Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 74-year-old man on the orthopaedic ward is found drowsy six hours after his first dose of slow-release oxycodone for a fractured neck of femur. He rouses brie…
Acute Care · Pre-internship · middle twist
A 17-year-old girl weighing 55 kg says she swallowed 45 tablets of immediate-release paracetamol 500 mg about ten hours ago after an argument with her partner.…
Acute Care · Pre-internship · middle twist
A 70 kg man has a 12 cm laceration across the extensor surface of his right forearm from a falling pane of glass. Tendon function through the full range of move…
Acute Care · Pre-internship · middle twist
A 7-year-old girl fell from a scooter onto her outstretched hand yesterday. Her wrist is swollen and tender about 2 cm proximal to the wrist crease, she is usin…
Acute Care · Pre-internship · middle twist
A 28-year-old man jumped from a first-floor window to escape a house fire and has blistered burns over about 30% of his body surface. Forty-five minutes after t…
Acute Care · Pre-internship · niche
A 24-year-old man is brought in by ambulance after his motorcycle struck a guardrail. His left leg is partly amputated below the knee and bright blood is wellin…
Acute Care · Pre-internship · common
A 71-year-old woman who speaks only Vietnamese is ready to leave the emergency department after chest pain with normal troponin results. She is to start a new m…
Acute Care · Pre-internship · common
A 9-year-old girl is brought to a Western Australian emergency department by her mother with three weeks of intermittent abdominal pain. While her mother is out…
Acute Care · Pre-internship · middle twist
A 63-year-old man presents 30 hours after a garden fork went through his boot into the sole of his foot while he was turning manure. The puncture is 2 cm deep a…
Acute Care · Pre-internship · niche
A 24-year-old woman is brought in by ambulance after being found unrousable at home. She had swallowed six of her flatmate's morphine tablets, which he takes tw…
Acute Care · Pre-internship · middle twist
A 23-year-old woman is medically cleared six hours after taking 20 of her flatmate's quetiapine tablets at the end of a relationship. She says she regrets it, i…
Acute Care · Pre-internship · middle twist
A 74-year-old woman is being discharged from the emergency department after a fall at home with an undisplaced pubic ramus fracture on radiography. She can weig…
Acute Care · Pre-internship · middle twist
The mother of a 5-year-old girl admitted to a Perth public hospital with gastroenteritis tells the bedside nurse that her daughter is going flat and is not hers…
Acute Care · Pre-internship · middle twist
A 74-year-old man collapses in a shopping centre and is brought to the emergency department in cardiac arrest. Resuscitation is unsuccessful and he is declared…
Acute Care · Pre-internship · middle twist
An 89-year-old man with advanced dementia is in the emergency department with aspiration pneumonia. He cannot retain or weigh information about treatment. He ma…
Acute Care · Pre-internship · niche
A 68-year-old woman is brought to a Perth emergency department unconscious after her neighbour found her with empty amitriptyline packets and a note. Her airway…
Acute Care · Pre-internship · niche
A 58-year-old man dies in the resuscitation bay after an out-of-hospital cardiac arrest. His wife and adult daughter have been waiting in the relatives room wit…
Acute Care · Pre-internship · middle twist
An 82-year-old woman with advanced dementia is admitted to a Perth hospital with a fractured neck of femur. She cannot repeat back or weigh up any part of the d…
Acute Care · Pre-internship · middle twist
A 34-year-old man is brought to a Perth emergency department with a stab wound to the thigh. He is alert, gives a clear account of the assault, and knows the da…
Acute Care · Pre-internship · middle twist
A 76-year-old man taking ramipril and spironolactone attends with three days of vomiting and increasing lethargy. He is drowsy but rousable. Pulse is 42/min and…
Acute Care · Pre-internship · common