Specialist training

Know it. Explain it. Apply it.

Prepare for the clinical conversation: recall knowledge, reason through cases and close specific gaps.

Choose a question bank Practise a case

Choose your specialty

Existing question banks · German-language content

112 questions · 15 topics

Cardiology

Echo, ECG, coronary disease, heart failure, rhythm and devices. Practise concise answers across the specialty.

EKG / EchoCoronary diseaseRhythm & devices

Open question bank (German)

203 questions · 12 topics

Internal medicine

From cardiology and nephrology to gastroenterology, haematology and emergency medicine. Connect knowledge across organ systems.

Organ systemsDifferential diagnosisEmergencies

Open question bank (German)

Filter by topic, shuffle questions and reveal answers. The current banks show your position within the session; they do not save long-term progress.

A structure for thinking aloud

Use it alone or with a learning partner.

Summarise
State the central problem in one sentence.
Prioritise
Name immediate risks and plausible alternatives.
Justify
Explain which next test or action changes your decision.
Reassess
State what you will monitor and when you would escalate.

Schematic discussion structure — adapt it to the clinical situation.

Four cases. Start the conversation.

Fictional teaching cases. Discuss first, then reveal the key points.

01Cardiology · Set priorities

Chest pain without clear ST elevation

A person presents with ongoing retrosternal pressure. The first ECG shows no clear ST elevation. How would you structure the next steps?

Discuss aloud

What do you assess immediately, before committing to a diagnosis?
What does an initially nondiagnostic ECG tell you?

Reveal key discussion points

Assess clinical stability and vital signs first. Interpret the history, examination and twelve-lead ECG together; consider dangerous alternative diagnoses.
Absent ST elevation does not exclude ACS. Repeat the ECG with ongoing symptoms and interpret serial high-sensitivity troponin using a validated pathway. Escalate urgently for instability or suspected acute occlusion.

A single reassuring result does not end the clinical assessment.

02Cardiology · Connect the findings

Breathlessness and ankle oedema

A person reports progressive exertional breathlessness and swollen ankles. You suspect heart failure. What information would help establish the diagnosis?

Discuss aloud

Which investigations complement your clinical assessment?
Why is ejection fraction alone insufficient?

Reveal key discussion points

Symptoms and congestion are starting points but are not specific. ECG, natriuretic peptides and echocardiography help establish the diagnosis; consider alternative causes and comorbidities.
Assess chamber size, valves, right heart and evidence of raised filling pressures. Preserved ejection fraction does not exclude heart failure; interpret findings in their clinical context.

The diagnosis combines clinical assessment with objective findings, not one number.

Loss of consciousness during exertion

A person briefly lost consciousness while climbing stairs and is now orientated again. Which history and findings determine your risk assessment?

Discuss aloud

What would you ask the person and witnesses?
Which initial tests and warning features matter?

Reveal key discussion points

Ask about triggers, prodrome, duration, recovery, palpitations, medication and cardiac history; obtain a witness account. Establish whether the event is consistent with syncope.
Initial assessment includes examination, supine and standing blood pressure, and ECG. Exertional syncope, structural heart disease or an abnormal ECG indicate higher risk and warrant prompt targeted assessment, with monitoring when appropriate.

Rapid recovery alone does not establish low risk.

04Internal medicine · Distinguish mechanisms

Hyperkalaemia with kidney dysfunction

Severe hyperkalaemia is reported in a person with worsening kidney function. The initial ECG appears unremarkable. Explain your priorities and the principles of treatment.

Discuss aloud

Can the ECG exclude risk?
How do cardiac protection, potassium shifting and removal differ?

Reveal key discussion points

Severe hyperkalaemia may occur without typical ECG changes. Assess urgently, monitor, obtain help and verify the laboratory result without delaying necessary treatment.
Calcium protects the myocardium when indicated but does not lower potassium. Insulin/glucose shifts potassium into cells; elimination removes it from the body. Recheck potassium and glucose, treat causes and assess the need for renal replacement therapy.

A normal ECG does not exclude dangerous hyperkalaemia.

Turn a knowledge gap into a learning goal.

Revisit the relevant chapter, explain it in your own words, then return to the questions.

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