Middle twist
One twist — a threshold, a comorbidity, an atypical presentation. 741 questions.
A 14-month-old boy is being discharged with amoxicillin oral suspension to be given three times a day for five days. His mother arrived in Australia four months…
Paediatrics · Pre-internship · middle twist
A 3-year-old boy weighing 18 kg has a bulging left tympanic membrane with purulent discharge in the ear canal, and antibiotic treatment is indicated. He is at l…
Paediatrics · Pre-internship · middle twist
A 9-year-old boy has a forearm fracture and needs regular oral paracetamol in the emergency department. He weighs 52 kg; the 50th centile weight for his age and…
Paediatrics · Pre-internship · middle twist
A 4-year-old girl admitted with a severe exacerbation of a chronic illness has a nasogastric tube in situ and cannot swallow tablets. One of her regular medicin…
Paediatrics · Pre-internship · middle twist
A 12-month audit of a paediatric ward identifies four prescriptions in which a weight-based dose was written ten times higher than intended; two of these reache…
Paediatrics · Clinical rotations · middle twist
A 26-month-old girl with no known epilepsy is brought in convulsing. The seizure began 14 minutes ago; paramedics gave buccal midazolam at six minutes and a fur…
Paediatrics · Pre-internship · middle twist
A woman telephones the practice about her 3-week-old, who was born at term and is thriving on exclusive breastfeeding. Yesterday another doctor started her on a…
Paediatrics · Pre-internship · middle twist
A 31-year-old woman weighing 60 kg restarts sertraline 100 mg daily for recurrent depression. She is exclusively breastfeeding a healthy, thriving 4-month-old b…
Paediatrics · Clinical rotations · middle twist
A 7-year-old boy has had atopic dermatitis since infancy. Over two years his height has fallen from the 50th to the 10th centile, with weight falling in paralle…
Paediatrics · Clinical rotations · middle twist
A 6-year-old girl is referred because her teacher has noticed her stopping mid-sentence and staring for a few seconds, then carrying on as though nothing had ha…
Paediatrics · Clinical rotations · middle twist
A 15-year-old girl attends a general practice for a repeat of her salbutamol inhaler. She has had asthma since childhood. She uses salbutamol two or three times…
Paediatrics · Pre-internship · middle twist
A 5-year-old boy with spastic quadriplegic cerebral palsy is reviewed in a community clinic. His mother says every meal now takes 45 minutes, that he coughs and…
Paediatrics · Clinical rotations · middle twist
A 12-year-old Aboriginal girl from a remote community has been admitted to a tertiary hospital with newly diagnosed type 1 diabetes. English is the family's fir…
Paediatrics · Pre-internship · middle twist
A 15-year-old girl with type 1 diabetes since the age of nine attends the clinic with her father. Her glycated haemoglobin has risen steadily over 12 months. He…
Paediatrics · Pre-internship · middle twist
A 7-year-old boy has had atopic dermatitis since infancy. His skin is currently red, thickened and excoriated across both antecubital and popliteal fossae and h…
Paediatrics · Pre-internship · middle twist
A 16-month-old girl who arrived in Australia from overseas six months ago is brought to a general practice because she is not gaining weight. Her weight has fal…
Paediatrics · Clinical rotations · middle twist
A 5-week-old boy is admitted after a fortnight of vomiting that now shoots across the change table after every feed. The vomit has never been green. He feeds hu…
Paediatrics · Pre-internship · middle twist
A 7-month-old girl has had six hours of episodes in which she suddenly screams, draws her knees up and stiffens for a minute or two, then lies pale and floppy u…
Paediatrics · Clinical rotations · middle twist
A 2-year-old boy is brought to a regional emergency department at 3 am with two days of runny nose and a harsh barking cough. Forty minutes ago he was given dex…
Paediatrics · Pre-internship · middle twist
A 10-week-old girl is brought to the emergency department by both parents with a bruise on the left cheek and a smaller one over the left ear. Her father says h…
Paediatrics · Pre-internship · middle twist