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Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case I: Brain Abscess), a 50-year-old female is brought to the emergency room with complaints of fever, headache, and projectile vomiting for 5 days duration. She had a right ear surgery 2 weeks ago for chronic otitis media. She is hypertensive on ACE inhibitors. She works as a tailor. She is febrile with no meningeal signs. There is papilledema and left upper limb weakness. She has leukocytosis with space occupying lesion on a brain CT-scan. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case H: Systemic Lupus Erythematosus), a 21-year-old female college student presents to you with an 8 week history of joints pains. She is not married and her menstrual period is regular. She does not smoke. She takes ibuprofen for temporary relief. She has pericardial chest pain, hair loss, photosensitive rash, malar rash, and mouth ulcers. She has polyarthritis and lymphadenopathy by physical exam. She has hemolytic anemia, pericarditis, and glomerulonephritis. She has a positive antinuclear antibodies, anti-double-stranded DNA, and low complements. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case G: Asthma), a 45-year-old Saudi female teacher complains of recurrent breathlessness for the past 2 years, increasing to two to three times per week recently. She complains of wheezing and dry cough as well. She is allergic to penicillin, dust, and perfumes. She is known to have hypertension. She has a history of nasal polyps removal. Her physical exam demonstrates expiratory wheezes. Chest X-ray is hyperinflated and spirometry confirms the presence of reversible airway obstruction. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case F: Upper Gastrointestinal Bleeding), a 68-year-old male not known to have any medical illness complains of passing black stool for 1 week and vomiting blood for a day. He has a prior history of a gastric ulcer. There are signs of volume depletion, lymphadenopathy, and gastric mass. Complete blood count demonstrates microcytic hypochromic anemia. There are ischemic changes in ECG from severe anemia. The endoscopic biopsy confirms the presence of gastric adenocarcinoma. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case C), a 65-year-old male patient is referred to your clinic complaining of progressive shortness of breath and lower limb edema for 2 months duration. He is a retired teacher. He does not take any medications and has no allergies. He is tachycardic with irregular pulse, hypoxemic, hypertensive, and has signs of volume overload. ECG shows atrial fibrillation. Chest x-ray demonstrates pulmonary edema with cardiomegaly. Echocardiogram shows low ejection fraction. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract Introduction This resource is a structured oral examination in internal medicine designed for sixth-year medical students. This resource is part of a series of nine cases published in MedEdPORTAL. In this case, a 55-year-old businessman presents to the emergency room with a 1-day history of chest pain. He has returned recently from a long business trip. He is tachycardic with signs of pleural effusion. Methods There is an introductory statement for the case which is given to the candidate at the beginning of the 30-minute exam time. The examiner will then ask the candidate to inquire about further relevant historical points. The candidate will be fed with the points that he/she requested and will be prompted to ask important questions that were missed. There are no patients or patient simulators required. The candidate will then be asked in a similar fashion to mention what physical findings will be expected to look for with this history. The exam will continue with requesting and interpreting investigations related to the case. The exam for each case will end by exploring the differential diagnosis and discussing with the candidate the general management principles for this case. Safety issues and professionalism are also addressed in the checklist provided for each case. Results A majority of our students enjoyed the exam from personal and written feedback we got after the exam. Discussion This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with the long case format.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case B), a 65-year-old Saudi male patient is brought to the emergency room by his son at 10:00 pm with history of right-sided weakness and inability to talk since 6:00 AM that morning. He is diabetic and hypertensive for 15 years. He is hypertensive in physical exam with right-sided hemiplegia. Brain CT-scan demonstrates infarction in the left temporaparietal area. There is more than 80% of carotid stenosis and ejection fraction is 45%. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case D: Pyelonephritis and Diabetic Ketoacidosis), an 18-year-old Saudi female patient presents to emergency room with 3 days history of high grade fever and pain while passing urine. She is a college student passing through a stressful exam time. She takes no medication and has no allergies. She has a history of repeated genital fungal infections. Her parents are both diabetic. She is febrile with signs of volume depletion and left renal angle tenderness. She has leukocytosis and findings consistent with diabetic ketoacidosis. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with a long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.

Abstract This resource is one component of the nine-part Structured Oral Examinations in Internal Medicine series. In this case (Case E: Community-Acquired Pneumonia and Empyema and Diabetic Ketoacidosis [DKA]), a 60-year-old female diabetic patient complains of fever, productive cough for a day, and left-sided chest pain for 2 days. She is febrile and in respiratory distress with signs of consolidation and pleural effusion. She has all signs of empyema from pleural fluid analysis (pH= 7, Gram + cocci and pus) as well as high anion gap metabolic acidosis. She also has DKA as an additional cause of her acidosis. This approach of examination is very convenient to both students and examiners. It is structured and standardized. We were successfully able to avoid almost all disadvantages associated with long case format. The majority of our students enjoyed the exam from personal and written feedback we received after the exam.