Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 62-year-old man has a regular broad-complex tachycardia at 190 beats per minute three hours after treatment for an acute myocardial infarction. He is consciou…
Emergency and Toxicology · Pre-internship · common
A 39-year-old man with bipolar disorder is brought to the emergency department one hour after becoming agitated and incoherent. His medicines are sertraline, tr…
Emergency and Toxicology · Pre-internship · common
A 46-year-old man with schizophrenia becomes restless and confused two days after his haloperidol dose was increased. He is febrile at 39.8°C, has widespread mu…
Emergency and Toxicology · Pre-internship · common
A 32-year-old man is rescued from a burning warehouse. He is confused, hypotensive and tachypnoeic, with soot on his face but no wheeze. His pulse oximeter read…
Emergency and Toxicology · Pre-internship · middle twist
A 55-year-old man with severe depression is admitted after refusing food and fluids for several days. He understands that electroconvulsive therapy has been rec…
Ethics and Professional Practice · Pre-internship · common
A 36-year-old man with schizophrenia attends with his sister after stopping risperidone. He hears a voice commenting on his actions but is calm, has no thoughts…
Ethics and Professional Practice · Pre-internship · common
A 9-year-old refugee presents with a sore throat and neck swelling after arriving in Australia from a region with limited vaccination coverage. He is febrile bu…
Infectious Diseases · Pre-internship · middle twist
A 29-year-old Aboriginal man attends an annual health assessment. He injects methamphetamine intermittently and reports sharing a needle once four months ago; h…
Infectious Diseases · Pre-internship · middle twist
A 74-year-old man with type 2 diabetes presents with several days of lethargy and increasing confusion. His blood glucose concentration is 42 mmol/L, calculated…
Emergency and Toxicology · Pre-internship · common
A 52-year-old man with alcohol dependence is brought to the emergency department after being found confused at home. He has had several days of vomiting and is…
Emergency and Toxicology · Pre-internship · common
A 79-year-old man has fallen three times in two months, usually when walking to the toilet at night. He has slowed reactions and feels unsteady for several hour…
Geriatrics and Palliative Care · Pre-internship · common
A 20-year-old university student with bipolar disorder is admitted voluntarily during a manic episode. She has capacity and agrees that her sister may be told t…
Ethics and Professional Practice · Pre-internship · common
A 56-year-old man with severe depression has decision-making capacity and agrees that electroconvulsive therapy may be appropriate. Before signing consent, he a…
Ethics and Professional Practice · Pre-internship · common
A 34-year-old man with major depression tells his general practitioner that he has thought about dying and has imagined taking an overdose. He has no tablets at…
Ethics and Professional Practice · Pre-internship · common
A 42-year-old woman with recurrent bipolar disorder has made a written advance statement saying that she would want lithium during a future manic relapse. She i…
Ethics and Professional Practice · Pre-internship · middle twist
A 29-year-old woman with type 1 diabetes refuses her evening insulin after becoming convinced that the injections are being used to poison her. She can repeat t…
Ethics and Professional Practice · Pre-internship · common
A 34-year-old woman is reviewed 18 hours after an emergency caesarean section complicated by a 1.6 L postpartum haemorrhage. The bleeding has been controlled fo…
Obstetrics and Gynaecology · Pre-internship · common
A woman develops ongoing haemorrhage during an emergency caesarean section for uterine atony. After 3 units of red blood cells and 2 units of fresh frozen plasm…
Obstetrics and Gynaecology · Pre-internship · middle twist
A 46-year-old man with recurrent major depression tells his general practitioner that he intends to take all his prescribed medicines after his partner leaves f…
Psychiatry and Mental Health · Pre-internship · common
A 29-year-old man with schizophrenia is brought to the emergency department after threatening another patient. He is pacing, shouting and clenching his fists; h…
Psychiatry and Mental Health · Pre-internship · common