Station - Instructions for candidate
You are a medical student on placement in a general practice.
Dean Karagiannis, a 26-year-old plumber, presents to a general practice with six weeks of severe anal pain associated with bowel motions and small amounts of bright red bleeding. No examination findings or investigation results are available at the start of the station.
Results provided:
Full blood examination
| Item | Value | Reference range |
|---|---|---|
| Haemoglobin | 145 g/L | 130-170 g/L |
| White cell count | 7.8 x 10^9/L | 4.0-11.0 x 10^9/L |
| Platelet count | 282 x 10^9/L | 150-400 x 10^9/L |
C-reactive protein
| Item | Value | Reference range |
|---|---|---|
| C-reactive protein | 2 mg/L | <5 mg/L |
Your tasks are to:
- Take a focused history of the presenting problem and relevant background, including medications, allergies and social factors.
- Perform a focused examination including abdominal examination and perianal inspection. Describe to the examiner what you would like to examine and the relevant findings will be provided to you. Defer digital rectal examination if it would be too painful.
- Request appropriate investigations. Results will be provided by the examiner if appropriately indicated.
- State the most likely diagnosis and two to four differentials with brief justification.
- Outline your initial management plan, including treatment, follow-up, referral and safety-netting.
- Summarise your findings to the examiner.
- Please verbalise your examination to the examiner; findings will be provided when you request the relevant step.
- You do NOT need to perform a digital rectal examination if it would be too painful.
- You are required to summarise your findings to the examiner at the end of the station.
This is a 15-minute station, with 2 minutes of reading time.