Shock

A 3-year-old boy weighing 15 kg has had two days of profuse vomiting and diarrhoea. On arrival he was drowsy with cold mottled legs, capillary refill of five se…

Pre-internship · middle twist

An 11-month-old boy weighing 10 kg has had 36 hours of watery diarrhoea and vomiting. He lies quietly in his mother's arms and opens his eyes when spoken to. Hi…

Clinical rotations · common

A 19-year-old man is thrown from his motorcycle at highway speed. On arrival he is alert and complains only of neck pain. His blood pressure is 78/44 mmHg and h…

Clinical rotations · common

A 74-year-old man is reviewed on the ward because he has become drowsy. He is cold and mottled to the mid-forearms. Pulse 108 beats per minute and regular; bloo…

Foundations · common

A 24-year-old man is brought to the emergency department 40 minutes after he came off his motorcycle. He has a closed fracture of the right femur and a tense, s…

Foundations · common

A 29-year-old woman is admitted with nausea, jaundice and right upper-quadrant discomfort. Her alanine aminotransferase is 9200 U/L (5–40), aspartate aminotrans…

Clinical rotations · middle twist