Paediatrics

A 5-month-old girl has had a fever of 39.2 °C for 24 hours with vomiting and irritability, and no cough, runny nose or rash. Examination is otherwise unremarkab…

Clinical rotations · middle twist

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…

Pre-internship · middle twist

A 7-month-old girl has had fever above 39 °C for seven days despite paracetamol. She is irritable and difficult to console. Her eyes are red without discharge,…

Clinical rotations · middle twist

A 14-year-old boy is worried that he is the shortest in his class and has no signs of puberty. His height is on the 3rd centile and his weight on the 10th; his…

Clinical rotations · middle twist

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/…

Pre-internship · middle twist

A 4-year-old boy develops widespread bruising on his shins and trunk and a crop of pinpoint red spots on his legs over three days, two weeks after a cold. He is…

Clinical rotations · 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…

Pre-internship · middle twist

An 18-month-old boy is brought by his parents because he has no words. He walked at 13 months and runs and climbs well. He does not point to show things, does n…

Clinical rotations · middle twist

You are the intern in a regional hospital's paediatric outpatient clinic. A 3-year-old Aboriginal boy has bilateral middle ear effusions and a 35 dB conductive…

Pre-internship · middle twist

A coastal local government area has recorded four drownings of children under five years of age in five years, every one of them in a backyard swimming pool at…

Pre-internship · middle twist

A local health district in western Sydney surveys its primary schools and finds that one in three children aged 5 to 12 years is above the healthy weight range,…

Clinical rotations · middle twist

You are the intern on a Perth paediatric ward. Over three weeks you admit four toddlers from the same remote community with extensive impetigo, and a fifth chil…

Pre-internship · middle twist

You are a general practice registrar in a Western Australian coastal town of 6000 people. Over the past year the proportion of five-year-olds recorded as fully…

Clinical rotations · middle twist

You are a junior doctor at a regional Western Australian hospital. Hospital data show that Aboriginal children in the district are admitted with skin infections…

Pre-internship · middle twist

A Perth tertiary hospital's ear, nose and throat department plans a programme to reduce chronic suppurative otitis media in a remote Aboriginal community 1500 k…

Clinical rotations · middle twist

You are a general practice registrar in Perth. A 3-year-old boy attends with his mother for a routine pre-kindergarten review recorded in his personal health re…

Pre-internship · middle twist

A 6-year-old Aboriginal boy attends a Perth general practice with his mother for a certificate to return to school after chickenpox. He is well, fully immunised…

Clinical rotations · middle twist

A 6-year-old girl with spastic diplegic cerebral palsy attends a Perth outpatient clinic. She needs continuing physiotherapy and speech pathology to preserve fu…

Pre-internship · middle twist

A 4-year-old Aboriginal boy from a remote Kimberley community has bilateral chronic suppurative otitis media with a 35 dB conductive hearing loss and delayed sp…

Clinical rotations · middle twist

You are the intern on a Perth paediatric ward. A 6-year-old girl admitted with pneumonia tells you that a family friend does rude things to her when he babysits…

Pre-internship · middle twist