Febrile Neutropenia in a Breast Cancer Patient: A Case Study
A branching clinical case simulation for a patient presenting with fever and feeling unwell ten days after chemotherapy. 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
- 51 years, female
- Presenting complaint
- Fever and feeling unwell ten days after chemotherapy
- Decision stages
- History, Examination, Investigations, Diagnosis, Treatment, Monitoring
The presentation
You are the junior doctor in the emergency department of a district general hospital. A 51-year-old woman presents with a temperature of 38.5°C, ten days after her last cycle of chemotherapy for breast cancer. The triage nurse notes that she looks unwell and is tachycardic. The patient's neutrophil count from today is 0.3 × 10^9/L, but the laboratory result only just landed on your screen. You are about to see her.
What this case teaches
Treat febrile neutropenia as an emergency; start empirical antibiotics within an hour after cultures; assess for a source; know when to add or change cover.
How the case unfolds
- 1Initial history and triageHistory
- 2Physical examinationExamination
- 3Initial investigationsInvestigations
- 4Diagnosis and risk assessmentDiagnosis
- 5Immediate managementTreatment
- 6Reassessment and ongoing careMonitoring
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.