Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 29-year-old woman requests emergency contraception 4 days after unprotected intercourse. Her BMI is 36 kg/m², she is not pregnant and has no contraindication…
Emergency and Toxicology · Pre-internship · middle twist
A 63-year-old woman with acute myeloid leukaemia has had febrile neutropenia for 96 hours despite piperacillin-tazobactam. She remains haemodynamically stable,…
Emergency and Toxicology · Pre-internship · middle twist
A 45-year-old man becomes acutely unwell after receiving approximately 20 mL of an incompatible red-cell unit. He develops fever, severe flank pain, hypotension…
Emergency and Toxicology · Pre-internship · common
A 67-year-old woman develops a temperature of 38.3°C and rigors 30 minutes after a red-cell transfusion begins. She is haemodynamically stable and has no dyspno…
Haematology and Oncology · Pre-internship · common
A 74-year-old woman with advanced dementia is unable to make decisions and has no advance care directive. Her husband is the recognised substitute decision-make…
Ethics and Professional Practice · Pre-internship · common
A 77-year-old man with metastatic prostate cancer and an estimated glomerular filtration rate of 18 mL/min/1.73 m² has been receiving regular oral morphine. Ove…
Geriatrics and Palliative Care · Pre-internship · middle twist
A 90-year-old man is dying from advanced heart failure and is no longer able to swallow. His breathing is noisy because of pooled respiratory secretions, but he…
Ethics and Professional Practice · Pre-internship · common
A 72-year-old woman with metastatic breast cancer has decision-making capacity and asks that cardiopulmonary resuscitation not be attempted if she becomes unabl…
Ethics and Professional Practice · Pre-internship · common
A 79-year-old man has taken diazepam 5 mg nightly for 10 years and wants to stop because of morning unsteadiness. He has no seizures, severe anxiety disorder or…
Geriatrics and Palliative Care · Pre-internship · common
A 45-year-old woman is brought to the emergency room after developing diffuse skin tenderness and blistering. Her symptoms initially started with fever and mala…
Year 4 · Pre-internship · middle twist
A 52-year-old male is currently an inpatient on a hospital ward. He developed rapid-onset swelling of the lips and face during his hospital stay. He reports no…
Year 4 · Pre-internship · common
A 72-year-old man with Alzheimer’s disease is brought to the emergency room by his daughter due to confusion and lethargy over the past few days. His daughter s…
Year 4 · Pre-internship · middle twist
A 75-year-old male presents to the clinic with generalized fatigue, weight loss, and chronic abdominal pain. He was diagnosed with pancreatic cancer a year ago…
Year 4 · Pre-internship · common
A 59-year-old male presents to the emergency room after he develops a fever of 38.5°C (101.3°F). He was recently diagnosed with leukemia and started chemotherap…
Year 4 · Pre-internship · middle twist
A 20-year-old college student presents to the emergency department with a fever, severe headache, and neck stiffness for the past 12 hours. One of his roommates…
Year 4 · Pre-internship · middle twist
Which electrolyte imbalance is most commonly associated with acute pancreatitis?
Year 4 · Pre-internship · common