CANDIDATE INSTRUCTIONS

You are a resident year 1 doctor working in the GP Clinic. A 30-year-old lady presents with a history of progressive hearing loss for 5 months. 

  1. Take a focused patient's history. 

  2. 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:

  • Answer 1: Otosclerosis (1 mark) of the RIGHT EAR (1 mark)

  • Answer 2:

    • Perform a full Ears, Nose, and Throat Examination (1 mark),

    • Refer for an audiometry (1 mark) and tympanometry (1 mark)

  • Otosclerosis of the RIGHT EAR

PATIENT INSTRUCTIONS

  • Name: Georgia Green

    Age: 30 Years Old

    Date of Birth: 5th May 1984

    Location: GP Clinic

    Occupation: Gardener

  • I have been having this hearing loss for the past 5 months. I have just given birth to my child 8 months ago”.

    • Site : Right ear 

    • Onset : Sudden onset, first time, no previous trauma or significant event, no exposure to loud music/ use of headphones

    • Character : Find it difficult to hear soft sounds
      (if asked, can’t whispering and low pitched sounds) 

    • Radiating : Non-radiating 

    • Associated symptoms : Occasionally has tinnitus 

    • Timing : Progressively gotten worse

    • Exacerbating : None 

    • Alleviating factors : None 

    • Severity: Nil

    • Ideas: “Does it have to do with my weight?"

    • Expectations: “Tell me more, I want to change!”

    • Concerns: “Will I get a heart attack if I don't stop my bad habits?”

    • Otherwise, NO fever, recent infections

    • NO headache, vertigo, dizziness, otalgia, otorrhea, and fullness in ear.

    • NO chest pain, palpitations, shortness of breath

    • NO vomiting, diarrhea, abdominal pain.

    • Normal urinary flow and bowel habits.

  • Previous hospital admissions: None

    Previous surgeries: None

    Medical conditions: None (No Thalassemia)

    Medications:

    • None. No use of ototoxic drugs.

    Over the counters:

    • None.

    Allergies:

    • None.

  • Father and mother are healthy and well.

    Has 2 brothers, healthy and well.

    • Smoking: Does not smoke

    • Alcohol: Does not drink alcohol

    • Recreational drugs: Never

    • Diet: Eats a well balanced diet

    • Exercise: Haven't been exercising since pregnancy

    • Ill contacts: No one around me was recently ill

    • Home: Lives with husband.

    • Active Daily Living: Gardening

    • Occupation: Gardener for the local neighbourhood.

    • Menstrual history: LMP 2 weeks ago. Regular Flow. No dysmenorrhea and menorrhagia

    • Obstetrics history: NORMAL. No use of ototoxic drugs/ antibiotics

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: 18-32

Borderline Pass: 12 – 16

Fail: 0-11

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