Location: You are an F1 doctor on the acute general surgical take
Patient: 35 year old women has presented to hospital with severe upper abdominal pain
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 35 year old who has had severe upper abdominal pain for the past 12 hours. It started after eating a Chinese last night with your family. The pain is under your ribs and travels through to your back, it is a 10/10. You have vomited multiple times and you feel very nauseous. You were given IV morphine in the ambulance and that helped with the pain. You have never had pain like this before.
If asked, you have pale stools and dark urine. Your bowels opened this morning, there has been no change in frequency or consistency of your stools. You have been shivering but you feel very hot. On the whole you feel very unwell. If directly asked, your partner has said you look a bit yellow recently and you are very concerned about this.