SCA practice case · Video consultation
“She’s drinking all the time and wetting the bed again — can she have a blood test next week?”
Video consultation
Child patient
Someone else speaking
Typical
Children & young peopleUrgent & unscheduled careNew & undifferentiated presentations
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
Tolu Adeyemi (video call with her mother, Folake Adeyemi) · 9 years · female
Setting
Video consultation with a mother; her 9-year-old daughter is in the room.
Past history
- Mild asthma — salbutamol inhaler, used rarely
- Dry at night since age 4
Medication
- Salbutamol 100 micrograms inhaler, 2 puffs as needed (last issued 8 months ago)
Allergies
NKDA
Recent notes
No consultations in the past year. eConsult from mother yesterday 21:15: “Daughter very thirsty for 3 weeks, wetting the bed. Checked with my dad’s machine: 23.4. Can she have a blood test next week?” Weight last recorded age 7: 24 kg.
Reason for contact
Video consultation booked by mother. Consent: mother has parental responsibility; Tolu is present.
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)
A child with thirst, polyuria, new bedwetting, weight loss or tiredness has type 1 diabetes until proven otherwise. If capillary glucose is high (over 11 mmol/L), or even on symptoms alone, refer the same day to the paediatric diabetes team — phone them. Do not arrange fasting glucose, HbA1c or a glucose tolerance test first: they delay diagnosis and a quarter or more of children present in DKA. Screen for DKA (vomiting, abdominal pain, Kussmaul breathing, drowsiness, ketotic breath): if present, this is an emergency (999). Explain clearly that type 1 diabetes is autoimmune and not caused by diet, and help the family overcome practical barriers to attending today. Video lets you see the child — use it.
The guidance behind it
Similar SCA cases
gpreasoning.uk is not affiliated with or endorsed by the RCGP. Our cases are original teaching material written for practice; none is an exam recall. For anything official about the SCA, check the RCGP SCA pages.