Gastrointestinal System
CANDIDATE INSTRUCTIONS
You are a medical student currently in your acute medicine rotation. You have asked to perform an abdomen examination on a 24-year-old female, who has presented to the acute assessment unit. This patient has been clerked; you are not required to take a history.
Please perform a complete abdominal examination and report your findings.
At 9 minutes, the examiner may ask you further questions
2 Minutes Reading Time
10 Minutes Station Time
Total 12 Minutes
EXAMINER INSTRUCTIONS
Timing Instructions: At 9 minutes, stop the candidate and ask the following questions:
Question 1: What are your top 3 differential diagnosis?
Answer 1: Acute appendicitis, Pelvic Inflammatory Disease, Ectopic Pregnancy
Question 2: What are your diagnostic workup?
Answer 2:
Bedside- abdominal examination, urine hCG
Laboratory- full blood count, coagulation profile, group and save
Imaging- consider abdomen/pelvis ultrasound
-
Acute Appendicitis
PATIENT INSTRUCTIONS
-
Name- Stephanie Lee
Date of birth- 21/06/2000
-
General inspection- visibly in distress due to pain, vomit bowl insight
Give vital signs findings, if asked directly:
Pulse rate: 88 bpm, strong and regular
Blood pressure: 120/80 mmHg
Respiratory rate: 20 bpm
Temperature: 38.1℃
Abdomen findings-
Exhibit right lower abdominal tenderness on palpation
Show rebound tenderness (pain when the examinee removes their palpating hand)
Demonstrate guarding (contraction of the abdominal muscles when palpating the RLQ)
Experience pain the RLQ when the candidate presses on the LLQ (Rovsing sign)
Experience pain when the candidate extends your right hip (psoas sign)
MARK SCHEME
Introduction
General Inspection
Hands and Arms
Eyes, Face, Mouth
Neck and Chest
Abdomen
Legs
Endpieces
Questions
Patient Scores
Enter Your Score Here: /46
SCORE GUIDE
High Pass: > 35
Pass: > 23
Borderline Pass: 18 – 22
Fail: < 18
Help us make this site even better—got ideas, requests, or just want to shake things up? Let us know with a quick click below!