Carousel 1 – brief clinical encounter b ( free trial )

Candidate Brief

Station 5: BRIEF CLINICAL CONSULTATION

Patient details: James Stanford aged 46-years

Your role: You are the doctor in the General Medical clinic

You have 10-minutes to assess each patient. You will receive a 6-minute warning and you will stopped at 8-minutes. In the final 2-minutes, you will be asked by an Examiner to explain any abnormalities in the focused clinical history and clinical signs you may have found, along with a diagnosis or differential diagnoses and to provide a management plan (if this was not apparent from your consultation).

Referral

Clinical problem: this gentleman was referred by his GP after arranging for an echocardiogram after finding a murmur on cardiac auscultation. The echo demonstrates mitral valve prolapse with trivial mitral valve incompetence. The aortic root was mildly dilated at 30mm with no current evidence of aortic valve incompetence. The rest of the echocardiogram was unremarkable.

Baseline observations:

  • Respiratory rate / minute 16
  • Pulse rate / minute 64
  • Systolic blood pressure (mmHg) 126
  • Diastolic blood pressure (mmHg) 70
  • Oxygen saturations (%) 98
  • Temperature (॰C) 36.7

Your task is to:

  • Make an assessment of the patient’s referring problem via a focused clinical history and associated focused clinical examination. You do not need to finish the history prior to your physical examination
  • Make a diagnosis or differential diagnosis and explain this to the patient as well as your investigative and management plan
  • Address any queries or concerns the patient may have.

Any notes you make prior to entering the examination can be taken with you, but these have to be given to the Examiner prior to leaving the Station.