Pelvic pain scenario

candidate brief

actor brief

  1. 32yo pelvic pain for last 2/52 (pointing toward PID)
  2. 18yo sudden onset R pelvic pain/RIF pain, nausea. Previously told she had ovarian cysts but no active f/up. PMH: nil. DHx: COCP. NDKA. LMP (pointing toward ovarian torsion)

examiner brief

  • washes hands, introduces self
  • confirms patient identity
  • ensures no immediate pain/discomfort
  • obtains history of presenting complaint
    • duration and onset
    • nature of pain
  • asks about associated symptoms
    • vaginal discharge
    • dyspareunia
    • dysuria
    • abnormal PV bleeding
    • infective symptoms
    • B symptoms
    • nausea/vomiting
  • States need to examine patient
  • PMH
  • DHx and allergies
  • Social history
  • Gynae history, LMP

scenario 1:

  • Signposts sexual history + explains relevance
  • Suggests appropriate investigations at appropriate pace
    • high vaginal swabs
    • TVUS

scenario 2:

  • recognise time-critical nature of presentation
  • Suggests appropriate investigations - pregnancy test,
  • States need for gynae r/v, potentially to theatre as an emergency

#mrcem-osce #osce-complex-stable

Ovarian torsion
menorrhagia