CASE 01

You are a doctor in the medical outpatient clinic. Please read the
following letter from the patient’s general practitioner (GP). You may
make notes on the paper provided. When the bell sounds, enter the
examination room to begin the consultation.

Dear Dr, Thank you for seeing this 35-year-old MrS. kamila Parker, a
teacher urgently. I am concerned she has had a pulmonary embolus. She
developed central pleuritic chest pain during the course of yesterday;
however, she has felt generally unwell for a week. She was on the
combined oral contraceptive pill until 1 year ago. She currently takes
fluoxetine for depression and nifedipine for Raynaud’s syndrome. On
examination she was a little breathless. Pulse 100; BP 170/100. Chest
clear

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 02
You are a doctor in the medical outpatient clinic. Please read the
following letter from the patient’s general practitioner (GP). You may
make notes on the paper provided. When the bell sounds, enter the
examination room to begin the consultation.

Dear Dr, This 26-year-old female Ema watson attended my surgery

today complaining of difficulty walking that had come on over a few
days. On examination she has a markedly ataxic gait but no other
abnormality. She has no significant past medical history and takes only
simple analgesia for headaches. I would be grateful for your urgent
assessment.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 03
You are a doctor in the medical outpatient clinic. Please read the
following letter from the patient’s general practitioner (GP). You may
make notes on the paper provided. When the bell sounds, enter the
examination room to begin the consultation.

Dear Dr, I would be grateful if you would see this 22-year-old language
student MISS Ema Watson who has had persistent diarrhoea since
returning from Russia 2 months ago. Several of her friends on 30 Station
2 her trip also had diarrhoea whilst abroad but unlike them her
symptoms have not settled with antibiotics.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 04
You are a doctor in the medical outpatient clinic. Please read the
following letter from the patient’s general practitioner (GP). You may
make notes on the paper provided. When the bell sounds, enter the
examination room to begin the consultation.
Dear Dr, I would be grateful for your opinion on this 78-year-old man
who has recurrent dizzy spells and on two occasions he has blacked out
at home. He had a pacemaker inserted 2 years ago following an episode
of heart block, which complicated an anterior myocardial infarction. I
wondered if the pacemaker was malfunctioning, though a recent check
was satisfactory. His only other medical history is hypertension. In the
surgery today his pulse was 70 regular and BP 135/85.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 05
You are a doctor in the medical outpatient clinic. Please read the
following letter from the patient’s general practitioner (GP). You may
make notes on the paper provided. When the bell sounds, enter the
examination room to begin the consultation.

Dear Doctor Please could you see Mr Kevin Walker, a 47-year-man who
was found by his daughter at home, living in squalid conditions and
unable to cope. He has a background of excess alcohol consumption and
has only been home from hospital for 5 weeks following a period of
detoxification. I found him to be jaundiced today and with a temperature
of 38.1 degrees. Yours sincerely, Dr Mahfooj Rahman

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.
 CASE 06
You are a doctor in the Hematology clinic. Please read the following
letter from the patient’s general practitioner (GP). You may make notes
on the paper provided. When the bell sounds, enter the examination
room to begin the consultation.

Dear Doctor
Please could you see Mr Kevin Walker, a 40-year-man who has been
suffering from Headache and Blurring of vision. I am really concerned
about the possibility of a brain tumor. His only other medical history is
hypertension. In the surgery today his pulse was 70 regular and BP
160/100.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 07
You are a doctor in the medical outpatiet clinic. Please read the
following letter from the patient’s general practitioner (GP). You may
make notes on the paper provided. When the bell sounds, enter the
examination room to begin the consultation.

Dear Doctor
Please could you see Mrs Jessica Williams, a 32-year-female who has
been suffering from Fatigue for last 6 months. In the surgery today his
pulse was 70 regular and BP 100/70 mmHG.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 08
Patient’s information Jonathan Tate, a 70-year-old man.

You are an ST2 in the Care of the Elderly medical clinic. You have been
asked by a GP to see this 70-year-old man with a long history of tremor.
The patient is concerned that he may have Parkinson’s disease, and
hadn’t wanted to try any medications from his GP without a specialist
review.
Your task: to assess the patient’s problems and address any questions or
concerns raised by him.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 09
Patient’s information Shawn Williams, a 60-year-old man.
His Son: Mr. Andrew Williams

you are the ST2 in the MAU. You have been asked to take a history from
patient’s son who has been transferred from the acute oncology unit. The
oncology clinical nurse specialist referred the patient with fever of
38.3°C. Pulse was 120, BP 90/55 in oncology, and he was given some
intravenous fluids.

Your task: to assess the patient’s problems and address any questions or
concerns raised by his son.
Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.

CASE 10
Patient’s information Dunkan Fletehr, a 45-year-old man.

you are the ST2 in the Gastroenterology Clinic. You have been asked to
take a history from patient who has Abdominal pain and also has
previous history of jaundice. Pulse was 120, BP 130/85.

Your task: to assess the patient’s problems and address any questions or
concerns raised by his son.

Please take a history from the patient (you may continue to make notes if
you wish on the paper provided). Your examiners will warn you when
12 minutes have elapsed. You have 14 minutes to take a history from the
patient followed by 1 minute of reflection. There will then follow 5
minutes of discussion with the examiners. Be prepared to discuss
solutions to the problems posed by the case and how you might reply to
the GP’s letter. You are not required to examine the patient.