Pre-internship
The harder call — the unwell patient, escalation, prioritisation, prescribing detail, ethics and law. 488 questions.
A 42-year-old farmer attends because his wife insisted. She left him four months ago and he has been drinking a bottle of wine most nights. He has lost 6 kg, wa…
Psychiatry and Mental Health · Pre-internship · common
A 45-year-old woman with bipolar I disorder, stable on lithium carbonate 1,000 mg nightly for six years with levels consistently 0.7–0.8 mmol/L, presents with t…
Psychiatry and Mental Health · Pre-internship · middle twist
A 3-year-old girl has refused to walk or stand since waking this morning and screams when her right leg is moved. She had a cold last week. Her temperature is 3…
Paediatrics · Pre-internship · common
A 5-week-old boy, first child, has had one week of vomiting that occurs within 30 minutes of every feed and is now forceful, landing well away from him. The vom…
Paediatrics · Pre-internship · middle twist
A 4-month-old boy is brought in by his mother's partner with a swollen right thigh, which he says happened when the baby rolled off the couch this morning.…
Paediatrics · Pre-internship · common
A 3-year-old girl is brought to a rural general practice, two hours by road from the nearest hospital, with 12 hours of fever, vomiting and increasing drowsines…
Paediatrics · Pre-internship · common
An 8-month-old boy is brought in because his 5-year-old cousin, who visited the house two days ago and played with him for an afternoon, has today been diagnose…
Paediatrics · Pre-internship · niche
A 9-year-old girl weighing 30 kg presents in diabetic ketoacidosis as the first presentation of type 1 diabetes: pH 7.02, glucose 34 mmol/L, bicarbonate 6 mmol/…
Paediatrics · Pre-internship · middle twist
A 3-day-old boy, born at term and discharged well at 24 hours, is brought back because he has become grey, floppy and uninterested in feeding over six hours. Hi…
Paediatrics · Pre-internship · middle twist
A 24-year-old woman with seven weeks of amenorrhoea and a positive home pregnancy test presents with two days of left-sided lower abdominal pain and light vagin…
Obstetrics and Gynaecology · Pre-internship · middle twist
A 34-year-old woman at 33 weeks in her third pregnancy, who smokes and has chronic hypertension, presents with two hours of constant severe abdominal pain that…
Obstetrics and Gynaecology · Pre-internship · middle twist
A 31-year-old woman in her first pregnancy presents at 36 weeks with a frontal headache and "flashing lights" for six hours. Her blood pressure was 11…
Obstetrics and Gynaecology · Pre-internship · common
A 22-year-old man was struck on the right temple by a cricket ball three hours ago in a country town. He was briefly unconscious, then walked off the field and…
Emergency and Toxicology · Pre-internship · middle twist
A 19-year-old man had a closed mid-shaft tibial fracture reduced and placed in a below-knee cast eight hours ago after a football tackle. He now has severe pain…
Rheumatology and Musculoskeletal · Pre-internship · middle twist
A 78-year-old man presents with three days of inability to pass urine and a painful lower abdomen, on a background of months of a poor stream and nocturia. A ur…
Renal, Urology and Electrolytes · Pre-internship · niche
A 72-year-old woman with atrial fibrillation who stopped her anticoagulant six months ago after a nosebleed wakes at 3 am with sudden severe pain in her left le…
Surgery and Perioperative Care · Pre-internship · middle twist
A 76-year-old man reports that for three months he has felt light-headed and has twice nearly fainted walking up the hill to the shops, together with a tight fe…
Cardiovascular · Pre-internship · common
A 62-year-old woman with type 2 diabetes is booked for an elective laparoscopic right hemicolectomy for a caecal cancer in one week. She will be fasting from mi…
Surgery and Perioperative Care · Pre-internship · niche
A 74-year-old man is on day 2 after an emergency Hartmann procedure for perforated diverticulitis. He takes spironolactone and perindopril for heart failure. He…
Renal, Urology and Electrolytes · Pre-internship · common
A 58-year-old interstate truck driver has had two unprovoked generalised tonic-clonic seizures in the past month and a diagnosis of epilepsy has been confirmed…
Ethics and Professional Practice · Pre-internship · middle twist