Station - Instructions for candidate
You are a final-year medical student on placement in a general practice in Armadale. Your supervising GP has asked you to see this patient first.
Deng Deng, 27, has booked a long appointment because of four months of sudden episodes of a racing heart and breathlessness. Results from an Emergency Department visit and from tests your supervisor ordered last month are on the practice record.
| Practice record | ED attendance 2 months ago: ECG and troponin normal, discharged. Last month: TSH 1.9 mIU/L, free T4 14 pmol/L, FBC, UEC, calcium and fasting glucose all normal. No regular medicines. No allergies. Non-smoker. |
|---|---|
| Observations today (practice nurse) | HR 78 /min regular, BP 124/78 mmHg, RR 14 /min, SpO2 99% on room air, T 36.7 degrees C, BMI 24 |
Your tasks are to:
- Take a focused history of the episodes and their effect on his life.
- Request any further investigations you think are needed. The examiner will provide results or tell you they are not indicated.
- State your most likely diagnosis and the differential diagnoses to the examiner.
- Outline your initial management plan and explain it to Deng.
- You do NOT need to examine the patient.
- You do NOT need to summarise the history to the examiner.
- State drug, dose and route where relevant.
This is a 10-minute station, with 2 minutes of reading time.