04/04/2018 recalls

Station 1
22 yr lady with 1 month of nervousness, tired, and weight loss of 3 kg.
Task- do relevant examination
Tell most likely diagnosis and dds with reasons

On exam- thin lean girl with brittle hair, Muscle wasting, palmar erythema, and no sweating,
proximal muscle weakness,White nail polish on nails.
There was a cat scratch mark on neck, and 1 on arm. No lymphadenopathy present.
She was pretending to be exophthalmos, and lid lag.
Thyroid exam was normal.
Examiner didnt tell anything

Station 2
2 months old baby with runny nose for 2 days. He on breastfeed and growing well
Task, further history
Pefe
Diagnosis and dds

On history there was dry cough, watery nasal discharges, sometimes mouth breathing, decreased
feeding.
On exam vitals normal, growth chart normal,chest clear.

Station 3- rest

Station 4
50 yr old man with scrotum enlargement for months, its painless, no problem in urination
Tasks- do relevant examination
Most likely diagnosis with Dds
Investigations.
On table torch and measuring tape was there.
On exam there was small nodule on top of left testes. It was hard and round but transillumination
was positive.

Station 5
Partner died few months ago, now has sad mood for a month. This month partner had birthday,
on birthday they had lot of plans. He goes out with friends. Visits his children often.
Task. Explain diag and dds with reasons
Further mx plan
Inside room, male was teary and faking alot.

Station 6
7 yr child with generalized seizures for 1 min in school. With eye rolling and urine incontinence.
He complained of sickness and then had fit. After fit he became drowsy. Now in hospital with
vitals stable. Mother is here ti discuss. BSL 6.5mmol/L
Task- further hx
Most likely diagnosis with future management.
On hx nothing was positive.

Station 7
3 days Post c- section
Temp chart was given with recent temp of 37.5. She was given enoxaparin 2 times, now only on
panadol. No antibiotic. Pt wants to go home. Baby is alright
Task- further history.
Pefe,
Explain the reasons whether she is fit to discharge or not.

Everything normal on hx and examination apart from fever.

Station 8 rest

Station 9
Prostrate adenocarcinoma same case as before with gleason score 6 (4 to 7 -intermediate
written)

Station 10
Cyclist and runner having ankle pain for few days.
Task- perform PE
Diag and dds with reasons

Exam for Achilles tendinitis +

Station 11
8 weeks early pregnancy. Everything normal except
Hb-8.5
Mcv- 65.
iron studies with ferritin level normal
Task- hx
Most likely diagnosis with reasons
Further investigations.

On hx, she was from italy and partner from italy as well.
No other history postive.
No family hx
Most likely Thalasemia minor.

Station 12
23 yrs with mentrual abnormalities
Task- hx
Pefe
Most likely diagnosis and and investigations.

On hx- 2 cylces for 1 yr, before normal with no heavy bleed. Acne postive, overweight positive.
Remaining hx normal
Pefe- bmi 31, acne and hirsutism positive.
Pcos

Station13 rest

Station 14
Bullemia nervosa- exact same karen case referred from dentist with poor oral hygiene and
calusses.

Station 15
27 yr male with runny nose with hx of hay fever for years. Had family hx of asthma and hay fever
in brothers and father.
Vitals stable. Chest clear, turbinates enlarged, watery nasal discharge.
Task
2 min hx about what treatment or medication he had taken
Acute management of his symptoms
Future mx.

Roleplayer was wearing glasses. And cleaning nose with tissues

Was moving his face like showing his all teeth it was seemed to be involuntary reponse. Had hay
fever for years but this year it was worse. Had yearly vaccination done.

Station 16
47 yr lady concerened about weight loss
Task Hx
Pefe on card
Possible reasons

On Hx- she was on diet with less portions and proteins for 3 months. Doing workout for 1 hr daily
for 3 months. Trying to reduce weight, lost 5 kg.
On card weight 66, bmi 24, rest normal.

Station 17
77 yr old lady with bluish discolouration and swelling of both feet for 5 yrs, on antihypertensive
and statins
Task- history
Pefe
Diag with reasons.
Dds with reasons.
On hx condition getting worse for a yr. less swelling in morning. Worried about gangrene.
Pefe- pic was given, pitting edema with blue feet. Dorsalis pedis absent, tibialis post weak.
Remaining normal. Buerger negative.

Station 18 rest

Station 19
3 months old Irritable baby for 3 weeks. Today mother noticed lump on inguinal area.
Task- further hx
Pefe
Diag and Further mx.
On Hx, crying more in evening with reduce feed in evening.
Pulls leg up while crying, gets better with feed.
On asking hernial orifices pic was given of inguinal hernia with normal skin and reducible.

Station 20
Abdominal pain. Vitals stable given.
Task- hx
Diag and dd with reasons
Investigations With reasons.

On hx pain was epigastric radiating to back, relieved by leaning forward, alcohol 5-6 glasses per
day, smoking 1 pack per day.
All remaining hx negative.
Most likely- acute pancreatitis