Mavis Francis is a 22-year old footballer playing for the Newcastle united football team. He had sustained a fall on his outstretched hand during the game and now complains of pain at the base of his right thumb. Examine his right hand and discuss the plan of management with the examiner.

The X ray reports are back. Discuss the findings with the examiner. Also discuss the plan of management with the examiner.

Joan booth is a 28-year-old teacher in the Mersey side primary school. She had submitted an application for the post of a head teacher and has been short listed for the interview scheduled for this afternoon. However, she presented to the gynaecology clinic this morning with an 8-week history of amenorrhoea and abdominal pain and was diagnosed with ectopic pregnancy. The consultant has advised that she should undergo admission. However, she is very keen to attend the interview, as she thinks it is a stepping-stone in her career. She is requesting you to discharge her. Talk to Mrs. Booth

Robert Edwards had been diagnosed with a right-sided indirect inguinal hernia fourteen months back. He had to wait for fourteen months to get his name in the operating list and was listed for the operation scheduled for tomorrow. However, the anaesthetist mentioned that he was overweight and decided not to go ahead with the operation, unless he brings his weight under control. Mr. Edwards has come to the surgical clinic to see you about this issue. Talk to him and address his concerns.

Little Nodder is an 8-year-old boy and he had sustained a road traffic accident whilst he was playing with his roller skates this morning. He has been examined in the emergency and was resuscitated. The results of the investigations are back and ultrasonography has demonstrated rupture of his spleen. An emergency splenectomy needs to be performed. Mr. Robert Nodder is very worried about the condition of his son. Discuss the management of his condition to Mr. Nodder.

 You are the SHO in the gynecology out patient clinic. Mrs. Eileen savage has been referred to the clinic by her general practitioner because she has been having per vaginal bleeding.  Take a history from Mrs. Savage and discuss the differential diagnosis with the examiner.

You are the SHO in the pediatric out patient clinic.  Mr. Hampton has come to the clinic with his little son. He is worried that his son has not yet started walking. He states that his son in up to date with the immunizations. Take a history form Mr. Hampton and discuss the condition with him.

Mrs. Dawn is a 26-year-old sales person at the Tesco supermarket. She has presented to the genito urinary clinic with the complaints of per vaginal discharge. Examination has been done and investigations reveal that she has Gonorrhea. Talk to Mrs. Dawn about the condition and treatment. Also talk about partner management. She is currently on Oral Contraceptive pills.

Miss Beryl Wyatt is starting her university this summer and she is eagerly looking forward for it. However, she had a second attack of seizure a couple of days back and was diagnosed with Epilepsy. She was evaluated by the neurologist and has been started on Carbamazepine. Miss Wyatt is worried about the implications this diagnosis could have on her lifestyle. Talk to Miss Wyatt about the necessary measures and precautions one needs to take once diagnosed with Epilepsy

Allen Moreland, 28 years old male is a rugby player in the Sheffield team. A couple of months back he had sustained injury to his right ankle during the final rugby match, and has been off the game since then.  He had fractured his right ankle and an open reduction and internal fixation was carried out.  He has now come for the removal of the screws. You are the anesthetic SHO in the clinic.  Talk to Mr. Moreland and assess his suitability for day case surgery.

You are the SHO in the department of surgery. You have been asked by the nurse in the high dependency unit to see a patient who had a right hemicolectomy six hours back for a localized early tumor. The following are the current observations:

Temperature: 38 degree CentigradeBlood Pressure: 80/60 mm. Hg

Pulse: 130/min

Abdomen: distended.

Your registrar is busy in the theater. Ring  your consultant and talk to him about this patient.

June Carter is a 32-year-old teacher. She has presented to the emergency department with a history of pain in her abdomen of ten hours duration. Take a history from Mrs. Carter and talk to her.

GP has referred 35 yr old Mrs Smith to the A & E. She has been suffering from rheumatoid arthritis for last 5 years and has been taking regular pain killers. She had recently gone to see her GP complaining of worsening of pain in the small joints of her hand over last 3 months. She has lost her job due to the sickness. She is extremely concerned about the pain and her future. Take a detailed history and discuss the DD with the examine

 Mr. Frances, a 57-year-old man has come to the Department of Neurology with his complaints of seeing things “double”.

Apart from double vision, he has no other medical problems. He is a very healthy man who goes for a walk in the evenings and is very particular about what he eats.

He smokes about 10 cigarettes daily and occasionally drinks alcohol.

Do the relevant examination of this patient and report your findings to the examiner.

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