Location: You are a junior doctor
Patient: A 25 year old patient has noticed scrotal swelling
– Take a focused history from the patient
– After 6 minutes you will be asked a series of questions by the examiner.
– Answer any questions that the patient may have
Note to actor: Try to restrain yourself from volunteering too 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 man who has come into A&E.
You have recently been abroad in mykonos for the week, you have just got back yesterday, since then you have been having pain and swelling on the right side of your scrotum. You originally thought was because of the flight but it has not been getting any better overnight. You were having awful night sweats and had to change your sheets twice. You have a headache as well which is noticed when you woke up.
If directly asked you have been having pain on urination for the past 4 days. You have noticed some penile discharge, this is thick yellow.
You are a sexually active gay male, you have not been using protection whilst abroad. You had an STI check before going abroad which was negative for everything. When you went away you had sex (oral, anal both active and passive) with 5 different people.
You have had no trauma.
Your bowel habit is normal.
PMH No ongoing medical issues
No previous operations
No regular medications
No known drug allergies
You stopped smoking about 4 months ago
You drink about 20 units per week
You live with your partner
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.