CANDIDATE INSTRUCTIONS
You are a resident year 1 doctor working in the GP Clinic. A 46-year-old lady presents with a blurry vision for 2 months. She also notices a numbing sensation in her legs.
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?
Answer 1: Newly diagnosed Diabetes Mellitus
Question 2: What are the relevant examinations you will be conducting for this patient?
Answer 2:
Vital Signs: Heart Rate, Respiratory Rate, Blood Pressure, SpO2, Temperature, BMI
Random Blood Sugar (RBS)
Cardiovascular Examination
Diabetic Foot Examination
Sensory Examination
Question 3: What are the non-pharmacological interventions that the patient can do?
Answer 3:
Diet: Change to a low-carbohydrate diet, high in protein and fibre
Exercise: Moderate aerobic exercise for 30 minutes, 5 days a week
Loose Weight
Avoid sugary food and drinks
Question 4: What does HbA1c tell about the patient?
Answer 4: HbA1c is the amount of glucose in the patient's blood for the past recent 3 months
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Type 2 Diabetes Mellitus
PATIENT INSTRUCTIONS
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Name: Deborah Jones
Age: 46 Years Old
Date of Birth: 1st March 1978
Location: GP Clinic
Occupation: Housewife
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“I have been having difficulty seeing for the past 2 months”.
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Site : Both Eyes
Onset : 2 months ago, first time
Character : Blurry
Radiating : N/A
Associated symptoms
Polyuria: "I've been using the loo more often than usual recently"
Nocturia: "I tend to use the loo at night"
Polydipsia: "I notice I have become more thirsty recently"
Paresthesia: "I've been having some tingling and numbness over my hands and feet"
"I've noticed my urine is more frothy and bubbly!"
Timing : Persistent
Exacerbating : N/A
Alleviating factors : N/A
Severity : N/A
Red flag symptoms :
NO eye pain, red eye (▲ Acute Closed Angle Glaucoma)
NO fever, red eye, watery discharge (▲ Acute Conjunctivitis)
NO headache, sudden weakness of the body (▲ TIA)
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Otherwise, NO fever, lost of weight, loss of appetite (constitutional symptoms)
Previous episodes: Never experienced this before.
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Ideas: “Do I have diabetes?"
Expectations: “Please help me doctor?”
Concerns: “Am I going to be blind forever??”
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NO fever, recent infections, cough, flu, chest pain,
NO abdominal pain, vomiting, diarrhea
NO weakness of upper limbs and lower limbs.
Normal 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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Father and mother has diabetes. Diagnosed in their 40s. Compliant with medications. Siblings are otherwise healthy and well.
Married with two children. Otherwise healthy and well.
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Smoking: Does not smoke
Alcohol: Does not drink alcohol
Recreational drugs: Never
Diet: Always eat a lot of bread and rice
Exercise: Never.
Ill contacts: No one around me was recently ill
Home: Lives with husband and children
Active Daily Living: Takes care of grandchildren
Occupation: Housewife
MARK SCHEME
Introduction
Chief Complaint
History of Presenting Complaint
Systems Review
Past Medical History
Previous surgeries done
Drug History
Family History
Social History
Questions
Patient Scores
Enter Your Score Here: /27
SCORE GUIDE
Pass: 18-27
Borderline Pass: 12 – 17
Fail: 0-11
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