Middle twist
One twist — a threshold, a comorbidity, an atypical presentation. 741 questions.
A 4-year-old girl attends a general practice with her father for a pre-kindergarten check. Her weight is above the 97th centile and her body mass index has been…
Paediatrics · Clinical rotations · 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 9-year-old boy is referred to a paediatric clinic because his weight is above the 97th centile. Both parents are overweight, he spends most of his free time o…
Paediatrics · Clinical rotations · 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 13-year-old boy is brought to the emergency department with six weeks of ache in the left knee, worse after football and now making him limp. There has been n…
Paediatrics · Clinical rotations · 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 12-year-old Aboriginal boy is seen at a community clinic for a sports form. His body mass index is well above the 95th centile for age. His mother mentions th…
Paediatrics · Clinical rotations · 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 5-month-old boy is brought to a regional general practice because he "is not filling out". Born at term weighing 3.4 kg, he tracked along the 50th centile unt…
Paediatrics · Clinical rotations · 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 9-month-old boy is brought by his mother, who is worried he is too small because her sister's baby of the same age is much bigger. He was born at term weighin…
Paediatrics · Clinical rotations · 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
A 20-month-old boy of Greek-Australian parents is investigated for pallor and irritability. He drinks about 1.2 litres of full-cream milk a day from a bottle, i…
Paediatrics · Clinical rotations · middle twist
A 30-year-old woman, three weeks after giving birth, has had 24 hours of pain in the left breast. There is a tender, red, wedge-shaped area in the upper outer q…
Paediatrics · Pre-internship · middle twist
A 14-year-old girl has lost 9 kg over five months, restricts herself to about 800 kilojoules a day and exercises for two hours daily. Her heart rate is 58 beats…
Paediatrics · Pre-internship · middle twist
At an immunisation visit, the mother of a 3-year-old boy says he hits his 10-month-old sister several times a day, usually while she is being fed. She has tried…
Paediatrics · Clinical rotations · middle twist
A 5-year-old boy wets the bed on four nights each week and has never been dry for more than a few nights at a time. He has been dry by day since he was three, h…
Paediatrics · Clinical rotations · middle twist
A 15-year-old girl is seen alone at a general practice. During the psychosocial interview she says she has been cutting her left forearm most weeks for three mo…
Paediatrics · Pre-internship · middle twist