Common
The decision you make weekly on the ward. 494 questions.
A 58-year-old man is found to have a serum calcium concentration of 2.78 mmol/L (2.15–2.55) on two occasions. His phosphate is 0.72 mmol/L (0.80–1.50), creatini…
Endocrine and Metabolic · Clinical rotations · common
A 42-year-old woman has progressive fatigue, reduced appetite and dizziness when standing. Her serum sodium is 127 mmol/L (135–145), potassium is 5.8 mmol/L (3.…
Endocrine and Metabolic · Clinical rotations · common
A 46-year-old man notices sudden hearing loss in his left ear on waking 48 hours ago. He has no pain, discharge or recent upper respiratory infection, and otosc…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 15-year-old boy has six months of recurrent, predominantly right-sided epistaxis and progressive right nasal obstruction. He has no fever or facial pain, and…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 14-month-old child has fever and irritability after several days of coryza. The child is pulling at the right ear and wakes repeatedly overnight. Otoscopy sho…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 64-year-old woman develops sudden, profound painless loss of vision in her left eye 90 minutes before assessment. The left pupil has a relative afferent pupil…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 71-year-old man develops severe pain and blurred vision in his right eye over two hours. He reports coloured haloes around lights and nausea; examination show…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 38-year-old woman experiences brief episodes of spinning when she rolls over in bed or looks upward. Each episode lasts less than a minute, and she is well be…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 42-year-old woman presents with recurrent anterior epistaxis from the right nostril. She is haemodynamically stable, and firm compression for 15 minutes plus…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 67-year-old man notices flashes of light and a sudden increase in dark spots in his right eye. Several hours later he describes a grey curtain progressing fro…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 58-year-old woman presents with a unilateral red eye that began this morning. She reports marked discomfort and says bright light is unpleasant, but has no hi…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 29-year-old woman presents with painful genital lesions that began as small blisters 3 days ago. She describes burning on urination and has bilateral tender i…
General Practice and Population Health · Clinical rotations · common
A 68-year-old man presents with fever, rigors, dysuria and perineal pain. He has been unable to pass urine for 10 hours, and examination shows a markedly tender…
Renal, Urology and Electrolytes · Clinical rotations · common
A 61-year-old man has erectile dysfunction and stable angina treated with regular glyceryl trinitrate spray. He would like to resume sexual activity and has no…
Cardiovascular · Clinical rotations · common
A 27-year-old woman presents with 2 days of lower abdominal pain and deep dyspareunia. She has purulent cervical discharge, a temperature of 38.1 °C and marked…
Obstetrics and Gynaecology · Clinical rotations · common
A 74-year-old woman with metastatic breast cancer presents with sudden dyspnoea and pleuritic chest pain. CT pulmonary angiography confirms bilateral pulmonary…
Emergency and Toxicology · Clinical rotations · common
A 29-year-old woman has painless cervical and mediastinal lymphadenopathy that has progressed over 2 months. She reports drenching night sweats and pruritus but…
Haematology and Oncology · Clinical rotations · common
A 71-year-old man presents with headache, blurred vision and spontaneous bruising. Blood tests show haemoglobin 86 g/L (reference range 130–170), total protein…
Haematology and Oncology · Clinical rotations · common
A 58-year-old man receiving induction chemotherapy for acute myeloid leukaemia presents with a temperature of 39.1°C. His absolute neutrophil count is 0.05 × 10…
Haematology and Oncology · Clinical rotations · common
A 45-year-old man becomes acutely unwell after receiving approximately 20 mL of an incompatible red-cell unit. He develops fever, severe flank pain, hypotension…
Emergency and Toxicology · Pre-internship · common