Patient Instructions
Name of Patient:
Lorraine White
Description of the patient & instructions to simulator:
Loraine is 25, normally fit and well working as a GP receptionist.
Her mum has been found to have CKD3b and has just been diagnosed as having polycystic
kidney disease.
Lorraine is in a stable relationship and is wanting to start a family and is worried as her mum
has told her that her consultant mentioned that polycystic kidneys 'run in families' and her
children should be 'checked out'.
Lorraine is worried she might get polycystic kidney disease and that her children might also
be affected
She would like to know what it is, the chances of her having it and the chances of her
children having it and whether ‘you can be tested for it’.
No one else in the family is known to have it
She has no urinary, abdominal or gynae symptoms or problems
No previous medical problems
4 units of alcohol per week and a non smoker
She would be happy with an explanation, PILealfet, USS +/-blood tests and or referral to a
specialist
1
Doctor’s (GP ST) Instructions
Name & age of patient
Lorraine White
Summary Card
PMH: Nil
DH: Nil
Allergies:None
BP/BMI/ ?smoking and alcohol hx:
Case Notes - Last few entries in records:
2010 – flu like symptoms, advised re rest, fluids and paracetamol
2
CSA EXAMINATION CARD
Patient Name: Lorraine White
Examination findings:
BP 120/60
Urine dip negative for blood, glucose and protein
Abdo exam – no enlarged kidneys felt, no masses
3
CSA Case Marking Sheet
Case Name: Lorraine White
Case Title:ADPKD
Context of case

Mum has polycystic kidney disease,
Lorraine worried as wanting to start a
family
Assessment Domain:
1.
Data-gathering, technical and assessment skills
Positive descriptors:

Negative descriptors:
Explores Ideas (knows little about it other
than it runs in families), Concerns (do I
have it? Might my children have it?),
Expectations
(information,
testing,
advice)

FH explored

Asks re abdo pain, abdo swelling, hx of
renal stones (renal stone hx in 1 in 5
patients with ADPKD!), haematuria?


Does not identify ICE especially concerns
re he plans to have children

Does not ask about urinary symptoms e.g.
haematuria

Does not ask about abdominal symptoms

FH not explored

Inadequate examination

No urine dip test
Appropriate exam (BP, urine dip test and
abdo exam)
Assessment Domain:
2.
Clinical Management Skills
Positive descriptors:
Negative descriptors:

Comprehensible explanation
conditions and inheritance

ICE addressed

Offer of blood test (kidney function), ACR,
USS

Offer of a Pileaflet – with contents
explained

of
the

Incomprehensible explanation

Aspects of ICE not addressed

Inappropriate tests or no tests

Lack of signposting to website or PIlealfet

Inadequate safetynetting
Review after results

Consideration of the merits of genetic
counselling referral

Safetynetting
Assessment Domain:
3.
Interpersonal skills
Positive descriptors:
Negative descriptors:

Empathetic, rapport built


Concerns explored


Shared management plan achieved
Concerns not handled
unsympathetically

Understanding explored

Paternalistic approach to management
Cues missed
or
handled
4