Station - Instructions for candidate
You are a final-year medical student on placement in a general practice in Perth. Your supervising GP has asked you to see this patient first.
Maricel Dela Cruz, 58, has booked because for the past week the room has been spinning when she rolls over in bed or looks up. She is worried it might be a stroke.
| Practice record | Hypertension on amlodipine 5 mg daily. No other history. No allergies. Non-smoker. |
|---|---|
| Observations (practice nurse) | HR 76 /min regular, BP 138/84 mmHg sitting, 134/82 mmHg standing, T 36.7 degrees C, SpO2 98% on room air |
Your tasks are to:
- Take a focused history of the dizziness.
- Perform a focused examination: the Dix-Hallpike manoeuvre on the patient, and a screen of eye movements, cranial nerves, coordination and gait. Perform the manoeuvres on the patient; the examiner will describe the eye findings.
- State your most likely diagnosis and the differential diagnoses to the examiner.
- Outline your initial management plan to the examiner and explain it to Mrs Dela Cruz.
- You do NOT need to summarise your history and examination findings to the examiner.
- No investigations are required in this station.
- You may perform a treatment manoeuvre on the patient if you judge it appropriate; describe each step as you do it.
This is a 10-minute station, with 2 minutes of reading time.