Results for “heart failure”

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…

Paediatrics · Pre-internship · middle twist

A 76-year-old man reports that for three months he has felt light-headed and has twice nearly fainted walking up the hill to the shops, together with a tight fe…

Cardiovascular · Pre-internship · common

A 74-year-old man is on day 2 after an emergency Hartmann procedure for perforated diverticulitis. He takes spironolactone and perindopril for heart failure. He…

Renal, Urology and Electrolytes · Pre-internship · common

A 3-year-old boy weighing 15 kg has had two days of profuse vomiting and diarrhoea. On arrival he was drowsy with cold mottled legs, capillary refill of five se…

Paediatrics · Pre-internship · middle twist

An 11-month-old boy weighing 10 kg has had 36 hours of watery diarrhoea and vomiting. He lies quietly in his mother's arms and opens his eyes when spoken to. Hi…

Paediatrics · Clinical rotations · common

A 4-month-old girl with a large ventricular septal defect is reviewed before surgical repair. She breastfeeds every two hours but takes 40 minutes each time, sw…

Paediatrics · Pre-internship · middle twist

A 30-year-old woman, three weeks after giving birth, has had 24 hours of pain in the left breast. There is a tender, red, wedge-shaped area in the upper outer q…

Paediatrics · Pre-internship · middle twist

A 24-year-old man with schizophrenia has been taking clozapine for 17 days, titrated to 250 mg daily after two other antipsychotics failed. He reports three day…

Psychiatry · Clinical rotations · middle twist

A 23-year-old man with treatment-resistant schizophrenia started clozapine eighteen days ago and now takes 250 mg daily. He tells the nurse he feels as though h…

Psychiatry · Clinical rotations · middle twist

A 46-year-old man with schizophrenia has taken clozapine 400 mg daily for four years without a dose change. Over the past ten days he has become drowsy in the a…

Psychiatry · Pre-internship · niche

You are the intern covering a paediatric ward at a Perth public hospital at 2100. The mother of a 6-year-old boy admitted this morning with fever and vomiting s…

Acute Care · Pre-internship · middle twist

A 74-year-old woman is on day 4 after an open right hemicolectomy. Sodium chloride 0.9% 1 L eight-hourly, charted in the emergency department before her operati…

Acute Care · Pre-internship · common

A 3-year-old boy is pulled unresponsive from a community swimming pool. He is not breathing normally and a lifeguard has started chest compressions while an amb…

Acute Care · Clinical rotations · middle twist

A 66-year-old man has had ninety minutes of central chest pain with sweating. His electrocardiogram shows 3 mm ST elevation in leads II, III and aVF with ST dep…

Acute Care · Pre-internship · niche

You are the intern on night cover. At 02:00 the nurse asks you to see a 68-year-old man on the second night after a right hemicolectomy. His respiratory rate is…

Acute Care · Pre-internship · middle twist

A 58-year-old man is admitted with three days of fever and a productive cough. He weighs 138 kg, uses continuous positive airway pressure at home for witnessed…

Acute Care · Pre-internship · middle twist

An 84-year-old woman is on the ward on the evening of the first day after hemiarthroplasty for a fractured neck of femur. She has a morphine patient-controlled…

Acute Care · Clinical rotations · middle twist

A 31-year-old man is brought in after his utility vehicle struck a tree at speed. He is pale and cold and speaks in short phrases. Heart rate 132/min, blood pre…

Acute Care · Clinical rotations · common

A 68-year-old woman having a computed tomography scan develops flushing, wheeze and hypotension eight minutes after the intravenous contrast injection. She take…

Acute Care · Pre-internship · niche

You are the intern on an evening shift at a public hospital in Perth. A 3-year-old boy was admitted this morning with a febrile illness. His mother has told the…

Acute Care · Pre-internship · middle twist