fear of contamination

15.epigastric pain and heart burn(ddx)

16.depression/ anxiety

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