Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 398 questions.
A 9-year-old boy attends a child and adolescent mental health clinic for severe attention deficit hyperactivity disorder. The psychiatrist explains the risks, b…
Psychiatry · Clinical rotations · middle twist
You are the resident on a Perth adult psychiatric inpatient unit. A 41-year-old man with bipolar disorder is a voluntary inpatient and has capacity. Over one we…
Psychiatry · Clinical rotations · middle twist
A 79-year-old woman with mild Alzheimer disease is an inpatient with a severe depressive episode. Electroconvulsive therapy is proposed. An hour after the discu…
Psychiatry · Clinical rotations · middle twist
A 24-year-old man with schizophrenia has been made an involuntary inpatient at an authorised hospital in Perth under the Mental Health Act 2014 (WA) after refus…
Psychiatry · Clinical rotations · middle twist
An 84-year-old woman is brought to a Perth general practice by her daughter, with whom she lives, for a third presentation this year with dehydration. She has l…
Psychiatry · Clinical rotations · middle twist
A 49-year-old woman with schizophrenia has taken olanzapine for 12 years and attends a community clinic. Over three months she has become thirsty, gets up twice…
Psychiatry · Clinical rotations · middle twist
A 46-year-old carpenter has had a major depressive episode for seven months. He completed eight weeks of sertraline 100 mg daily with no change, then twelve wee…
Psychiatry · Clinical rotations · middle twist
A 24-year-old man had a first episode of schizophrenia nine months ago and has remained well on risperidone. He lives with his mother, who gave up her part-time…
Psychiatry · Clinical rotations · middle twist
A 27-year-old man with schizophrenia has been well for 18 months on paliperidone palmitate and attends a community mental health team. He lives with his parents…
Psychiatry · Clinical rotations · middle twist
A 34-year-old Aboriginal man attends a general practice in a regional Western Australian town six weeks after his uncle died. He sleeps poorly, has stopped goin…
Psychiatry · Clinical rotations · middle twist
A 3-year-old boy is brought by his mother, who says he never sits still, runs off in car parks and has been asked to leave two childcare centres. He was born at…
Psychiatry · Clinical rotations · middle twist
A 35-year-old intern is caring for a 62-year-old woman with alcohol-related liver disease on a general medical ward. She is the same age as his mother and speak…
Psychiatry · Clinical rotations · middle twist
A 22-year-old university student in a wheat-belt town has had six weeks of low mood, poor concentration and loss of interest since failing two units. There is n…
Psychiatry · Clinical rotations · middle twist
A 74-year-old woman has been in hospital for eleven days with a severe depressive episode. She is convinced her bowel has rotted away and that she is being puni…
Psychiatry · Clinical rotations · middle twist
A 33-year-old woman is reviewed six weeks after the birth of her first child. She has persistent low mood, early morning waking, poor concentration and guilt at…
Psychiatry · Clinical rotations · middle twist
A 24-year-old man with schizophrenia has been taking clozapine for 17 days, titrated to 250 mg daily after two other antipsychotics failed. He reports three day…
Psychiatry · Clinical rotations · middle twist
A general practice registrar reads a news report that the Australian regulator has issued a new warning about a mood stabiliser she prescribes, concerning a pos…
Psychiatry · Clinical rotations · middle twist
A 31-year-old woman stopped paroxetine four days ago; she had taken 20 mg daily for eight months for panic disorder and ran out of tablets while interstate for…
Psychiatry · Clinical rotations · middle twist
A 23-year-old man with treatment-resistant schizophrenia started clozapine eighteen days ago and now takes 250 mg daily. He tells the nurse he feels as though h…
Psychiatry · Clinical rotations · middle twist
A 34-year-old man with schizophrenia, well for two years on aripiprazole 15 mg daily, has not collected a prescription for six weeks and is again hearing neighb…
Psychiatry · Clinical rotations · middle twist