New headache and a brief loss of vision in an older woman - Emergency Department

CurtinYear 510 min + 2 min readingNeurologyStandardPre-internship
  • Focused history
  • Request investigations
  • Dx + differentials
  • Initial Mx

Ready

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

Focus the timer and press Space to start or pause.

Station - Instructions for candidate

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

Rosa Bianchi, a 74-year-old retired university lecturer, has been brought in by her daughter after her vision in the right eye 'went grey' for about five minutes this morning and then came back. She has had a headache for two weeks. The triage nurse has recorded her observations and she is now sitting in a cubicle, feeling well. Her daughter has gone to move the car.

Observations at triageTemperature 37.6 degrees C, heart rate 84 /min regular, blood pressure 146/84 mmHg, respiratory rate 16 /min, SpO2 97% on room air, GCS 15, fingerprick glucose 7.9 mmol/L
Triage noteBrief loss of vision R eye ~5 min, resolved. Headache 2/52. Type 2 diabetes on metformin. Category 3.

Your tasks are to:

  1. Take a focused history.
  2. Request the investigations you would arrange now. The examiner will provide results where they are available.
  3. State your most likely diagnosis and the differential diagnoses to the examiner.
  4. Outline your immediate management plan to the examiner, including the drug, dose and route of any treatment you would start today and who you would involve.
  • You do NOT need to examine the patient; examination findings will be provided by the examiner on request.
  • You do NOT need to summarise your history to the examiner.
  • You do not need to write a drug chart in this station.

This is a 10-minute station, with 2 minutes of reading time.

Ask the examiner

Say what you want out loud, then open it below. Each result stays hidden until you reveal it.

Investigations

Ask for a category the way you would in the station: β€œCan 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.