Principles of medical law and ethics

A 58-year-old interstate truck driver has had two unprovoked generalised tonic-clonic seizures in the past month and a diagnosis of epilepsy has been confirmed…

Pre-internship · middle twist

You are the intern on a Perth paediatric ward. A 6-year-old girl admitted with pneumonia tells you that a family friend does rude things to her when he babysits…

Pre-internship · middle twist

You are a resident in a Perth children's hospital and have had concerns about five children this week. Each concern is soundly based, you believe each on reason…

Pre-internship · niche

At 2 am you are the intern who admits a 2-year-old girl with a spiral fracture of the humeral shaft and bruising over the upper arm and back, for which her pare…

Pre-internship · middle twist

A 4-year-old boy is brought to a Perth emergency department with a swollen, bruised left forearm. At triage his mother said he fell from a kitchen chair. When y…

Clinical rotations · middle twist

A 16-year-old girl attends a Perth general practice on her own and asks for the contraceptive pill. She has been with her 17-year-old boyfriend for a year and t…

Clinical rotations · common

A 15-year-old girl is seen alone at a general practice. During the psychosocial interview she says she has been cutting her left forearm most weeks for three mo…

Pre-internship · middle twist

A 74-year-old man is reviewed in a memory clinic. Over the past year he has twice been brought home by police after becoming lost while driving to familiar plac…

Pre-internship · middle twist

A 16-year-old girl is seen alone at a youth health service, where she has been attending for low mood. Today she tells you that for the past fortnight she has b…

Pre-internship · middle twist

A 15-year-old girl is brought to a general practice by her mother, who is worried about three months of falling grades, weight loss and irritability. After the…

Clinical rotations · middle twist

A 15-year-old girl with profound intellectual disability and cerebral palsy attends a gynaecology clinic with both parents and her treating psychiatrist. She is…

Pre-internship · niche

A 9-year-old boy attends a child and adolescent mental health clinic for severe attention deficit hyperactivity disorder. The psychiatrist explains the risks, b…

Clinical rotations · middle twist

A psychiatry registrar in Perth tells you, a fellow registrar, that since his father died four months ago he has had low mood, waking at 4 am and poor concentra…

Pre-internship · common

You are an intern on a Perth psychiatry ward. At handover for the evening shift the other intern smells strongly of alcohol, is unsteady and slurring slightly,…

Pre-internship · middle twist

A 19-year-old man is an inpatient with a first episode of psychosis. He has capacity and told the team yesterday, without being asked, that his family are not t…

Pre-internship · middle twist

You are the resident on a Perth adult psychiatric inpatient unit. A 41-year-old man with bipolar disorder is a voluntary inpatient and has capacity. Over one we…

Clinical rotations · middle twist

You are a psychiatry registrar in a country town in Western Australia. A close friend from your football club telephones you at home. He has slept badly for thr…

Pre-internship · middle twist

A psychiatry registrar treated a 29-year-old woman for a depressive episode in a Perth outpatient clinic, seeing her weekly for eight months. She was discharged…

Pre-internship · middle twist

A 38-year-old man with bipolar I disorder has been well on lithium for two years. At review he says he has decided to stop it because of tremor and a 9 kg weigh…

Pre-internship · middle twist

A 79-year-old woman with mild Alzheimer disease is an inpatient with a severe depressive episode. Electroconvulsive therapy is proposed. An hour after the discu…

Clinical rotations · middle twist

A 31-year-old man with schizophrenia stopped his aripiprazole six weeks ago because of restlessness. His mother brings him to a Perth community mental health cl…

Pre-internship · niche

A 46-year-old woman was admitted as a voluntary patient to an authorised psychiatric hospital in Perth three days ago with a severe depressive episode. This mor…

Pre-internship · middle twist

A 24-year-old man with schizophrenia has been made an involuntary inpatient at an authorised hospital in Perth under the Mental Health Act 2014 (WA) after refus…

Clinical rotations · middle twist

A 34-year-old woman attends a Perth general practice for insomnia. On direct questioning she says her partner pushed her into a wall last week, checks her phone…

Pre-internship · middle twist

An 84-year-old woman is brought to a Perth general practice by her daughter, with whom she lives, for a third presentation this year with dehydration. She has l…

Clinical rotations · middle twist

A 16-year-old girl has been treated for a first episode of psychosis and is well on aripiprazole. She missed most of Year 11 and wants to return part time. Her…

Pre-internship · middle twist

A 79-year-old woman lives alone in the house she owns. She tells the general practice registrar that her grandson shouts at her when he visits and has twice sho…

Pre-internship · middle twist

An 82-year-old widow attends her general practitioner with her son, who lives in her house and answers most questions for her. Seen alone, she says he shouts at…

Clinical rotations · common

An 81-year-old woman has a severe depressive episode with nihilistic delusions. She has refused all food and fluid for four days and is dehydrated, saying that…

Pre-internship · niche

A 27-year-old man with schizophrenia is assessed at home in Perth after his sister contacted the community mental health team. He stopped his olanzapine six wee…

Pre-internship · niche

A 39-year-old man is brought to a regional Western Australian emergency department by police after climbing onto a shop roof shouting that transmitters have bee…

Pre-internship · middle twist

A 15-year-old girl attends the adolescent mental health clinic alone. She has moderate depression and, after discussion, wants to start an antidepressant. She d…

Pre-internship · middle twist

A 15-year-old girl attends a general practice with her mother, who says her daughter has become withdrawn and is failing subjects at school. The doctor has aske…

Pre-internship · middle twist

A 24-year-old man was admitted yesterday to the psychiatric unit as a voluntary patient with a first episode of psychosis. He has told the team he does not want…

Pre-internship · middle twist

A 74-year-old man attends for a repeat prescription. He drives himself and his wife to the shops and to church each week. He has had dry age-related macular deg…

Pre-internship · middle twist

An 81-year-old man had a large left middle cerebral artery infarct ten days ago. He cannot swallow safely and can neither understand nor communicate a decision.…

Pre-internship · middle twist

A 74-year-old man collapses in a shopping centre and is brought to the emergency department in cardiac arrest. Resuscitation is unsuccessful and he is declared…

Pre-internship · middle twist

An intern covering a Perth hospital's wards and its residential aged care liaison service is asked about five deaths in one afternoon. All five are Western Aust…

Clinical rotations · middle twist

An 89-year-old man with advanced dementia is in the emergency department with aspiration pneumonia. He cannot retain or weigh information about treatment. He ma…

Pre-internship · niche

A 68-year-old woman is brought to a Perth emergency department unconscious after her neighbour found her with empty amitriptyline packets and a note. Her airway…

Pre-internship · niche