Paediatrics

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…

Pre-internship · middle twist

A couple in their early thirties have had three consecutive first-trimester miscarriages and have no living children. Both are well and neither has a family his…

Clinical rotations · middle twist

A 28-year-old woman who has had type 1 diabetes since she was twelve asks how to prepare for a pregnancy she hopes to start in about six months. Her most recent…

Pre-internship · middle twist

You are the intern in a newborn follow-up clinic. A 9-day-old boy has been recalled because his newborn bloodspot screening result shows a markedly raised thyro…

Pre-internship · middle twist

A boy born at 38 weeks is hypotonic and feeds slowly. Rapid chromosome testing has confirmed trisomy 21. He is pink in air with a normal respiratory rate, the p…

Pre-internship · middle twist

A term girl weighing 2.6 kg is examined before discharge. The backs of both hands and both feet are puffy and doughy, and there is loose redundant skin over the…

Clinical rotations · middle twist

The parents of a healthy 3-day-old boy ask you to arrange his circumcision before they go home. They give family and cultural reasons. His foreskin is normal fo…

Pre-internship · middle twist

A boy was born at term to a woman with chronic hepatitis B infection. He was given hepatitis B immunoglobulin and monovalent hepatitis B vaccine within twelve h…

Pre-internship · middle twist

A healthy boy is born at term after an uncomplicated pregnancy. His mother takes no regular medicines. She tells the midwife she does not want him to have any i…

Pre-internship · middle twist

A 4-week-old exclusively breastfed boy is brought to the emergency department because he is still yellow. He feeds hungrily and has gained 900 g since birth. Hi…

Pre-internship · middle twist

A girl born at 36 weeks weighing 2050 g is three hours old and has fed twice at the breast. She becomes jittery with a weak high-pitched cry, and then has an ep…

Pre-internship · middle twist

A boy born at 38 weeks is 44 hours old on the postnatal ward. His mother attends a treatment program for a daily supervised dose of buprenorphine and reports no…

Pre-internship · middle twist

A girl born at 38 weeks weighs 2.2 kg and her head circumference is well below the third centile. Scattered purple-red spots over the trunk do not blanch, and t…

Clinical rotations · middle twist

A boy is born at 39 weeks after spontaneous labour. The membranes ruptured 26 hours before birth and his mother had a temperature of 38.4 degrees during labour;…

Pre-internship · middle twist

A five-week-old exclusively breastfed boy is brought to the general practitioner because he is still yellow. He was born at term weighing 3.4 kg and now weighs…

Clinical rotations · middle twist

A 32-year-old woman attends her general practitioner for the six-week postnatal check with her healthy son. She says she is coping, sleeping when he sleeps and…

Pre-internship · middle twist

A woman who has had no antenatal care presents in advanced labour and gives birth to a boy weighing 2350 g. She is unsure of her dates and there has been no ult…

Clinical rotations · middle twist

A boy born at 39 weeks by spontaneous vaginal birth is 60 hours old. He has a high-pitched cry, tremors when he is undressed, sneezes repeatedly and takes the b…

Clinical rotations · middle twist

A woman whose vaginal-rectal swab at 36 weeks grew group B streptococcus labours spontaneously at 39 weeks and 4 days. Her membranes rupture six hours before bi…

Pre-internship · middle twist

A 15-year-old boy attends the renal clinic two years after a living-donor kidney transplant. He takes tacrolimus, mycophenolate and low-dose prednisolone daily,…

Pre-internship · middle twist