SCA practice case · Telephone consultation
“Pink urine and a cruise”
The candidate brief
This is what you would read in the 3-minute window before the patient connects. Read it once, note two or three hypotheses and one thing you must not miss, then stop.
Patient
Victor Aldridge · 67-year-old man
Setting
Telephone appointment — booked "because the wife insisted".
Past history
- Hypertension
- Ex-smoker — 30 pack-years, stopped 5 years ago
Medication
- Ramipril (dose as per repeat)
- Multivitamin (bought over the counter, recently started)
Allergies
No known drug allergies
Recent notes
No recent consultations. Not on anticoagulants or antiplatelets. Retired painter and decorator. Telephone appointment booked this morning: “pink urine last week — wife insisted I ring”.
Reason for contact
Telephone appointment about discoloured urine.
Practise this case
The full case is in the Hot Seat with the Gold plan. You get a 12-minute timer, a role-player script with facts released only when asked, examiner checkpoints by the three RCGP domains, a model consultation and the guidance behind it.
What this case tests
Show the learning points (spoiler: read after you have practised)
NICE NG12: aged 45+ with unexplained visible haematuria (no UTI, or persisting or recurring after UTI treatment) = suspected cancer pathway urology referral — with PSA and DRE considered in men — made on the day, never deferred for convenience, holidays, or a beetroot story. Anticoagulation never explains haematuria away. The consultation’s real work is the hidden agenda: a friend’s death from the same first symptom, and a cruise he’s scared to lose — the reframe ("investigated beats frightened; the timeline works") is what converts referral into attendance.
The guidance behind it
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