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.
Margaret Kearney, 46, has booked an urgent appointment because her left calf has been swollen and aching for three days. She returned from a trip to London four days ago.
| Practice record | Heavy menstrual bleeding, on levonorgestrel 150 microgram / ethinylestradiol 30 microgram (Levlen ED) for 6 years. No other history. No allergies. Non-smoker. Cervical screening and mammogram up to date. |
|---|---|
| Observations (practice nurse) | HR 84 /min regular, BP 132/82 mmHg, RR 14 /min, SpO2 98% on room air, T 37.1 degrees C, weight 84 kg, BMI 31 |
Your tasks are to:
- Take a focused history.
- Perform a focused examination of the lower limbs: inspection, calf measurement, palpation for swelling and tenderness, and the pulses. Verbalise each step and the examiner will provide findings.
- Request the investigations you need and justify each. The examiner will provide results where appropriate.
- State your most likely diagnosis and the differential diagnoses to the examiner, then outline your initial management plan and explain it to Mrs Kearney.
- You do NOT need to summarise your history and examination findings to the examiner.
- State drug, dose and route where relevant, including any change to her current medicines.
- A tape measure is on the table.
This is a 10-minute station, with 2 minutes of reading time.