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A 29-year-old woman has 6 weeks of amenorrhoea and two days of increasing right iliac fossa pain. Transvaginal ultrasonography shows a 30-mm right tubal gestati…
Obstetrics and Gynaecology · Clinical rotations · middle twist
Immediately after delivery, a woman becomes pale and hypotensive and reports severe pelvic pain. A smooth, dark-red mass is visible at the introitus; the placen…
Obstetrics and Gynaecology · Clinical rotations · middle twist
Thirty-five minutes after a vaginal birth, the placenta has not separated and the woman has lost 900 mL of blood. The uterus is firm, the placenta is palpable a…
Obstetrics and Gynaecology · Clinical rotations · common
A 32-year-old woman presents seven days after an uncomplicated delivery with five sudden, severe headaches over 48 hours. Each begins abruptly during bathing or…
AMC · Clinical rotations · middle twist
A 35-year-old woman at 31 weeks’ gestation has six weeks of low mood, guilt and early-morning waking. During the past week she has stopped eating, believes her…
Psychiatry and Mental Health · Clinical rotations · common
A 29-year-old woman has a plasma bicarbonate concentration of 15 mmol/L (reference 22–29 mmol/L) and a normal anion gap. Her urine pH is 6.2 during bicarbonate…
Biomedical Science · Mechanisms of disease · middle twist
A healthy adult receives an intravenous glucose load. Plasma glucose is 12 mmol/L (reference 3.5–7.8 mmol/L), the measured glomerular filtration rate is 120 mL/…
Biomedical Science · Mechanisms of disease · common
A 62-year-old woman is receiving her first unit of packed red blood cells for symptomatic anaemia. Fifteen minutes after commencement her temperature rises from…
Nursing · Pre-internship · common
A registered nurse is preparing to administer flucloxacillin 1 g in 100 mL of sodium chloride 0.9% intravenously over 30 minutes. No infusion pump is available,…
Nursing · Clinical rotations · common
A 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…
Emergency and Toxicology · Clinical rotations · common
A 31-year-old woman presents six weeks after the birth of her first child. She tearfully describes vivid, unwanted images of smothering the baby with a pillow t…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 31-year-old primigravida at 33 weeks gestation reports one week of intense generalised itching that is worst at night and most severe over her palms and the s…
Obstetrics and Gynaecology · Clinical rotations · common
A 28-year-old primigravida gives birth vaginally at 38 weeks gestation. During labour she was commenced on oral labetalol for blood pressure readings of 160/108…
Obstetrics and Gynaecology · Clinical rotations · common
A 29-year-old woman, gravida 2 para 1, is in spontaneous labour at 39 weeks gestation. One hour after her cervix was 5 cm dilated, the membranes rupture spontan…
Obstetrics and Gynaecology · Clinical rotations · common
A 34-year-old woman attends her general practitioner eight weeks after the vaginal birth of her first child. Her pregnancy was complicated by gestational diabet…
Obstetrics and Gynaecology · Clinical rotations · common
A 24-day-old girl is brought to the emergency department after her mother measured an axillary temperature of 38.3°C at home. She was born at term after an unco…
Paediatrics · Clinical rotations · common
A 34-year-old man presents with five days of fever, drenching sweats, severe headache behind the eyes and aching muscles. He started work at a rural Queensland…
General Practice and Population Health · Clinical rotations · middle twist
A 29-year-old woman presents ten days after an uncomplicated vaginal delivery under epidural analgesia with four days of worsening headache, which she says is w…
Obstetrics and Gynaecology · Clinical rotations · middle twist
A 45-year-old woman is admitted with epigastric pain radiating to the back and a serum lipase of 2400 U/L (<60). Ultrasound shows multiple small stones in the g…
Gastroenterology and Hepatology · Clinical rotations · middle twist
A 68-year-old woman presents with two days of constant right upper quadrant and epigastric pain. Overnight she had two episodes of violent, uncontrollable shaki…
Gastroenterology and Hepatology · Clinical rotations · common