Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 371 questions.
A 72-year-old man with hypertension and a 40 pack-year smoking history presents with sudden severe left flank pain radiating to the groin that began one hour ag…
Cardiovascular · Clinical rotations · common
A 78-year-old man from a residential aged care facility, with long-standing constipation, presents with three days of increasing abdominal distension and no pas…
Gastroenterology and Hepatology · Clinical rotations · common
A 68-year-old woman presents with two days of constant right upper quadrant and epigastric pain. Overnight she had two episodes of violent, uncontrollable shaki…
Gastroenterology and Hepatology · Clinical rotations · common
A 66-year-old man with ischaemic cardiomyopathy attends for review. Echocardiography shows a left ventricular ejection fraction of 30%, and he remains breathles…
Cardiovascular · Clinical rotations · common
A 68-year-old man presents with 30 minutes of rapid palpitations and light-headedness. Three years ago he had a heart attack treated with a coronary artery sten…
Cardiovascular · Clinical rotations · common
A 61-year-old man presents with four days of fever, a dry cough and increasing breathlessness. His wife reports he has been muddled since yesterday and has pass…
Respiratory · Clinical rotations · common
A 76-year-old man is brought to the emergency department after losing consciousness while pushing his lawnmower up a slope. His wife reports he went pale and co…
Cardiovascular · Clinical rotations · common
A 58-year-old man presents with three weeks of progressive breathlessness and a dull right-sided chest ache. He has smoked 30 cigarettes daily for 35 years and…
Respiratory · Clinical rotations · common
A 38-year-old man is reviewed because his blood pressure remains elevated despite perindopril 10 mg and amlodipine 10 mg daily. He feels well, sleeps soundly wi…
Cardiovascular · Clinical rotations · common
A 28-year-old woman presents to the emergency department with two days of right-sided chest pain that is worse on deep inspiration. She takes a combined oral co…
Cardiovascular · Clinical rotations · common
A 38-year-old woman presents with two weeks of pain in the front of her neck radiating to her jaw, together with palpitations, sweating and 2 kg of weight loss.…
Endocrine and Metabolic · Clinical rotations · common
A 62-year-old woman who takes sertraline for depression is brought to the emergency department after a witnessed generalised tonic-clonic seizure at home. She i…
Renal, Urology and Electrolytes · Clinical rotations · common
A 23-year-old man presents because his urine has turned dark brown, which he noticed this morning. Two days ago he developed a sore throat and runny nose, which…
Renal, Urology and Electrolytes · Clinical rotations · common
A 76-year-old woman taking perindopril for hypertension and regular ibuprofen for knee osteoarthritis presents after three days of vomiting and watery diarrhoea…
Renal, Urology and Electrolytes · Clinical rotations · common
A 35-year-old man born in Vietnam attends for pre-employment health screening and is found to have the following results: HBsAg negative, anti-HBs positive at 8…
Gastroenterology and Hepatology · Clinical rotations · common
A 58-year-old man is reviewed after routine blood tests show ALT 68 U/L (<40), AST 44 U/L (<40) and GGT 80 U/L (<60). He has type 2 diabetes and hypertension, h…
Gastroenterology and Hepatology · Clinical rotations · common
A 28-year-old woman presents with eight months of crampy lower abdominal pain that eases after opening her bowels, together with bloating and a bowel habit alte…
Gastroenterology and Hepatology · Clinical rotations · common
A 38-year-old woman has recurrent episodes of visible haematuria, but her renal function is normal and urine protein excretion is minimal. The episodes begin wi…
Renal, Urology and Electrolytes · Clinical rotations · common
A 46-year-old woman presents with a generalised tonic-clonic seizure. Serum sodium is 112 mmol/L, serum osmolality is 240 mOsm/kg and glucose is 5.2 mmol/L. She…
Neurology · Clinical rotations · common
A 67-year-old woman develops oliguria and a creatinine rise from 84 to 310 micromol/L after several days of septic shock. Urinalysis shows 2+ blood but no signi…
Renal, Urology and Electrolytes · Clinical rotations · common