Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 371 questions.
An 82-year-old woman is assessed after falling in her kitchen. She remembers reaching for a shelf but denies spinning, loss of consciousness, palpitations or li…
Geriatrics and Palliative Care · Clinical rotations · common
A 31-year-old woman with chronic hypertension was taking labetalol before conception. At 30 weeks, her blood pressure has risen from 132/82 to 154/98 mmHg. A ur…
Obstetrics and Gynaecology · Clinical rotations · common
A 37-year-old woman at 37 weeks has a small amount of vaginal bleeding shortly after her membranes rupture. She remains haemodynamically stable, with no abdomin…
Obstetrics and Gynaecology · Clinical rotations · common
A 41-year-old woman presents with sudden right arm weakness and difficulty speaking. Her partner saw rhythmic jerking of the right hand for 90 seconds followed…
Neurology · Clinical rotations · common
A 70-year-old woman is recovering from a small ischaemic stroke and is found to have persistent atrial fibrillation. She has normal renal function and no eviden…
Cardiovascular · Clinical rotations · common
A 72-year-old woman with hypertension reports three episodes in the past week in which the vision in her right eye became obscured from the top down, each lasti…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 72-year-old man is admitted with pneumonia after three days of fever, cough and increasing breathlessness. He is alert, but his respiratory rate is 34/min and…
Infectious Diseases · Clinical rotations · common
A 68-year-old man presents with a two-day history of fever, productive cough and pleuritic chest pain. He is alert, has a respiratory rate of 32/min, blood pres…
Respiratory · Clinical rotations · common
A 32-year-old man is found confused after ingesting an unknown number of amitriptyline tablets. He has a blood pressure of 86/54 mmHg, a pulse of 126/min and a…
Emergency and Toxicology · Clinical rotations · common
A 58-year-old man is brought to the emergency department after being found drowsy beside an empty bottle of methadone mixture. He has a respiratory rate of 7/mi…
Emergency and Toxicology · Clinical rotations · common
A 24-year-old woman presents 30 hours after taking repeated doses of paracetamol for a dental infection. She estimates taking 10–12 g daily for four days; her p…
Emergency and Toxicology · Clinical rotations · common
A 62-year-old woman is reviewed three months after a large anterior myocardial infarction. She has mild exertional breathlessness but no recurrent chest pain; t…
Cardiovascular · Clinical rotations · common
A 71-year-old man is monitored after an inferior ST-elevation myocardial infarction. He becomes dizzy but remains conscious; the ECG shows regular P waves at 84…
Cardiovascular · Clinical rotations · common
A 64-year-old man becomes hypotensive shortly after reperfusion of an inferior ST-elevation myocardial infarction. He is distressed but has clear breath sounds,…
Cardiovascular · Clinical rotations · common
A 67-year-old man is recovering on the fourth day after an inferior myocardial infarction treated with primary percutaneous coronary intervention. He suddenly d…
Cardiovascular · Clinical rotations · common
A 41-year-old woman has been stable on clozapine for 18 months but presents with fever, painful swallowing and malaise. Her temperature is 38.5°C and her absolu…
Haematology and Oncology · Clinical rotations · common
A 58-year-old man is being treated with unfractionated heparin for a proximal deep vein thrombosis. On day 7, his platelet count has fallen from 224 to 86 × 10⁹…
Cardiovascular · Clinical rotations · common
A 31-year-old woman developed a proximal deep vein thrombosis at 32 weeks gestation and has received therapeutic low-molecular-weight heparin since diagnosis. S…
Obstetrics and Gynaecology · Clinical rotations · common
A 25-year-old woman had a levonorgestrel-releasing intrauterine device inserted six months ago. She now has a missed period, lower abdominal pain worse on the r…
Obstetrics and Gynaecology · Clinical rotations · common
A 34-year-old woman who is breastfeeding at four weeks after birth requests contraception. She has migraine with visual aura and reports that her periods were p…
Obstetrics and Gynaecology · Clinical rotations · common