Note to actor: Try to restrain yourself from volunteering to much information – you may do so when prompted (that is, by a specific question, not a general one). If a student is on the wrong line of clinical reasoning do not fuel this line of thinking, state no to the question as being ambiguous may prompt further questioning and does not allow the student to be appropriately tested. The aim of the exercise is to take a focused history; short answers are required.
You are a 25 year old female. You were out for dinner last night and felt a bit sick, with some abdominal pain, went home and went to bed. Woke up at 2am and vomited. You had severe abdominal pain much worse over the right hand side. You vomited again and was unable to sleep because of the pain. You decided to wait until the morning and booked an appointment with your GP, they have sent you straight into hospital and you don’t know what is going on. You are completely off your food, you have not had anything to eat and drink since yesterday evening.
If asked your periods are regular, you have just had your period over the last couple of days. You are not sexually active and take the combined pill. You do not think you could be pregnant.
Past Medical History
Drug History
- Salbutmaol when you need it
- Combined oral contraceptive pill
- If asked you are allergic to Clarithromycin (you have diarrhoea when you have this)
Social History
- Drink socially on the weekends
- You are a non-smoker and you have never smoked
Ideas, Concerns, Expectations & Feelings
- You are worried about the pain as it does not seem to be getting any better.
If the candidate appears to have finished early remind them how long is left at the station and enquire if there is anything else they would like to ask, or whether they have finished. If they have finished, please remain silent and allow the candidate that time for reflection.
