Niche but important
Rare, but missing it harms. 109 questions.
A 16-year-old girl with anorexia nervosa is reviewed in an outpatient eating disorder clinic. Over the past six weeks her weight has fallen 3 kg to 42 kg; she i…
Paediatrics · Pre-internship · niche
A 15-year-old girl has never had a period. Her breasts and pubic hair have been fully developed and unchanged for about a year, and she has grown 1 cm in the pa…
Paediatrics · Pre-internship · niche
A 14-year-old boy is brought in by both parents, who are worried that he is the shortest in his year and has not started to change. His height has followed the…
Paediatrics · Clinical rotations · niche
A 13-year-old boy who received a kidney transplant two years ago attends the renal clinic. He takes tacrolimus and mycophenolate and his graft function is stabl…
Paediatrics · Pre-internship · niche
A 16-week-old girl is brought to a general practice by her family, who arrived in Australia three weeks ago. She has no immunisation records and her parents are…
Paediatrics · Pre-internship · niche
A 7-year-old boy is referred because he is disruptive at school, cannot wait his turn, and is two years behind in reading. He has lived with his grandmother sin…
Paediatrics · Clinical rotations · niche
A 4-month-old girl is referred because her head circumference has fallen from the 25th percentile at birth to below the 3rd percentile. She was born at 39 weeks…
Paediatrics · Clinical rotations · niche
A 4-year-old boy attends for a preschool health check. His parents want to move him into the booster seat his 7-year-old sister has outgrown, because he says hi…
Paediatrics · Clinical rotations · niche
A 14-year-old boy attends the renal clinic. He received a deceased-donor kidney transplant at age 9 and takes tacrolimus, mycophenolate and low-dose prednisolon…
Paediatrics · Pre-internship · niche
A 12-year-old boy had blood taken during a work-up for recurrent abdominal pain, which has since settled without treatment. He is well, is Tanner stage 3, and h…
Paediatrics · Pre-internship · niche
A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…
Psychiatry · Pre-internship · niche
A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…
Psychiatry · Pre-internship · niche
A 15-year-old girl with profound intellectual disability and cerebral palsy attends a gynaecology clinic with both parents and her treating psychiatrist. She is…
Psychiatry · Pre-internship · niche
A 68-year-old woman is an involuntary inpatient at an authorised hospital in Perth with a severe depressive episode with psychotic features. She has not respond…
Psychiatry · Pre-internship · niche
A 31-year-old man with schizophrenia stopped his aripiprazole six weeks ago because of restlessness. His mother brings him to a Perth community mental health cl…
Psychiatry · Pre-internship · niche
A 46-year-old man taking venlafaxine 225 mg daily for depression is admitted after a fall at work. The orthopaedic team started slow-release tramadol two days a…
Psychiatry · Pre-internship · niche
A 29-year-old woman is admitted with a first manic episode. She has not slept for four nights, has telephoned strangers at 3 am and has spent her rent money on…
Psychiatry · Pre-internship · niche
A 32-year-old man with bipolar I disorder has been euthymic for three years on sodium valproate 1200 mg daily, after two manic admissions in his twenties. At a…
Psychiatry · Pre-internship · niche
A 46-year-old man with schizophrenia has taken clozapine 400 mg daily for four years without a dose change. Over the past ten days he has become drowsy in the a…
Psychiatry · Pre-internship · niche
A 68-year-old man is reviewed by the intern on a general medical ward. His wife died sixteen months ago. He says he thinks about her for most of every day, stil…
Psychiatry · Pre-internship · niche