Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 62-year-old woman is receiving her first unit of packed red blood cells for symptomatic anaemia. Fifteen minutes after commencement her temperature rises from…
Nursing · Pre-internship · common
A 68-year-old man is on the surgical ward 6 hours after an open appendicectomy. The nurse records a respiratory rate of 28 breaths/min, heart rate 132/min, bloo…
Nursing · Pre-internship · common
A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…
Emergency and Toxicology · Pre-internship · common
A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…
Emergency and Toxicology · Pre-internship · common
A 32-year-old woman develops widespread urticaria, lip swelling and wheeze within 15 minutes of eating a satay dish at a restaurant. On arrival of paramedics he…
Emergency and Toxicology · Pre-internship · common
A 19-year-old man presents six hours after an acute ingestion of an unknown number of immediate-release paracetamol tablets in a suicide attempt. He is alert, w…
Emergency and Toxicology · Pre-internship · middle twist
A 24-year-old woman presents to the emergency department two hours after impulsively swallowing 32 tablets of 500 mg immediate-release paracetamol (16 g) follow…
Emergency and Toxicology · Pre-internship · middle twist
An 84-year-old woman who lives alone is found to have a 2.5 cm breast mass, and core biopsy shows invasive carcinoma. The surgeon has recommended wide local exc…
Ethics and Professional Practice · Pre-internship · common
A 24-year-old man presents with four days of fever, a runny nose, red watery eyes and a dry cough, ten days after returning from Bali. This morning a blotchy re…
Ethics and Professional Practice · Pre-internship · common
A 79-year-old retired farmer was diagnosed with Alzheimer disease eight months ago. At that time you advised him and his family that he should stop driving, and…
Ethics and Professional Practice · Pre-internship · middle twist
A 15-year-old girl attends alone requesting the combined oral contraceptive pill. She has recently become sexually active with her 16-year-old boyfriend and the…
Ethics and Professional Practice · Pre-internship · middle twist
A 35-year-old man with a known diagnosis of schizophrenia is brought to the emergency department by police after neighbours reported him shouting in the street…
Psychiatry and Mental Health · Pre-internship · middle twist
An 8-week-old boy is brought to a general practice for his scheduled immunisations. While preparing the injections the practice nurse notices a 1.5 cm oval brui…
Paediatrics · Pre-internship · middle twist
A 24-year-old man sustains a closed fracture of the midshaft of the left tibia playing football. A plaster backslab with encircling crepe bandage is applied and…
Emergency and Toxicology · Pre-internship · middle twist
A 58-year-old woman presents with two days of right loin pain radiating to the groin, associated with shaking chills. Her temperature is 38.9°C, pulse 118/min a…
Emergency and Toxicology · Pre-internship · middle twist
A 19-year-old man is brought to a rural general practice, 45 minutes from the nearest hospital, with six hours of fever, vomiting and severe pain in his legs. H…
Emergency and Toxicology · Pre-internship · common
A 35-year-old man is admitted six hours after a house fire with burns to 25% of his body surface area, including a burn encircling the entire right forearm wher…
Emergency and Toxicology · Pre-internship · common
A 25-year-old motorcyclist is brought to the emergency department after a high-speed crash, complaining of left-sided chest pain and severe breathlessness; he c…
Emergency and Toxicology · Pre-internship · common
A 58-year-old man with chronic kidney disease presents with weakness. Serum potassium is 7.1 mmol/L, and the laboratory result has been confirmed on a repeat no…
Emergency and Toxicology · Pre-internship · common
A 64-year-old woman has had an estimated glomerular filtration rate of 26 mL/min/1.73 m² on two measurements 4 months apart. Her urine albumin:creatinine ratio…
Haematology and Oncology · Pre-internship · middle twist