Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 15-year-old boy is referred by the Children's Court after a series of thefts. His mother reports that from the age of eight he lit fires in the backyard and r…
Psychiatry · Clinical rotations · middle twist
A 15-year-old girl is brought to the general practice by her mother because her grades have fallen and she is tired all the time. The mother answers most of the…
Psychiatry · Clinical rotations · common
A 24-year-old woman with borderline personality disorder has cut her forearms after arguments about once a fortnight for two years, and has attended the emergen…
Psychiatry · Clinical rotations · common
A 19-year-old university student is seen the morning after taking twelve paracetamol tablets and scratching her forearm, three weeks after her parents separated…
Psychiatry · Clinical rotations · middle twist
A 38-year-old man on remand is referred to the prison health service for "anger management". He is charming and articulate. He was expelled from school at 13, h…
Psychiatry · Clinical rotations · common
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
A 56-year-old man is referred by his employer after lodging a third complaint alleging that colleagues are conspiring to have him dismissed. He keeps a dated fo…
Psychiatry · Clinical rotations · middle twist
A 29-year-old woman has been treated for "depression" for six years and has now been referred for electroconvulsive therapy after adequate trials of three antid…
Psychiatry · Clinical rotations · middle twist
A 63-year-old retired postal worker is referred with four months of "insomnia". He falls asleep within ten minutes but wakes at about 4 am and cannot get back t…
Psychiatry · Clinical rotations · common
A 44-year-old accountant has had trouble getting to sleep for eight months. She goes to bed at 9.30 pm hoping to catch up, then lies awake for two or three hour…
Psychiatry · Clinical rotations · middle twist
A 45-year-old man with major depressive disorder has been treated for seven weeks and his mood has clearly improved. He now reports intensely vivid, unpleasant…
Psychiatry · Clinical rotations · middle twist
An 8-year-old boy is brought by his parents because two or three nights a week, usually about an hour after falling asleep, he sits bolt upright and screams. He…
Psychiatry · Clinical rotations · common
A 16-year-old girl attends your general practice with her mother, who announces at the desk that her daughter needs to go on the pill for her periods. In the ro…
Psychiatry · Clinical rotations · common
A 15-year-old girl has lost 7 kg over eight months by cutting out fats and running before school, and is frightened of gaining weight. She is 160 cm tall and we…
Psychiatry · Clinical rotations · common
A 24-year-old primary school teacher is referred because of painless swelling at the angles of both jaws over four months. She is 165 cm tall and weighs 61 kg,…
Psychiatry · Clinical rotations · middle twist
Six days ago a 27-year-old childcare worker was the front-seat passenger in a head-on collision in which the driver was killed. Since then she has had intrusive…
Psychiatry · Clinical rotations · common
A 23-year-old law student describes episodes that begin during arguments with her partner. She suddenly feels as though she has floated up to the ceiling and is…
Psychiatry · Clinical rotations · common
A 38-year-old woman has attended your general practice eleven times in six months. Each visit follows a new bodily sensation - a headache, a skin blemish, a twi…
Psychiatry · Clinical rotations · common
A 52-year-old woman attends your practice 20 to 30 times a year with headaches, bloating, dizziness and aching limbs that she says rule her days. She has had tw…
Psychiatry · Clinical rotations · common
A 34-year-old operating theatre nurse has had eight admissions in a year with episodes of sweating and confusion. Today her blood glucose is 1.6 mmol/L (3.0 to…
Psychiatry · Clinical rotations · middle twist