💡 CASE REVIEW: Progressive dysphagia in an older smoker This is a classic examiner favourite — and easy marks if you spot the pattern. Here’s the OSCE-style breakdown: – Most likely diagnosis: Oesophageal cancer – Why? – Progressive dysphagia (solids → liquids) – Weight loss cachexia – Long smoking history – Regurgitation supports obstruction rather than motility 🧠 Next steps & management: – Urgent upper GI endoscopy with biopsy – CT chest/abdomen for staging – MDT referral early (upper GI onc

💡 OBSTETRIC HISTORY: What you MUST ask in OSCEs & finals Here’s the high-yield structure for pregnancy histories: Nausea & vomiting → normal vs hyperemesis (weight loss, ketones, electrolytes) Reduced fetal movements → fetal distress / early demise 🚨 Vaginal bleeding → placenta praevia vs abruption vs cervical cause Abdominal pain → UTI, abruption, pelvic causes Loss of fluid → think rupture of membranes Headache, visual changes, epigastric pain, oedema → pre-eclampsia Pruritus (palms & soles)

Love this one — proper geriatrics meds electrolytes trap case 🔥 Here you go in your exact format. 💡 CASE CHALLENGE: Recurrent falls in an elderly man This is NOT automatically a stroke. Pause and think: 82-year-old with 2 falls this week Increasing confusion tiredness On thiazide diuretic Postural hypotension Dry skin Bloods: hyponatraemia hypokalaemia 🧠 What’s going on here? Key differentials: TIA / stroke Medication-induced electrolyte imbalance 🚨 Dehydration Delirium secondary to metaboli