Clinical rotations
Working out what is wrong and starting treatment — history, examination, diagnosis, investigations, first-line management. 832 questions.
A 68-year-old man reports persistent thoracic back pain and fatigue for 3 months. His haemoglobin is 92 g/L (reference range 130–170), creatinine is 180 micromo…
Haematology and Oncology · Clinical rotations · common
A 59-year-old man has a painless left cervical mass that has enlarged over 6 weeks. He reports drenching night sweats and has no dental infection, pharyngitis o…
Haematology and Oncology · Clinical rotations · middle twist
A 40-year-old woman presents for routine preventive care and has never had an abnormal cervical screening result. She is asymptomatic, immunocompetent and has n…
Obstetrics and Gynaecology · Clinical rotations · common
A 62-year-old man attends his general practitioner for preventive health care and has no gastrointestinal symptoms. He has no personal or family history suggest…
Gastroenterology and Hepatology · Clinical rotations · common
A 91-year-old man with moderate dementia is admitted after a fall and has developed new agitation overnight. He is afebrile, oxygen saturation is 96% on room ai…
Geriatrics and Palliative Care · Clinical rotations · common
An 88-year-old woman has a dry, adherent black eschar covering the heel. The surrounding skin is warm but not erythematous, there is no drainage or fluctuance,…
Geriatrics and Palliative Care · Clinical rotations · common
A 79-year-old woman with limited mobility has a sacral ulcer measuring 5 cm in diameter. The ulcer extends through the dermis, with visible subcutaneous fat and…
Geriatrics and Palliative Care · Clinical rotations · common
A 76-year-old man with probable dementia with Lewy bodies has recurrent visual hallucinations that are frightening but not associated with aggression or immedia…
Geriatrics and Palliative Care · Clinical rotations · middle twist
An 87-year-old woman living independently develops confusion over 2 days after a chest infection. Her alertness varies during the day, and she cannot sustain at…
Geriatrics and Palliative Care · Clinical rotations · common
An 84-year-old inpatient becomes agitated and inattentive over 12 hours. He repeatedly tries to pass urine, reports lower abdominal discomfort and has a palpabl…
Geriatrics and Palliative Care · Clinical rotations · common
An 82-year-old man has had two falls since his blood pressure treatment was intensified. His seated blood pressure is 138/72 mmHg, falling to 108/60 mmHg after…
Geriatrics and Palliative Care · Clinical rotations · common
A 78-year-old woman is assessed after three falls over 2 months. She has not sustained a major injury and denies a clear loss of consciousness. Her medicines in…
Geriatrics and Palliative Care · Clinical rotations · common
A 24-year-old man has 9 months of low back pain that began gradually and improves after exercise but not with rest. He wakes in the second half of the night and…
Rheumatology and Musculoskeletal · Clinical rotations · middle twist
A 67-year-old woman has new bilateral shoulder and hip girdle aching with difficulty lifting her arms and rising from a chair. Symptoms are worst in the morning…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 36-year-old woman with systemic lupus erythematosus has increasing ankle swelling and foamy urine. Her urine protein-to-creatinine ratio is 180 mg/mmol (refer…
Renal, Urology and Electrolytes · Clinical rotations · common
A 42-year-old woman has 6 months of symmetrical swelling and tenderness of the metacarpophalangeal and proximal interphalangeal joints. Morning stiffness lasts…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 58-year-old man develops severe pain and swelling at the base of his right great toe overnight. He is afebrile and has no skin wound or prosthetic joint. Syno…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 67-year-old man has recurrent sinusitis, otitis and a persistent cough with occasional blood-streaked sputum. Urinalysis shows dysmorphic red cells and red-ce…
Rheumatology and Musculoskeletal · Clinical rotations · middle twist
A 29-year-old woman has photosensitive facial erythema, painless oral ulcers and symmetrical pain and swelling of the small joints of both hands. Urinalysis sho…
Rheumatology and Musculoskeletal · Clinical rotations · common
A 69-year-old man presents with 2 months of progressive low back pain that is worse at night and is not relieved by rest. He has lost 6 kg unintentionally and h…
Rheumatology and Musculoskeletal · Clinical rotations · common