Overdose

A 45-year-old woman with bipolar I disorder, stable on lithium carbonate 1,000 mg nightly for six years with levels consistently 0.7–0.8 mmol/L, presents with t…

Psychiatry and Mental Health · Pre-internship · middle twist

A 19-year-old woman presents six hours after taking 30 × 500 mg paracetamol tablets in a single impulsive act following an argument. She also took "a few&q…

Emergency and Toxicology · Clinical rotations · common

A 68-year-old man taking gliclazide modified release for type 2 diabetes is found drowsy with a blood glucose concentration of 2.1 mmol/L. He improves after int…

Emergency and Toxicology · Clinical rotations · middle twist

A 46-year-old man is found vomiting beside an open container of an automotive fluid. He has tachypnoea, flank pain and oliguria; arterial blood gas analysis sho…

Emergency and Toxicology · Clinical rotations · common

A 42-year-old man is brought to hospital 45 minutes after taking an unknown number of amitriptyline tablets. He is drowsy, has a blood pressure of 78/46 mmHg an…

Emergency and Toxicology · Clinical rotations · common

A 32-year-old man is rescued from a burning warehouse. He is confused, hypotensive and tachypnoeic, with soot on his face but no wheeze. His pulse oximeter read…

Emergency and Toxicology · Pre-internship · middle twist

A 29-year-old man presents two days after running out of prescribed oxycodone, which he had been taking in increasing amounts for a year. He is yawning, restles…

Emergency and Toxicology · Clinical rotations · common

A 34-year-old woman presents with anxiety, poor sleep, nausea and a sense that people are watching her. She stopped taking alprazolam 72 hours ago after using 6…

Emergency and Toxicology · Clinical rotations · common

A 19-year-old man is brought to hospital 90 minutes after swallowing approximately 60 g of paracetamol. He is drowsy, sweaty and vomiting. Arterial blood gas an…

Emergency and Toxicology · Clinical rotations · niche

A 27-year-old man is bitten while walking through long grass near Tamworth, New South Wales. He brings a photograph of a slender brown snake, but the species ca…

Emergency and Toxicology · Clinical rotations · middle twist

A 32-year-old man is found confused after ingesting an unknown number of amitriptyline tablets. He has a blood pressure of 86/54 mmHg, a pulse of 126/min and a…

Emergency and Toxicology · Clinical rotations · common

A 58-year-old man is brought to the emergency department after being found drowsy beside an empty bottle of methadone mixture. He has a respiratory rate of 7/mi…

Emergency and Toxicology · Clinical rotations · common

A 24-year-old woman presents 30 hours after taking repeated doses of paracetamol for a dental infection. She estimates taking 10–12 g daily for four days; her p…

Emergency and Toxicology · Clinical rotations · common

A laboratory technician is found unconscious in a poorly ventilated garage. Arterial blood shows pH 7.39, PaO2 13.0 kPa (reference 10.7–13.3 kPa), and PaCO2 5.1…

Biomedical Science · Mechanisms of disease · 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 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…

Emergency and Toxicology · Pre-internship · common

A 34-year-old man in suburban Sydney felt a sharp pinprick on the back of his hand while moving pot plants stacked against the house. Over the next two hours he…

Emergency and Toxicology · Clinical rotations · common

A 9-year-old boy is brought to a regional Victorian hospital 45 minutes after a suspected snakebite to the calf while walking through long grass. A pressure imm…

Emergency and Toxicology · Clinical rotations · middle twist

A 58-year-old farmer near Dubbo, New South Wales, felt a sharp scratch on his ankle while moving hay bales and briefly lost consciousness about ten minutes late…

Emergency and Toxicology · Clinical rotations · niche

A 19-year-old man presents six hours after an acute ingestion of an unknown number of immediate-release paracetamol tablets in a suicide attempt. He is alert, w…

Emergency and Toxicology · Pre-internship · middle twist