AMC Clinical

Collection
2017-2018
(PE)

1. Young
patient
presented with rash

Tasks
- take history
- Perform PE
- Explain DX & DDx to patient

2. You are HMO at ED. 20 year old young patient presented due to a motor vehicle accident.
Primary and secondary survey, as well as a series of X-ray of swollen left leg were done. X-ray
is given.

Tasks

- Perform PE on lower leg of the patient. Explain the patient what you are doing. (Do not remove
the bandage on the patient's leg.

- Explain the X-ray to the patient

- Explain to the patient about further immediate management.

3. 50 year old patient who has history of hypertension for more than 10 years and is on enalapril.
Patient complaint of blurred vision for a few seconds. Now it's completely resolved.

Task

- Perform physical examination

- Dx and DDx to patient.

4. Young patient woke up in the morning with the asymmetrical face. He is worried about having
stroke.

Tasks
- Perform PE of facial nerve

- Other relevant examination to rule out the cause of his symptoms

- tell the patient the most likely Dx and DDx with reasons.

5. 60 year old patient comes to GP clinic to see you for difficulty in walking. She has no history
of injury to her leg. She does not have diabetes mellitus and is not taking any medication. She
drinks 5-6 bottles of beer per day for many years.

Tasks

- Perform relevant neurological examination

- Explain Dx & DDx

6. Young man who is a cherry picker presented to you with complaints of walking difficulty and
tingling and numbness of the right leg

Task

- Perform PE & tell the examiner what you are doing during the examination

- Explain Dx and DDx to patient

7. 30 year old man, 5 days history of fever, nasal congestion, feeling tired. BP 120/80 mmHg,
Temperature - 38 C, Pulse 100 BPM, Respiratory rate 12, SpO2 98%.

Tasks

- Take history

- Perform PE

- Explain DDx to patient with reason

8. Unconscious patient presented in ED. Primary survey done.

Tasks

- assess Glasgow Coma Scale (chart given)

- Perform other relevant examination

- Tell most likely Dx and 4 DDx to the examiner

9. 30 year old man came for check up to GP clinic before he increase his health insurance. He
was told by his previous GP one year ago that there was abnormal heart sound murmur in his
heart.

Tasks

- Perform relevant PE excluding abdomen and lower limb

- Explain findings to patient

- Discuss about management

10. 50 year old man, complaints of right sided headache and also pain while chewing food. BP is
stable.

Task

- Perform relevant physical examination

- Tell your DDx with reasons to the patient

11. 45 year old man presented to GP clinic, has shortness of breath after recent viral URTI.

Tasks

- Perform respiratory system examination (4 minutes)

- Teach patient how to do peak flow meter

- Explain what you are testing to the patient

12. Patient came to GP clinic, presented with foot pain

Tasks
- Take history (2 minutes)

- Examine the foot

- Tell the Dx with reasons

13. A patient complaint of foot pain for the past 3 months, worst in morning when steps out from
bed

Tasks

- Perform PE

- Explain DX with reasons to examiner

14. Patient has involved in MVA. LOC for 3 minutes. Primary survey is done and all normal.
Cervical spine injury has been excluded and collar is already removed. Patient complaint of
blurred vision.

Tasks

- Perform physical examination on head and vision.

- Report the findings to examiner while you're examining

- Explain the findings, Dx, DDx with reasons to the patient.

15. A worker comes to your practice with complaint of back pain which started suddenly a few
minutes ago after lifting a heavy box. He never had any problems before.

Tasks

- Examine him (with running commentary)

- Explain the most probable diagnosis for the patient

16. 64 year old man with a history of pain on his right hip joint for the last 6 months comes to
your GP clinic. The pain is worse with activity. He tried Panadol but did not get relieved from
the pain.

Tasks

- Do relevant hip examination + running commentary

- Tell Dx

- Tell management

17. A young female came to ED where you are working as HMO after she had MVA. She was
sitting in the passenger seat and had her seat belt on. She had injury in her face. Patient is now
hemodynamically stable and neck is clear.

Tasks

- Perform PE

- Explain DX and DDx to patient

18. A 52 year old man who goes to bodybuilding center has come with complaint of large
breasts.

Tasks

- Perform PE by telling the examining steps that you want to do

- Explain the most likely DX and give reasons

19. 62 year old man with calf pain on walking uphill and night pain but no pain at rest. He has
history of DM and is a chronic smoker for 20 years.

Tasks

- Perform PE

- Explain Dx to patient

- Tell management
20. A middle age woman presented to you with burning and tingling sensation of feet and leg
calf pain. She has known history of diabetes.

Tasks

- do sensory neurological examination and relevant physical examination

- Explain Dx and DDx to patient

21. Young patient had a fall.

- Explain Xray

- Perform focus PE

- Do management with given material

22. 32 year old woman comes to your GP practice. She has history of depression with psychotic
features. She is on risperidone and mirtazapine. She developed tremor three weeks ago and come
today for prescription renewal.

Tasks

- Ask focus history

- Perform PE

- Explain condition and management

23. Your next patient in GP practice is a 27 year old lady with restlessness and weight loss. The
patient is on propranolol 20 mg for prevention of migraine headache. The migraine is well
controlled.

Tasks

- Perform relevant PE

- Explain your findings to the patient

- Tell the possible DDx.

24. Young man presented with ear pain

Tasks

- Take history (not more than 2 minutes)

- Perform PE

- Explain diagnosis to the patient

25. 60 year old man with transient weakness of his right leg, known history of diabetes and
hypertension. You already completed upper and lower limb sensory examination which are
normal.

Tasks

- Perform lower limb neurological examination and other relevant examination

- Explain Dx and DDx to the patient

26. 16 year old boy presents with bilateral knee pain on playing football. He was training to join
the professional team soon.

Tasks

- Perform PE

- Explain Dx and DDx

- Advice him about management

27. 10 days old baby was brought in by mother for routine check up. Baby's weight is 3000
grams, height is 50cm, head circumference is 35cm.

Tasks

- Take history including pregnancy and delivery history (not more than 2 minutes)

- Perform PE (tell the mother what you are going to do)

- Tell findings to the mother

28. Middle age man with watery diarrhoea, vomiting, headache and brown coloured stool for 1
day.

- Take history

- Perform PE to assess hydration status

- Explain most likely Dx and DDx to patient

29. You are in GP practice and 55 year old lady came with complaint of lump in right breast. Her
mother was diagnosed with breast cancer and she is concerned about it.

Tasks

- Do relevant PE with running commentary to examiner

- Explain about possible causes to patient

- Discuss what investigation you would like to do

30. A 55-year-old woman is in your GP clinic, the surgeon has excised a lump (lymph node) on
the left side of her neck and sent some specimens for histopathology that revealed squamous cell
carcinoma.

Task

a. Relevant physical examination

b. Primary and differential diagnosis

c. Order relevant investigations

31. Young lady just return from triathlon event. presented with pain in right foot for 1 weeks .
Tasks

-Do PE

-explain D/DX to patient

32. 55 yr old man comes to your GP for check up. You did some blood tests. Liver function
results are given all normal Alb 32 and GGT 500. Significant alcohol consumption history (+)
Tasks:

1.Relevant examination of the patient

2.Explain your findings and give reasons

33. Young girl companying of lower abdominal pain both left and right side for two days. Have
passed bowel since and few flatus. LPM is 3 weeks ago and it was normal.

Task: PE, Dx and D/D

34. 50 year old man with gradual painless swelling of left testis tasks
1-perform scrotal examination
2-dx and ddx
3-management

35. Your next patient is a 27-year-old lady who is supposed to have a sinus surgery due to
recurrent sinusitis. Several years ago she had an episode of low platelet count.

Tasks

-Perform a hematological examination on her, with running commentaries to the examiner

-Dx and ddx

36. An old aged man came with pain and tingling sensation in his soles for several weeks. Some
findings of liver function test are given. (All enzymes are normal but GGT is slightly increased)

Task:
- Perform neurological examination to lower limbs.
- Explain what you are going to do to the patient.
- Tell the possible diagnosis (es) to the patient.
37. Patient had a high blood pressure recording of 170/90 while in a blood donation campaign.
Fundoscopy picture given in the stem Task.

-CVS ex

-Explained fundoscopy picture to examiner.

-Tell the Dx to pt

38. 67 yrs old woman c/o brownish vaginal d/c few months, pt is taking female hormone like the
pills for many years for osteoporosis. last pap smear 18 months ago. Ask consent for examining
of pt, Perform VE and Explain the most likely cause to pt.

39. Young male patient having fever, difficulty swallowing for 2 days, was feeling unwell/tired
for last 2 weeks
⁃ Do
relevant examination on patient
⁃ Exa
mine ear on dummy
⁃ Dia
gnosis

40. GP practice, next patient 37 weeks of gestation, she has done all her antenatal care and
everything has been well. She is coming this time for a follow up consultation. It was more
information but everything was normal.

Tasks :
- Perform PE to the mannequin
- describing to the examiner what are you doing.

41. A 50 year old factory worker is coming with the complaint of tingling in his right hand.

Tasks:
- pe diagnosis and differentials

42. A 40 yr old female, factory worker comes to you because she had been having some funny
feeling in the fingers of her right hand for some time. Sometimes wakes up from sleep having
that feeling. Shaking her hand vigorously helps.
Task:

- Perform PE on patient

- tell examiner what are u doing and ur findings

- explain Dx and DD to patient.

43. A 27 year old man was playing with friends suddenly fall from tree around 2 meters. during
fall tried to hold himself by his hands. Comes with claw hand and no any other injuries.

task:

- do p/ e
- explain to examiner what you are doing
- explain condition to pt

44. 35 year old lady Jane presents to you with some tingling sensation and severe burning pain in
both her hands. She had been diagnosed with hypothyroidism for the past 7 years and she has
recently had a surgery for goiter (thyroidectomy), she has been feeling like this since after the
surgery.

TASKS

-Perform PE

-Advise patient
45. old patient with right hand pain tasks

-physical examination

-dx and ddx

46. Your next patient in GP practice is a 76-year-old man who had one episode of urinary
retention 3 days ago. His retention was resolved with catheterization. He has come to see you for
further assessment.

- Perform abdominal examination on him.

- Perform DRE on a mannequin.
- Explain your examinations findings to the examiner and the possible differentials to the
patient.

47. A young person present with H/O Mild to Mod Pain at Right elbow since a week, presenting
to GP Avoided job today
Task
- Focused history,P/E and explain to patient what you doing,
- DD or Diagnosis to Patient and immediate management

48. 60-65 years old man with past history of diabetes and hypertension, presented to you with
sudden onset of double vision Tasks

-perform examination

-Dx and Ddx to patient

49. GP, 50 yrman , right handed, fall and got injury to rt shoulder.

- Perform Shoulder examination

- D& DD

50. old age male presented with tummy pain , first he was constipated now also vomit, abdomen
is tense and distended. He had lost weight involuntarily, and feel tired.

TASK

-Abdominal examination ( you don’t have to wear gloves )

-Ask for investigations and then explain it to the examiner

-Advice the pt. of his condition