Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 9-year-old boy has a forearm fracture and needs regular oral paracetamol in the emergency department. He weighs 52 kg; the 50th centile weight for his age and…
Paediatrics · Pre-internship · middle twist
A 4-year-old girl admitted with a severe exacerbation of a chronic illness has a nasogastric tube in situ and cannot swallow tablets. One of her regular medicin…
Paediatrics · Pre-internship · middle twist
A 3-year-old inpatient was given 15 mg of oral morphine instead of the prescribed 1.5 mg one hour ago, because a decimal point on the drug chart was misread. He…
Paediatrics · Pre-internship · common
A 26-month-old girl with no known epilepsy is brought in convulsing. The seizure began 14 minutes ago; paramedics gave buccal midazolam at six minutes and a fur…
Paediatrics · Pre-internship · middle twist
An 8-year-old boy who had a right tympanostomy tube inserted last year has a two-week history of an itchy, discharging right ear after swimming lessons. He has…
Paediatrics · Pre-internship · niche
A 5-year-old boy has had a clear runny nose and a dry night cough for four days. He is afebrile and eating normally, and his chest, throat and ears are normal.…
Paediatrics · Pre-internship · common
A woman telephones the practice about her 3-week-old, who was born at term and is thriving on exclusive breastfeeding. Yesterday another doctor started her on a…
Paediatrics · Pre-internship · middle twist
A 15-year-old boy with Crohn disease attends a routine clinic review with his mother. He has lost 4 kg in three months and has missed a third of school days thi…
Paediatrics · Pre-internship · common
An 8-month-old boy is brought to a general practice with six weeks of dry, pink, scaly patches on both cheeks and around the mouth. He rubs at them and wakes se…
Paediatrics · Pre-internship · niche
A 15-year-old girl attends a general practice for a repeat of her salbutamol inhaler. She has had asthma since childhood. She uses salbutamol two or three times…
Paediatrics · Pre-internship · middle twist
The bone marrow result for a 4-year-old girl admitted with pallor and bruising has confirmed acute lymphoblastic leukaemia. You are to be present while the cons…
Paediatrics · Pre-internship · common
A 12-year-old Aboriginal girl from a remote community has been admitted to a tertiary hospital with newly diagnosed type 1 diabetes. English is the family's fir…
Paediatrics · Pre-internship · middle twist
A 6-year-old boy with cystic fibrosis is admitted for his third pulmonary exacerbation this year. His mother tells the team she resigned from her job to manage…
Paediatrics · Pre-internship · common
A 15-year-old girl with type 1 diabetes since the age of nine attends the clinic with her father. Her glycated haemoglobin has risen steadily over 12 months. He…
Paediatrics · Pre-internship · middle twist
A 7-year-old boy has had atopic dermatitis since infancy. His skin is currently red, thickened and excoriated across both antecubital and popliteal fossae and h…
Paediatrics · Pre-internship · middle twist
A 9-year-old girl with newly diagnosed type 1 diabetes has been on the paediatric ward for eight hours receiving intravenous fluid and an insulin infusion for k…
Paediatrics · Pre-internship · niche
A 5-week-old boy is admitted after a fortnight of vomiting that now shoots across the change table after every feed. The vomit has never been green. He feeds hu…
Paediatrics · Pre-internship · middle twist
A 2-year-old boy is brought to a regional emergency department at 3 am with two days of runny nose and a harsh barking cough. Forty minutes ago he was given dex…
Paediatrics · Pre-internship · middle twist
A 10-week-old girl is brought to the emergency department by both parents with a bruise on the left cheek and a smaller one over the left ear. Her father says h…
Paediatrics · Pre-internship · middle twist
A 5-month-old ex-term boy is on day four of bronchiolitis. Over the past 24 hours he has taken about 40 per cent of his usual milk and had two wet nappies. Resp…
Paediatrics · Pre-internship · middle twist