Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 31-year-old man is intubated in the emergency department after falling from a roof and is transferred to the intensive care unit. Sedation has been withheld f…
Acute Care · Pre-internship · middle twist
A 24-year-old woman is admitted with an exacerbation of asthma. After an hour of nebulised salbutamol and ipratropium and oral prednisolone she is speaking in f…
Acute Care · Pre-internship · niche
A 74-year-old woman is on day 4 after an open right hemicolectomy. Sodium chloride 0.9% 1 L eight-hourly, charted in the emergency department before her operati…
Acute Care · Pre-internship · common
A 70 kg man is brought to the emergency department three hours after his clothing caught fire at a campsite. He has deep burns covering 40% of his total body su…
Acute Care · Pre-internship · niche
A 68-year-old woman weighing 65 kg is in the emergency department with urinary sepsis. Intravenous antibiotics were given within 30 minutes of arrival and she h…
Acute Care · Pre-internship · middle twist
A 71-year-old man is on day 2 after a Hartmann procedure for perforated diverticulitis. He remains nil by mouth and his nasogastric tube has drained 1400 mL in…
Acute Care · Pre-internship · niche
You are the intern asked to collect a group and hold sample from a 68-year-old man before an elective hip replacement. When you arrive the ward clerk hands you…
Acute Care · Pre-internship · common
A 78-year-old woman is admitted overnight for observation after a mechanical fall. She is eating and drinking, takes only oral medications, and no intravenous t…
Acute Care · Pre-internship · common
A 62-year-old man collapses in a hospital foyer and is found to be in ventricular fibrillation. Compressions have been continuous, adrenaline 1 mg has been give…
Acute Care · Pre-internship · niche
A 54-year-old man presents to a metropolitan hospital with a catheter laboratory after seventy minutes of central chest pain, which is continuing. His blood pre…
Acute Care · Pre-internship · middle twist
A 66-year-old man has had ninety minutes of central chest pain with sweating. His electrocardiogram shows 3 mm ST elevation in leads II, III and aVF with ST dep…
Acute Care · Pre-internship · niche
A 68-year-old woman is brought in from a residential aged care facility with fever and new confusion. Her temperature is 38.9 degrees Celsius, blood pressure 82…
Acute Care · Pre-internship · middle twist
A 28-year-old man is stung by a bee in a hospital car park. In the emergency department he has generalised urticaria, audible wheeze and a blood pressure of 84/…
Acute Care · Pre-internship · middle twist
A 71-year-old man collapses in the radiology department and is apnoeic with a palpable carotid pulse. You are first to arrive with a self-inflating bag, mask an…
Acute Care · Pre-internship · middle twist
You are the intern on night cover. At 02:00 the nurse asks you to see a 68-year-old man on the second night after a right hemicolectomy. His respiratory rate is…
Acute Care · Pre-internship · middle twist
A 58-year-old man is admitted with three days of fever and a productive cough. He weighs 138 kg, uses continuous positive airway pressure at home for witnessed…
Acute Care · Pre-internship · middle twist
A 24-year-old man is brought to the emergency department after falling four metres from scaffolding onto concrete. He opens his eyes to voice, is confused and l…
Acute Care · Pre-internship · middle twist
You are the intern on a paediatric ward in Perth at 9 pm. A 3-year-old admitted that morning with bronchiolitis has observations that all sit inside the normal…
Acute Care · Pre-internship · middle twist
You are the first doctor to reach a 68-year-old man found slumped in a chair in the day therapy unit. He does not respond to voice or to a firm shake, he makes…
Acute Care · Pre-internship · middle twist
A 46-year-old man who came to Australia from South Sudan eight years ago is on the fourth day of treatment for community-acquired pneumonia. Asked by the nurse…
Acute Care · Pre-internship · niche