Public health

You are the intern attached to a regional public health unit. Its annual child health profile for a town of 4,000 people reports: two-dose measles-mumps-rubella…

Pre-internship · niche

You are the intern in a regional hospital's paediatric outpatient clinic. A 3-year-old Aboriginal boy has bilateral middle ear effusions and a 35 dB conductive…

Pre-internship · middle twist

A coastal local government area has recorded four drownings of children under five years of age in five years, every one of them in a backyard swimming pool at…

Pre-internship · middle twist

You are a general practice registrar in a regional town of 6,000 people. Over six weeks the public health unit has confirmed seven cases of measles, four of the…

Clinical rotations · common

A local health district in western Sydney surveys its primary schools and finds that one in three children aged 5 to 12 years is above the healthy weight range,…

Clinical rotations · middle twist

You are the intern on a Perth paediatric ward. Over three weeks you admit four toddlers from the same remote community with extensive impetigo, and a fifth chil…

Pre-internship · middle twist

You are a general practice registrar in a Western Australian coastal town of 6000 people. Over the past year the proportion of five-year-olds recorded as fully…

Clinical rotations · middle twist

You are a junior doctor at a regional Western Australian hospital. Hospital data show that Aboriginal children in the district are admitted with skin infections…

Pre-internship · middle twist

A Perth tertiary hospital's ear, nose and throat department plans a programme to reduce chronic suppurative otitis media in a remote Aboriginal community 1500 k…

Clinical rotations · middle twist

A 6-year-old Aboriginal boy attends a Perth general practice with his mother for a certificate to return to school after chickenpox. He is well, fully immunised…

Clinical rotations · middle twist

A 6-year-old girl with spastic diplegic cerebral palsy attends a Perth outpatient clinic. She needs continuing physiotherapy and speech pathology to preserve fu…

Pre-internship · middle twist

A 4-year-old Aboriginal boy from a remote Kimberley community has bilateral chronic suppurative otitis media with a 35 dB conductive hearing loss and delayed sp…

Clinical rotations · middle twist

A public health registrar is reviewing a local council's childhood injury prevention plan after a rise in emergency department presentations for household poiso…

Clinical rotations · middle twist

A 12-year-old Aboriginal girl from a remote community has been admitted to a tertiary hospital with newly diagnosed type 1 diabetes. English is the family's fir…

Pre-internship · middle twist

A 6-year-old boy with cystic fibrosis is admitted for his third pulmonary exacerbation this year. His mother tells the team she resigned from her job to manage…

Pre-internship · common

A 6-year-old boy with laboratory-confirmed SARS-CoV-2 infection is admitted to a paediatric ward. Over an hour his oxygen saturation falls to 88 per cent on 6 L…

Pre-internship · common

A 9-week-old girl is brought to a regional emergency department with three weeks of cough. Her mother describes bouts of coughing that leave her red in the face…

Clinical rotations · middle twist

A 4-year-old girl attends a general practice with her father for a pre-kindergarten check. Her weight is above the 97th centile and her body mass index has been…

Clinical rotations · middle twist

A metropolitan mental health service is examining why Aboriginal and Torres Strait Islander inpatients leave the ward against medical advice far more often than…

Clinical rotations · middle twist

A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…

Pre-internship · niche

A 22-year-old Aboriginal man is brought to a regional hospital by his aunt six weeks after his grandfather's funeral. At night he hears his grandfather calling…

Clinical rotations · middle twist

A 38-year-old Aboriginal woman is on the caseload of a metropolitan community mental health team after her third admission this year for a depressive episode wi…

Pre-internship · middle twist

You are a final-year medical student on a Perth psychiatry ward. During the ward round the registrar tells a nursing student, in front of the patient and the wh…

Pre-internship · middle twist

You are the intern on an adult inpatient psychiatric unit. At the morning meeting the occupational therapist reports that a woman due for discharge tomorrow cou…

Pre-internship · middle twist

A 24-year-old man had a first episode of schizophrenia nine months ago and has remained well on risperidone. He lives with his mother, who gave up her part-time…

Clinical rotations · middle twist

A 27-year-old man with schizophrenia has been well for 18 months on paliperidone palmitate and attends a community mental health team. He lives with his parents…

Clinical rotations · middle twist

A 34-year-old primary school teacher describes six months of constant worry, difficulty getting to sleep and irritability that is now affecting her teaching. Sh…

Clinical rotations · common

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…

Clinical rotations · middle twist

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…

Clinical rotations · middle twist

A 16-year-old Aboriginal boy is brought to a regional clinic by his aunt six weeks after his grandmother died. He says he hears his grandmother calling his name…

Pre-internship · niche

At a hospital grand round on mental health funding, a registrar is asked how much Australia spends on mental health. She finds several different figures in circ…

Clinical rotations · niche

A 47-year-old woman, whose mother died six weeks ago, tells her general practitioner that she has three times seen and spoken with her mother in the family home…

Clinical rotations · middle twist

You are the intern on a geriatric medicine ward in Perth. An 84-year-old woman who developed a hyperactive delirium during her admission for pneumonia is being…

Clinical rotations · niche

A resident is completing the discharge summary for a woman treated for a first manic episode. The diagnosis was made at the bedside against the criteria in the…

Pre-internship · niche

A 67-year-old Yolŋu man from a remote community in north-east Arnhem Land is admitted to a Darwin hospital for assessment of low mood and weight loss. His first…

Clinical rotations · middle twist

A 62-year-old Aboriginal woman from a remote Kimberley community is admitted to a Broome hospital with small bowel obstruction and listed for laparotomy on tomo…

Pre-internship · middle twist

You are the intern on a paediatric ward in Perth at 9 pm. A 3-year-old admitted that morning with bronchiolitis has observations that all sit inside the normal…

Pre-internship · middle twist

You are the intern in a Western Australian emergency department. A 3-year-old girl was triaged two hours ago with fever and vomiting. The paediatric registrar r…

Pre-internship · middle twist

A 58-year-old man is treated in the emergency department for a Colles fracture sustained tripping over a gutter. He smokes 25 cigarettes a day and lights the fi…

Clinical rotations · middle twist

A 41-year-old bricklayer attends the emergency department after cutting his forearm on a broken glass door at home. The wound is cleaned and sutured. On routine…

Clinical rotations · middle twist