Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 398 questions.
A 58-year-old man is found collapsed at home and brought to the emergency department. He does not respond when his name is called loudly and does not open his e…
Acute Care · Clinical rotations · middle twist
A 63-year-old woman with type 2 diabetes presents with two days of vomiting and upper abdominal pain, during which she has eaten almost nothing. She takes metfo…
Acute Care · Clinical rotations · middle twist
A 58-year-old man was admitted 36 hours ago with severe acute pancreatitis and has been given 7 litres of sodium chloride 0.9%. He is alert and normotensive, is…
Acute Care · Clinical rotations · middle twist
A 4-year-old girl has had three days of watery diarrhoea and vomiting. She is irritable with dry mucous membranes and reduced urine output; her hands are warm,…
Acute Care · Clinical rotations · middle twist
A well 24-year-old woman has routine blood tests before starting a combined oral contraceptive. She takes no medication and her blood pressure is 112/70 mmHg. B…
Acute Care · Clinical rotations · middle twist
A 58-year-old man is receiving intravenous vancomycin for a prosthetic joint infection through a 20 gauge cannula in the dorsum of the left hand. Six hours into…
Acute Care · Clinical rotations · middle twist
A 3-year-old boy is pulled unresponsive from a community swimming pool. He is not breathing normally and a lifeguard has started chest compressions while an amb…
Acute Care · Clinical rotations · middle twist
A 7-year-old boy is brought to the emergency department because he has been breathing hard since the morning. He has vomited repeatedly for two days and says hi…
Acute Care · Clinical rotations · middle twist
In late July a 34-year-old man attends with both his housemates. All three have had headache, nausea and poor concentration that build up through each evening a…
Acute Care · Clinical rotations · middle twist
A 47-year-old man chokes on a piece of bread roll while talking at a workplace lunch. He coughs hard for a few seconds, then the coughing becomes silent and his…
Acute Care · Clinical rotations · middle twist
A 58-year-old man is seen in a pre-admission clinic before a hernia repair. He weighs 138 kg and his upper arm circumference is 42 cm. The nurse records 176/98…
Acute Care · Clinical rotations · middle twist
An 84-year-old woman is on the ward on the evening of the first day after hemiarthroplasty for a fractured neck of femur. She has a morphine patient-controlled…
Acute Care · Clinical rotations · middle twist
A 63-year-old man wakes at 5 am with swelling of his lower lip and the left side of his tongue. There is no rash and nothing itches. His voice is normal, his ch…
Acute Care · Clinical rotations · middle twist
A 71-year-old man presents with two hours of severe left loin pain radiating into the groin, with vomiting. He has never had pain like this before. He smokes 20…
Acute Care · Clinical rotations · middle twist
A 23-year-old university student is reviewed after being given a salbutamol inhaler by a locum six months ago. He uses it about three times most weeks for chest…
Acute Care · Clinical rotations · middle twist
A 62-year-old man with treated hypertension develops severe pain between his shoulder blades while carrying a bag of potting mix. It was as bad in the first few…
Acute Care · Clinical rotations · middle twist
A 19-year-old woman walks into a metropolitan emergency department with her sister ninety minutes after swallowing thirty modified-release paracetamol tablets.…
Acute Care · Clinical rotations · middle twist
A 34-year-old man is brought to the emergency department six hours after his general practitioner increased his sertraline and added tramadol for back pain. He…
Acute Care · Clinical rotations · middle twist
A 34-year-old man is brought in after a petrol fire in a shed. The skin over the whole front of his chest and abdomen is blistered, moist and painful. His right…
Acute Care · Clinical rotations · middle twist
A 58-year-old man is treated in the emergency department for a Colles fracture sustained tripping over a gutter. He smokes 25 cigarettes a day and lights the fi…
Acute Care · Clinical rotations · middle twist