Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 29-year-old woman presents at 7 weeks of pregnancy with increasing right lower abdominal pain and light vaginal bleeding. She conceived after in-vitro fertili…
Obstetrics and Gynaecology · Clinical rotations · common
A 19-day-old girl is reviewed for jaundice that has persisted since discharge from hospital. Her mother reports that the urine has stained the nappy dark and th…
Paediatrics · Clinical rotations · common
A 3-week-old boy is brought with persistent jaundice, poor weight gain and two episodes of jitteriness before feeds. He was born at term with a small penis and…
Paediatrics · Clinical rotations · middle twist
A 31-year-old woman presents 12 days after a vaginal birth with increasing bleeding, fever and lower abdominal discomfort. Her temperature is 39.1°C, the uterus…
Obstetrics and Gynaecology · Clinical rotations · common
A 7-year-old boy receiving chemotherapy for acute lymphoblastic leukaemia develops a temperature of 38.6°C at home. In hospital he is alert, has normal perfusio…
Haematology and Oncology · Clinical rotations · middle twist
An 8-month-old girl has a temperature of 39.4°C and has been unsettled for two days. She is drinking, has normal work of breathing and perfusion, and examinatio…
Paediatrics · Clinical rotations · middle twist
A 4-year-old boy presents with fever, vomiting and severe pain in both legs. Over the preceding two hours, dark purple spots have appeared over his buttocks and…
Paediatrics · Clinical rotations · common
A 59-year-old woman is admitted after vomiting for two days and taking sotalol for recurrent atrial fibrillation. She has several brief episodes of faintness as…
Cardiovascular · Clinical rotations · common
A 24-year-old woman presents with abrupt pounding in her neck and mild breathlessness that began while she was sitting at work. She is alert, warm and normotens…
Cardiovascular · Clinical rotations · middle twist
A 41-year-old woman develops a daily headache after several weeks of intense exercise. At first it occurred only after she stood for long periods, but it now be…
Neurology · Clinical rotations · common
A 44-year-old woman develops a severe headache while lifting her young child; she says it was already unbearable before she could put the child down. She has vo…
Neurology · Clinical rotations · middle twist
An otherwise well 29-year-old woman presents eight days after an uncomplicated vaginal delivery with a headache that has gradually intensified over four days. I…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 45-year-old man presents after four days of worsening right lower quadrant pain, fever and anorexia. Examination finds a tender, relatively fixed mass in the…
Surgery and Perioperative Care · Clinical rotations · middle twist
A 79-year-old woman presents with four days of intermittent cramping abdominal pain, vomiting and increasing abdominal distension. She has no history of abdomin…
Gastroenterology and Hepatology · Clinical rotations · common
A 76-year-old man with persistent atrial fibrillation develops sudden severe abdominal pain and vomiting. He is pale and distressed, but his abdomen is initiall…
Emergency and Toxicology · Clinical rotations · middle twist
A 67-year-old man with a previous midline laparotomy presents with colicky abdominal pain, vomiting and progressive distension. Initially the pain came in waves…
Gastroenterology and Hepatology · Clinical rotations · middle twist
A 24-year-old woman presents with 12 hours of abdominal pain, nausea and anorexia. The pain began around the umbilicus and is now most severe in the right iliac…
Surgery and Perioperative Care · Clinical rotations · common
A 67-year-old man has become withdrawn and stopped eating over six weeks. He says his organs have rotted and that his family will be financially ruined because…
Psychiatry and Mental Health · Clinical rotations · common
A 30-year-old woman is brought by her partner 10 days after giving birth. For four nights she has slept for less than two hours, says the infant has been exchan…
Psychiatry and Mental Health · Clinical rotations · common
A 66-year-old man is admitted with melaena from a duodenal ulcer and undergoes successful endoscopic haemostasis. He has taken aspirin 100 mg daily since a myoc…
Cardiovascular · Clinical rotations · middle twist