Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 398 questions.
A 45-year-old man admitted involuntarily believes that a government agency has been recording him. He sits with his back to the wall, keeps the door in view, an…
Psychiatry · Clinical rotations · middle twist
A 54-year-old restaurateur is brought by her husband with three weeks of elevated mood, sleeping two hours a night and plans to buy a second premises. She has n…
Psychiatry · Clinical rotations · middle twist
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…
Psychiatry · Clinical rotations · middle twist
A 74-year-old woman is referred three months after her husband died. Two or three times a week, while she is standing at the kitchen sink, she hears him call he…
Psychiatry · Clinical rotations · middle twist
A 34-year-old woman has had a gritty, watering right eye since walking home through a dust storm yesterday afternoon. It hurts most when she blinks. She has nev…
Ophthalmology · Clinical rotations · middle twist
A 4-year-old boy is screened at his preschool in Sydney under the state vision screening programme. Using a matching-letter chart he scores 6/9 in the left eye…
Ophthalmology · Clinical rotations · middle twist
A 54-year-old man with type 2 diabetes of 14 years attends his general practice for review. His most recent glycated haemoglobin is 9.4% (79 mmol/mol) and his b…
Ophthalmology · Clinical rotations · middle twist
A 58-year-old woman has twice walked into the left-hand door frame this month and has scraped the driver's side of her car. She has noticed nothing wrong with h…
Ophthalmology · Clinical rotations · middle twist
A 76-year-old man with long-standing asthma has needed his reliever most nights for six weeks and now wakes twice a night wheezing. His preventer, budesonide wi…
Ophthalmology · Clinical rotations · middle twist
A 52-year-old woman wakes with a drooping right eyelid and double vision. She has had a boring pain behind the right eye since yesterday. When the lid is lifted…
Ophthalmology · Clinical rotations · middle twist
A 31-year-old cyclist has had a gritty, watering right eye since riding home in a strong wind two days ago. It hurts most each time he blinks. Visual acuity is…
Ophthalmology · Clinical rotations · middle twist
A 28-year-old man has had a deep ache in the right eye for three days with blurred vision. The right eye is red, most intensely in a narrow ring around the corn…
Ophthalmology · Clinical rotations · middle twist
A 7-year-old boy is ready to leave a Perth emergency department six hours after a moderate asthma flare-up. He has had salbutamol by spacer and a first dose of…
Acute Care · Clinical rotations · middle twist
A 78-year-old woman is being discharged after an admission with melaena. She takes apixaban for atrial fibrillation. Gastroscopy showed a bleeding duodenal ulce…
Acute Care · Clinical rotations · middle twist
A 68-year-old woman is admitted with three days of increasing breathlessness. She has smoked 30 cigarettes a day for 40 years and has lost 6 kg over three month…
Acute Care · Clinical rotations · middle twist
A 7-year-old girl falls from the monkey bars onto an outstretched right hand. She is tender about 2 cm proximal to the wrist with mild swelling, no deformity, f…
Acute Care · Clinical rotations · middle twist
An 81-year-old woman catches her shin on a tow bar. There is a 6 cm triangular flap of skin over the front of the lower leg, based distally, pink to its tip, wi…
Acute Care · Clinical rotations · middle twist
An 84-year-old man with prostate cancer and bone metastases is catheterised in the emergency department for painless retention that has built up over several we…
Acute Care · Clinical rotations · middle twist
A 68-year-old man on the stroke unit has a fine-bore nasogastric tube inserted for feeding after a large middle cerebral artery infarct. Insertion was straightf…
Acute Care · Clinical rotations · middle twist
A 19-year-old woman with type 1 diabetes is on the surgical ward the evening after an appendicectomy. Two hours after her usual insulin she becomes sweaty and t…
Acute Care · Clinical rotations · middle twist