Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 35-year-old woman at 35+2 weeks has had two episodes of painless vaginal bleeding, each settling with bed rest. Ultrasound shows placental tissue covering the…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 31-year-old woman with chronic hypertension was taking labetalol before conception. At 30 weeks, her blood pressure has risen from 132/82 to 154/98 mmHg. A ur…
Obstetrics and Gynaecology · Clinical rotations · common
A 29-year-old woman at 29 weeks has gestational diabetes managed with dietary advice and exercise. For the past 2 weeks, her fasting capillary glucose concentra…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 37-year-old woman at 37 weeks has a small amount of vaginal bleeding shortly after her membranes rupture. She remains haemodynamically stable, with no abdomin…
Obstetrics and Gynaecology · Clinical rotations · common
A 33-year-old woman at 33+5 weeks has a blood pressure of 168/112 mmHg on two occasions despite oral treatment. She has persistent right upper quadrant pain; pl…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 41-year-old woman presents with sudden right arm weakness and difficulty speaking. Her partner saw rhythmic jerking of the right hand for 90 seconds followed…
Neurology · Clinical rotations · common
A 48-year-old man has a large right middle cerebral artery infarction despite reperfusion treatment. Twenty-four hours later he becomes increasingly drowsy, dev…
Neurology · Clinical rotations · middle twist
A 70-year-old woman is recovering from a small ischaemic stroke and is found to have persistent atrial fibrillation. She has normal renal function and no eviden…
Cardiovascular · Clinical rotations · common
A 66-year-old man develops abrupt spinning vertigo and vomiting while gardening. Six hours later he remains unable to stand without support; examination shows h…
Neurology · Clinical rotations · middle twist
A 72-year-old woman with hypertension reports three episodes in the past week in which the vision in her right eye became obscured from the top down, each lasti…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 79-year-old woman with a previous stroke develops fever, cough and a new right lower-zone infiltrate 36 hours after vomiting during a meal. She is alert, has…
Infectious Diseases · Clinical rotations · middle twist
A 72-year-old man is admitted with pneumonia after three days of fever, cough and increasing breathlessness. He is alert, but his respiratory rate is 34/min and…
Infectious Diseases · Clinical rotations · common
A 68-year-old man presents with a two-day history of fever, productive cough and pleuritic chest pain. He is alert, has a respiratory rate of 32/min, blood pres…
Respiratory · Clinical rotations · common
A 19-year-old man is brought to hospital 90 minutes after swallowing approximately 60 g of paracetamol. He is drowsy, sweaty and vomiting. Arterial blood gas an…
Emergency and Toxicology · Clinical rotations · niche
A 27-year-old man is bitten while walking through long grass near Tamworth, New South Wales. He brings a photograph of a slender brown snake, but the species ca…
Emergency and Toxicology · Clinical rotations · middle twist
A 32-year-old man is found confused after ingesting an unknown number of amitriptyline tablets. He has a blood pressure of 86/54 mmHg, a pulse of 126/min and a…
Emergency and Toxicology · Clinical rotations · common
A 58-year-old man is brought to the emergency department after being found drowsy beside an empty bottle of methadone mixture. He has a respiratory rate of 7/mi…
Emergency and Toxicology · Clinical rotations · common
A 24-year-old woman presents 30 hours after taking repeated doses of paracetamol for a dental infection. She estimates taking 10–12 g daily for four days; her p…
Emergency and Toxicology · Clinical rotations · common
A 62-year-old woman is reviewed three months after a large anterior myocardial infarction. She has mild exertional breathlessness but no recurrent chest pain; t…
Cardiovascular · Clinical rotations · common
A 71-year-old man is monitored after an inferior ST-elevation myocardial infarction. He becomes dizzy but remains conscious; the ECG shows regular P waves at 84…
Cardiovascular · Clinical rotations · common