Ear, Nose and Throat
CANDIDATE INSTRUCTIONS
You are a resident year 2 doctor working in the GP Clinic. A 44-year-old man, has come to you with a history of dizziness.
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:
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Answer 1: Benign Paroxysmal Positional Vertigo (BPPV)
Note: Say FULL diagnosis for marks.
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Answer 2:
Diagnosis: Dix-Hallpike Maneuver
Treatment: Epley's Maneuver
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Benign Paroxysmal Positional Vertigo
PATIENT INSTRUCTIONS
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Name: Adam Graham
Age: 44 Years Old
Date of Birth: 2nd May 1980
Location: GP Clinic
Occupation: Taxi Driver
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“I feel like everything around me is spinning! I had to take time off work because of this.”
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It has happened for about 3 times now.
Has not fallen down because of this
Does not happen when suddenly stands up from a sitting position
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Site : N/A
Onset : 5 days ago
Character : The room is spinning
Radiating : N/A
Associated symptoms
Nausea
Timing: Last for 30 seconds
Exacerbating : When moving head left to right, up to down; happens when turning around in bed
Alleviating factors : None
Severity : Nil
Red flag symptoms : N/A
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Ideas: “No idea Doctor"
Expectations: “I just wish to get back to work Dr”
Concerns: “Do I have a brain tumour?”
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Otherwise, NO fever, recent infections, flu-like symptoms
NO headache, numbness around face
NO ear pain, tinnitus, hearing loss, feeling faint
NO chest pain, palpitations, shortness of breath,
NO vomiting, 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:
None.
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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 with wife.
Active Daily Living: Works as a taxi driver. Not stressful.
Occupation: Taxi driver
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: /33
SCORE GUIDE
Pass: 19-33
Borderline Pass: 12 – 18
Fail: 0-11
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