Using Investigations to Prescribe Safely - Station 1 - Notes for Candidate

Sep 20, 2026

Upload by Aldword

Training station notes for a FY1 on an AMU describing the clinical presentation of Julie Ward (68F) with an 8-week history of dyspepsia and abdominal pain. The 10-minute station requires summarising history and examination, generating differential diagnoses, selecting and justifying initial investigations, interpreting results, confirming a diagnosis, and prescribing safely. Included are clerking notes, observation details, initial investigations with results (including an awaited OGD and a positive urea breath test), and an examiner marking rubric focused on reasoning, investigation choice, and safe documentation.

LanguageEnglish

CategoryExam

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Station Overview

Candidate Expectations (0-5 minutes)

Candidate Expectations (5-10 minutes)

Clerking Notes

History and Examination

Past Medical and Drug History

Lifestyle and Measurements

Investigations and Results

Urine Dip

Bloods and Organ Function

CRP and Urea Breath Test

OGD (Awaited)

Examiner Marking Rubric

Example Answer

PRESCRIBING Please have the BNF, a calculator and a drug chart handy before commencing the mock station. Using Investigations to Prescribe Safely 1 – Notes for Candidate Using Investigations to Prescribe Safely Station: 10 minutes Patient: Julie Ward (68F) DOB: 03/02/1956 E34876502 You are the FY1 on the AMU. Julie Ward has presented with dyspepsia and abdominal pain for the last 8 weeks. The station will last 10 minutes. Please review the notes and observation chart. The BNF and a calculator are available for you to use You are expected to: 0-5 minutes: • Summarise the key points in the history and examination and explain the differential diagnosis. • Suggest appropriate initial investigations, explaining why • Review the results and confirm your diagnosis 5-10 minutes: • Prescribe safely and appropriately for this patient, given the information provided in the station. Using Investigations to Prescribe Safely: Station documents | Clerking notes | | --- | | HPC:
8/52 history of heartburn, epigastric pain with occasional vomiting. The nausea is worsened after meals and she is often bloated. There is no haematemesis or melaena. No history of fevers, jaundice or diarrhoea. Nil travel history.
No history of weight loss, night sweats or dysphagia.
O/E:
Chest : clear, HS I+II+0
Abdomen: Epigastric tenderness, otherwise soft, non-distended abdomen. BSP. Murphy’s negative. No masses.
Calves: SNT
PMH:
Previous peptic ulcers, T2DM, osteoarthritis
DHx: paracetamol, lansoprazole, Gaviscon, metformin
Allergies: penicillin
SHx:
Alcohol 10 units/week, smokes 10 cigs/day
Patient height, weight:
Height: 172cm
Weight: 53kg | NOW TAKE A MOMENT TO SUGGEST APPROPRIATE INITIAL INVESTIGATIONS BEFORE SCROLLING DOWN Come up with a list of differentials. | Investigations | | | --- | --- | | Urine dip:
Negative for nitrites, leucocytes, ketones, blood
Bloods:
FBC: Hb 135, WCC 9, neuts 6, plts 350
U&Es: Na+ 142, K+ 4 . 1, Ur 5.3, Cr 139,
eGFR 32.7, CrCl: 29ml/min
LFTs: NAD
Bone profile: Adj. Ca 2+ 2.4 Mg2+: 0.9
CRP: 19
Urea breath test:
Positive
OGD:
Awaited |

| Using Investigations to Prescribe Safely 1 – Examiner marksheet | MARKING RUBRIC | ✓ | | --- | --- | | Assimilation of information
• Confident, accurate approach to reviewing and summarising information | | | Investigations
• Requests appropriate initial investigations and appropriately justifies these | | | Interpretation of results and diagnostic reasoning
• Concise, structured approach to interpretation of results
• Generates appropriate list of differential diagnoses and uses investigation results to refine this appropriately, giving an appropriate most-likely diagnosis | | | Clearly documented prescription
• Capitals, time, date, signature with block print name
• Legible, black ink | | | Confident prescriber
• Can prescribe correctly (without using the BNF if it is straightforward)
• Evidence of having practiced prescribing | | | Prescribes safely (patient details)
• Allergies documented
• Correct boxes completed, including any special instructions | | | Prescribes safely (Drug)
• Drug name, dose, route, frequency
• Confident accurate approach
• Considers relevant investigation results: and makes appropriate adjustments | | Global Impression: • Excellent • Good • Pass • Borderline • Fail Using Investigations to Prescribe Safely: Example answer Differential diagnosis: 1. H. pylori infection 2. GORD 3. Peptic ulcers Prescribing considerations: H pylori infection warrants 7 days of triple therapy. This includes 1 PPI, and two antibiotics. First line non-penicillin allergy: PPI + amoxicillin + clarithromycin/metronidazole BUT patient is penicillin allergic. So, the following regime must be used: PPI + metronidazole + clarithromycin Given the patient has renal impairment, we ne

FAQs

What is the candidate expected to do in the first 0–5 minutes of the station?

Summarise key points from the history and examination, explain differential diagnoses, suggest appropriate initial investigations with justification, and review results to confirm the diagnosis.

Which investigations are provided with results in the station materials?

The materials include urine dip results, blood tests (FBC, U&Es, LFTs, bone profile), CRP, and a positive urea breath test; OGD is awaited.

How should prescribing account for the patient’s penicillin allergy and renal impairment?

Penicillin allergy requires a non-penicillin triple therapy regimen. Renal impairment (CrCl ~29 ml/min) requires dose adjustment, with clarithromycin needing a halved dose in the example approach.

Sep 20, 2026

Upload by Aldword