Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A healthy 55-year-old man with no family history of prostate cancer asks for a PSA test after seeing an online advertisement. He has no urinary symptoms, haemat…
General Practice and Population Health · Clinical rotations · middle twist
A 68-year-old man presents with fever, rigors, dysuria and perineal pain. He has been unable to pass urine for 10 hours, and examination shows a markedly tender…
Renal, Urology and Electrolytes · Clinical rotations · common
A 61-year-old man has erectile dysfunction and stable angina treated with regular glyceryl trinitrate spray. He would like to resume sexual activity and has no…
Cardiovascular · Clinical rotations · common
A 52-year-old man reports a 9-month history of gradually worsening erectile difficulty and reduced sexual desire. He has obesity, hypertension and type 2 diabet…
Cardiovascular · Clinical rotations · middle twist
A 32-year-old woman wants highly effective contraception and would prefer predictable light bleeding. She does not want a method requiring daily action and has…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 27-year-old woman presents with 2 days of lower abdominal pain and deep dyspareunia. She has purulent cervical discharge, a temperature of 38.1 °C and marked…
Obstetrics and Gynaecology · Clinical rotations · common
A 74-year-old woman with metastatic breast cancer presents with sudden dyspnoea and pleuritic chest pain. CT pulmonary angiography confirms bilateral pulmonary…
Emergency and Toxicology · Clinical rotations · common
A 66-year-old man with diffuse large B-cell lymphoma is receiving chemotherapy through a tunnelled central venous catheter. On day 8 he develops fever of 38.6°C…
Haematology and Oncology · Clinical rotations · middle twist
A 29-year-old woman has painless cervical and mediastinal lymphadenopathy that has progressed over 2 months. She reports drenching night sweats and pruritus but…
Haematology and Oncology · Clinical rotations · common
A 71-year-old man presents with headache, blurred vision and spontaneous bruising. Blood tests show haemoglobin 86 g/L (reference range 130–170), total protein…
Haematology and Oncology · Clinical rotations · common
A 58-year-old man receiving induction chemotherapy for acute myeloid leukaemia presents with a temperature of 39.1°C. His absolute neutrophil count is 0.05 × 10…
Haematology and Oncology · Clinical rotations · common
A 54-year-old woman has a symptomatic isolated posterior calf-vein thrombosis found on ultrasound. She has no cancer, previous venous thromboembolism, marked sw…
Cardiovascular · Clinical rotations · middle twist
A 31-year-old woman at 10 weeks of pregnancy develops unilateral calf swelling and pleuritic discomfort. Ultrasound confirms a proximal femoral deep-vein thromb…
Obstetrics and Gynaecology · Clinical rotations · common
A 68-year-old man reports persistent thoracic back pain and fatigue for 3 months. His haemoglobin is 92 g/L (reference range 130–170), creatinine is 180 micromo…
Haematology and Oncology · Clinical rotations · common
A 59-year-old man has a painless left cervical mass that has enlarged over 6 weeks. He reports drenching night sweats and has no dental infection, pharyngitis o…
Haematology and Oncology · Clinical rotations · middle twist
A 40-year-old woman presents for routine preventive care and has never had an abnormal cervical screening result. She is asymptomatic, immunocompetent and has n…
Obstetrics and Gynaecology · Clinical rotations · common
A 62-year-old man attends his general practitioner for preventive health care and has no gastrointestinal symptoms. He has no personal or family history suggest…
Gastroenterology and Hepatology · Clinical rotations · common
A 91-year-old man with moderate dementia is admitted after a fall and has developed new agitation overnight. He is afebrile, oxygen saturation is 96% on room ai…
Geriatrics and Palliative Care · Clinical rotations · common
An 88-year-old woman has a dry, adherent black eschar covering the heel. The surrounding skin is warm but not erythematous, there is no drainage or fluctuance,…
Geriatrics and Palliative Care · Clinical rotations · common
A 79-year-old woman with limited mobility has a sacral ulcer measuring 5 cm in diameter. The ulcer extends through the dermis, with visible subcutaneous fat and…
Geriatrics and Palliative Care · Clinical rotations · common