Emergency · History + examination

Chest pain after forceful vomiting - Emergency Department

HardYear 5 · Curtin style · 15 min + 2 min reading · 5 tasks

Ready

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

Station - Instructions for candidate

You are an intern in the Emergency Department of a Perth teaching hospital.

Ray Sutherland, a 54-year-old bricklayer, has been brought in by ambulance with severe chest and upper abdominal pain that started early this morning. He is in a resuscitation bay. The triage nurse has recorded his observations and has asked you to see him urgently.

Triage observationsHR 118 regular, BP 102/66 mmHg, RR 28, SpO2 92% on room air, temperature 38.1 C, GCS 15, pain score 9/10. Ambulance gave 5 mg morphine IV en route with little effect.

Your tasks are to:

  1. Take a focused history.
  2. Perform a focused examination.
  3. Request any relevant investigations and interpret the results provided.
  4. State your most likely diagnosis and differential diagnoses to the examiner.
  5. Outline your management plan to the examiner.
  • You do NOT need to summarise your findings to the examiner.
  • Please verbalise your examination to the examiner; findings will be provided on request.

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

Ask the examiner

Say what you would examine or request, the way you would in the station. Nothing is named until you ask for it.

Whatever the examiner recognises is revealed below. Or pick a numbered item to reveal it blind.

Investigations

Ask for a category the way you would in the station: “Can I have the obs and a set of bloods?”

Examination

Say what you would examine and how; the examiner reports what you would find.

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