Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 309 questions.
A 70 kg man has a 12 cm laceration across the extensor surface of his right forearm from a falling pane of glass. Tendon function through the full range of move…
Acute Care · Pre-internship · middle twist
A 7-year-old girl fell from a scooter onto her outstretched hand yesterday. Her wrist is swollen and tender about 2 cm proximal to the wrist crease, she is usin…
Acute Care · Pre-internship · middle twist
A 9-year-old girl is brought to a Western Australian emergency department by her mother with three weeks of intermittent abdominal pain. While her mother is out…
Acute Care · Pre-internship · middle twist
A 24-year-old woman is brought in by ambulance after being found unrousable at home. She had swallowed six of her flatmate's morphine tablets, which he takes tw…
Acute Care · Pre-internship · middle twist
A 23-year-old woman is medically cleared six hours after taking 20 of her flatmate's quetiapine tablets at the end of a relationship. She says she regrets it, i…
Acute Care · Pre-internship · middle twist
A 74-year-old woman is being discharged from the emergency department after a fall at home with an undisplaced pubic ramus fracture on radiography. She can weig…
Acute Care · Pre-internship · middle twist
The mother of a 5-year-old girl admitted to a Perth public hospital with gastroenteritis tells the bedside nurse that her daughter is going flat and is not hers…
Acute Care · Pre-internship · middle twist
A 74-year-old man collapses in a shopping centre and is brought to the emergency department in cardiac arrest. Resuscitation is unsuccessful and he is declared…
Acute Care · Pre-internship · middle twist
A 58-year-old man dies in the resuscitation bay after an out-of-hospital cardiac arrest. His wife and adult daughter have been waiting in the relatives room wit…
Acute Care · Pre-internship · middle twist
An 82-year-old woman with advanced dementia is admitted to a Perth hospital with a fractured neck of femur. She cannot repeat back or weigh up any part of the d…
Acute Care · Pre-internship · middle twist
A 34-year-old man is brought to a Perth emergency department with a stab wound to the thigh. He is alert, gives a clear account of the assault, and knows the da…
Acute Care · Pre-internship · middle twist
A 63-year-old man with renal colic is receiving morphine 2.5 mg intravenously every 5 minutes on your instruction. He has now had 12.5 mg and says the pain has…
Acute Care · Pre-internship · middle twist
A 5-year-old boy is pulled from a backyard swimming pool in Mandurah after an unknown time under the water. He is limp and blue and is not breathing normally. H…
Acute Care · Pre-internship · middle twist
A 34-year-old bushwalker is winched out of a gully in the Stirling Range after a night in cold rain. He is unresponsive and pulseless. Cardiopulmonary resuscita…
Acute Care · Pre-internship · middle twist
A 19-year-old man walks into a small country hospital 40 minutes after being bitten on the right calf by a snake he disturbed while moving hay bales. A bystande…
Acute Care · Pre-internship · middle twist
A 22-year-old man is brought in 20 minutes after eating a satay skewer at a food van. On arrival he had widespread welts, audible wheeze and a blood pressure of…
Acute Care · Pre-internship · middle twist
An 81-year-old woman was brought from a residential aged care facility two hours ago with fever and dysuria; her observations were normal at triage and she was…
Acute Care · Pre-internship · middle twist
You are the intern on an evening shift at a public hospital in Perth. A 3-year-old boy was admitted this morning with a febrile illness. His mother has told the…
Acute Care · Pre-internship · middle twist
A 79-year-old woman is brought in drowsy and clammy after two episodes of collapse at home. The monitor shows complete heart block with a ventricular rate of 34…
Acute Care · Pre-internship · middle twist
A 58-year-old man had a witnessed collapse at a shopping centre. Bystanders started compressions, ambulance officers delivered one shock, and spontaneous circul…
Acute Care · Pre-internship · middle twist