Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 832 questions.
A 38-year-old woman experiences brief episodes of spinning when she rolls over in bed or looks upward. Each episode lasts less than a minute, and she is well be…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 42-year-old woman presents with recurrent anterior epistaxis from the right nostril. She is haemodynamically stable, and firm compression for 15 minutes plus…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 34-year-old swimmer has had increasing right ear pain for three days. Moving the pinna and pressing the tragus markedly worsen the pain, and the external cana…
Eyes, Ears, Nose and Throat · Clinical rotations · middle twist
A 67-year-old man notices flashes of light and a sudden increase in dark spots in his right eye. Several hours later he describes a grey curtain progressing fro…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 58-year-old woman presents with a unilateral red eye that began this morning. She reports marked discomfort and says bright light is unpleasant, but has no hi…
Eyes, Ears, Nose and Throat · Clinical rotations · common
A 29-year-old woman presents with painful genital lesions that began as small blisters 3 days ago. She describes burning on urination and has bilateral tender i…
General Practice and Population Health · Clinical rotations · common
A 31-year-old woman attends for routine care and has never had cervical screening. She has no abnormal bleeding, pelvic pain or visible cervical lesion. A self-…
Obstetrics and Gynaecology · Clinical rotations · niche
A healthy 55-year-old man with no family history of prostate cancer asks for a PSA test after seeing an online advertisement. He has no urinary symptoms, haemat…
General Practice and Population Health · Clinical rotations · middle twist
A 68-year-old man presents with fever, rigors, dysuria and perineal pain. He has been unable to pass urine for 10 hours, and examination shows a markedly tender…
Renal, Urology and Electrolytes · Clinical rotations · common
A 61-year-old man has erectile dysfunction and stable angina treated with regular glyceryl trinitrate spray. He would like to resume sexual activity and has no…
Cardiovascular · Clinical rotations · common
A 52-year-old man reports a 9-month history of gradually worsening erectile difficulty and reduced sexual desire. He has obesity, hypertension and type 2 diabet…
Cardiovascular · Clinical rotations · middle twist
A 32-year-old woman wants highly effective contraception and would prefer predictable light bleeding. She does not want a method requiring daily action and has…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 27-year-old woman presents with 2 days of lower abdominal pain and deep dyspareunia. She has purulent cervical discharge, a temperature of 38.1 °C and marked…
Obstetrics and Gynaecology · Clinical rotations · common
A 74-year-old woman with metastatic breast cancer presents with sudden dyspnoea and pleuritic chest pain. CT pulmonary angiography confirms bilateral pulmonary…
Emergency and Toxicology · Clinical rotations · common
A 66-year-old man with diffuse large B-cell lymphoma is receiving chemotherapy through a tunnelled central venous catheter. On day 8 he develops fever of 38.6°C…
Haematology and Oncology · Clinical rotations · middle twist
A 29-year-old woman has painless cervical and mediastinal lymphadenopathy that has progressed over 2 months. She reports drenching night sweats and pruritus but…
Haematology and Oncology · Clinical rotations · common
A 71-year-old man presents with headache, blurred vision and spontaneous bruising. Blood tests show haemoglobin 86 g/L (reference range 130–170), total protein…
Haematology and Oncology · Clinical rotations · common
A 58-year-old man receiving induction chemotherapy for acute myeloid leukaemia presents with a temperature of 39.1°C. His absolute neutrophil count is 0.05 × 10…
Haematology and Oncology · Clinical rotations · common
A 54-year-old woman has a symptomatic isolated posterior calf-vein thrombosis found on ultrasound. She has no cancer, previous venous thromboembolism, marked sw…
Cardiovascular · Clinical rotations · middle twist
A 31-year-old woman at 10 weeks of pregnancy develops unilateral calf swelling and pleuritic discomfort. Ultrasound confirms a proximal femoral deep-vein thromb…
Obstetrics and Gynaecology · Clinical rotations · common