Gastrointestinal System
CANDIDATE INSTRUCTIONS
You are a resident doctor currently working on a gastroenterology ward. A 60-year-old male complains of blood stools this morning. You have completed an abdominal examination and now wish to examine his back passage.
Please perform a digital rectal examination on this patient
You may be stopped at 8 minutes to answer further questions from the examiner
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: List are the contraindications in performing a DRE
Answer 1: Without patient consent, severe anal pain i.e. recent anal surgery, anal fissures/fistula
Question 2: List 3 common causes of blood in stools
Answer 2: Haemorrhoids, Anal fissures, Rectal prolapse, Diverticular disease, Colorectal Cancer.
Question 3: What are your diagnostic workup?
Answer 3:
Bedside- abdominal examination, stool sample
Laboratory- full blood count, U&Es, LFTs, coagulation profile, group and save, CRP
Imaging- Colonoscopy, CT scan
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N/A (Normal DRE)
PATIENT INSTRUCTIONS
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Name: Ryan Ghosting
Date of birth: 01/07/1964
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General inspection - Nil
Palpation - Nil pain, blood, or mucus or stools
MARK SCHEME
Introduction
Preparation
Inspection
Examination
Completion
Questions
Patient Scores
Enter Your Score Here: /32
SCORE GUIDE
High Pass: > 25
Pass: > 16
Borderline Pass: 10 – 15
Fail: < 10
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