Ear, Nose and Throat
CANDIDATE INSTRUCTIONS
You are a resident year 2 doctor working in the GP Clinic. A 30-year-old gentleman presents with a history of right ear pain for the 2 days.
Take a focused patient's history.
At 7 minutes, the examiner will stop you to ask you some questions.
2 Minutes Reading Time
10 Minutes Station Time
Total 12 Minutes
EXAMINER INSTRUCTIONS
Timing Instructions: At 7 minutes, stop the candidate and ask the following questions:
Question 1: What is your provisional diagnosis for this patient?
Answer 1: Acute Otitis Media (1 mark) of the RIGHT EAR (1 mark)
Note: Please specify which ear for FULL diagnosis.
Question 2: What is the general management for this patient?
Answer 2:
Reassure that it is self-limiting
Paracetamol for the fever-like symptoms and pain
Arrange follow-up in case of persistent otalgia, systematically unwell, or otorrhoea due to perforation
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Acute Otitis Media of the RIGHT EAR
PATIENT INSTRUCTIONS
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Name: Adam Fletcher
Age: 30 Years Old
Date of Birth: 2nd May 1994
Location: GP Clinic
Occupation: Businessman
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“Doctor, I have been having pain in my ear for the past 3 days!”.
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“This pain affects my sleep, Doctor!”
“I had a recent flu infection 1 week ago, but now I have recovered.”
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Site : Right Ear
Onset : 3 days
Character : Burning pain
Radiating : No
Associated symptoms
Feels hot “feverish”
Timing: Persistent
Exacerbating : None
Alleviating factors : None
Severity : 7/10
Red flag symptoms :
No acute trauma
No chills and rigor, systematically unwell (TRO systemic infection)
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Ideas: “I think I have an ear infection?"
Expectations: “None”
Concerns: “Is it an infection?”
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Otherwise, NO headache, nausea and vomtiing
NO otorrhoea, hearing loss, tinnitus, vertigo
NO lumps and bumps
NO chest pain, palpitations, cough, shortness of breath,
NO diarrhea, abdominal pain.
Normal urinary flow and bowel habits.
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Previous hospital admissions: None
Previous surgeries: None
Medical conditions: None
Medications:
None
Over the counters:
None.
Allergies:
Amoxicillin
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Everyone in the family is healthy and well
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Smoking: Does not smoke
Alcohol: Does not dirnk alcohol
Recreational drugs: Never
Diet: Eats a well-balanced meal
Exercise: Never
Ill contacts: None
Home: Stays alone
Active Daily Living: Normal
Occupation: Businessman
No recent travels
MARK SCHEME
Introduction
Chief Complaint
History of Presenting Complaint
Systems Review
Past Medical History
Drug History
Family History
Social History
Questions
Patient Scores
Enter Your Score Here: /32
SCORE GUIDE
Pass: 19-32
Borderline Pass: 12 – 18
Fail: 0-11
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