Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 74-year-old man is referred after three falls over two months. He describes a brief feeling of faintness after rising from a chair, without spinning sensation…
Geriatrics and Palliative Care · Clinical rotations · common
A 35-year-old primigravida at 37 weeks’ gestation is found to have blood pressure readings of 148/96 and 146/94 mmHg 4 hours apart. Urine protein is 2+, platele…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 31-year-old woman at 34 weeks’ gestation presents with a severe frontal headache and flashing lights. Her blood pressure is 176/114 mmHg on two measurements 1…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 68-year-old man with a recent transurethral resection of a bladder tumour presents with worsening suprapubic pain and inability to pass urine. He has passed b…
Renal, Urology and Electrolytes · Clinical rotations · middle twist
A 29-year-old woman at 25 weeks of pregnancy presents with right flank pain, rigors and vomiting. Her temperature is 39.2°C, pulse 132/min and blood pressure 92…
Emergency and Toxicology · Clinical rotations · middle twist
A 78-year-old man presents with a lesion on the sun-exposed forearm that has enlarged from a pinpoint mark to 18 mm over seven weeks. It is a firm, smooth, red-…
Dermatology · Clinical rotations · middle twist
A 35-year-old woman is referred for a brown plaque on the upper back that has slowly enlarged over nine years. It was initially flat, but several firm reddish-b…
Dermatology · Clinical rotations · middle twist
A 63-year-old man has a brown papule on the bridge of his nose that has slowly enlarged over two years and occasionally leaves a spot of blood on his handkerchi…
Dermatology · Clinical rotations · middle twist
A 59-year-old man suddenly develops difficulty speaking and weakness of the right arm while driving. His wife reports that, immediately beforehand, the right si…
Neurology · Clinical rotations · common
A 63-year-old woman has three sudden episodes over two days of dizziness followed by double vision, slurred speech and veering to the left; each episode lasted…
Neurology · Clinical rotations · common
A 54-year-old man presents with five days of fever, dry cough, headache and diarrhoea after returning from a Mediterranean cruise. He is confused, respiratory r…
Respiratory · Clinical rotations · middle twist
A 70-year-old woman vomits during a generalised seizure and becomes cyanosed. One hour later her temperature is 38.4°C, oxygen saturation is 88% on room air and…
Infectious Diseases · Clinical rotations · common
A 59-year-old man develops rapidly worsening breathlessness five days after an influenza-like illness. He has a temperature of 39.8°C, respiratory rate of 38/mi…
Respiratory · Clinical rotations · middle twist
A 5-month-old boy is brought to hospital with 2 days of nasal congestion, cough and reduced breastfeeds. He is alert but has subcostal recession and widespread…
Paediatrics · Clinical rotations · common
A 42-year-old man is brought to hospital 45 minutes after taking an unknown number of amitriptyline tablets. He is drowsy, has a blood pressure of 78/46 mmHg an…
Emergency and Toxicology · Clinical rotations · common
A 29-year-old woman presents with three days of worsening unilateral throat pain, fever and difficulty swallowing. She cannot open her mouth fully, her voice is…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 56-year-old man develops sharp central chest pain 36 hours after an uncomplicated inferior myocardial infarction. The pain is worse when he lies flat or takes…
Cardiovascular · Clinical rotations · middle twist
A 64-year-old man is recovering in hospital four days after an inferior ST-elevation myocardial infarction treated with primary percutaneous coronary interventi…
Cardiovascular · Clinical rotations · middle twist
A 72-year-old man with Parkinson disease is brought by his wife because he has begun speaking to people who are not present and has become suspicious of her. He…
Psychiatry and Mental Health · Clinical rotations · middle twist
A 16-year-old female long-distance runner develops gradually worsening right groin pain over six weeks. She has recently increased her training volume and repor…
Rheumatology and Musculoskeletal · Clinical rotations · middle twist