Station - Instructions for candidate
You are a final-year medical student on placement in a general practice in Mount Lawley. The GP has asked you to see the next patient, who has booked to discuss hormone therapy.
Janine Marsh, 51, has booked a long appointment. The GP has reviewed the file and asked you to talk with her, counsel her on the regimen noted in the record, and give preventive advice.
| Practice record | 51 F. Non-smoker. BMI 27. BP 124/78 today. No medical history. No regular medicines. Allergies nil. Combined oral contraceptive pill in her 20s, no problems. Two normal vaginal deliveries. Uterus intact. Mammogram 8 months ago normal. Cervical screening test 2 years ago negative. Bowel screening done. Lipids last year: total cholesterol 5.4, LDL 3.2, HDL 1.5. No personal or family history of breast cancer or venous thromboembolism recorded. GP note: suitable for menopausal hormone therapy if she wants it - suggest transdermal oestradiol 50 microgram patch twice weekly with micronised progesterone 200 mg nightly for 12 days a month (or 100 mg nightly continuously). |
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Your tasks are to:
- Take a focused history of her symptoms and of the factors relevant to hormone therapy.
- Counsel her about menopausal hormone therapy - what it does, its benefits and risks for her, how to use the regimen the GP has suggested (transdermal oestradiol with a progestogen), side effects, warning symptoms and follow-up - and support her decision.
- Provide patient-centred lifestyle advice relevant to her symptoms and long-term health, including contraception.
- You do NOT need to summarise your findings to the examiner.
- You do NOT need to examine the patient.
- Plan the station: about 3 minutes for the history and 7 minutes for counselling.
This is a 10-minute station, with 2 minutes of reading time.