Introduction to the Short Case

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People can learn the shorts, and the 'dance' of it in different ways. I wrote out 'scripts' for the common cases as a way of structuring my examinations as well as practising presenting in a concise, coherent way. This site contains those scripts. In general the order I present my findings is the order I examine (to keep it simple), and so my scripts also generally served as my sequence of examination steps. They also contain the classical findings for each short and hence were my way of remembering what to look for. I used them as a base and then could adapt my presentation based on what I found.  This is not necessarily the best way, but it is what worked for me. Use them as much or as little as you like. 

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A couple of things worth mentioning with the shorts. 

 

What question you are answering:

The first part is to think about what questions you are trying to answer. This is slightly different based on the prompt and the type of short case. 

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For example, in Neurology shorts, it is mainly about logically discussing the underlying aetiology and differential diagnoses. 

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In Rheumatology, the diagnosis is often more straight forward, and so it is about discussing the 1) differential diagnoses, 2) severity (i.e. of arthritis) and functional impact, and 3) complications / extra-articular manifestations. 

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Likewise, in Cardiology, it may be about discussing the 1) differentials of the murmur, 2) if confident in the murmur, the underlying aetiology (e.g. aetiology of MR), and 3) the severity (e.g. severity of MR or AS). 

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In a Renal Transplant short, it will be about 1) identifying the transplant, 2) discussing aetiology of the initial ESKD, 3) assessing adequacy of graft function, and 4) assessing complications of disease and treatment (immunosuppression). 

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You get the gist. In summary, think about what questions you need to answer when examining and presenting for each short. 

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What else would you like to do?

At the end of the short, when asked 'is there anything else you would like to do?', mention what you want to do, but also the reasoning for this. For example, in a hand exam, "I would have liked to examine the cardiac system to assess for any associated valvular disease"

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Investigations:

When asked to interpret an investigation, alway relate it back to the patient you just examined. For example, interpet the test (be it an X-Ray, RFTs etc.), and then say, "relating this back to my examination, this is consistent/discordant....and supports/suggests a differential", or something to this effect.