Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 32 questions.
A 7-year-old girl returns from a camping trip in far north Queensland with five days of fever, headache and severe myalgia. There is a 1 cm black-crusted ulcer…
Paediatrics · Clinical rotations · niche
A 13-year-old girl attends a general practice in the first week of September. Every year from the first week of October until Christmas she has a blocked, itchy…
Paediatrics · Clinical rotations · niche
A boy is born at 39 weeks weighing 2.5 kg to a woman with epilepsy who took a single antiepileptic drug throughout the pregnancy. He has a broad flat nasal brid…
Paediatrics · Clinical rotations · niche
A 7-day-old breastfed girl is admitted with a two-day history of poor feeding and vomiting. She is deeply jaundiced, lethargic and hypothermic, with a liver edg…
Paediatrics · Clinical rotations · 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 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 26-year-old woman is assessed by a community mental health team. She has a lifelong pattern of unstable relationships, impulsive self-harm and chronic emptine…
Psychiatry · Clinical rotations · niche
At a hospital grand round on mental health funding, a registrar is asked how much Australia spends on mental health. She finds several different figures in circ…
Psychiatry · Clinical rotations · niche
A 22-year-old woman is admitted after three weeks of increasingly odd behaviour. Her mother says she had a flu-like illness a month ago, then became convinced h…
Psychiatry · Clinical rotations · niche
You are the intern on a geriatric medicine ward in Perth. An 84-year-old woman who developed a hyperactive delirium during her admission for pneumonia is being…
Psychiatry · Clinical rotations · niche
A 23-year-old woman is brought in by her partner with three weeks of escalating persecutory beliefs, agitation and rambling speech. Over the past week he has no…
Psychiatry · Clinical rotations · niche
An 81-year-old woman who came to Australia from Vietnam at the age of 45 is referred because her family say she forgets appointments and repeats herself. She le…
Psychiatry · Clinical rotations · niche
A 54-year-old Aboriginal man attends his general practice in a regional town for a diabetes review. Type 2 diabetes was diagnosed four years ago. His HbA1c is 5…
Ophthalmology · Clinical rotations · niche
A 9-year-old boy is brought to a regional emergency department after a heavy tackle at football. He is alert and orientated with a Glasgow Coma Scale score of 1…
Acute Care · Clinical rotations · niche
A 58-year-old man who works at a piggery near Griffith, New South Wales, is brought in one February with four days of fever and headache and one day of confusio…
Acute Care · Clinical rotations · niche
A 46-year-old man with osteoarthritis is brought in three hours after taking twenty-four modified-release paracetamol tablets, each 665 mg, at one sitting. He w…
Acute Care · Clinical rotations · niche
A 19-year-old woman is brought to the emergency department by her flatmate two hours after swallowing a handful of paracetamol tablets following an argument. Sh…
Acute Care · Clinical rotations · niche
A 46-year-old man who drinks a bottle of spirits most days has vomited for three days and eaten nothing; he stopped drinking two days ago. He is alert, with epi…
Acute Care · Clinical rotations · niche