The Short Case Exam

From now onwards, every patient that you see in hospital, be it a ward patient, ED admission or a patient that you’re seeing in clinic should be a short case examination.

This is the time when you should be focusing on developing good clinical habits.

Get hold of some good books on clinical examination techniques, stick to that style and do it over and over again.

The most important thing is to be doing it properly each time. No more 10 seconds neurological exam and documenting in the notes, NAD (No Abnormality Detected) or some cynics would say ‘Not Actually Done’.

Just like the most decorated Olympic athlete in history, Michael Phelps, you need to develop a routine when practicing your short case but to also be prepared for every possible scenario that they may throw at you during the exam.

Again, having a good strategy is key to being successful in the exam. In one of the articles taken from the RACP News 2009, the college released a list of short case diagnoses that came out in the actual FRACP Adult Medicine Clinical Examination for that year.

The article can be viewed HERE.

Note the frequency or number of cases for each diagnoses as this should provide you with some strategy as to which type of cases you should be practicing for and how best to prepare for it. For example, there were a total of 27 cases for mitral incompetence but only 4 cases of pulmonary incompetence.

This does not mean that you should ignore the murmurs of pulmonary incompetence as such, but to rather focus your efforts and your precious practice time to become very familiar and well versed when faced with a case of mitral incompetence in your exam.

I can’t stress it enough but nothing beats practice when it comes to good presentation and discussion in the clinical exam both the short and long cases. You should be practicing on as many cases as you can get your hands on and have a plan of ‘attack’ for each possible question that the examiners may ask you in the exam.

There is no fixed way of presenting. Every person have their own style of presentation and you will over time develop your  own style of presentation as you practice on more and more patients each day.

As part of my preparation for the clinical exam, I created some audio recording of the short cases which I would listen to during my commute to and back from work and whenever the opportunity arises (even before bedtime). It helped me to ‘visualize’ the case and prepare my thoughts for the real exam.

Here is an example of one of the audio recordings I made on the case of a patient with optic neuritis.

 

So if you are interested in purchasing my audio recordings, please Signup here.

The set of audio recordings include ALL of the following cases as per below (All attached with a written format in pdf for easy reference).

Please note that the product will be delivered in digital form via a website link rather than a physical product.

 

Cardiology:

  • Aortic regurgitation
  • Aortic stenosis
  • Hypertrophic Cardiomyopathy
  • Mitral incompetence
  • Tetralogy of fallot
  • Tricuspid incompetence
  • Ventricular septal defect.

Endocrinology:

  • Acromegaly
  • Ankylosing spondylitis
  • Goitre

Respiratory:

  • Interstitial lung disease
  • Lobectomy
  • Bronchiectasis
  • Dullness at the bases
  • Pneumonectomy

Neurology:

  • Bulbar palsy
  • Charcot Marie Tooth Disease
  • Fascioscapulohumeral dystrophy
  • Friedreich’s ataxia
  • Multiple sclerosis
  • Myasthenia Gravis
  • Myotonic Dystrophy
  • Optic neuritis
  • Parkinson’s disease
  • Motor neuron disease
  • Peripheral neuropathy

Rheumatology:

  • Psoriatic arthropathy
  • Rheumatoid arthritis
  • Marfan’s syndrome
  • Dermatomyositis

Gastroenterology:

  • Liver cirrhosis

Hematology:

  • Splenomegaly.

Renal:

  • PCKD with renal transplant
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Clinical Exam Short Case

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