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 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 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

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

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 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

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

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 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

A 3-year-old girl attends a rural general practice for the fourth time in six months, twice with minor bruises and twice with abdominal pain. Dry at night for a…

Clinical rotations · middle twist

A 4-year-old boy is brought to a Perth emergency department with a swollen, bruised left forearm. At triage his mother said he fell from a kitchen chair. When y…

Clinical rotations · middle twist

A 2-year-old girl is brought to the emergency department by her father after falling from a play structure onto grass. She is walking, playing and interactive,…

Clinical rotations · middle twist

A previously well 2-year-old boy has passed two large, dark red stools today. He has had no abdominal pain, has not drawn up his legs, has not vomited and has h…

Clinical rotations · middle twist

A 2-year-old boy weighing 13 kg is brought to the emergency department 40 minutes after his mother found him beside her open bottle of iron tablets, with an ora…

Clinical rotations · middle twist

A mother brings her 18-month-old son to the general practice for a routine check. Her own mother has just moved in and keeps her tablets in a weekly pill organi…

Clinical rotations · middle twist

An 18-month-old boy is brought to a rural emergency department after being found in a farm shed beside a spilt container, with his clothing wet. He is drowsy bu…

Clinical rotations · middle twist

A two-year-old boy is brought to a regional emergency department 30 minutes after drinking from a soft drink bottle in the garage that his father had filled wit…

Clinical rotations · middle twist

A public health registrar is reviewing a local council's childhood injury prevention plan after a rise in emergency department presentations for household poiso…

Clinical rotations · middle twist

A 6-year-old girl weighing 20 kg is admitted with severe gastroenteritis. She was shocked on arrival and was given sodium chloride 0.9% 400 mL intravenously ove…

Clinical rotations · middle twist