Middle twist
One twist — a threshold, a comorbidity, an atypical presentation. 741 questions.
A 4-year-old boy has been in foster care for a year, having been removed from his mother's care because of neglect. At kindergarten he walks up to visiting adul…
Paediatrics · Clinical rotations · middle twist
A 14-year-old girl has had daily tiredness and central abdominal pain for eight months and has attended school on only nine days this term. Full blood count, in…
Paediatrics · Pre-internship · middle twist
A 15-year-old girl has had six episodes over three months in which she falls to the floor and her arms and legs thrash irregularly for fifteen to twenty minutes…
Paediatrics · Clinical rotations · middle twist
A 9-year-old girl has had five months of intermittent central abdominal pain, worst on school mornings. Her parents separated six months ago and she has missed…
Paediatrics · Clinical rotations · middle twist
A 14-year-old girl is brought by her mother because her marks have dropped over three months, she has quit netball, and she is irritable and withdrawn. Her pare…
Paediatrics · Pre-internship · middle twist
A 7-year-old girl's teacher reports that her schoolwork has fallen away this year and that she "drifts off". Her mother says that twenty or thirty times a day s…
Paediatrics · Clinical rotations · middle twist
An 8-year-old boy is brought in by his mother, who describes fourteen months of daily arguing with adults, deliberate refusal to follow instructions, blaming hi…
Paediatrics · Clinical rotations · middle twist
A 9-year-old boy has primary nocturnal enuresis with no daytime urinary symptoms, normal growth, normal blood pressure and a normal urinalysis. An eight-week al…
Paediatrics · Pre-internship · middle twist
A 7-week-old girl is brought in because she cries inconsolably for four to five hours each evening, drawing her legs up, and has done so since three weeks of ag…
Paediatrics · Clinical rotations · middle twist
A 2-year-old boy attends with his mother after his childcare educator commented that he "plays on his own". He walks and runs well, uses about sixty single word…
Paediatrics · Pre-internship · middle twist
A 14-year-old boy is brought by his parents because he is the shortest in his class and has no signs of puberty. His height is on the 3rd centile and he has gro…
Paediatrics · Clinical rotations · middle twist
A 14-year-old boy attends the general practice with his mother because his school marks have collapsed over two terms and he has begun refusing to go on Monday…
Paediatrics · Pre-internship · middle twist
A term-born 10-month-old boy attends for his routine child health check. He sits unsupported, crawls, pulls to stand and transfers objects between his hands; he…
Paediatrics · Clinical rotations · middle twist
A 9-year-old boy is brought by his mother, who has completed a standardised parent rating scale scoring highly for inattention and hyperactivity. She says he ca…
Paediatrics · Clinical rotations · middle twist
An 18-month-old boy is brought back to the general practice by his father. At his 15-month check he was walking, waving goodbye, using eight words and handing h…
Paediatrics · Pre-internship · middle twist
A boy born at 28 weeks gestation is brought to the general practice at 20 months of age because he is not yet walking. He was discharged home at term with no in…
Paediatrics · Pre-internship · middle twist
A 3-year-old boy is assessed because he is behind his twin sister. He walked at 22 months and now runs stiffly but symmetrically; tone, power and deep tendon re…
Paediatrics · Clinical rotations · middle twist
A 30-month-old boy is reviewed after the practice nurse completed an Ages and Stages Questionnaire with his mother. He scores below the cut-off for communicatio…
Paediatrics · Pre-internship · middle twist
A 7-month-old girl is brought to a rural general practice. Her weight has fallen from the 50th centile to below the 0.4th centile over three months; her length…
Paediatrics · Pre-internship · middle twist
A 7-month-old boy is brought to the emergency department by his 19-year-old mother because of a cold. His weight has crossed from the 50th percentile at 4 month…
Paediatrics · Pre-internship · middle twist