Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 488 questions.
A 17-year-old man with cystic fibrosis has attended the same paediatric respiratory clinic since infancy and will move to the adult service next year. His mothe…
Paediatrics · Pre-internship · middle twist
A 16-year-old girl with focal epilepsy attends a general practice alone and asks for contraception. She has been seizure-free for two years on carbamazepine and…
Paediatrics · Pre-internship · middle twist
A 17-year-old boy attends a sexual health clinic alone. Five days ago he had receptive anal intercourse without a condom with a man he met online, whose HIV sta…
Paediatrics · Pre-internship · niche
A 16-year-old boy has had a moderate depressive episode for five months. He has completed eight sessions of cognitive behavioural therapy with a psychologist an…
Paediatrics · Pre-internship · middle twist
A 16-year-old girl with anorexia nervosa is reviewed in an outpatient eating disorder clinic. Over the past six weeks her weight has fallen 3 kg to 42 kg; she i…
Paediatrics · Pre-internship · niche
A 16-year-old boy is brought to a regional emergency department by his mother, who found messages in which he described wanting to die. Seen alone, he says he h…
Paediatrics · Pre-internship · middle twist
A 17-year-old girl asks for help to stop vaping. She has used a disposable device every day for two years, now wakes at night to use it, and has failed three at…
Paediatrics · Pre-internship · middle twist
A 16-year-old girl attends with three months of worsening acne. There are deep tender lumps on both cheeks and along the jaw, two of them discharging, and four…
Paediatrics · Pre-internship · middle twist
A 15-year-old girl has never had a period. Her breasts and pubic hair have been fully developed and unchanged for about a year, and she has grown 1 cm in the pa…
Paediatrics · Pre-internship · niche
A 14-year-old girl attends a Perth general practice alone and asks for emergency contraception after a condom broke last night. She tells you she has been seein…
Paediatrics · Pre-internship · middle twist
A 15-year-old boy who lives on a wheat farm 300 km from Perth is brought in by his mother after she found a note in his room. He tells you that for the past mon…
Paediatrics · Pre-internship · middle twist
A 6-year-old boy with laboratory-confirmed SARS-CoV-2 infection is admitted to a paediatric ward. Over an hour his oxygen saturation falls to 88 per cent on 6 L…
Paediatrics · Pre-internship · common
A 16-year-old girl asks you to sign a clearance form for state-level netball. Twice this year she has collapsed without warning, once in the third quarter of a…
Paediatrics · Pre-internship · common
A 3-year-old boy is in the emergency department of a Perth hospital with a forearm fracture after falling from a trampoline. While you are applying the backslab…
Paediatrics · Pre-internship · middle twist
A 5-year-old boy with steroid-sensitive nephrotic syndrome finished a six-week course of oral prednisolone 2 mg/kg daily yesterday. He is in remission, is well…
Paediatrics · Pre-internship · middle twist
A 13-year-old boy who received a kidney transplant two years ago attends the renal clinic. He takes tacrolimus and mycophenolate and his graft function is stabl…
Paediatrics · Pre-internship · niche
A 16-week-old girl is brought to a general practice by her family, who arrived in Australia three weeks ago. She has no immunisation records and her parents are…
Paediatrics · Pre-internship · niche
A 5-month-old boy is brought to the emergency department by his parents because he has been unsettled overnight. He is well grown, afebrile and feeding normally…
Paediatrics · Pre-internship · middle twist
A 13-month-old girl attends for a routine check. She is well and walking, and her weight and length are on the 75th centile. Her parents want to stop buying inf…
Paediatrics · Pre-internship · middle twist
A 3-week-old girl is brought to a general practice by her mother, who is exhausted and believes her milk supply is failing. The baby was born at term weighing 3…
Paediatrics · Pre-internship · middle twist