Middle twist
One twist — a threshold, a comorbidity, an atypical presentation. 776 questions.
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 79-year-old retired farmer was diagnosed with Alzheimer disease eight months ago. At that time you advised him and his family that he should stop driving, and…
Ethics and Professional Practice · Pre-internship · middle twist
A 15-year-old girl attends alone requesting the combined oral contraceptive pill. She has recently become sexually active with her 16-year-old boyfriend and the…
Ethics and Professional Practice · Pre-internship · 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 35-year-old man with a known diagnosis of schizophrenia is brought to the emergency department by police after neighbours reported him shouting in the street…
Psychiatry and Mental Health · Pre-internship · 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
An 8-week-old boy is brought to a general practice for his scheduled immunisations. While preparing the injections the practice nurse notices a 1.5 cm oval brui…
Paediatrics · Pre-internship · 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
A 24-year-old man sustains a closed fracture of the midshaft of the left tibia playing football. A plaster backslab with encircling crepe bandage is applied and…
Emergency and Toxicology · Pre-internship · middle twist
A 58-year-old woman presents with two days of right loin pain radiating to the groin, associated with shaking chills. Her temperature is 38.9°C, pulse 118/min a…
Emergency and Toxicology · Pre-internship · middle twist
A 45-year-old woman presents because a mole on her calf has become darker and larger over three months. It is 8 mm across with an irregular edge and several sha…
Dermatology · Clinical rotations · middle twist