All questions

Station

Clinical Scenario

Acute presentations, management plans, escalation.

Acute Internal Medicine 7 min

A 68-year-old presents with sudden-onset breathlessness, SpO2 88% on air, HR 122, BP 90/60. Walk me through your assessment and initial management.

Neurology 6 min

A 55-year-old is brought in with right-sided weakness that started 90 minutes ago. How would you manage this?

Gastroenterology 6 min

A 45-year-old alcoholic presents with haematemesis and melaena. Outline your approach.

Respiratory Medicine 6 min

How do you assess and manage an acute exacerbation of COPD presenting with confusion and SpO2 of 84%?

Endocrinology & Diabetes 6 min

A 22-year-old with type 1 diabetes presents drowsy with glucose 32, ketones 5.6, pH 7.15. Manage this patient.

Renal Medicine 5 min

An 80-year-old has K+ 7.2 on routine bloods. They feel mildly unwell. What is your approach?

Respiratory Medicine 7 min

You are the medical registrar called to review a 28-year-old with worsening asthma. Talk us through your assessment and management.

Respiratory Medicine 3 min

What are the features of life-threatening asthma, and why is a normal CO2 concerning?

Respiratory Medicine 6 min

A 72-year-old with known COPD is drowsy and breathless. ABG on 28% O2: pH 7.28, PaCO2 8.5, PaO2 7.2. Manage this patient.

Respiratory Medicine 3 min

After one hour on NIV the patient's pH is 7.26. How do you proceed?

Respiratory Medicine 2 min

What are the contraindications to NIV?

Respiratory Medicine 3 min

Invasive ventilation is not appropriate and the patient is deteriorating. How would you manage them now?

Respiratory Medicine 4 min

How would you manage suspected SVC obstruction?

Endocrinology & Diabetes 6 min

A 22-year-old woman with T1DM is admitted with her third DKA in 6 months. How would you manage her?

Endocrinology & Diabetes 6 min

A 72-year-old woman is confused with sodium 114 mmol/L. How would you manage her?

Endocrinology & Diabetes 5 min

A 45-year-old with known Addison's presents with vomiting, hypotension and confusion. How would you manage her?

Endocrinology & Diabetes 5 min

A 35-year-old woman has palpitations, tremor and weight loss with suppressed TSH and elevated free T4. How would you approach this?

Endocrinology & Diabetes 3 min

She tells you she is trying to conceive. How does that change your management?

Endocrinology & Diabetes 5 min

A 68-year-old man is constipated and confused. Calcium is 3.3 mmol/L. How would you manage him?

Endocrinology & Diabetes 4 min

A 72-year-old with T2DM on insulin is found confused at home; capillary glucose 2.3 mmol/L. Manage him.

Endocrinology & Diabetes 4 min

A 32-year-old woman has irregular periods, galactorrhoea and elevated prolactin. How would you approach this?

Neurology 7 min

A 72-year-old man arrives in ED with sudden right-sided weakness and slurred speech, started 1 hour ago. Walk us through your management.

Neurology 3 min

What are the key contraindications to thrombolysis in acute stroke?

Neurology 3 min

What stroke mimics must you consider, and what would you do if CT shows haemorrhage instead?

Acute Internal Medicine 8 min

Community Acquired Pneumonia with High NEWS2 — manage the first hour.

Cardiology 8 min

Anterior STEMI complicated by cardiogenic shock — talk us through your management.

Respiratory Medicine 6 min

A patient on the respiratory ward coughs up >250ml of blood. Manage.

Endocrinology & Diabetes 6 min

A patient on long-term prednisolone presents shocked after gastroenteritis. Manage.

Cardiology 6 min

An 82-year-old presents after a witnessed syncopal episode. ECG shows complete heart block with a ventricular escape of 28 bpm. BP 84/52. How will you manage?

Cardiology 7 min

A 70-year-old with known HFrEF (EF 25%) presents with acute breathlessness, frothy sputum, bilateral crackles to the apices, SpO2 86% on air. Talk us through your management.

Gastroenterology 7 min

A 28-year-old with known UC presents with 10 bloody stools per day, abdominal pain, HR 112, temp 38.2. Talk through your assessment and management.

Gastroenterology 7 min

A 52-year-old with gallstones presents with severe epigastric pain, lipase 2400, lactate 4.2, SpO2 90% on air, oliguric. Walk us through your management.

Renal Medicine 6 min

A 55-year-old presents with malaise, haemoptysis and creatinine 420 (baseline 90). Urine dip: blood +++, protein ++. How will you proceed?

Renal Medicine 6 min

A 68-year-old with newly diagnosed myeloma presents drowsy and dehydrated. Adjusted calcium 3.8 mmol/L. Manage.

Geriatric Medicine 6 min

An 87-year-old with dementia is admitted after two falls and confusion. CFS 7, lives alone, normally walks with a frame. Manage the admission.

Respiratory Medicine 4 min

A young trauma patient becomes acutely breathless and hypotensive. Trachea deviated to the right, absent breath sounds on the left. What now?

Acute Internal Medicine 4 min

A 40-year-old develops urticaria, lip swelling and wheeze 10 minutes after starting IV co-amoxiclav. BP 78/40. How do you manage?