Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 76 questions.
A 16-year-old girl with anorexia nervosa is reviewed in an outpatient eating disorder clinic. Over the past six weeks her weight has fallen 3 kg to 42 kg; she i…
Paediatrics · Pre-internship · niche
A 15-year-old girl has never had a period. Her breasts and pubic hair have been fully developed and unchanged for about a year, and she has grown 1 cm in the pa…
Paediatrics · Pre-internship · niche
A 13-year-old boy who received a kidney transplant two years ago attends the renal clinic. He takes tacrolimus and mycophenolate and his graft function is stabl…
Paediatrics · Pre-internship · niche
A 16-week-old girl is brought to a general practice by her family, who arrived in Australia three weeks ago. She has no immunisation records and her parents are…
Paediatrics · Pre-internship · niche
A 14-year-old boy attends the renal clinic. He received a deceased-donor kidney transplant at age 9 and takes tacrolimus, mycophenolate and low-dose prednisolon…
Paediatrics · Pre-internship · niche
A 12-year-old boy had blood taken during a work-up for recurrent abdominal pain, which has since settled without treatment. He is well, is Tanner stage 3, and h…
Paediatrics · Pre-internship · niche
A 34-year-old man who came to Australia from Somalia six years ago is reviewed by his general practitioner for a depressive episode. After eight weeks of sertra…
Psychiatry · Pre-internship · niche
A 52-year-old man born in Vietnam, who has had schizophrenia for 25 years, comes to an emergency department with six hours of epigastric pain. He speaks limited…
Psychiatry · Pre-internship · niche
A 15-year-old girl with profound intellectual disability and cerebral palsy attends a gynaecology clinic with both parents and her treating psychiatrist. She is…
Psychiatry · Pre-internship · niche
A 68-year-old woman is an involuntary inpatient at an authorised hospital in Perth with a severe depressive episode with psychotic features. She has not respond…
Psychiatry · Pre-internship · niche
A 31-year-old man with schizophrenia stopped his aripiprazole six weeks ago because of restlessness. His mother brings him to a Perth community mental health cl…
Psychiatry · Pre-internship · niche
A 46-year-old man taking venlafaxine 225 mg daily for depression is admitted after a fall at work. The orthopaedic team started slow-release tramadol two days a…
Psychiatry · Pre-internship · niche
A 29-year-old woman is admitted with a first manic episode. She has not slept for four nights, has telephoned strangers at 3 am and has spent her rent money on…
Psychiatry · Pre-internship · niche
A 32-year-old man with bipolar I disorder has been euthymic for three years on sodium valproate 1200 mg daily, after two manic admissions in his twenties. At a…
Psychiatry · Pre-internship · niche
A 46-year-old man with schizophrenia has taken clozapine 400 mg daily for four years without a dose change. Over the past ten days he has become drowsy in the a…
Psychiatry · Pre-internship · niche
A 68-year-old man is reviewed by the intern on a general medical ward. His wife died sixteen months ago. He says he thinks about her for most of every day, stil…
Psychiatry · Pre-internship · niche
An 81-year-old woman has a severe depressive episode with nihilistic delusions. She has refused all food and fluid for four days and is dehydrated, saying that…
Psychiatry · Pre-internship · niche
An 80-year-old woman is admitted for assessment of cognitive decline. Her daughter says her memory 'fell off a cliff' in the five months since her husband died.…
Psychiatry · Pre-internship · niche
A 16-year-old Aboriginal boy is brought to a regional clinic by his aunt six weeks after his grandmother died. He says he hears his grandmother calling his name…
Psychiatry · Pre-internship · niche
A 29-year-old woman with borderline personality disorder has been in dialectical behaviour therapy for four months. Her self-harm has fallen from weekly to once…
Psychiatry · Pre-internship · niche