Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 832 questions.
A 72-year-old man is found to have a serum creatinine of 286 micromol/L, compared with 98 micromol/L 3 months earlier. He reports six months of poor urinary str…
Gastroenterology and Hepatology · Clinical rotations · common
A 26-year-old woman who is 9 weeks pregnant is planning a 3-week trip to rural areas of Papua New Guinea. She will stay in local villages and has no psychiatric…
Obstetrics and Gynaecology · Clinical rotations · middle twist
An 8-year-old child has written documentation of two valid diphtheria-tetanus-acellular pertussis doses given at 2 and 4 months of age, but no subsequent doses…
Paediatrics · Clinical rotations · common
A 10-week pregnant woman is found to be non-immune to rubella during antenatal screening. She has no symptoms and has never had an immediate hypersensitivity re…
Obstetrics and Gynaecology · Clinical rotations · common
A 10-month-old child presents for routine care after recently arriving in Australia, and the parents have no written immunisation records. The child appears wel…
Paediatrics · Clinical rotations · common
A 34-year-old woman with known autoimmune Addison disease presents with vomiting, abdominal pain and profound weakness. Her blood pressure is 82/48 mmHg, sodium…
Endocrine and Metabolic · Clinical rotations · common
A 29-year-old man has progressive bone pain, proximal weakness and two atraumatic metatarsal fractures. Serum phosphate is 0.44 mmol/L (0.80–1.50), calcium is 2…
Endocrine and Metabolic · Clinical rotations · niche
A 63-year-old woman reports several months of bone pain and difficulty climbing stairs. She has no focal neurological deficit. Serum calcium is 2.19 mmol/L (2.1…
Endocrine and Metabolic · Clinical rotations · common
A 48-year-old woman has a slowly enlarging thyroid nodule, intermittent diarrhoea and facial flushing. Her TSH is 1.6 mIU/L (0.4–4.0), and serum calcitonin is 1…
Endocrine and Metabolic · Clinical rotations · common
A 61-year-old man has a 1.5-cm thyroid nodule with a solid markedly hypoechoic appearance, irregular margins and punctate echogenic foci on ultrasound. His TSH…
Endocrine and Metabolic · Clinical rotations · common
A 52-year-old woman has progressive headaches and difficulty seeing objects to either side. MRI shows a 2.6-cm sellar mass elevating and compressing the optic c…
Endocrine and Metabolic · Clinical rotations · middle twist
A 44-year-old man has an incidental 8-mm pituitary lesion discovered during MRI for headaches. He has normal visual fields, normal pituitary hormone testing, an…
Endocrine and Metabolic · Clinical rotations · middle twist
A 58-year-old man is found to have a serum calcium concentration of 2.78 mmol/L (2.15–2.55) on two occasions. His phosphate is 0.72 mmol/L (0.80–1.50), creatini…
Endocrine and Metabolic · Clinical rotations · common
A 42-year-old woman has progressive fatigue, reduced appetite and dizziness when standing. Her serum sodium is 127 mmol/L (135–145), potassium is 5.8 mmol/L (3.…
Endocrine and Metabolic · Clinical rotations · common
A 46-year-old man notices sudden hearing loss in his left ear on waking 48 hours ago. He has no pain, discharge or recent upper respiratory infection, and otosc…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 15-year-old boy has six months of recurrent, predominantly right-sided epistaxis and progressive right nasal obstruction. He has no fever or facial pain, and…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 59-year-old man presents with eight hours of continuous vertigo, vomiting and difficulty walking. He has spontaneous right-beating nystagmus and no hearing lo…
Eyes, Ears, Nose and Throat · Clinical rotations · middle twist
A 14-month-old child has fever and irritability after several days of coryza. The child is pulling at the right ear and wakes repeatedly overnight. Otoscopy sho…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 64-year-old woman develops sudden, profound painless loss of vision in her left eye 90 minutes before assessment. The left pupil has a relative afferent pupil…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 71-year-old man develops severe pain and blurred vision in his right eye over two hours. He reports coloured haloes around lights and nausea; examination show…
Eyes, Ears, Nose and Throat · Clinical rotations · common