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A 7-year-old boy is brought to the emergency department because he has been breathing hard since the morning. He has vomited repeatedly for two days and says hi…

Acute Care · Clinical rotations · middle twist

In late July a 34-year-old man attends with both his housemates. All three have had headache, nausea and poor concentration that build up through each evening a…

Acute Care · Clinical rotations · middle twist

A 58-year-old man is admitted with three days of fever and a productive cough. He weighs 138 kg, uses continuous positive airway pressure at home for witnessed…

Acute Care · Pre-internship · middle twist

A 24-year-old man is brought to the emergency department after falling four metres from scaffolding onto concrete. He opens his eyes to voice, is confused and l…

Acute Care · Pre-internship · middle twist

A 47-year-old man chokes on a piece of bread roll while talking at a workplace lunch. He coughs hard for a few seconds, then the coughing becomes silent and his…

Acute Care · Clinical rotations · middle twist

You are a medical student on placement in a rural general practice 90 minutes by road from the nearest hospital. A grandmother brings in her 2-year-old grandson…

Acute Care · Clinical rotations · common

A 7-month-old infant on a children's ward is found unresponsive and making occasional gasps. You and the paediatric registrar, both trained in paediatric basic…

Acute Care · Pre-internship · niche

A 71-year-old man at a restaurant suddenly stands and clutches at his throat during the main course. He cannot speak or make any sound. He is conscious and is s…

Acute Care · Clinical rotations · common

A 24-year-old man is brought to a regional emergency department after his motorcycle struck a guard rail. The ambulance officers report that he lost his output…

Acute Care · Pre-internship · middle twist

A 63-year-old man wakes at 5 am with swelling of his lower lip and the left side of his tongue. There is no rash and nothing itches. His voice is normal, his ch…

Acute Care · Clinical rotations · middle twist

A 34-year-old woman arrives 20 minutes after eating a satay skewer at a food van. She has widespread weals, a hoarse voice and expiratory wheeze. Blood pressure…

Acute Care · Pre-internship · middle twist

A 23-year-old university student is reviewed after being given a salbutamol inhaler by a locum six months ago. He uses it about three times most weeks for chest…

Acute Care · Clinical rotations · middle twist

A 46-year-old man with osteoarthritis is brought in three hours after taking twenty-four modified-release paracetamol tablets, each 665 mg, at one sitting. He w…

Acute Care · Clinical rotations · niche

A 24-year-old motorcyclist is brought in thirty minutes after a high-speed collision. Blood is pulsing from a deep laceration on the medial aspect of his left t…

Acute Care · Pre-internship · middle twist

A 19-year-old woman walks into a metropolitan emergency department with her sister ninety minutes after swallowing thirty modified-release paracetamol tablets.…

Acute Care · Clinical rotations · middle twist

A 52-year-old man who lives alone is found drowsy on his kitchen floor and brought in by ambulance. He drinks heavily, is visibly thin, and his neighbour says h…

Acute Care · Pre-internship · middle twist

A 26-year-old woman is brought in three hours after taking about 40 alprazolam tablets with wine. She sleeps but rouses to a loud voice, gags on an oropharyngea…

Acute Care · Pre-internship · niche

A 24-year-old man is brought in by ambulance after his motorcycle struck a guardrail. His left leg is partly amputated below the knee and bright blood is wellin…

Acute Care · Pre-internship · common

A 58-year-old man walks up to the triage desk of a metropolitan emergency department. He says a heavy tightness spread across the front of his chest while he wa…

Acute Care · Clinical rotations · common

A 58-year-old man walks into a Perth emergency department at 1900 hours saying he has had heavy central chest pain radiating to his jaw for the past 40 minutes.…

Acute Care · Clinical rotations · middle twist