Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 398 questions.
A 72-year-old woman has developed a new unilateral temporal headache over three weeks. She reports pain when chewing and two recent episodes in which vision in…
AMC · Clinical rotations · middle twist
A 29-year-old woman presents with 10 days of progressive daily headache and brief episodes of greying vision. She is six weeks postpartum and takes a combined o…
AMC · Clinical rotations · middle twist
A 38-year-old woman with bipolar disorder started haloperidol 10 days ago for a manic episode. She now reports that she cannot sit still, repeatedly walks aroun…
Psychiatry and Mental Health · Clinical rotations · middle twist
A 32-year-old woman at 10 weeks’ gestation presents with four days of almost no sleep, excessive spending and increasingly intrusive plans to start several busi…
Obstetrics and Gynaecology · Clinical rotations · middle twist
An 84-year-old man admitted three days ago with a fractured neck of femur is found to have an area of skin change over the sacrum during hygiene cares. The skin…
Nursing · Clinical rotations · middle twist
A 71-year-old woman attends a community nursing service with a shallow ulcer above the left medial malleolus present for 8 weeks. The surrounding skin is brown-…
Nursing · Clinical rotations · middle twist
A 9-year-old boy is brought to a regional Victorian hospital 45 minutes after a suspected snakebite to the calf while walking through long grass. A pressure imm…
Emergency and Toxicology · Clinical rotations · middle twist
A 30-year-old Aboriginal man attends a regional clinic for an annual health assessment. He feels well, smokes ten cigarettes daily, drinks alcohol most weekends…
Cardiovascular · Clinical rotations · middle twist
A 47-year-old Aboriginal man from a regional town has type 2 diabetes and hypertension, for which metformin, perindopril and rosuvastatin are prescribed. At rev…
General Practice and Population Health · Clinical rotations · middle twist
A mother brings her 16-week-old son for his first vaccinations. The family recently arrived from overseas and he has received no vaccines apart from a hepatitis…
Paediatrics · Clinical rotations · middle twist
A 27-year-old woman attends for a travel health consultation. She has never had cervical screening despite two invitation letters from the National Cancer Scree…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 31-year-old woman presents six weeks after the birth of her first child. She tearfully describes vivid, unwanted images of smothering the baby with a pillow t…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 58-year-old woman presents after a single episode of light vaginal bleeding one week ago. Her last menstrual period was at age 51 and she has never used menop…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 31-year-old woman presents with two days of right iliac fossa pain and light vaginal spotting. Her last menstrual period was six weeks ago and a home pregnanc…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 27-year-old nulliparous woman requests reliable long-term contraception. Several times a year she has severe unilateral throbbing headaches that are preceded…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 6-day-old boy born at term is brought to the emergency department after vomiting three times over four hours; the most recent vomitus was dark green. He fed n…
Paediatrics · Clinical rotations · middle twist
A 15-month-old boy presents with two days of vomiting and frequent watery stools. He is alert but subdued, with dry lips, mildly sunken eyes, heart rate 148/min…
Paediatrics · Clinical rotations · middle twist
A 78-year-old woman presents with sudden painless loss of vision in her right eye on waking this morning. For the past three weeks she has had a right-sided hea…
Eyes, Ears, Nose and Throat · Clinical rotations · middle twist
A 48-year-old man who migrated from southern China ten years ago presents with six weeks of a blocked sensation and reduced hearing in the right ear. On several…
Eyes, Ears, Nose and Throat · Clinical rotations · middle twist
A 72-year-old woman presents with an ulcer above her left medial malleolus that has been present for eight weeks. She has type 2 diabetes and smoked a packet of…
Cardiovascular · Clinical rotations · middle twist