Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 785 questions.
A 34-year-old Aboriginal man attends a general practice in a regional Western Australian town six weeks after his uncle died. He sleeps poorly, has stopped goin…
Psychiatry · Clinical rotations · middle twist
A 3-year-old boy is brought by his mother, who says he never sits still, runs off in car parks and has been asked to leave two childcare centres. He was born at…
Psychiatry · Clinical rotations · middle twist
A 35-year-old intern is caring for a 62-year-old woman with alcohol-related liver disease on a general medical ward. She is the same age as his mother and speak…
Psychiatry · Clinical rotations · middle twist
A 22-year-old university student in a wheat-belt town has had six weeks of low mood, poor concentration and loss of interest since failing two units. There is n…
Psychiatry · Clinical rotations · middle twist
A 29-year-old woman has had eight episodes over four months in which her heart pounds, she cannot get enough air, her hands tingle and she becomes certain she i…
Psychiatry · Clinical rotations · common
A 74-year-old woman has been in hospital for eleven days with a severe depressive episode. She is convinced her bowel has rotted away and that she is being puni…
Psychiatry · Clinical rotations · middle twist
A 24-year-old woman started sertraline 50 mg daily eleven days ago for a moderate depressive episode, with no previous psychiatric history. She telephones to sa…
Psychiatry · Clinical rotations · common
A 33-year-old woman is reviewed six weeks after the birth of her first child. She has persistent low mood, early morning waking, poor concentration and guilt at…
Psychiatry · Clinical rotations · middle twist
A general practice registrar is deciding which antidepressant to start for a 40-year-old man with a first episode of major depression of moderate severity. She…
Psychiatry · Clinical rotations · common
A 24-year-old man with schizophrenia has been taking clozapine for 17 days, titrated to 250 mg daily after two other antipsychotics failed. He reports three day…
Psychiatry · Clinical rotations · middle twist
A general practice registrar reads a news report that the Australian regulator has issued a new warning about a mood stabiliser she prescribes, concerning a pos…
Psychiatry · Clinical rotations · middle twist
A 31-year-old woman stopped paroxetine four days ago; she had taken 20 mg daily for eight months for panic disorder and ran out of tablets while interstate for…
Psychiatry · Clinical rotations · middle twist
A 23-year-old man with treatment-resistant schizophrenia started clozapine eighteen days ago and now takes 250 mg daily. He tells the nurse he feels as though h…
Psychiatry · Clinical rotations · middle twist
A 26-year-old woman consults her general practitioner five weeks after her relationship ended. She feels flat most days, cries easily and takes an hour to fall…
Psychiatry · Clinical rotations · common
A 15-year-old boy is brought to a general practice by his mother, who says he has become withdrawn over four months. He has stopped playing football, his marks…
Psychiatry · Clinical rotations · common
A 34-year-old man with schizophrenia, well for two years on aripiprazole 15 mg daily, has not collected a prescription for six weeks and is again hearing neighb…
Psychiatry · Clinical rotations · middle twist
A 24-year-old man with schizophrenia has been prescribed risperidone 6 mg daily for eight weeks since his first admission. He still hears two voices commenting…
Psychiatry · Clinical rotations · middle twist
A 44-year-old woman is seen in the emergency department after telling her general practitioner that she felt like giving up. She has four weeks of low mood, poo…
Psychiatry · Clinical rotations · middle twist
A 17-year-old girl is brought to her general practitioner by her father. Over eight months she has stopped seeing friends, dropped from an A to a D average, sle…
Psychiatry · Clinical rotations · middle twist
A 19-year-old man is admitted with a four-week history of persecutory beliefs and voices commenting on his actions. He has used methamphetamine most days for a…
Psychiatry · Clinical rotations · middle twist