Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 456 questions.
A 14-month-old girl has been crying, pulling at both ears and febrile for a day. She has had paracetamol, is drinking normally and is not vomiting. Temperature…
Paediatrics · Pre-internship · middle twist
A 2-year-old boy brought in at 2 am has a harsh barking cough and a hoarse cry. His general practitioner gave him prednisolone 1 mg/kg nine hours ago and he set…
Paediatrics · Pre-internship · middle twist
A 3-year-old girl who arrived from Ethiopia six months ago is screened after her grandmother, who shares the house, was diagnosed with smear-positive pulmonary…
Paediatrics · Pre-internship · middle twist
A 6-day-old term girl, home since day two and feeding well until this morning, is brought in mottled and lethargic. Heart rate is 186 per minute, respiratory ra…
Paediatrics · Pre-internship · middle twist
A 4-year-old girl has refused to walk since yesterday and cries whenever her right leg is moved. Temperature is 38.9 degrees Celsius and heart rate 148 per minu…
Paediatrics · Pre-internship · middle twist
You are drawing a three-generation pedigree for a 7-year-old girl referred with recurrent headaches. Her mother mentions that the child's father, from whom she…
Paediatrics · Pre-internship · middle twist
A 7-year-old boy is brought in by his mother, who has biopsy-proven coeliac disease, as does his older sister. He is well, on the 50th centile for height and we…
Paediatrics · Pre-internship · niche
A woman has an amniocentesis at 17 weeks after a cell-free DNA test reported a high chance of trisomy 21. She is booked to fly interstate in three days for a fa…
Paediatrics · Pre-internship · middle twist
A 39-year-old woman at 12 weeks of her fourth pregnancy is told that her cell-free DNA screening test reports a high chance of trisomy 21. Her nuchal translucen…
Paediatrics · Pre-internship · common
A 28-year-old woman who has had type 1 diabetes since she was twelve asks how to prepare for a pregnancy she hopes to start in about six months. Her most recent…
Paediatrics · Pre-internship · middle twist
You are the intern in a newborn follow-up clinic. A 9-day-old boy has been recalled because his newborn bloodspot screening result shows a markedly raised thyro…
Paediatrics · Pre-internship · middle twist
A boy born at 38 weeks is hypotonic and feeds slowly. Rapid chromosome testing has confirmed trisomy 21. He is pink in air with a normal respiratory rate, the p…
Paediatrics · Pre-internship · middle twist
The parents of a healthy 3-day-old boy ask you to arrange his circumcision before they go home. They give family and cultural reasons. His foreskin is normal fo…
Paediatrics · Pre-internship · middle twist
A boy was born at term to a woman with chronic hepatitis B infection. He was given hepatitis B immunoglobulin and monovalent hepatitis B vaccine within twelve h…
Paediatrics · Pre-internship · middle twist
A healthy boy is born at term after an uncomplicated pregnancy. His mother takes no regular medicines. She tells the midwife she does not want him to have any i…
Paediatrics · Pre-internship · middle twist
A 4-week-old exclusively breastfed boy is brought to the emergency department because he is still yellow. He feeds hungrily and has gained 900 g since birth. Hi…
Paediatrics · Pre-internship · middle twist
A girl born at 36 weeks weighing 2050 g is three hours old and has fed twice at the breast. She becomes jittery with a weak high-pitched cry, and then has an ep…
Paediatrics · Pre-internship · middle twist
A boy born at 38 weeks is 44 hours old on the postnatal ward. His mother attends a treatment program for a daily supervised dose of buprenorphine and reports no…
Paediatrics · Pre-internship · middle twist
A boy is born at 39 weeks after spontaneous labour. The membranes ruptured 26 hours before birth and his mother had a temperature of 38.4 degrees during labour;…
Paediatrics · Pre-internship · middle twist
A 32-year-old woman attends her general practitioner for the six-week postnatal check with her healthy son. She says she is coping, sleeping when he sleeps and…
Paediatrics · Pre-internship · middle twist