Station - Instructions for candidate
You are an intern on placement in a general practice.
Elena Chen, a 28-year-old university administrator, has booked an urgent appointment with you because of three months of pain in her hands and wrists, a rash on her face that flares in the sun, and persistent tiredness. The GP has asked you to see her and work out what is going on.
| Triage observations | HR 78 regular, BP 118/76 mmHg, RR 16, SpO2 98% on room air, temperature 37.1 C |
|---|---|
| Patient's request | 'I just want to know if this is serious and when I'll feel normal again.' |
Your tasks are to:
- Take a focused history, exploring the joint pain, the rash, fatigue and relevant background.
- Perform a focused examination of the hands, skin and joints. Describe to the examiner what you would like to examine and the relevant findings will be provided to you.
- Request appropriate investigations to clarify the diagnosis. Results will be provided by the examiner if appropriately indicated.
- State your most likely diagnosis and two to three differentials with brief justification.
- Outline your initial management plan, including any prescriptions, referrals and patient education.
- You do NOT need to summarise your history and examination findings to the examiner before giving your diagnosis.
This is a 15-minute station, with 2 minutes of reading time.