Medicine · History + examination

Fever and low saturations the morning after surgery - Hospital ward

MediumYear 5 · Curtin style · 10 min + 2 min reading · 4 tasks

Ready

2 min reading, 10 min station, warning at 2 min

Focus the timer and press Space to start or pause. 2 min reading, 10 min station, warning at 2 min.

2 min reading, 10 min station, warning at 2 min.

Station - Instructions for candidate

You are an intern on the general surgical ward of a Perth teaching hospital.

Les Harmon, a 66-year-old retired baker, had his gallbladder removed yesterday; the operation was converted from keyhole to open. The nurse has called you because his morning observations show a fever and low oxygen saturations. His observation chart is printed on your sheet.

Nursing observations this morning (day 1 post-operative)	Temperature 38.2 C, HR 92 regular, BP 132/80 mmHg, RR 22, SpO2 92% on room air (98% on air pre-operatively), pain score 7/10 on movement. Operation: laparoscopic cholecystectomy converted to open, subcostal incision, 2 hours 40 minutes, uneventful. Enoxaparin 40 mg given at 2200. Catheter removed in recovery. Analgesia chart: paracetamol 1 g four times daily; oxycodone 5 mg as needed - two doses given.

Nursing observations this morning (day 1 post-operative)

Temperature 38.2 C, HR 92 regular, BP 132/80 mmHg, RR 22, SpO2 92% on room air (98% on air pre-operatively), pain score 7/10 on movement. Operation: laparoscopic cholecystectomy converted to open, subcostal incision, 2 hours 40 minutes, uneventful. Enoxaparin 40 mg given at 2200. Catheter removed in recovery. Analgesia chart: paracetamol 1 g four times daily; oxycodone 5 mg as needed - two doses given.

Your tasks are to:

Take a focused history.
Perform a focused examination.
Request any relevant investigations and state your most likely diagnosis and differential diagnoses to the examiner.
Outline your initial 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 10-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.

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.