Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 76-year-old man with probable dementia with Lewy bodies has recurrent visual hallucinations that are frightening but not associated with aggression or immedia…
Geriatrics and Palliative Care · Clinical rotations · middle twist
An 87-year-old woman living independently develops confusion over 2 days after a chest infection. Her alertness varies during the day, and she cannot sustain at…
Geriatrics and Palliative Care · Clinical rotations · common
An 84-year-old inpatient becomes agitated and inattentive over 12 hours. He repeatedly tries to pass urine, reports lower abdominal discomfort and has a palpabl…
Geriatrics and Palliative Care · Clinical rotations · common
An 82-year-old man has had two falls since his blood pressure treatment was intensified. His seated blood pressure is 138/72 mmHg, falling to 108/60 mmHg after…
Geriatrics and Palliative Care · Clinical rotations · common
A 78-year-old woman is assessed after three falls over 2 months. She has not sustained a major injury and denies a clear loss of consciousness. Her medicines in…
Geriatrics and Palliative Care · Clinical rotations · common
A 24-year-old man has 9 months of low back pain that began gradually and improves after exercise but not with rest. He wakes in the second half of the night and…
Rheumatology and Musculoskeletal · Clinical rotations · middle twist
A 67-year-old woman has new bilateral shoulder and hip girdle aching with difficulty lifting her arms and rising from a chair. Symptoms are worst in the morning…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 36-year-old woman with systemic lupus erythematosus has increasing ankle swelling and foamy urine. Her urine protein-to-creatinine ratio is 180 mg/mmol (refer…
Renal, Urology and Electrolytes · Clinical rotations · common
A 42-year-old woman has 6 months of symmetrical swelling and tenderness of the metacarpophalangeal and proximal interphalangeal joints. Morning stiffness lasts…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 58-year-old man develops severe pain and swelling at the base of his right great toe overnight. He is afebrile and has no skin wound or prosthetic joint. Syno…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 67-year-old man has recurrent sinusitis, otitis and a persistent cough with occasional blood-streaked sputum. Urinalysis shows dysmorphic red cells and red-ce…
Rheumatology and Musculoskeletal · Clinical rotations · middle twist
A 29-year-old woman has photosensitive facial erythema, painless oral ulcers and symmetrical pain and swelling of the small joints of both hands. Urinalysis sho…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 69-year-old man presents with 2 months of progressive low back pain that is worse at night and is not relieved by rest. He has lost 6 kg unintentionally and h…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 74-year-old woman has 3 weeks of a new unilateral temporal headache and pain in her jaw when chewing. She has no visual symptoms, limb weakness or constitutio…
Rheumatology and Musculoskeletal · Clinical rotations · middle twist
A 72-year-old woman sustains a low-trauma vertebral compression fracture while lifting a light shopping bag. She has no renal impairment, oesophageal disease or…
Endocrine and Metabolic · Clinical rotations · common
A 67-year-old woman reports several years of pain at the bases of both thumbs and in the distal finger joints. The pain is worse after gardening, morning stiffn…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 54-year-old woman presents with a painful, swollen right knee that became symptomatic over 12 hours. She has a temperature of 37.8°C and is unable to fully fl…
Infectious Diseases · Clinical rotations · common
A a 68-year-old man with a history of gastroesophageal reflux disease presents with worsening kidney function over the past two weeks. He started a proton pump…
Year 4 · Clinical rotations · common
A 54-year-old man with no family history of prostate cancer attends his GP for a routine check-up. He is asymptomatic and has no significant past medical histor…
Year 4 · Clinical rotations · middle twist
A 58-year-old man with no symptoms attends your clinic for a general health check. He is concerned because his uncle and cousin both died of pancreatic cancer.…
Year 4 · Clinical rotations · middle twist