Acute Kidney Injury in an Older Patient with Diarrhoea
A branching clinical case simulation for a patient presenting with diarrhoea and weakness. Take a history, examine, investigate, diagnose and treat while the patient responds to every decision, then see the score by clinical domain with the reasoning for each mark.
Year 4medium20 min6 stages
- Patient
- 78 years, female
- Presenting complaint
- Diarrhoea and weakness
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
Mrs Whitfield, a 78-year-old woman, is brought to the emergency department by her daughter. She has had diarrhoea for 3 days and is now very weak. Her past medical history includes hypertension and mild renal impairment. She is taking ramipril, bendroflumethiazide, and ibuprofen. On arrival, she is drowsy, with a heart rate of 112 bpm, blood pressure 96/58 mmHg, respiratory rate 24, oxygen saturations 95% on air, and temperature 36.9°C. You are the junior doctor assessing her. Take a focused history, examine her, then manage her. Remember: this is a teaching exercise, not a real patient. Base your decisions on guidelines; do not give actual patient-specific management.
What this case teaches
Stage acute kidney injury; stop nephrotoxic and hypotensive drugs; replace fluids by assessment; manage hyperkalaemia; know the indications for renal replacement.
How the case unfolds
- 1History TakingHistory
- 2Examine the PatientExamination
- 3Initial InvestigationsInvestigations
- 4DiagnosisDiagnosis
- 5Immediate ManagementTreatment
- 6Monitoring and Next StepsMonitoring
The decisions available at each stage, and what each one costs or earns, appear when you run the case.
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A free account opens the simulator: the patient's observations move with your decisions, and every choice is scored and explained.
Taught in
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Educational content for students and clinicians in training. It does not replace professional judgement, local protocols or current prescribing information.