Rectal bleeding and reduced exercise tolerance - General practice

CurtinYear 515 min + 2 min readingSurgery & perioperativeChallengingPre-internship
  • Focused history
  • Focused examination (abdomen with right iliac fossa, perianal inspection and digital rectal)
  • Request investigations
  • Dx + differentials
  • Initial Mx
  • Summary to examiner

Ready

2 min reading, 15 min station, warning at 2 min

Focus the timer and press Space to start or pause.

Station - Instructions for candidate

You are a final-year medical student on placement in a general practice in Rockingham.

Name/Name, a 74-year-old retired boilermaker from Rockingham, has booked a general practice appointment because of intermittent bright red bleeding from the back passage over several months. The patient believes this is a flare of previously diagnosed haemorrhoids and is asking about treatment. The patient also reports becoming less able to walk uphill.

Your tasks are to:

  1. Take a focused history of the presenting complaint and relevant background, including medications and allergies.
  2. Perform a focused abdominal examination, perianal inspection and digital rectal examination. Describe to the examiner what you would like to examine or do, and the relevant findings will be provided to you.
  3. Request appropriate investigations. Results will be provided by the examiner if appropriately indicated.
  4. State the most likely diagnosis and two to four differentials, with brief justification.
  5. Outline your initial management plan, including the key medication considerations, referral and safety-netting.
  6. Summarise your findings to the examiner using a concise structured handover.
  • Please obtain consent before the perianal inspection and digital rectal examination.
  • Please verbalise your examination to the examiner; findings will be provided when you request the relevant step.
  • You do NOT need to perform any procedure beyond the examination described or write a prescription.
  • You must summarise your findings to the examiner before the station ends.

This is a 15-minute station, with 2 minutes of reading time.

Ask the examiner

Solo practice: say out loud what you would ask for, then choose the category. Names appear only after you commit, and a result is revealed only when you ask for it.

Generated by AI for practice; check doses and pathways against eTG / AMH before relying on them.