Recall Adelaide Sept 06

Recall- Clinical Examination at Adelaide on 23rd Sept 06

i")... ~ 1. 12 years old girl Emily brought in by her mother. Emily had her menarche 10
'./
days ago and still bleeding quite profusely.
a. Task: History from the mother (Emily has consented)
b. Examination findings from the examiner
c. Relevant investigations
Make sure you ask for pregnancy test
2. You are a resident in the ward. Midwife called you to talk to a mother who
delivered 24 hours ago. Her son had greenish vomiting since 12 hours of birth.
Not passed meconium, Now abdomen is distended .
(Xray shows small bowel obstruction with fluid levels)
Task: Differential diagnosis, Counseling.
3. 18 months old Antony was holidaying with his parents. He developed cold last
week and was seen by another GP who sent some investigation because Antony
was looking pale. Now the investigation results have come to you . His growth
parameters are above 50th percenti Ie.
Results: Hb 7.5 (N 11.5 - 14.00)
Microcytic hypochromic picture
Serum ion 6 (very low)
Ferritn (low)
Task: ask relevant history from the father. Talk to Dad about the results and'
management.
.
.
18 months Jack has been having episodes of becoming suddenly apnic, pale and
. jerky movements for d fev.- seconds past 4 months. Recovers c(;mpletely and ease
otherwise well. Examiner tells you that you have seen him a week ago and he is
not pale.
Task. : further relevant history from the mother.
Advice the mother
5. 25 year old lady primi in labour for 4 hours. She is tenn pregnancy, uneventful.
Midwife asks you to talk to her about pain relief She also told you that she felt it
was occipitoposterior.
Task: relevant history, examination findings from the examiner. Management
plan.
6. 22 years young lady came to you with acute abdominal pain for 6 hours.
Task: Rei history, exam findings, and investigations
Talk about pain relief
(case of ectopic pregnancy)
7. 25 year old male comes with shortness of breath for 4 hours. He has been playing
around when this happened otherwise healthy. He has been seen by a colleague
and handed over to you saying his physical examination and vitals are nonnal.
Task: further relevant history.
Investigation from the examiner
(xray was given. Talk to the patient about the diagnosis and management)
8. 60 year old lady presented for annual routine follow up of her blood pressure and
diabetes. During the conversation she suddenly had an outburst of emotions. Her
BP and vitals were nonnal. Husband died a year ago.

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Recall Adelaide Sept 06

Task: History from the patient, DifTere~tial diagnosis, counsel the patient

40 year old lady visited you, her GP, with the weight loss. She lost 7 Kg over 3
months. Task : further history from the patient.
Examination findings from the examiner
BM120, rest normal.
Investigation
10.60 year old male patient presented with difficulty passing urine. \
Task: relevant history, examination findings and talk to the patient.
/1 t . 28 year old lady presented with premenstrual breast pain. Examination findings
' .'
were normal. Her mother diagnosed to have breast cancer and operated few years
ago. You had sent her for a ultrasound which showed small cyst. Surgeon did a
biopsy and reported as no malignancy.
Task: talk to the patient about the result
(find out about OCP and advice)
12.60 year old male who had undergone CABG 2 years ago and is on 3 medications.
(I forgot the nariles ..including statin) for cholesterol and BP.
He has now come to you for eye examination because he had diminished vision
fora week.
Relevant history, examination findings from the examiner, investigation and
diagnose and explain to the patient (TIA)
. 131: Young uni student has been sent to you by his professor for aSsessment. He has
.... recently changed the topic of his thesis (something to do with mathematics earlier
and now it is sex related). He teels he can give them fullness of life.
Talk to the patient, differential dragnosis and management plan...
14. Middle aged woman comes to you her GP with pain in the heels for 3 months.
History, examination of foot- comment as you do
Xray given - planter fascietis.
15. You are working in a remote aboriginal area in NT. Young nurse who has
recently joined the area has been doing some community visits. She has seen
something which she had no idea about. She had a camera and took some
pictures.
Task: diagnosis - pictures are given of eye -trachoma
t 6. 12 years old girl had a fall in the school and had developed painful swelling of the
right elbow. She has been xrayed and now sent to you with her mother.
Explain the findings to the mother
Management plan.

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