Drowsy and muddled

Instructions

You are an intern on the oncology ward. It is 2 pm, and the nurse has asked you to see Margaret Eklund, 62, who has breast cancer in her bones and has become drowsy and muddled over 3 days. Over the weekend her family were told she may be dying. Her husband Graeme is at the bedside.

1. 1

   Assess and manage the patient using an A to E approach

2. 2

   Outline to the examiner:

   • Your most likely diagnosis and differentials
   • Your initial management plan

• A ward nurse will carry out your instructions; describe procedures rather than performing them
• You do not need to take a full history
• You do not need to summarise your findings