Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 28-year-old woman presents with eight months of crampy lower abdominal pain that eases after opening her bowels, together with bloating and a bowel habit alte…
Gastroenterology and Hepatology · Clinical rotations · common
A 54-year-old man with cirrhosis secondary to chronic hepatitis C presents with two episodes of haematemesis over the past hour. On arrival his blood pressure i…
Gastroenterology and Hepatology · Clinical rotations · middle twist
A 45-year-old woman has a 7-mm calculus in the distal ureter on non-contrast CT. Her pain is controlled with oral analgesia, creatinine is normal, and she is af…
Renal, Urology and Electrolytes · Clinical rotations · middle twist
A 47-year-old man with chronic kidney disease presents with palpitations and proximal muscle weakness. Serum potassium is 6.8 mmol/L, the sample is non-haemolys…
Cardiovascular · Clinical rotations · middle twist
A 38-year-old woman has recurrent episodes of visible haematuria, but her renal function is normal and urine protein excretion is minimal. The episodes begin wi…
Renal, Urology and Electrolytes · Clinical rotations · common
A 70-year-old man with diabetic kidney disease takes ramipril and spironolactone. Routine testing shows potassium 6.4 mmol/L, confirmed on a non-haemolysed samp…
Renal, Urology and Electrolytes · Clinical rotations · middle twist
A 46-year-old woman presents with a generalised tonic-clonic seizure. Serum sodium is 112 mmol/L, serum osmolality is 240 mOsm/kg and glucose is 5.2 mmol/L. She…
Neurology · Clinical rotations · common
A 42-year-old man presents with haemoptysis, fatigue and rapidly worsening renal function. Creatinine is 486 micromol/L, urine microscopy shows dysmorphic red c…
Renal, Urology and Electrolytes · Clinical rotations · middle twist
A 59-year-old man has an eGFR of 52 mL/min/1.73 m² on repeated testing over 4 months. His urine albumin:creatinine ratio is 12 mg/mmol, and there is no haematur…
Haematology and Oncology · Clinical rotations · middle twist
A 67-year-old woman develops oliguria and a creatinine rise from 84 to 310 micromol/L after several days of septic shock. Urinalysis shows 2+ blood but no signi…
Renal, Urology and Electrolytes · Clinical rotations · common
A 31-year-old woman at 18 weeks' gestation presents with sudden left flank pain and microscopic haematuria. She is afebrile, her blood pressure is 126/74 mmHg a…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 35-year-old man reports drinking approximately 6 L of water daily because of anxiety about dehydration. He is alert, euvolaemic and not taking diuretics or an…
Renal, Urology and Electrolytes · Clinical rotations · common
A 29-year-old man presents with facial puffiness, dark urine and ankle swelling. He had an impetigo-like skin infection 18 days ago, and his blood pressure is 1…
Renal, Urology and Electrolytes · Clinical rotations · common
A 72-year-old man is found to have a serum creatinine of 286 micromol/L, compared with 98 micromol/L 3 months earlier. He reports six months of poor urinary str…
Gastroenterology and Hepatology · Clinical rotations · common
A 26-year-old woman who is 9 weeks pregnant is planning a 3-week trip to rural areas of Papua New Guinea. She will stay in local villages and has no psychiatric…
Obstetrics and Gynaecology · Clinical rotations · middle twist
An 8-year-old child has written documentation of two valid diphtheria-tetanus-acellular pertussis doses given at 2 and 4 months of age, but no subsequent doses…
Paediatrics · Clinical rotations · common
A 10-week pregnant woman is found to be non-immune to rubella during antenatal screening. She has no symptoms and has never had an immediate hypersensitivity re…
Obstetrics and Gynaecology · Clinical rotations · common
A 10-month-old child presents for routine care after recently arriving in Australia, and the parents have no written immunisation records. The child appears wel…
Paediatrics · Clinical rotations · common
A 34-year-old woman with known autoimmune Addison disease presents with vomiting, abdominal pain and profound weakness. Her blood pressure is 82/48 mmHg, sodium…
Endocrine and Metabolic · Clinical rotations · common
A 29-year-old man has progressive bone pain, proximal weakness and two atraumatic metatarsal fractures. Serum phosphate is 0.44 mmol/L (0.80–1.50), calcium is 2…
Endocrine and Metabolic · Clinical rotations · niche