Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 69-year-old man has had three episodes of melaena over two months and requires repeated iron infusions. He takes no non-steroidal anti-inflammatory drugs and…
Gastroenterology and Hepatology · Clinical rotations · common
A 67-year-old man presents with recurrent passage of bright-red blood and clots. After initial fluid replacement, his blood pressure is 126/74 mmHg and pulse is…
Cardiovascular · Clinical rotations · middle twist
A 71-year-old man receiving an unfractionated heparin infusion for a recent pulmonary embolus develops recurrent haematemesis and hypotension. The infusion is s…
Cardiovascular · Clinical rotations · common
A 64-year-old woman with cirrhosis presents with fresh haematemesis and melaena. After intravenous access, cautious crystalloid and cross-matched blood have bee…
Cardiovascular · Clinical rotations · middle twist
A 32-year-old man presents to an Australian emergency department with fever, headache and myalgia 10 days after returning from Papua New Guinea. He took doxycyc…
Infectious Diseases · Clinical rotations · common
A 3-year-old child is admitted with invasive Haemophilus influenzae type b infection. The child lives with both parents and a 20-month-old sibling who has recei…
Infectious Diseases · Clinical rotations · niche
A 26-year-old woman is identified as a household contact of a patient with invasive meningococcal disease caused by Neisseria meningitidis serogroup B. She is 2…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 4-year-old child in a childcare centre has had paroxysmal coughing with post-tussive vomiting for 12 days, and PCR has detected Bordetella pertussis. He is ot…
Paediatrics · Clinical rotations · middle twist
A 32-year-old woman at 34 weeks gestation reports two weeks of intense itching that is worse at night and began on her hands and feet. She has no rash, abdomina…
Obstetrics and Gynaecology · Clinical rotations · common
A 34-year-old man with established primary sclerosing cholangitis develops worsening pruritus and jaundice over six weeks, with a 5 kg weight loss. His bilirubi…
Gastroenterology and Hepatology · Clinical rotations · middle twist
A 47-year-old woman has fatigue, pruritus and intermittent jaundice. Alanine aminotransferase is 680 U/L (5–40), IgG is 31 g/L (7–16), antinuclear and smooth-mu…
Gastroenterology and Hepatology · Clinical rotations · common
A 29-year-old woman is admitted with nausea, jaundice and right upper-quadrant discomfort. Her alanine aminotransferase is 9200 U/L (5–40), aspartate aminotrans…
Cardiovascular · Clinical rotations · middle twist
A 42-year-old man presents with several months of pruritus followed by yellowing of the eyes. He has ulcerative colitis, an alkaline phosphatase of 680 U/L (30–…
Gastroenterology and Hepatology · Clinical rotations · common
A 45-year-old man attends a health assessment. He has a sedentary occupation, a waist circumference of 108 cm and a first-degree relative with type 2 diabetes,…
Endocrine and Metabolic · Clinical rotations · middle twist
A 68-year-old man undergoes an abdominal ultrasound arranged during assessment of nonspecific back discomfort. He has no abdominal pain, vascular symptoms or kn…
Cardiovascular · Clinical rotations · middle twist
A 47-year-old woman with no personal or family history of breast cancer asks whether to continue mammographic screening. She has no breast lump or nipple change…
General Practice and Population Health · Clinical rotations · common
A 61-year-old man asks about bowel cancer screening. He has no change in bowel habit, rectal bleeding or iron deficiency, and his mother was diagnosed with bowe…
Gastroenterology and Hepatology · Clinical rotations · common
A 34-year-old woman attends her general practitioner for routine preventive care. She has no symptoms, has never had cervical intraepithelial neoplasia, and her…
Obstetrics and Gynaecology · Clinical rotations · common
A 63-year-old woman with type 2 diabetes accidentally injects 60 units of insulin glargine instead of her usual 20 units. She becomes confused with a capillary…
Emergency and Toxicology · Clinical rotations · common
A 28-year-old man with type 1 diabetes uses a continuous subcutaneous insulin infusion. He develops nausea after the pump gives an occlusion alarm; his blood gl…
Endocrine and Metabolic · Clinical rotations · common