Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 328 questions.
A coastal local government area has recorded four drownings of children under five years of age in five years, every one of them in a backyard swimming pool at…
Paediatrics · Pre-internship · middle twist
You are the intern on a Perth paediatric ward. Over three weeks you admit four toddlers from the same remote community with extensive impetigo, and a fifth chil…
Paediatrics · Pre-internship · middle twist
You are a junior doctor at a regional Western Australian hospital. Hospital data show that Aboriginal children in the district are admitted with skin infections…
Paediatrics · Pre-internship · middle twist
You are a general practice registrar in Perth. A 3-year-old boy attends with his mother for a routine pre-kindergarten review recorded in his personal health re…
Paediatrics · Pre-internship · middle twist
A 6-year-old girl with spastic diplegic cerebral palsy attends a Perth outpatient clinic. She needs continuing physiotherapy and speech pathology to preserve fu…
Paediatrics · Pre-internship · middle twist
You are the intern on a Perth paediatric ward. A 6-year-old girl admitted with pneumonia tells you that a family friend does rude things to her when he babysits…
Paediatrics · Pre-internship · middle twist
A 9-year-old girl is brought to a Perth emergency department by her mother at 9 pm. At triage she told the nurse that her mother's partner puts his hands inside…
Paediatrics · Pre-internship · middle twist
You are the intern caring for a 3-year-old boy admitted with bronchiolitis at a Perth hospital. On the second night his mother tells you that his father drinks…
Paediatrics · Pre-internship · middle twist
At 2 am you are the intern who admits a 2-year-old girl with a spiral fracture of the humeral shaft and bruising over the upper arm and back, for which her pare…
Paediatrics · Pre-internship · middle twist
You are discharging a 5-week-old boy after an admission with bronchiolitis. His mother smokes ten cigarettes a day outdoors. She tells you she is so exhausted t…
Paediatrics · Pre-internship · middle twist
A 3-year-old girl weighing 15 kg is brought in one hour after swallowing tablets from her mother's iron bottle. Each tablet contains 65 mg of elemental iron and…
Paediatrics · Pre-internship · middle twist
A father telephones the emergency department. Twenty minutes ago he found his 20-month-old daughter with the back of the television remote prised open and one o…
Paediatrics · Pre-internship · middle twist
A three-year-old girl is brought to a regional emergency department 30 minutes after drinking from an unlabelled bottle her father had decanted drain cleaner in…
Paediatrics · Pre-internship · middle twist
A two-year-old girl weighing 12 kg is brought to a regional emergency department 90 minutes after being found with her mother's iron tablets. The pack accounts…
Paediatrics · Pre-internship · middle twist
A 15-year-old boy weighing 60 kg presents to a metropolitan emergency department six hours after swallowing forty paracetamol 500 mg tablets in one go. He has v…
Paediatrics · Pre-internship · middle twist
A three-year-old girl weighing 14 kg is found with her grandmother's dose administration aid, which contains amitriptyline. Two hours later she is drowsy with 5…
Paediatrics · Pre-internship · middle twist
A two-year-old girl is brought to the emergency department 40 minutes after her mother saw her swallow an unknown number of the grandmother's paracetamol tablet…
Paediatrics · Pre-internship · middle twist
A five-month-old boy is brought to a regional emergency department at 2 am because he cannot be roused. His respiratory rate is 12 per minute and his pupils are…
Paediatrics · Pre-internship · middle twist
A 10-year-old boy weighing 32 kg is admitted to the ward for observation after an appendicectomy. He is comfortable, normotensive and well perfused, has not vom…
Paediatrics · Pre-internship · middle twist
A 7-month-old boy has had 18 hours of loose stools and two vomits. His mother says the nappies are as wet as usual and he is still breastfeeding well. He is ale…
Paediatrics · Pre-internship · middle twist