Specification and Characterization of the Searching Questions

Case (x)	woman 30; Hodgkin's disease; autologous bone marrow transplantation	category
day 10	You are on duty and a nurse of the haemato-oncology department calls you. Mrs. (x) has got fever
1.	What was the indication for hospitalization?	I
2.	Which diagnoses and treatments were given in the past?	I
3.	What was the initial treatment plan after intake?	II
4.	History and physical examination are negative. Make up a differential diagnosis for the cause of the fever (at least 3 options).	II
day 29:	Discharge
>	Mrs (x) has been discharged. You saw her only the last two days and you must dictate the discharge letter.
discharge:
5.	How many cells were in the bone marrow transplant?	II
6.	Which was, in retrospect, the cause of the stomatitis that started on the 15th day, and how was it treated.	II
7.	Which was, in retrospect, the cause of the fever that occurred on the 10th day?	II
Case (y)	man 47; liver cirrhosis with alcohol abuse; renal failure	category
day 2:	Mr. (y) was hospitalised yesterday via the emergency ward. Today you see him for the first time, being the physician of the inpatient ward.
8.	Were there signs of ascites found in the emergency ward?	III
9.	Were there signs of ascites found in the past?	I
10.	Which were, yesterday, the considerations for requesting a bone marrow punction?	II
11.	Mr. (y) has symptoms at hands and feet. How were they designated and what was done to support this diagnosis?	II
day 21	You are on duty and you are called because Mr. (y) has got fever.
12.	What do you find during physical examination and what is the most likely cause of the fever?	III
day 56	It is considered to transfer Mr (y) to a nursing home You are asked for a second opinion.
13.	You read that Mr (y) has a renal failure. Which tests were performed to determine its aetiology, and which diagnosis has been established?	II
14.	You read about a positive blood culture with staphylococcus aureus. Yet, the treatment with flucloxicilline was interrupted and replaced by other antibiotics. Why?	II
Case (z)	woman 53; acute myeloid leukaemia; diagnosis and first chemotherapy	category
day 12:	You are on weekend duty and are making rounds. Mrs (z) lost 13 kilos within 1 week.
15.	Did the diuretic treatment exceed its goal or not? Find also treatment considerations to support your answer.	III
day 23	You are on duty and read a remark on day 22 “no haematuria any more”.
16.	Since when were there signs of haematuria, and what was considered as its cause?	III
day 27	Discharge
>	Mrs (z) has been discharged. You saw her only the last two days and must dictate the discharge letter.
discharge:
17.	What was considered the cause of the leg ulcers and how were they treated?	II
>	Mrs (z) has been discharged. You are auditing protocol adherence.
discharge:
18.	Did Mrs (z) receive GM-CSF, as a part of the protocol? Why was this treatment not accomplished conforming the protocol?	II
19.	You are looking for complications of the treatment. Were there signs of congestive heart failure, during the treatment or before?	III
Category: I = past history; II = progress notes; III = medical history or physical examination.