Management

A 68-year-old man is on the surgical ward 6 hours after an open appendicectomy. The nurse records a respiratory rate of 28 breaths/min, heart rate 132/min, bloo…

Nursing · Pre-internship · 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 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…

Emergency and Toxicology · Pre-internship · common

A 32-year-old woman develops widespread urticaria, lip swelling and wheeze within 15 minutes of eating a satay dish at a restaurant. On arrival of paramedics he…

Emergency and Toxicology · Pre-internship · common

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

A 24-year-old woman presents to the emergency department two hours after impulsively swallowing 32 tablets of 500 mg immediate-release paracetamol (16 g) follow…

Emergency and Toxicology · Pre-internship · middle twist

A 47-year-old Aboriginal man from a regional town has type 2 diabetes and hypertension, for which metformin, perindopril and rosuvastatin are prescribed. At rev…

General Practice and Population Health · Clinical rotations · middle twist

A mother brings her 16-week-old son for his first vaccinations. The family recently arrived from overseas and he has received no vaccines apart from a hepatitis…

Paediatrics · Clinical rotations · middle twist

A 61-year-old man returns to discuss the result of a bowel cancer screening kit he completed through the national program, which detected blood in one of two sa…

Gastroenterology and Hepatology · Clinical rotations · common

A 35-year-old man with a known diagnosis of schizophrenia is brought to the emergency department by police after neighbours reported him shouting in the street…

Psychiatry and Mental Health · Pre-internship · middle twist

A 24-year-old university student commenced sertraline 50 mg daily three weeks ago for a depressive episode. His flatmates bring him to the emergency department…

Psychiatry and Mental Health · Clinical rotations · common

A 28-year-old man with schizophrenia that failed to respond to two previous antipsychotics has been taking clozapine for four months with good effect. He presen…

Psychiatry and Mental Health · Clinical rotations · common

A 52-year-old man is admitted to hospital after a fall at home and is managed with analgesia and bed rest. Thirty-six hours after admission he becomes restless…

Psychiatry and Mental Health · Clinical rotations · common

A 51-year-old woman presents with eight months of frequent hot flushes and drenching night sweats that wake her four to five times each night and are affecting…

Obstetrics and Gynaecology · Clinical rotations · common

A 27-year-old nulliparous woman requests reliable long-term contraception. Several times a year she has severe unilateral throbbing headaches that are preceded…

Obstetrics and Gynaecology · Clinical rotations · middle twist

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

An 8-week-old boy is brought to a general practice for his scheduled immunisations. While preparing the injections the practice nurse notices a 1.5 cm oval brui…

Paediatrics · Pre-internship · middle twist

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 15-month-old boy presents with two days of vomiting and frequent watery stools. He is alert but subdued, with dry lips, mildly sunken eyes, heart rate 148/min…

Paediatrics · Clinical rotations · middle twist