Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 488 questions.
An 8-month-old boy is brought to a general practice with six weeks of dry, pink, scaly patches on both cheeks and around the mouth. He rubs at them and wakes se…
Paediatrics · Pre-internship · niche
A 15-year-old girl attends a general practice for a repeat of her salbutamol inhaler. She has had asthma since childhood. She uses salbutamol two or three times…
Paediatrics · Pre-internship · middle twist
The bone marrow result for a 4-year-old girl admitted with pallor and bruising has confirmed acute lymphoblastic leukaemia. You are to be present while the cons…
Paediatrics · Pre-internship · common
A 12-year-old Aboriginal girl from a remote community has been admitted to a tertiary hospital with newly diagnosed type 1 diabetes. English is the family's fir…
Paediatrics · Pre-internship · middle twist
A 6-year-old boy with cystic fibrosis is admitted for his third pulmonary exacerbation this year. His mother tells the team she resigned from her job to manage…
Paediatrics · Pre-internship · common
A 15-year-old girl with type 1 diabetes since the age of nine attends the clinic with her father. Her glycated haemoglobin has risen steadily over 12 months. He…
Paediatrics · Pre-internship · middle twist
A 7-year-old boy has had atopic dermatitis since infancy. His skin is currently red, thickened and excoriated across both antecubital and popliteal fossae and h…
Paediatrics · Pre-internship · middle twist
A 9-year-old girl with newly diagnosed type 1 diabetes has been on the paediatric ward for eight hours receiving intravenous fluid and an insulin infusion for k…
Paediatrics · Pre-internship · niche
A 5-week-old boy is admitted after a fortnight of vomiting that now shoots across the change table after every feed. The vomit has never been green. He feeds hu…
Paediatrics · Pre-internship · middle twist
A 2-year-old boy is brought to a regional emergency department at 3 am with two days of runny nose and a harsh barking cough. Forty minutes ago he was given dex…
Paediatrics · Pre-internship · middle twist
A 10-week-old girl is brought to the emergency department by both parents with a bruise on the left cheek and a smaller one over the left ear. Her father says h…
Paediatrics · Pre-internship · middle twist
A 5-month-old ex-term boy is on day four of bronchiolitis. Over the past 24 hours he has taken about 40 per cent of his usual milk and had two wet nappies. Resp…
Paediatrics · Pre-internship · middle twist
A 14-month-old girl has been crying, pulling at both ears and febrile for a day. She has had paracetamol, is drinking normally and is not vomiting. Temperature…
Paediatrics · Pre-internship · middle twist
A 2-year-old boy brought in at 2 am has a harsh barking cough and a hoarse cry. His general practitioner gave him prednisolone 1 mg/kg nine hours ago and he set…
Paediatrics · Pre-internship · middle twist
A 3-year-old girl who arrived from Ethiopia six months ago is screened after her grandmother, who shares the house, was diagnosed with smear-positive pulmonary…
Paediatrics · Pre-internship · middle twist
A 6-day-old term girl, home since day two and feeding well until this morning, is brought in mottled and lethargic. Heart rate is 186 per minute, respiratory ra…
Paediatrics · Pre-internship · middle twist
A 4-year-old girl has refused to walk since yesterday and cries whenever her right leg is moved. Temperature is 38.9 degrees Celsius and heart rate 148 per minu…
Paediatrics · Pre-internship · middle twist
You are drawing a three-generation pedigree for a 7-year-old girl referred with recurrent headaches. Her mother mentions that the child's father, from whom she…
Paediatrics · Pre-internship · middle twist
A 7-year-old boy is brought in by his mother, who has biopsy-proven coeliac disease, as does his older sister. He is well, on the 50th centile for height and we…
Paediatrics · Pre-internship · niche
A woman has an amniocentesis at 17 weeks after a cell-free DNA test reported a high chance of trisomy 21. She is booked to fly interstate in three days for a fa…
Paediatrics · Pre-internship · middle twist