AFP @ Clinical Communication

Your role: Doctor in the Pulmonology clinic

Problem: Disscussing the diagnosis and further treatment plan
Patient: Mr. Shib Shekhar Das,37 years

Please read the scenario printed below. When the bell sound,enter the room.You have 14
minutes for your consultation with the patient/relative,1 minute to collect your thought and 5
minutes for discussion.You may take notes if you wish.

Where relevant assume you have the patients consent to discuss their condition with the
relative/surrogate.

Scenario:

Mr. Shib Sekhar Das is known to have RA for last 1 year. He is on Tab. Methotrexate 15 mg
weekly along with Tab. Folic acid and Tab. Sulfasalazine 2gm daily. His RA in on remission and
has good functional status. However for the last 2 months he noticed exertional SOB. For this
reasons he went to his GP who referred him to this clinic. He was thoroughly evaluated and
was found to have reticulonudular opacities on HRCT. Consultant has diagnosed him with
Methltrexate induced Pulmonary Fibrosis. Methotrexate will be stopped and not be taken in
future. He will be put on Tab. Prednisolone for minimum 3 months. Sulfasalazine will be
continued and RA follow up to be continued

Talk with him about the diagnosis ,plan and precautions before starting prednisolone.

DO NOT EXAMINE THE PATIENT

DO NOT TAKE HISTORY
Any notes you take must be handed to the examiner at the end of station.