CANDIDATE INSTRUCTION
Please take a history of a middle-agedmale withright
upper abdominal pain, fever, and a history of
dysentery 2 weeks back. He had visited interior Sindh
some time back. The examiner will observe you and
score you during the history-taking process.
Standardized Patient Instruction
The candidate (doctor) will ask you about your illness
through a series of questions which may not be in the
order that you have been given. Please try and
answer as close to the written questions and try to act
nervous. If you do not know the answer of to a
question which the doctor asks say you are not clear
about the question. Examiner will be present
throughout the session.
Possible Questions Which the Doctor Should Ask
Question. What is your name?
Answer. My name is Rehan
Question. How old you are?
Answer. I am 35 years old.
Question. Where do you live?
Answer. In Sohrab Goth
Question: Are you muslim?
Answer: Yes
Question. Are you married?
Answer. Yes
What is your occupation?
Answer: I am plumber
Question. With which complaint you came here?
Answer. I am having pain in right side upper abdomen for 5 day.
Question: Is it confined here in right upper abdomen or it spreads anywhere?
Answer. Its fixed pain
Question: Does it happened after any specific kind of food?
Answer: No.
Question: what is the character of pain?
Answer: its continuous and throbbing type of pain.
Question: How it is relieved?
Answer: I have to take pain killers.
Question: What thing aggravates this pain?
Answer: Nothing aggravate this pain.
Question: what is the intensity of pain?
Answer: its intensity is increasing gradually, now it is severe
Question: on the scale of 1 to 10, how will you rate your pain?
Answer: its 7
Question: Do you feel pain in shoulder?
Answer: Yes. I am feeling pain in the tip of right shoulder
Question: Do you feel nausea or experience vomiting?
Answer: I am having nausea and vomiting for the last 3 days.
Question: What is the frequency?
Answer: Approximately 5 to 6 per day.
Question: what does it contain?
Answer: it contains food particles
Question: does it contain blood?
Answer: No.
Question: Does it falls on clothes or in floor at some distance?
Answer: It falls on floor.
Question: Do you have normal appetite?
Answer: No, my appetite is suppressed. I don’t want to eat anything.
Question: Do you have fever?
Answer: I am having fever for one week.
Question: is it low grade or high grade?
Answer: Its high grade fever.
Question: Is it associated with chills and rigors.
Answer: Yes, It is associated with rigors.
Question: How is it relieved?
Answer: it is relieved only by taking paracetamol
Question: Do you have jaundice or notice in change in colour of eyes or urine?
Answer: No.
Question: Do you have any problem in passing stool?
Answer: I had loose motions with passage of mucous per rectum 2 weeks back.
Question: what treatment did you take?
Answer: Doctor gave me medicine which I took for two days then got better.
Question: Do you have hypertension, diabetes or any chronic medical illness.
Answer: Nil
Question: what are the living conditions in house?
Answer: I live in 2 rooms house, ill ventilated, 8 persons living in house
Question: What type of drinking water do you use?
Answer: I use tap water.
Examiner Instruction
These are candidate instructions
Please take a history of a middle age male with
rightupper abdominal pain, fever and history of
dysentery 2 weeks back, the examiner will observe
you and score you during the history taking process.
And the instructions given to standardized patients are
The candidate (doctor) will ask you about your illness
through a series of questions which may not be in the
order that you have been given. Please try and
answer as close to the written questions and try to act
nervous. If you do not know the answer of to a
question which the doctor asks say you are not clear
about the question. Examiner will be present
throughout the session.
Specific Instructions for examiners
You will ask the candidate to read the instructions and proceed accordingly
and the standardized patient has the questions and answers to them. If the
candidate asks a question to which the simulated patient cannot respond
appropriately you can interject or ask the candidate to ask a different
question relevant to the history.
You have been provided the history of the simulated patient and the
scoring checklist. Please mark according to the closest response you feel is
correct. Thank you
A Simulated patient with right upper abdominal pain, fever
and history of dysentery
;
Bio Data:
Name:Rehan
Age: 35 years
Gender: Male
Religion: Islam
Residence:Sohrab Goth
Occupation: Plumber
Marital Status: Married
Presenting complaint:
Pain right upper abdomen for 5 days.
Fever for 5 days
Vomiting for 3 days
History of presenting complaints
I am in usual state of health 5 days back then I felt pain right upper
abdomen. This pain was continuous and throbbing and got relieve by
taking pain killer. There is no aggravating factor. It is fixed in right
upper abdomen and simultaneously I feel pain at the tip of right
shoulder. Its intensity is increasing gradually and now it is severe and
in the scale of 1 to 10 I can grade it 7.
This pain is associated with high grade fever with rigors which is
relieved by taking paracetamol.
I am having nausea and vomiting for 3 days. Vomitus contains food
particle and no blood. It’s about 5 to 6 episodes per day. It is
projectile. My appetite is suppressed and I don’t want to eat
anything.
Past Surgical History
No history of surgery.
Past Medical History
No history of jaundice.
I had dysentery 2 weeks back treated partially for 2 days.
No history of medical illness.
Socioeconomic History
I live in 2 rooms house and use tap water for drinking.
Station No:_____________ Date:____________
Questions Marks
Introduction
Tell the name 0.5
Purpose of conversation 0.5
Biodata
Age 0.5
Religion 0.5
Residence 0.5
Occupation 0.5
Pain
Duration 01
Character 01
Intensity 01
Radiation 01
Referred pain 01
Aggravating factor 01
Relieving factor 01
Nausea and vomiting
Duration 01
Frequency 01
Contents 01
Anorexia 01
Fever
Duration 01
Grade of fever 01
Rigors or chills 01
Relieving factor 01
Past Medical History
Treatment taken for dysentry 01
History of Jaundice 01
History of medical illness 01
Past Surgical History 01
Socioeconomic History
2 rooms house 01
Type of drinking water 01
Total 24
Examiner Name:________________
Examiner Signature:_____________
