Results for “thyroid”

A 12-year-old boy had blood taken during a work-up for recurrent abdominal pain, which has since settled without treatment. He is well, is Tanner stage 3, and h…

Paediatrics · Pre-internship · niche

A 49-year-old woman with schizophrenia has taken olanzapine for 12 years and attends a community clinic. Over three months she has become thirsty, gets up twice…

Psychiatry · Clinical rotations · middle twist

A 46-year-old carpenter has had a major depressive episode for seven months. He completed eight weeks of sertraline 100 mg daily with no change, then twelve wee…

Psychiatry · Clinical rotations · middle twist

A 34-year-old primary school teacher describes six months of constant worry, difficulty getting to sleep and irritability that is now affecting her teaching. Sh…

Psychiatry · Clinical rotations · common

A 29-year-old woman has had eight episodes over four months in which her heart pounds, she cannot get enough air, her hands tingle and she becomes certain she i…

Psychiatry · Clinical rotations · common

A 29-year-old woman is admitted with a first manic episode. She has not slept for four nights, has telephoned strangers at 3 am and has spent her rent money on…

Psychiatry · Pre-internship · niche

A 27-year-old man with schizophrenia has taken amisulpride 1200 mg daily for ten weeks and, before that, olanzapine 20 mg daily for twelve weeks. Both were give…

Psychiatry · Pre-internship · middle twist

A 78-year-old retired farmer is brought in by his wife with four months of tiredness, vague upper abdominal discomfort and aching legs. He has lost 5 kg. He sto…

Psychiatry · Clinical rotations · middle twist

A 73-year-old woman presents with four months of worry, restlessness and difficulty sleeping. She has never been an anxious person and nothing in her circumstan…

Psychiatry · Clinical rotations · middle twist

A 16-year-old boy is brought by his father because he has gone from the top of his class to failing in six months. He has quit the swimming squad, sleeps until…

Psychiatry · Pre-internship · middle twist

A 13-year-old boy's marks have fallen steadily over 12 months and his teacher reports that he dozes in afternoon classes, is irritable and forgets instructions.…

Psychiatry · Clinical rotations · middle twist

A 28-year-old woman is admitted after an overdose. The team cannot decide between a recurrent depressive illness and a personality disorder. She gives a vague,…

Psychiatry · Pre-internship · middle twist

A 29-year-old woman has been treated for "depression" for six years and has now been referred for electroconvulsive therapy after adequate trials of three antid…

Psychiatry · Clinical rotations · middle twist

A 45-year-old man with major depressive disorder has been treated for seven weeks and his mood has clearly improved. He now reports intensely vivid, unpleasant…

Psychiatry · Clinical rotations · middle twist

A 74-year-old woman is referred with six months of worry, restlessness and broken sleep. She has never been anxious before and can point to no trigger. She has…

Psychiatry · Pre-internship · common

A 29-year-old woman has had six months of abrupt attacks of pounding heartbeat, breathlessness and tingling fingers that peak within minutes. They have come on…

Psychiatry · Clinical rotations · common

A 31-year-old primary school teacher has felt low, flat and tearful for seven weeks. She still gets to work every day but finds preparing lessons harder than us…

Psychiatry · Clinical rotations · common

A 64-year-old woman attends the general practice with six weeks of low mood, tearfulness, broken sleep and loss of interest in everything she used to enjoy. Fiv…

Psychiatry · Pre-internship · middle twist

A 27-year-old man is assessed in the emergency department short-stay unit with three weeks of low mood, waking at 4 am and hopelessness. He has had two similar…

Psychiatry · Pre-internship · middle twist

A 22-year-old woman is admitted after three weeks of increasingly odd behaviour. Her mother says she had a flu-like illness a month ago, then became convinced h…

Psychiatry · Clinical rotations · niche