Location: You are an FY1 in general practice
Patient: 25 year old patient has noticed a 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 usually fit and well 25 year old man. Your partner noticed a lump down below about 3 months ago, you have agreed to come in because they keep asking you to make an appointment. You originally thought it would go away because it has not been painful but it seems to be slightly larger than it was before. Over the past week there has been a dull ache which you have been taking paracetamol for but it does not seem to of helped.
You are not sure if you have lost weight but you have noticed you have had to do up your belt tighter than you usually do.
You have had no trauma.
No lower urinary tract symptoms = frequency, dysuria, ect
Your bowel habit is normal.
You are sexually active. Sex with men, same partner for the past 3 years. You recently have had an STI test 3 weeks ago that was negative.
PMH No ongoing medical issues
You had to have an operation when you were younger because your testicles did not descend correctly but you were to young to remember the details of this.
You do not take any regular medications
No known drug allergies
You stopped smoking about 4 months ago, you now use a vaper
You drink about 10 pints of beer a week
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.