Station - Instructions for candidate
You are a final-year medical student on a general practice placement in Bunbury.
Priya Naidoo, a 34-year-old retail assistant, has come to the practice with three days of constant right-sided loin pain. She has felt hot and shivery and has had two shaking chills. The practice nurse took her observations before you went in and left a fresh urine sample on the desk.
| Temperature | 38.5 degrees C |
|---|---|
| Heart rate | 118 beats/minute |
| Blood pressure | 104/62 mmHg |
| Respiratory rate | 22 breaths/minute |
| Oxygen saturation | 97% on room air |
| Pain score | 8/10 in the right loin |
Results provided:
Urinalysis
| Item | Value | Reference range |
|---|---|---|
| Leucocytes | 3+ | negative |
| Nitrites | Positive | negative |
| Blood | 2+ | negative |
| Protein | 1+ | negative |
| pH | 6.0 | 4.5-8.0 |
Your tasks are to:
- Take a focused history of the presenting complaint.
- Perform a focused examination of the abdomen and renal angles. Describe to the examiner what you are looking for, and the relevant findings will be provided to you.
- Request any relevant investigations. Results will be provided by the examiner if appropriately indicated.
- Interpret the results provided to you.
- Outline your immediate management plan, including escalation and referral.
- Summarise your findings and differential diagnoses to the examiner.
- Findings will be provided by the examiner on request.
- You are not required to perform a vaginal or genital examination in this station.
- You do not need to prescribe or write in the notes.
This is a 15-minute station, with 2 minutes of reading time.