Rheumatology & Orthopaedics
CANDIDATE INSTRUCTIONS
You are a year 2 resident doctor in orthopaedics clinic. Mr James Hughes is referred in by his GP for numbness and tingling in his right hand.
Perform a hand and wrist examination, explaining and reporting your findings to the examiner
At 8 minutes, you will be stopped by the examiner and asked a few questions
2 Minutes Reading Time
10 Minutes Station Time
Total 12 Minutes
EXAMINER INSTRUCTIONS
Timing Instructions: At 8 minutes, stop the candidate and ask the following questions:
Question 1: What is the mostly likely diagnosis?
Answer 1: Carpal Tunnel's Syndrome
Question 2: What is the treatment/ management for Carpal Tunnel’s?
Answer 2:
Rest
Wrist Splint
Steroid Injections
Nerve Decompression Surgery
-
Carpal Tunnel Syndrome of the RIGHT Hand
PATIENT INSTRUCTIONS
-
Name: James Hughes
Age: 47
Date of birth:25/05/1977
-
General inspection- Well, not in any obvious pain or discomfort. Nothing seen at bedside.
Hand Findings:
Weak thumb abduction against resistance
Describe pins and needles/ numbing sensation in the wrist only if Phalen’s and Tinel’s test performed correctly.
Phalen’s test: You are asked to hold your wrists in a flexed position with the backs of both hands pressed together for 30-60s.
Tinel’s test: Candidate taps on the wrist on the palm side.
MARK SCHEME
Introduction
Look
Feel
History of Presenting Complaint
Move (Active Movements)
Special Tests
Completing Examination
Questions
Patient Scores
Enter Your Score Here: /41
SCORE GUIDE
High Pass: > 33
Pass: > 25
Borderline Pass: 20 - 25
Fail: < 20
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!