Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 371 questions.
A 24-year-old woman started sertraline 50 mg daily eleven days ago for a moderate depressive episode, with no previous psychiatric history. She telephones to sa…
Psychiatry · Clinical rotations · common
A general practice registrar is deciding which antidepressant to start for a 40-year-old man with a first episode of major depression of moderate severity. She…
Psychiatry · Clinical rotations · common
A 26-year-old woman consults her general practitioner five weeks after her relationship ended. She feels flat most days, cries easily and takes an hour to fall…
Psychiatry · Clinical rotations · common
A 15-year-old boy is brought to a general practice by his mother, who says he has become withdrawn over four months. He has stopped playing football, his marks…
Psychiatry · Clinical rotations · common
A 31-year-old woman is seen two months after her small business failed. She is tearful, sleeps poorly and has withdrawn from friends, but continues to care for…
Psychiatry · Clinical rotations · common
A 47-year-old man is seen six weeks after being told his position will be made redundant at the end of the year. He is tearful in the consultation, sleeps poorl…
Psychiatry · Clinical rotations · common
An 82-year-old widow attends her general practitioner with her son, who lives in her house and answers most questions for her. Seen alone, she says he shouts at…
Psychiatry · Clinical rotations · common
A 78-year-old man with moderate Alzheimer disease is brought in by his wife, who is his only carer and is exhausted. For six weeks he has been getting up at 2 a…
Psychiatry · Clinical rotations · common
A 71-year-old woman is seen seven weeks after the death of her husband of 48 years. She cries most days and sleeps poorly, and has lost 3 kg. She is still cooki…
Psychiatry · Clinical rotations · common
A 14-year-old girl attends your general practice with her mother for the fourth time this year with abdominal pain. She has lost 4 kg, stopped playing netball,…
Psychiatry · Clinical rotations · common
A 15-year-old girl is brought to the general practice by her mother because her grades have fallen and she is tired all the time. The mother answers most of the…
Psychiatry · Clinical rotations · common
A 24-year-old woman with borderline personality disorder has cut her forearms after arguments about once a fortnight for two years, and has attended the emergen…
Psychiatry · Clinical rotations · common
A 38-year-old man on remand is referred to the prison health service for "anger management". He is charming and articulate. He was expelled from school at 13, h…
Psychiatry · Clinical rotations · common
A 63-year-old retired postal worker is referred with four months of "insomnia". He falls asleep within ten minutes but wakes at about 4 am and cannot get back t…
Psychiatry · Clinical rotations · common
An 8-year-old boy is brought by his parents because two or three nights a week, usually about an hour after falling asleep, he sits bolt upright and screams. He…
Psychiatry · Clinical rotations · common
A 16-year-old girl attends your general practice with her mother, who announces at the desk that her daughter needs to go on the pill for her periods. In the ro…
Psychiatry · Clinical rotations · common
A 15-year-old girl has lost 7 kg over eight months by cutting out fats and running before school, and is frightened of gaining weight. She is 160 cm tall and we…
Psychiatry · Clinical rotations · common
Six days ago a 27-year-old childcare worker was the front-seat passenger in a head-on collision in which the driver was killed. Since then she has had intrusive…
Psychiatry · Clinical rotations · common
A 23-year-old law student describes episodes that begin during arguments with her partner. She suddenly feels as though she has floated up to the ceiling and is…
Psychiatry · Clinical rotations · common
A 38-year-old woman has attended your general practice eleven times in six months. Each visit follows a new bodily sensation - a headache, a skin blemish, a twi…
Psychiatry · Clinical rotations · common