Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 488 questions.
A 24-year-old man presents with four days of fever, a runny nose, red watery eyes and a dry cough, ten days after returning from Bali. This morning a blotchy re…
Ethics and Professional Practice · Pre-internship · common
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 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
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 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 19-year-old man is brought to a rural general practice, 45 minutes from the nearest hospital, with six hours of fever, vomiting and severe pain in his legs. H…
Emergency and Toxicology · Pre-internship · common
A 35-year-old man is admitted six hours after a house fire with burns to 25% of his body surface area, including a burn encircling the entire right forearm wher…
Emergency and Toxicology · Pre-internship · common
A 25-year-old motorcyclist is brought to the emergency department after a high-speed crash, complaining of left-sided chest pain and severe breathlessness; he c…
Emergency and Toxicology · Pre-internship · common
A 58-year-old man with chronic kidney disease presents with weakness. Serum potassium is 7.1 mmol/L, and the laboratory result has been confirmed on a repeat no…
Emergency and Toxicology · Pre-internship · common
A 64-year-old woman has had an estimated glomerular filtration rate of 26 mL/min/1.73 m² on two measurements 4 months apart. Her urine albumin:creatinine ratio…
Haematology and Oncology · Pre-internship · middle twist
A 29-year-old woman requests emergency contraception 4 days after unprotected intercourse. Her BMI is 36 kg/m², she is not pregnant and has no contraindication…
Emergency and Toxicology · Pre-internship · middle twist
A 63-year-old woman with acute myeloid leukaemia has had febrile neutropenia for 96 hours despite piperacillin-tazobactam. She remains haemodynamically stable,…
Emergency and Toxicology · Pre-internship · middle twist
A 45-year-old man becomes acutely unwell after receiving approximately 20 mL of an incompatible red-cell unit. He develops fever, severe flank pain, hypotension…
Emergency and Toxicology · Pre-internship · common
A 67-year-old woman develops a temperature of 38.3°C and rigors 30 minutes after a red-cell transfusion begins. She is haemodynamically stable and has no dyspno…
Haematology and Oncology · Pre-internship · common
A 74-year-old woman with advanced dementia is unable to make decisions and has no advance care directive. Her husband is the recognised substitute decision-make…
Ethics and Professional Practice · Pre-internship · common
A 77-year-old man with metastatic prostate cancer and an estimated glomerular filtration rate of 18 mL/min/1.73 m² has been receiving regular oral morphine. Ove…
Geriatrics and Palliative Care · Pre-internship · middle twist
A 90-year-old man is dying from advanced heart failure and is no longer able to swallow. His breathing is noisy because of pooled respiratory secretions, but he…
Ethics and Professional Practice · Pre-internship · common
A 72-year-old woman with metastatic breast cancer has decision-making capacity and asks that cardiopulmonary resuscitation not be attempted if she becomes unabl…
Ethics and Professional Practice · Pre-internship · common