Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 7-year-old boy has complained of pain in both thighs and an intermittent limp for one month. He is pale but afebrile, and there is no joint swelling; both hip…
Haematology and Oncology · Clinical rotations · common
A 13-year-old boy with obesity has had aching pain in his left knee for three weeks. He suddenly develops severe groin pain while rising from a chair and cannot…
Surgery and Perioperative Care · Clinical rotations · common
A 3-year-old boy is brought to the emergency department because he has stopped walking and cries when lifted. He has a temperature of 38.8°C, a heart rate of 13…
Paediatrics · Clinical rotations · middle twist
A 79-year-old woman falls at home and develops groin pain. Pelvic and hip radiographs show no fracture, but after analgesia she still cannot take four steps and…
Surgery and Perioperative Care · Clinical rotations · middle twist
A 24-year-old university student presents with three days of migratory joint pain involving both knees and one wrist. He has a temperature of 38.1°C and a small…
Infectious Diseases · Clinical rotations · common
A 7-year-old boy falls from playground equipment and sustains a displaced supracondylar fracture of the humerus. His hand is warm, capillary refill is 1.5 secon…
Paediatrics · Clinical rotations · middle twist
A 71-year-old man presents with three days of dyspnoea. CT pulmonary angiography shows bilateral pulmonary emboli and right ventricular enlargement; his blood p…
Cardiovascular · Clinical rotations · common
A 42-year-old woman has a second proximal deep vein thrombosis while taking rivaroxaban as prescribed. She has no interacting medicines, normal renal function a…
Cardiovascular · Clinical rotations · middle twist
A 68-year-old man with metastatic oesophageal cancer develops a symptomatic proximal deep vein thrombosis. He completed treatment for melaena from the tumour tw…
Cardiovascular · Clinical rotations · middle twist
A 29-year-old woman at 10 weeks of pregnancy presents with sudden pleuritic chest pain and breathlessness. Her heart rate is 108/min, oxygen saturation is 98% o…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 34-year-old woman wants reliable contraception while receiving rifampicin for pulmonary tuberculosis. She has previously used a combined oral contraceptive pi…
Obstetrics and Gynaecology · Clinical rotations · common
A 41-year-old woman is rescued from a vehicle fire with burns encircling the chest and upper abdomen. She is intubated and ventilated, but her peak airway press…
Emergency and Toxicology · Clinical rotations · middle twist
A 28-year-old electrician receives an electrical injury while working on industrial equipment. There is a small contact mark on the palm and a larger mark at th…
Emergency and Toxicology · Clinical rotations · middle twist
A 46-year-old man is brought from a house fire with burns to his face and upper chest. He is awake, has soot around his mouth and is coughing; initially his voi…
Emergency and Toxicology · Clinical rotations · common
A 76-year-old woman taking denosumab for osteoporosis develops pain around a mandibular molar and undergoes extraction. Twelve weeks later, a segment of hard ti…
Endocrine and Metabolic · Clinical rotations · common
A 58-year-old woman presents with tiredness, a sore tongue and difficulty judging the position of her feet in the dark. She has a macrocytic anaemia, a low seru…
Haematology and Oncology · Clinical rotations · common
A 67-year-old woman with long-standing rheumatoid arthritis reports increasing fatigue and reduced exercise tolerance. Her haemoglobin is 92 g/L (115–155), mean…
Haematology and Oncology · Clinical rotations · middle twist
A 72-year-old man with atrial fibrillation notices sudden, profound loss of vision in his right eye while eating breakfast. There is no pain, headache or preced…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 34-year-old woman at 13 weeks of gestation presents with vaginal bleeding and increasing abdominal distension. The uterus is approximately 18 weeks in size, h…
Obstetrics and Gynaecology · Clinical rotations · common
A 36-year-old woman at 8 weeks of gestation has vaginal bleeding and intermittent lower abdominal cramping. Transvaginal ultrasonography shows an intrauterine g…
Obstetrics and Gynaecology · Clinical rotations · middle twist