Credits:
Vanessa Rodwell (Co-ordinator & Examiner 1)
Leya Bedar (Examiner 2)
Emma Westwood (Medical Student)
Shakthi Nandakumar (Patient)
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The mark scheme for history-taking can be found below:
Respiratory history 1 Written by Olivia Nwosu Diagnosis: Tuberculosis (constitutional symptoms, recent travel history) Other differentials: Lung cancer (This is the main differential, but the travel history and low amount of cigarettes make this less likely) Sarcoidosis (can produce a cough and systemic features but less likely due to no SOB and other body systems…
Gastrointestinal history 5 Written by Leya Bedar Diagnosis: Peptic ulcer disease (nature of pain, epigastric, worse after eating but delayed onset, exacerbated by spicy food, NSAID use, smoking history) Other differentials: Gastric cancer (weight loss, abdominal pain, haematemesis) Pancreatitis (abdominal pain, delayed onset after eating, weight loss) Mark scheme for history taking can be found…
Musculoskeletal history 3 Written by Leya Bedar Diagnosis: Gout (attacks of pain, inflammatory features, alcohol use, dietary risk factors) Differential diagnosis: Pseudogout (similar features but unlikely to affect the big toe) Septic arthritis (inflammatory features, but not episodic or associated with these risk factors) Corns/callus on plantar surface of foot (possible to explain pain but…
Mental health history 2 Written by Leya Bedar Diagnosis: Depression (lethargy, weight loss due to lack of appetite, thoughts of self-harm and suicide, hopelessness, worthlessness, early-morning wakening, stress) Other differentials: Hypothyroidism (lethargy, loss of appetite however less likely as no weight gain or systemic features) Anxiety (due to stress but very unlikely as patient does…
Musculoskeletal history 5 Written by Leya Bedar Diagnosis: Psoriatic arthritis (stiffness, dactylitis, nail lesions, history of psoriasis) Differential diagnosis: Rheumatoid arthritis (morning stiffness, swelling, joint pain, age) Osteoarthritis (could be early osteoarthritis – could be Heberdens nodes at DIPs, stiffness, swelling, joint pain) Mark scheme for history taking can be found below
Gastrointestinal history 7 Written by Moriom Begum Diagnosis: Anal fissure (fresh blood, pain during bowel movement, previous constipation) Other differentials: Haemorrhoids (fresh blood, previous constipation but less likely due to sharp pain during bowel movement and no lumps or pruritus) Inflammatory bowel disease (possible due to family history, may present with perianal disease, blood in…
