Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 382 questions.
A 34-year-old woman attends for a routine health check. She drinks four to five standard drinks on each of five evenings a week and has done so for three years.…
Psychiatry · Clinical rotations · middle twist
A 47-year-old man completed inpatient alcohol withdrawal and has been abstinent for eight days. He wants medication to help him stay off alcohol and is attendin…
Psychiatry · Clinical rotations · middle twist
A 72-year-old woman who came to Australia from Vietnam forty years ago is brought to a memory clinic by her son, who describes two years of gradually worsening…
Psychiatry · Clinical rotations · middle twist
A 78-year-old woman is brought by her daughter because over eighteen months she has become slower at finding words and repeatedly mislays her keys. She still dr…
Psychiatry · Clinical rotations · middle twist
A 74-year-old man is brought by his wife because for the past year he has described the small children who come into the lounge room most afternoons; he can say…
Psychiatry · Clinical rotations · middle twist
An 84-year-old woman was admitted three days ago with cellulitis, which is settling on flucloxacillin. Since yesterday she has been muddled at night, insists th…
Psychiatry · Clinical rotations · middle twist
An 82-year-old man with Alzheimer disease diagnosed four years ago lives in residential care, where he usually plays cards each afternoon and needs help only wi…
Psychiatry · Clinical rotations · middle twist
A 34-year-old man with schizophrenia has relapsed twice in nine months, on each occasion a few weeks after stopping his oral risperidone. He is currently well,…
Psychiatry · Clinical rotations · middle twist
A 19-year-old university student is in the emergency department six hours after her flatmate found her drowsy on the bathroom floor beside an empty blister pack…
Psychiatry · Clinical rotations · middle twist
A 72-year-old woman born in Vietnam attends with her daughter, who reports that over two years her mother has become repetitive, has twice left the stove burnin…
Psychiatry · Clinical rotations · middle twist
A 62-year-old accountant is brought to the emergency department by police after he shoved a shop assistant who asked him to stop taking lollies from an open dis…
Psychiatry · Clinical rotations · middle twist
A 31-year-old man is waiting to be seen in a busy emergency department, brought in by his brother, who says he has stopped his medication. He has schizophrenia…
Psychiatry · Clinical rotations · middle twist
A 44-year-old man attends the community mental health clinic. He has recurrent major depressive disorder and came home nine days ago after a two-week admission…
Psychiatry · Clinical rotations · middle twist
A 58-year-old man was admitted three and a half days ago after a fall from a ladder; his wife said he drinks nightly at the club. He was settled and oriented fo…
Psychiatry · Clinical rotations · middle twist
An 84-year-old woman with metastatic breast cancer is admitted from her retirement village because over four days she has become drowsy by day, restless at nigh…
Psychiatry · Clinical rotations · middle twist
A 71-year-old man is flown in from a remote Aboriginal community in the far north of Western Australia with his daughter, who says that over two years he has be…
Psychiatry · Clinical rotations · middle twist
Eighteen months after her husband died, a 58-year-old woman is brought to the general practice by her daughter. She thinks about him for most of each day and ac…
Psychiatry · Clinical rotations · middle twist
A student writes up a new patient using a format taken from an older textbook: schizophrenia on Axis I, no personality disorder on Axis II, type 2 diabetes on A…
Psychiatry · Clinical rotations · middle twist
A 27-year-old man is interviewed on the ward. Asked why he came into hospital, he begins with the bus timetable, moves to his neighbour's dog and then to the pr…
Psychiatry · Clinical rotations · middle twist
A 29-year-old woman is referred with 'panic attacks': five months of episodes of pounding heartbeat, shaking hands and feeling unbearably hot, several of which…
Psychiatry · Clinical rotations · middle twist