Station - Instructions for candidate
You are an intern working in the Emergency Department of a metropolitan hospital in Perth.
Giulia Rossi, a 31-year-old hairdresser, has presented with a day of lower abdominal pain and some vaginal spotting. She had a positive home pregnancy test two weeks ago and calculates she is about seven weeks pregnant. The triage nurse has recorded her observations and a urine pregnancy test is positive. She is in a cubicle; your registrar has said she will perform the speculum and bimanual examination and will give you the findings when you reach that point.
| Observations at triage | Heart rate 92 /min, blood pressure 112/70 mmHg, respiratory rate 16 /min, SpO2 99% on room air, temperature 36.9 degrees C, pain 5/10, weight 62 kg |
|---|---|
| Triage note | 7/40 by LMP. Lower abdominal pain 24 h, PV spotting since this morning. Urine hCG positive. Category 3. |
Your tasks are to:
- Take a focused history.
- Perform a focused abdominal examination. Verbalise each step to the examiner and the findings will be provided; the speculum and bimanual examination findings will be provided when you ask for them.
- Request any investigations you would order now. Results will be provided by the examiner if appropriately indicated.
- State your most likely diagnosis and the differential diagnoses to the examiner.
- Outline your initial management plan to the examiner, and explain the diagnosis and the next steps to the patient.
- You do NOT need to summarise your history and examination findings to the examiner.
- State drug, dose and route where relevant.
- The examiner may hand you results at any point after you request them.
This is a 15-minute station, with 2 minutes of reading time.