1. OG GP: Recurrent miscarriage 3 times (8-10 wks) IV, Mx, Counselling. Patient What could be the cause?

e? Is there any treatment? What is my chance of pregnancy? What should I do? Examiner What investigations you want to do? What are you looking for? Why do you want to do it? 2. GP: FNAC result shows No features of malignancy with 50 yr mother with breast cancer. Explain FNAC result and answer patient concern and Mx accordingly. (same as the case in AMC book) Patient is on COC pill What should I do? Am I high risk of cancer? What can I do to prevent it? What should I do with the pill? I have my sister, what should she do? 3. PED ED: 3 year old child with painful hip has history of a recent flu. Focused History, Explain Blood test and D/Dx and Mx. Patients father What wrong with my girl? What does it mean from blood test? When she will recover? What should she see you again? 4. OG GP: 38 year old mother with one previous down syndrome (risk 1 in 100) comes for pregnancy advice. Answer patient questions. She wants to have a baby but her husband doesnt. What should I do? How can I know that my baby does not have Down Syndrome again? 5. PED GP: Mother of severely intellectually disabled 14 year old girl on phenytoin and phenobarbitone nearly for her life and her epilepsy is controlled, come for contraceptive advice. Answer mothers questions and Manage. She still hasnt had her period. Mother Can she have sterilization? Can I decide for her? Can you decide for her? What are the other options for contraception? Is she really at risk of unwanted pregnancy? Can she have a normal baby? 6. GP: 50 year old lady complains of bloating of her abdomen after eating relieve by bowel motion. USG given shows 3 Gall stones explain findings and Mx. Patient I dont know about the gall bladder, tell me about it? What could be the complications if I dont want to remove it? What kind of operation? How long will I stay in hospital? When can I go back to work? Will the bloating go away after operation?

7. GP: 25 yr old man with Focused History of schizophreniform disorder 3 years ago complain of dizziness and his GP recently started Risperidone 2 tablets cm (Patient unaware of the does). Focused History and Mx. Patient Dizziness after sudden change in posture He stop Risperidone himself this morning Exam show Postural hypotension What is the cause of dizziness? GP should have told me, isnt it? Why? What should I do? It takes long time to have an appointment with psychiatrist, can you do something? Examiner What is your immediate and long term Management plan for this patient?

8. GP: 23 yr old lady cannot speak after her mother recent hospitalization with liver failure and waiting for transplant. Focused History, explain, manage. Patient ask question by writing Will I ever talk again? Can I go to see my mum? 9. GP: 50 year old man with hypertension on ACEI complain of cramping pain right leg. Do Exam, Investigate and Manage. Patient What is wrong, Dr? What should I do? 10. ED: 65 year old lady complain of sudden onset of pleuritic pain recently after 6 weeks of colonoscopy for diverticulitis (seems to be slow to recover). On exam right base of lung reduce breath sounds and dull. CXR minimal effusion (loss of costophrenic angle) in PA and lateral. Explain CXR, suggest further investigation and D/Dx. Patient What is wrong with my lungs? What could be the cause? Could it be cancer? Is this related to the recent procedure? What are you going to do? Examiner What further investigations would you like to do? 11. GP: 25 yr old computer programmer complain of diarrhea. Focused History, suggest further investigations explain with reasons to patient. Patient Bloody one, 5-6 times/day No family history of CRC 12. GP: 25 year old man working as a courier service recently diagnosed as Idiopathic Generalized Tonic Clonic Epilepsy by a neurologist with EEG and on Cabamazepine for 3 weeks. Explain about Dx and answer patient questions. Patient Can I still drive? What should I do?

Can I ever drive again? Should I take the medication life long? What is my long term outlook? When can I start to work? What about sports? Do I need any investigations? When should I see you again? 13. GP: 25 year old lady recently confirmed mild hypertension 140/90-150/95. She is not overweight. Focused History, Investigate and Mx. Patient is on COC pill Do I need any investigation? 14. PED GP: A father of 9 month old baby girl comes to you because her daughter recently has foul smelling urine and mild temperature. Urine dip stick show pus cells ++++, Nitrate +++, RBC ++. Explain about Dx and investigate and Mx. What is wrong with my baby? Does she need any investigations? Suprapubic aspiration How do you do that? Is that painful? When should I bring my daughter again? Does she need further investigations? What does it mean when the recheck urine test is still positive for infection? 15. GP: Your previously seen patient, said that it will be soon to reach a state where she cannot handle the suffering especially her pain, 55 year old lady diagnosed with Pancreatic cancer recently stop having chemotherapy request you to do something to end her life as she doesnt want to be a burden of family and want to die decently. Response to patient question for 5 mins and give a management plan. (Same case from AMC book) 16. OG ED: A 25 year old mother primid with 30 week pregnancy complains of bleeding per vaginal associated with intial pain. Focused History and Manage. Patient Can I go home as I have 2 children at home? Is this serious? How long should I stay in hospital? What if there is no bleeding, baby is normal and all investigations are normal, can I go home? What if there is no bleeding, baby is normal and all investigations are normal for a week, can I go home as staying here means disturbance of my daily life?