Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 400 questions.
A 59-year-old woman is admitted after vomiting for two days and taking sotalol for recurrent atrial fibrillation. She has several brief episodes of faintness as…
Cardiovascular · Clinical rotations · common
A 41-year-old woman develops a daily headache after several weeks of intense exercise. At first it occurred only after she stood for long periods, but it now be…
Neurology · Clinical rotations · common
A 79-year-old woman presents with four days of intermittent cramping abdominal pain, vomiting and increasing abdominal distension. She has no history of abdomin…
Gastroenterology and Hepatology · Clinical rotations · common
A 24-year-old woman presents with 12 hours of abdominal pain, nausea and anorexia. The pain began around the umbilicus and is now most severe in the right iliac…
Surgery and Perioperative Care · Clinical rotations · common
A 67-year-old man has become withdrawn and stopped eating over six weeks. He says his organs have rotted and that his family will be financially ruined because…
Psychiatry and Mental Health · Clinical rotations · common
A 30-year-old woman is brought by her partner 10 days after giving birth. For four nights she has slept for less than two hours, says the infant has been exchan…
Psychiatry and Mental Health · Clinical rotations · common
A 69-year-old man has had three episodes of melaena over two months and requires repeated iron infusions. He takes no non-steroidal anti-inflammatory drugs and…
Gastroenterology and Hepatology · Clinical rotations · common
A 71-year-old man receiving an unfractionated heparin infusion for a recent pulmonary embolus develops recurrent haematemesis and hypotension. The infusion is s…
Cardiovascular · Clinical rotations · common
A 32-year-old man presents to an Australian emergency department with fever, headache and myalgia 10 days after returning from Papua New Guinea. He took doxycyc…
Infectious Diseases · Clinical rotations · common
A 32-year-old woman at 34 weeks gestation reports two weeks of intense itching that is worse at night and began on her hands and feet. She has no rash, abdomina…
Obstetrics and Gynaecology · Clinical rotations · common
A 47-year-old woman has fatigue, pruritus and intermittent jaundice. Alanine aminotransferase is 680 U/L (5–40), IgG is 31 g/L (7–16), antinuclear and smooth-mu…
Gastroenterology and Hepatology · Clinical rotations · common
A 42-year-old man presents with several months of pruritus followed by yellowing of the eyes. He has ulcerative colitis, an alkaline phosphatase of 680 U/L (30–…
Gastroenterology and Hepatology · Clinical rotations · common
A 47-year-old woman with no personal or family history of breast cancer asks whether to continue mammographic screening. She has no breast lump or nipple change…
General Practice and Population Health · Clinical rotations · common
A 61-year-old man asks about bowel cancer screening. He has no change in bowel habit, rectal bleeding or iron deficiency, and his mother was diagnosed with bowe…
Gastroenterology and Hepatology · Clinical rotations · common
A 34-year-old woman attends her general practitioner for routine preventive care. She has no symptoms, has never had cervical intraepithelial neoplasia, and her…
Obstetrics and Gynaecology · Clinical rotations · common
A 63-year-old woman with type 2 diabetes accidentally injects 60 units of insulin glargine instead of her usual 20 units. She becomes confused with a capillary…
Emergency and Toxicology · Clinical rotations · common
A 28-year-old man with type 1 diabetes uses a continuous subcutaneous insulin infusion. He develops nausea after the pump gives an occlusion alarm; his blood gl…
Endocrine and Metabolic · Clinical rotations · common
A 31-year-old woman with type 1 diabetes is being treated for diabetic ketoacidosis with intravenous insulin and 0.9% sodium chloride. Four hours later, her blo…
Endocrine and Metabolic · Clinical rotations · common
A 67-year-old woman with type 1 diabetes is admitted with community-acquired pneumonia and is not eating. She normally injects insulin glargine 24 units at nigh…
Emergency and Toxicology · Clinical rotations · common
A 74-year-old woman with severe chronic obstructive pulmonary disease presents with increasing dyspnoea and drowsiness during a respiratory infection. On room a…
Respiratory · Clinical rotations · common