Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 382 questions.
A general practice registrar reads a news report that the Australian regulator has issued a new warning about a mood stabiliser she prescribes, concerning a pos…
Psychiatry · Clinical rotations · middle twist
A 31-year-old woman stopped paroxetine four days ago; she had taken 20 mg daily for eight months for panic disorder and ran out of tablets while interstate for…
Psychiatry · Clinical rotations · middle twist
A 23-year-old man with treatment-resistant schizophrenia started clozapine eighteen days ago and now takes 250 mg daily. He tells the nurse he feels as though h…
Psychiatry · Clinical rotations · middle twist
A 34-year-old man with schizophrenia, well for two years on aripiprazole 15 mg daily, has not collected a prescription for six weeks and is again hearing neighb…
Psychiatry · Clinical rotations · middle twist
A 24-year-old man with schizophrenia has been prescribed risperidone 6 mg daily for eight weeks since his first admission. He still hears two voices commenting…
Psychiatry · Clinical rotations · middle twist
A 44-year-old woman is seen in the emergency department after telling her general practitioner that she felt like giving up. She has four weeks of low mood, poo…
Psychiatry · Clinical rotations · middle twist
A 17-year-old girl is brought to her general practitioner by her father. Over eight months she has stopped seeing friends, dropped from an A to a D average, sle…
Psychiatry · Clinical rotations · middle twist
A 19-year-old man is admitted with a four-week history of persecutory beliefs and voices commenting on his actions. He has used methamphetamine most days for a…
Psychiatry · Clinical rotations · middle twist
A 15-month-old girl is observed in a research playroom during brief separations from and reunions with her mother. On each reunion she runs towards her mother,…
Psychiatry · Clinical rotations · middle twist
A 14-year-old boy is brought in by his mother because of his behaviour over the past two months. Since his parents separated he has sworn at teachers, walked ou…
Psychiatry · Clinical rotations · middle twist
An 83-year-old man with moderate Alzheimer disease has a large symptomatic inguinal hernia and the surgeon has recommended repair. He lives in a hostel, cannot…
Psychiatry · Clinical rotations · middle twist
A 78-year-old retired farmer is brought in by his wife with four months of tiredness, vague upper abdominal discomfort and aching legs. He has lost 5 kg. He sto…
Psychiatry · Clinical rotations · middle twist
A 77-year-old woman is brought to the emergency department by her daughter because she has become confused and unsteady over three days. Five weeks ago her gene…
Psychiatry · Clinical rotations · middle twist
A general practice in a regional Western Australian town is auditing its patients aged 65 years and over as part of a suicide prevention programme. None of the…
Psychiatry · Clinical rotations · middle twist
A 73-year-old woman presents with four months of worry, restlessness and difficulty sleeping. She has never been an anxious person and nothing in her circumstan…
Psychiatry · Clinical rotations · middle twist
An 84-year-old woman is referred for assessment of memory loss. Her daughter says she has become withdrawn at family gatherings and often answers questions inap…
Psychiatry · Clinical rotations · middle twist
An 81-year-old woman who came to Australia from Viet Nam at the age of 55 is brought by her son because of two years of gradually worsening memory. She left sch…
Psychiatry · Clinical rotations · middle twist
A 12-year-old boy with autism spectrum disorder and moderate intellectual disability has been banging his head on walls and biting his forearms several times a…
Psychiatry · Clinical rotations · middle twist
A 13-year-old boy's marks have fallen steadily over 12 months and his teacher reports that he dozes in afternoon classes, is irritable and forgets instructions.…
Psychiatry · Clinical rotations · middle twist
A 13-year-old boy attends with his mother because his school has asked for a diagnosis. He has always been behind his peers and reads at a Year 3 level. He avoi…
Psychiatry · Clinical rotations · middle twist