Credits:
Vanessa Rodwell (Co-ordinator and Examiner 1)
Leya Bedar (Patient)
Olivia Nwosu (Medical student)
Thinn Aung (Examiner 2)
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The mark scheme for history-taking can be found below:
Respiratory history 3 Written by Leya Bedar Diagnosis: Pulmonary embolism (pleuritic chest pain, SOB, cough, recent surgery, signs of DVT, recent long journey) Other differentials: Acute coronary syndrome e.g. stable angina (possible due to chest pain but unlikely due to cough, pleuritic chest pain and lack of cardiovascular risk factors, past medical history and family…
Neurological history 1 Written by Leya Bedar Diagnosis: Tension headache (band-like distribution of pain, tight and constricting, link to stress, responds to painkillers, stress) Differential diagnosis: Migraine (generalised pain, stress, responds to painkillers but less likely due to nature of pain and lack of aura, photophobia, or clear triggers) Dehydration (dull headache but unlikely due…
Mental health history 4 Written by Leya Bedar Diagnosis: Anxiety – Panic Attack Disorder (episodic palpitations, SOB, dizziness, constant worrying, sources of stress) Other differentials: Hyperthyroidism (possible due to palpitations but less likely as lack of systemic features) Atrial fibrillation (possible due to tachycardia, SOB, dizziness but less likely due to features associated with anxiety)…
Mental health history 3 Written by Leya Bedar Diagnosis: Depression (lethargy, weight loss, episodes of self-harm and thoughts of suicide, triggers, early-morning wakening, isolation) Other differentials: Hypothyroidism (lethargy, however less likely as no weight gain or systemic features) Anxiety (due to stress but very unlikely as patient does not feel anxious) Mark scheme for history…
Gastrointestinal history 3 Written by Leya Bedar Diagnosis: Irritable bowel syndrome (flatulence, generalised abdominal pain, fluctuating between diarrhoea and constipation, link to anxiety) Other differentials: Inflammatory bowel disease – Crohn’s disease/ Ulcerative colitis (possible due to change in bowel habit but less likely due to lack of extra-gastrointestinal manifestations and no blood or mucus in…
Cardiovascular history 3 Written by Olivia Nwosu Diagnosis: Myocardial infarction (due to cardiac nature of pain, intense, autonomic features, family history of cardiovascular disease, T2DM, cardiovascular risk factors) Other differentials: Unstable angina (due to cardiac features, but pain usually goes away) Oesophageal spasm (due to chest pain and previous heartburn, unlikely as factors point to…
