Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 68-year-old woman presents with two days of constant right upper quadrant and epigastric pain. Overnight she had two episodes of violent, uncontrollable shaki…
Gastroenterology and Hepatology · Clinical rotations · common
A 22-year-old woman presents to the emergency department with 24 hours of lower abdominal pain that began around the umbilicus and is now most marked on the rig…
Surgery and Perioperative Care · Clinical rotations · middle twist
A 66-year-old man with ischaemic cardiomyopathy attends for review. Echocardiography shows a left ventricular ejection fraction of 30%, and he remains breathles…
Cardiovascular · Clinical rotations · common
A 71-year-old woman with chronic obstructive pulmonary disease presents with two days of worsening breathlessness and purulent sputum. She is treated with 28% o…
Respiratory · Clinical rotations · middle twist
A 24-year-old woman with asthma since childhood attends for review. Her only treatment is a salbutamol inhaler, which she now uses three to four times a week fo…
Respiratory · Clinical rotations · middle twist
A 59-year-old man presents 90 minutes after onset of severe central chest pain with sweating and nausea. The ECG shows 3 mm ST-segment elevation in leads II, II…
Cardiovascular · Clinical rotations · middle twist
A 68-year-old man presents with 30 minutes of rapid palpitations and light-headedness. Three years ago he had a heart attack treated with a coronary artery sten…
Cardiovascular · Clinical rotations · common
A 61-year-old man presents with four days of fever, a dry cough and increasing breathlessness. His wife reports he has been muddled since yesterday and has pass…
Respiratory · Clinical rotations · common
A 76-year-old man is brought to the emergency department after losing consciousness while pushing his lawnmower up a slope. His wife reports he went pale and co…
Cardiovascular · Clinical rotations · common
A 58-year-old man presents with three weeks of progressive breathlessness and a dull right-sided chest ache. He has smoked 30 cigarettes daily for 35 years and…
Respiratory · Clinical rotations · common
A 38-year-old man is reviewed because his blood pressure remains elevated despite perindopril 10 mg and amlodipine 10 mg daily. He feels well, sleeps soundly wi…
Cardiovascular · Clinical rotations · common
A 28-year-old woman presents to the emergency department with two days of right-sided chest pain that is worse on deep inspiration. She takes a combined oral co…
Cardiovascular · Clinical rotations · common
A 38-year-old woman presents with two weeks of pain in the front of her neck radiating to her jaw, together with palpitations, sweating and 2 kg of weight loss.…
Endocrine and Metabolic · Clinical rotations · common
A 64-year-old man with type 2 diabetes has an HbA1c of 62 mmol/mol (7.8%) despite maximal-dose metformin and attention to diet and activity. He had a myocardial…
Endocrine and Metabolic · Clinical rotations · middle twist
A 52-year-old man has a blood pressure of 162/98 mmHg despite adequate doses of perindopril, amlodipine and hydrochlorothiazide, with good adherence confirmed.…
Endocrine and Metabolic · Clinical rotations · middle twist
A 62-year-old woman who takes sertraline for depression is brought to the emergency department after a witnessed generalised tonic-clonic seizure at home. She i…
Renal, Urology and Electrolytes · Clinical rotations · common
A 23-year-old man presents because his urine has turned dark brown, which he noticed this morning. Two days ago he developed a sore throat and runny nose, which…
Renal, Urology and Electrolytes · Clinical rotations · common
A 76-year-old woman taking perindopril for hypertension and regular ibuprofen for knee osteoarthritis presents after three days of vomiting and watery diarrhoea…
Renal, Urology and Electrolytes · Clinical rotations · common
A 35-year-old man born in Vietnam attends for pre-employment health screening and is found to have the following results: HBsAg negative, anti-HBs positive at 8…
Gastroenterology and Hepatology · Clinical rotations · common
A 58-year-old man is reviewed after routine blood tests show ALT 68 U/L (<40), AST 44 U/L (<40) and GGT 80 U/L (<60). He has type 2 diabetes and hypertension, h…
Gastroenterology and Hepatology · Clinical rotations · common