Station - Instructions for candidate
You are a final-year medical student on placement in a general practice clinic.
Amira Halabi is a 23-year-old university student attending a general practice clinic with ten weeks of loose stools containing blood and mucus. She has been previously labelled with irritable bowel syndrome. No observations or investigation results are available at the start of the station.
Results provided:
Blood tests: FBC, CRP, ESR, UEC, LFTs, albumin, iron studies and ferritin
Stool microscopy, culture and sensitivity, multiplex PCR and Clostridioides difficile toxin
Faecal calprotectin
| Item | Value | Reference range |
|---|---|---|
| Faecal calprotectin | 860 ug/g | <50 ug/g |
CT abdomen and pelvis with contrast
No focal small or large bowel abnormality; no collection, obstruction or free gas.
imaging other - read aloud by the examiner
The bowel is not obstructed or perforated. There is no collection or free gas. There is no focal mass identified on this scan.
Look up an example image: Radiopaedia ulcerative colitis CT abdomen
Your tasks are to:
- Take a focused history of the presenting complaint and relevant background.
- Perform a focused abdominal examination and perianal inspection. Describe to the examiner what you would like to examine and the relevant findings will be provided to you.
- Request appropriate investigations. Results will be provided by the examiner if appropriately indicated.
- State your most likely diagnosis and two to four differentials, with brief justification for each.
- Outline your initial management plan, including treatment, referral and safety-netting.
- Summarise your findings to the examiner in a structured format.
- You do NOT need to prescribe or write a medication chart.
- Please verbalise your examination to the examiner; findings will be provided when you request the relevant examination step.
- The examiner will provide investigation results only when appropriately requested.
- Provide a structured summary to the examiner at the end of the station.
This is a 15-minute station, with 2 minutes of reading time.