Child

1. GP, A teenager boy with Type 1 DM hospitalised for DKA 12 months ago.
Currently his glycemic control is unsatisfactory. He is insisted by his Mom to see you
today.
Task - history, advice about reasons of treatment failure.
(finding - a very shy boy, plays sport, no inter current infection, knows how to inject
insulin and monitoring, teased by his friends, but no symptoms of depression).
2. 4 mth old baby came with noisy breathing to ED.
Task - history, ask PE, explain and Mx.
(Findings - SOB, not turning blue, not increased work of breathing, hot to touch,
cough +, not chesty, not Barky nor whooping cough, reduced feeding and nappy
change . PE - wheeze +, rhonchi+. (Fever 38 C, SaO2 91%. Dehydration signs not
present.)
3. GP - a 10 yr old girl came in with headache. Mom is talking about her.
Task - history, ask PE (a sheet of finding is given), tell the possible condition to her
mother and Mx plan for her.
(Finding, headache comes and go for 2 years, getting worse recently, unilateral
headache with seeing flashing light suggested migraine, family history of migraine
present, no other symptoms of DDx).
OG
1. Small for gestational age (fundal height 29 at 34 weeks of gestation, colleague has
done USD - which shows normal and alive baby). Task - further history, ask PE,
explain result and do further investigations.
2. Bleeding PV - 2 days. amenorrhea 9 weeks, pregnancy test positive. Still bleeding
during consultation. Task - history, ask PE, Mx.
3. A lady came with insomnia for 2 years. Mild depression present. Post menopausal
woman, not taking HRT.
Task - History and tell possible causes with reasons to patient.
Med - Sx
1. Renal colic - a middle aged man came in to ED with acute right sided abdominal
pain , pain score 10, consistent with renal colic, need to exclude DDx.
Task - brief history, ask investigations from the examiner, tell Mx plan to patient.
(ureteric stone, CT provided).
2. Alcoholic, LFT done (increased GGT), explain and counsel.
3. A muscician, RF positive. Counsel. Same as notes.

4. Post splenectomy counselling.

5. Chronic diarrhoea . Task - history, DDx with reasons. (Findings - had diarrhoea off
and on for 2 yrs, sometimes blood present, weight loss present, stressful man,
occupation - finance manager. Father also has bowel problem but he doesn't know
exact Dx. Smoking +)
PE
1. Wrist cut (at ulnar border).
2. DM peripheral neuropathy examination.
(Task - PE, tell findings to examiner, explain condition to patient)
3. Young man with persistent cough after flu.
(Task - PE, tell findings to patient, ask investigations you want to order,
explain the results to patient.
(Spirometry of asthma is given)
Psy
1. (Station 17) , a young male Chronic Schiz patient, taken by police to hospital.
Auditory hallucinations present. (Said he is special and is getting contact with God to
save people, no idea of suicidal or harm to other) Grandiosity present. Homeless, not
taking medication (antipsychotic and anti depressant) regularly.
Task - MSE and risk assessment (same as February 2015 recall).
2. Forgetfullness - Task - history, assess her orientation and memory function briefly no need to do full MMSE, advice the possible conditions with reasons to patient.
(An old lady, her family complaint of she is forgetful, forgets where to put keys,
forget to switch off stove, still driving, no personality change, not forget names and
past events, denied symptoms of depression, not drinking alcohol and any other
drugs, no past history of head injury, stroke and vascular events, apart from having
family history of dementia she doesn't have any other risk factors).