Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 400 questions.
A 59-year-old man suddenly develops difficulty speaking and weakness of the right arm while driving. His wife reports that, immediately beforehand, the right si…
Neurology · Clinical rotations · common
A 63-year-old woman has three sudden episodes over two days of dizziness followed by double vision, slurred speech and veering to the left; each episode lasted…
Neurology · Clinical rotations · common
A 70-year-old woman vomits during a generalised seizure and becomes cyanosed. One hour later her temperature is 38.4°C, oxygen saturation is 88% on room air and…
Infectious Diseases · Clinical rotations · common
A 5-month-old boy is brought to hospital with 2 days of nasal congestion, cough and reduced breastfeeds. He is alert but has subcostal recession and widespread…
Paediatrics · Clinical rotations · common
A 42-year-old man is brought to hospital 45 minutes after taking an unknown number of amitriptyline tablets. He is drowsy, has a blood pressure of 78/46 mmHg an…
Emergency and Toxicology · Clinical rotations · common
A 29-year-old woman presents with three days of worsening unilateral throat pain, fever and difficulty swallowing. She cannot open her mouth fully, her voice is…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 7-year-old boy has complained of pain in both thighs and an intermittent limp for one month. He is pale but afebrile, and there is no joint swelling; both hip…
Haematology and Oncology · Clinical rotations · common
A 13-year-old boy with obesity has had aching pain in his left knee for three weeks. He suddenly develops severe groin pain while rising from a chair and cannot…
Surgery and Perioperative Care · Clinical rotations · common
A 24-year-old university student presents with three days of migratory joint pain involving both knees and one wrist. He has a temperature of 38.1°C and a small…
Infectious Diseases · Clinical rotations · common
A 71-year-old man presents with three days of dyspnoea. CT pulmonary angiography shows bilateral pulmonary emboli and right ventricular enlargement; his blood p…
Cardiovascular · Clinical rotations · common
A 34-year-old woman wants reliable contraception while receiving rifampicin for pulmonary tuberculosis. She has previously used a combined oral contraceptive pi…
Obstetrics and Gynaecology · Clinical rotations · common
A 46-year-old man is brought from a house fire with burns to his face and upper chest. He is awake, has soot around his mouth and is coughing; initially his voi…
Emergency and Toxicology · Clinical rotations · common
A 76-year-old woman taking denosumab for osteoporosis develops pain around a mandibular molar and undergoes extraction. Twelve weeks later, a segment of hard ti…
Endocrine and Metabolic · Clinical rotations · common
A 58-year-old woman presents with tiredness, a sore tongue and difficulty judging the position of her feet in the dark. She has a macrocytic anaemia, a low seru…
Haematology and Oncology · Clinical rotations · common
A 72-year-old man with atrial fibrillation notices sudden, profound loss of vision in his right eye while eating breakfast. There is no pain, headache or preced…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 34-year-old woman at 13 weeks of gestation presents with vaginal bleeding and increasing abdominal distension. The uterus is approximately 18 weeks in size, h…
Obstetrics and Gynaecology · Clinical rotations · common
A 29-year-old woman presents at 7 weeks of pregnancy with increasing right lower abdominal pain and light vaginal bleeding. She conceived after in-vitro fertili…
Obstetrics and Gynaecology · Clinical rotations · common
A 19-day-old girl is reviewed for jaundice that has persisted since discharge from hospital. Her mother reports that the urine has stained the nappy dark and th…
Paediatrics · Clinical rotations · common
A 31-year-old woman presents 12 days after a vaginal birth with increasing bleeding, fever and lower abdominal discomfort. Her temperature is 39.1°C, the uterus…
Obstetrics and Gynaecology · Clinical rotations · common
A 4-year-old boy presents with fever, vomiting and severe pain in both legs. Over the preceding two hours, dark purple spots have appeared over his buttocks and…
Paediatrics · Clinical rotations · common