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Candidate
Actor
Mark Scheme
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P3 C Station 2

You are a physician associate working in GP and have an appointment with Iris Palmer who has come in today to discuss a recent change in her bowels.

 

  • Take a focused history 

  • Answer the examiners question in the final minute

Iris Palmer 

27 years old 

Store Manager

You are a 27 year old Store manager who has noticed a recent change in your bowels. You feel quite embarrassed to speak about this and ask the candidate if it's okay if you share all the details. Be reluctant to share the information unless the candidate makes you feel comfortable. You have seen blood a few times in your bowels. You thought it was your period at first but you are no longer on your period. Last menstrual period was 3 weeks ago. It is fresh blood often mixed with bowels. You have also noticed a strange watery thick discharge after you pass your bowels. You are quite unsure what this might be as you have never seen these happen before. They appeared 5 weeks ago and they occur nearly every bowel movement. You have decided to finally come in as you are on your holiday leave at work.

You have not noticed any bowel changes, no constipation and no diarrhoea. You open your bowels regularly. Twice a day, bleeding tends to occur at night. You deny having abdominal pain per say but you have noticed mild crampy pain but you have put it down to your periods. When asked about weight loss, deny any. No joint pains, no visual changes, no fever, no loss of appetite and no night sweats. 

 

You are concerned you may have a cut somewhere but there's no pain when passing bowels. You are worried you will lose a lot of blood and be too weak to work. You expect to have someone examine you.  

 

Past Medical History

Nil

No past surgical History

Drug History

Microgynon 30 

NKDA

Social History

Non smoker, occasionally drinks at events 

Family History

No bowel cancer

HTN ( mum ) 

COMPLETED

Category

Question

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Introduction

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History of presenting complaint

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Explore GI related symptoms

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System review

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Past Medical History

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Drug History

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Social History

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Family History

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ICE

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Summarise

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Answer examiner questions

Last 1 minute

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End

Submit

Pass

100%

Your Score

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