Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 398 questions.
A 74-year-old man is brought by his wife because for the past year he has described the small children who come into the lounge room most afternoons; he can say…
Psychiatry · Clinical rotations · middle twist
An 84-year-old woman was admitted three days ago with cellulitis, which is settling on flucloxacillin. Since yesterday she has been muddled at night, insists th…
Psychiatry · Clinical rotations · middle twist
An 82-year-old man with Alzheimer disease diagnosed four years ago lives in residential care, where he usually plays cards each afternoon and needs help only wi…
Psychiatry · Clinical rotations · middle twist
A 34-year-old man with schizophrenia has relapsed twice in nine months, on each occasion a few weeks after stopping his oral risperidone. He is currently well,…
Psychiatry · Clinical rotations · middle twist
A 19-year-old university student is in the emergency department six hours after her flatmate found her drowsy on the bathroom floor beside an empty blister pack…
Psychiatry · Clinical rotations · middle twist
A 72-year-old woman born in Vietnam attends with her daughter, who reports that over two years her mother has become repetitive, has twice left the stove burnin…
Psychiatry · Clinical rotations · middle twist
A 62-year-old accountant is brought to the emergency department by police after he shoved a shop assistant who asked him to stop taking lollies from an open dis…
Psychiatry · Clinical rotations · middle twist
A 31-year-old man is waiting to be seen in a busy emergency department, brought in by his brother, who says he has stopped his medication. He has schizophrenia…
Psychiatry · Clinical rotations · middle twist
A 44-year-old man attends the community mental health clinic. He has recurrent major depressive disorder and came home nine days ago after a two-week admission…
Psychiatry · Clinical rotations · middle twist
A 58-year-old man was admitted three and a half days ago after a fall from a ladder; his wife said he drinks nightly at the club. He was settled and oriented fo…
Psychiatry · Clinical rotations · middle twist
An 84-year-old woman with metastatic breast cancer is admitted from her retirement village because over four days she has become drowsy by day, restless at nigh…
Psychiatry · Clinical rotations · middle twist
A 71-year-old man is flown in from a remote Aboriginal community in the far north of Western Australia with his daughter, who says that over two years he has be…
Psychiatry · Clinical rotations · middle twist
Eighteen months after her husband died, a 58-year-old woman is brought to the general practice by her daughter. She thinks about him for most of each day and ac…
Psychiatry · Clinical rotations · middle twist
A student writes up a new patient using a format taken from an older textbook: schizophrenia on Axis I, no personality disorder on Axis II, type 2 diabetes on A…
Psychiatry · Clinical rotations · middle twist
A 27-year-old man is interviewed on the ward. Asked why he came into hospital, he begins with the bus timetable, moves to his neighbour's dog and then to the pr…
Psychiatry · Clinical rotations · middle twist
A 29-year-old woman is referred with 'panic attacks': five months of episodes of pounding heartbeat, shaking hands and feeling unbearably hot, several of which…
Psychiatry · Clinical rotations · middle twist
A 46-year-old teacher completes a brief consumption-based alcohol screen at a routine health check. She reports two 100 mL glasses of wine on each of Monday to…
Psychiatry · Clinical rotations · middle twist
A 74-year-old man who came to Australia from Vietnam at the age of 40 is brought to the general practice by his daughter. Over two years he has become repetitiv…
Psychiatry · Clinical rotations · middle twist
A medical student takes an alcohol history from a 55-year-old man in a general practice clinic. In a rapid run, without pausing, she asks: 'You don't drink much…
Psychiatry · Clinical rotations · middle twist
A 38-year-old woman is describing the end of her marriage at an outpatient appointment. She says she is fine about it now, honestly, while her voice shakes and…
Psychiatry · Clinical rotations · middle twist