Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 309 questions.
An 11-year-old girl has just been diagnosed with type 1 diabetes and will start insulin today. She is quiet, and her only questions are whether the injections w…
Paediatrics · Pre-internship · middle twist
A 17-year-old man with cystic fibrosis has attended the same paediatric respiratory clinic since infancy and will move to the adult service next year. His mothe…
Paediatrics · Pre-internship · middle twist
A 16-year-old girl with focal epilepsy attends a general practice alone and asks for contraception. She has been seizure-free for two years on carbamazepine and…
Paediatrics · Pre-internship · middle twist
A 16-year-old boy has had a moderate depressive episode for five months. He has completed eight sessions of cognitive behavioural therapy with a psychologist an…
Paediatrics · Pre-internship · middle twist
A 16-year-old boy is brought to a regional emergency department by his mother, who found messages in which he described wanting to die. Seen alone, he says he h…
Paediatrics · Pre-internship · middle twist
A 17-year-old girl asks for help to stop vaping. She has used a disposable device every day for two years, now wakes at night to use it, and has failed three at…
Paediatrics · Pre-internship · middle twist
A 16-year-old girl attends with three months of worsening acne. There are deep tender lumps on both cheeks and along the jaw, two of them discharging, and four…
Paediatrics · Pre-internship · middle twist
A 14-year-old girl attends a Perth general practice alone and asks for emergency contraception after a condom broke last night. She tells you she has been seein…
Paediatrics · Pre-internship · middle twist
A 15-year-old boy who lives on a wheat farm 300 km from Perth is brought in by his mother after she found a note in his room. He tells you that for the past mon…
Paediatrics · Pre-internship · middle twist
A 3-year-old boy is in the emergency department of a Perth hospital with a forearm fracture after falling from a trampoline. While you are applying the backslab…
Paediatrics · Pre-internship · middle twist
A 5-year-old boy with steroid-sensitive nephrotic syndrome finished a six-week course of oral prednisolone 2 mg/kg daily yesterday. He is in remission, is well…
Paediatrics · Pre-internship · middle twist
A 5-month-old boy is brought to the emergency department by his parents because he has been unsettled overnight. He is well grown, afebrile and feeding normally…
Paediatrics · Pre-internship · middle twist
A 13-month-old girl attends for a routine check. She is well and walking, and her weight and length are on the 75th centile. Her parents want to stop buying inf…
Paediatrics · Pre-internship · middle twist
A 3-week-old girl is brought to a general practice by her mother, who is exhausted and believes her milk supply is failing. The baby was born at term weighing 3…
Paediatrics · Pre-internship · middle twist
A 15-year-old girl attends a general practice with her mother, who is worried that she has stopped eating properly and has lost weight. Her mother says she has…
Paediatrics · Pre-internship · middle twist
A 13-year-old boy weighing 92 kg attends the emergency department with six weeks of left knee ache and a limp. Radiographs of the pelvis show a mild slip of the…
Paediatrics · Pre-internship · middle twist
A 44-year-old man is admitted under your team after a myocardial infarction. Genetic testing has confirmed familial hypercholesterolaemia and the lipid clinic h…
Paediatrics · Pre-internship · middle twist
A 7-month-old girl is referred to a paediatric clinic with slow weight gain. Her weight has fallen from the 50th to the 9th centile over three months while her…
Paediatrics · Pre-internship · middle twist
A 4-month-old girl with a large ventricular septal defect is reviewed before surgical repair. She breastfeeds every two hours but takes 40 minutes each time, sw…
Paediatrics · Pre-internship · middle twist
A 14-month-old girl who is still breastfed and has had no supplements is referred because she is not yet walking and her legs look bowed. Her mother has dark sk…
Paediatrics · Pre-internship · middle twist