MARCH 2009 SCENARIOS. POSTED BY A CANDIDATE........

Hey there Colleagues, Just finished the NZREX yesterday (14 March 2009). Would like to know what the other candidates thought of the exam. I will also post the questions that I could remember... There were 16 stations. 4 stations were static stations and I can't really recall them. They were all paper based with 4 to 8 case scenarios at each of them and results and a whole bunch of ECG's and 5 X-rays. You had to choose the most appropriate management plan. But in order to do so, you obviously had to know what the right diagnosis was. Now the active stations: 1) Take a history from a 9 year old boy with knee-joint pain; afterwards you have to talk to the examiner and give a diagnosis and perhaps answer one or two questions. 2) A middle aged male that complains of abdominal pain. LFT result is provided with slightly raised Bilirubin and raised GGT and ALP. The task is to perform an appropriate physical examination on him and tell the examiner what you are doing while you examine and what you are looking for. Afterwards talk to the examiner and give a differential diagnosis. There are no real physical signs on examination. They want to see how you examine the patient and the differential diagnosis you will have to base on the LFT results. 3) This was a communication station: Scenario of a 25 y/o female that has been diagnosed with PCOS and was started on Estelle (oestradial and cyproterone) for this. The diagnosis was already confirmed. You had to see her during her follow-up consultation and discuss and agree with her on a future management plan and if necessary further tests. Answers any questions she may have. 4) Another communication station: Middle aged female with a BMI of 32 that had a whole lot of tests done because she is concerned about how much weight she has put on. Tell her the results of the tests and talk to her or advise her on lifestyle modifications. 5) A young male has been admitted and was operated for a tendon repair to his right hand. The sisters in the ward called you to assist because he wants to leave the hospital and is threatening to remove his stitches. They have already performed a delirium screen which was NEGATIVE. Manage the situation. 6) Station where you had to suture a wound on a patients head. (Seems easy, but believe me when you are anxious and you have to perform every step right (working sterile etc.) it is not that simple; one can make stupid mistakes...) 7) A 62 y/o lady has been referred from the Blood Transfusion services because her Hb was low. Take a history. 8) 12 year old girl complaining of pain in right knee. Perform a physical exam and tell the examiner what you are doing and looking and feeling for. 9) Elderly male is complaining of chest pain. Take a history and afterwards discuss your findings with the examiner and give the most appropriate diagnosis and a list of differentials. 10) A middle aged male is complaining of headaches and a teary right eye with reduced vision as well as numbness to the right side of his face. Perform a focused and appropriate physical examination on him and tell the examiner what you are looking for. (PS: there was NO TUNING FORKS...) 11) Take a history from a women that was referred with high BP and 3 + protein uria. She is 32 weeks pregnant.