Middle twist
One twist — a threshold, a comorbidity, an atypical presentation. 776 questions.
A 7-year-old girl's teacher reports that her schoolwork has fallen away this year and that she "drifts off". Her mother says that twenty or thirty times a day s…
Paediatrics · Clinical rotations · middle twist
An 8-year-old boy is brought in by his mother, who describes fourteen months of daily arguing with adults, deliberate refusal to follow instructions, blaming hi…
Paediatrics · Clinical rotations · middle twist
A 9-year-old boy has primary nocturnal enuresis with no daytime urinary symptoms, normal growth, normal blood pressure and a normal urinalysis. An eight-week al…
Paediatrics · Pre-internship · middle twist
A 7-week-old girl is brought in because she cries inconsolably for four to five hours each evening, drawing her legs up, and has done so since three weeks of ag…
Paediatrics · Clinical rotations · middle twist
A 2-year-old boy attends with his mother after his childcare educator commented that he "plays on his own". He walks and runs well, uses about sixty single word…
Paediatrics · Pre-internship · middle twist
A 14-year-old boy is brought by his parents because he is the shortest in his class and has no signs of puberty. His height is on the 3rd centile and he has gro…
Paediatrics · Clinical rotations · middle twist
A 14-year-old boy attends the general practice with his mother because his school marks have collapsed over two terms and he has begun refusing to go on Monday…
Paediatrics · Pre-internship · middle twist
A term-born 10-month-old boy attends for his routine child health check. He sits unsupported, crawls, pulls to stand and transfers objects between his hands; he…
Paediatrics · Clinical rotations · middle twist
A 9-year-old boy is brought by his mother, who has completed a standardised parent rating scale scoring highly for inattention and hyperactivity. She says he ca…
Paediatrics · Clinical rotations · middle twist
An 18-month-old boy is brought back to the general practice by his father. At his 15-month check he was walking, waving goodbye, using eight words and handing h…
Paediatrics · Pre-internship · middle twist
A boy born at 28 weeks gestation is brought to the general practice at 20 months of age because he is not yet walking. He was discharged home at term with no in…
Paediatrics · Pre-internship · middle twist
A 3-year-old boy is assessed because he is behind his twin sister. He walked at 22 months and now runs stiffly but symmetrically; tone, power and deep tendon re…
Paediatrics · Clinical rotations · middle twist
A 30-month-old boy is reviewed after the practice nurse completed an Ages and Stages Questionnaire with his mother. He scores below the cut-off for communicatio…
Paediatrics · Pre-internship · middle twist
A 7-month-old girl is brought to a rural general practice. Her weight has fallen from the 50th centile to below the 0.4th centile over three months; her length…
Paediatrics · Pre-internship · middle twist
A 7-month-old boy is brought to the emergency department by his 19-year-old mother because of a cold. His weight has crossed from the 50th percentile at 4 month…
Paediatrics · Pre-internship · middle twist
A 12-year-old boy attends with his mother. His body mass index for age is above the 99.7th percentile on his growth chart, having been on the 92nd percentile at…
Paediatrics · Pre-internship · middle twist
A 5-month-old boy is brought by his mother, who has been told at the child health clinic that he is under the line and is frightened that something is being mis…
Paediatrics · Clinical rotations · middle twist
A 7-year-old girl is brought because her school photograph shows her much shorter than her friends. At 4 years of age her height and weight were both on the 50t…
Paediatrics · Clinical rotations · middle twist
A 14-year-old boy is brought by his mother because he is the shortest in his class and is being teased. His height has followed a line just below the 3rd percen…
Paediatrics · Clinical rotations · middle twist
A 9-month-old boy is brought by his mother, who has been told at day care that his head looks big and who asks whether he needs a scan. His head circumference h…
Paediatrics · Clinical rotations · middle twist