Medicine

An 82-year-old woman has fallen twice since her medicines were changed. She is slower when walking and has recently complained of constipation, blurred vision a…

A 62-year-old man has a regular broad-complex tachycardia at 190 beats per minute three hours after treatment for an acute myocardial infarction. He is consciou…

A 39-year-old man with bipolar disorder is brought to the emergency department one hour after becoming agitated and incoherent. His medicines are sertraline, tr…

A 46-year-old man with schizophrenia becomes restless and confused two days after his haloperidol dose was increased. He is febrile at 39.8°C, has widespread mu…

A 55-year-old man with severe depression is admitted after refusing food and fluids for several days. He understands that electroconvulsive therapy has been rec…

A 36-year-old man with schizophrenia attends with his sister after stopping risperidone. He hears a voice commenting on his actions but is calm, has no thoughts…

A 74-year-old man with type 2 diabetes presents with several days of lethargy and increasing confusion. His blood glucose concentration is 42 mmol/L, calculated…

A 52-year-old man with alcohol dependence is brought to the emergency department after being found confused at home. He has had several days of vomiting and is…

A 79-year-old man has fallen three times in two months, usually when walking to the toilet at night. He has slowed reactions and feels unsteady for several hour…

A 20-year-old university student with bipolar disorder is admitted voluntarily during a manic episode. She has capacity and agrees that her sister may be told t…

A 56-year-old man with severe depression has decision-making capacity and agrees that electroconvulsive therapy may be appropriate. Before signing consent, he a…

A 34-year-old man with major depression tells his general practitioner that he has thought about dying and has imagined taking an overdose. He has no tablets at…

A 29-year-old woman with type 1 diabetes refuses her evening insulin after becoming convinced that the injections are being used to poison her. She can repeat t…

A 34-year-old woman is reviewed 18 hours after an emergency caesarean section complicated by a 1.6 L postpartum haemorrhage. The bleeding has been controlled fo…

A 46-year-old man with recurrent major depression tells his general practitioner that he intends to take all his prescribed medicines after his partner leaves f…

A 29-year-old man with schizophrenia is brought to the emergency department after threatening another patient. He is pacing, shouting and clenching his fists; h…

A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…

A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…

A 32-year-old woman develops widespread urticaria, lip swelling and wheeze within 15 minutes of eating a satay dish at a restaurant. On arrival of paramedics he…

An 84-year-old woman who lives alone is found to have a 2.5 cm breast mass, and core biopsy shows invasive carcinoma. The surgeon has recommended wide local exc…