Diagnosis

A 10-day-old boy born at term is brought in with two days of poor feeding, vomiting and lethargy, and today is floppy and grey. He is afebrile, with a heart rat…

Paediatrics · Clinical rotations · niche

A 12-year-old boy who is on the 97th centile for weight has had three weeks of aching in his right knee and a limp that his parents noticed because his right fo…

Paediatrics · Clinical rotations · common

A 7-year-old boy is brought by his mother with a letter from his teacher. For the past year at school he cannot stay in his seat, blurts out answers before ques…

Paediatrics · Clinical rotations · common

A 7-month-old girl has had fever above 39 °C for seven days despite paracetamol. She is irritable and difficult to console. Her eyes are red without discharge,…

Paediatrics · Clinical rotations · middle twist

A 14-year-old boy is worried that he is the shortest in his class and has no signs of puberty. His height is on the 3rd centile and his weight on the 10th; his…

Paediatrics · Clinical rotations · middle twist

A 2-year-old girl is brought in by her mother, who felt a lump in the child's abdomen while bathing her. The child is well, eating normally and has not los…

Paediatrics · Clinical rotations · common

A term boy born by normal vaginal delivery after an uncomplicated pregnancy is noted by the midwife to be visibly jaundiced at 16 hours of age. He is feeding we…

Paediatrics · Clinical rotations · common

A 79-year-old man on apixaban for atrial fibrillation is brought in by his wife. Over three weeks he has become slower, sleeps much of the day, has twice lost t…

Neurology · Clinical rotations · common

A 66-year-old man with atrial fibrillation presents 40 minutes after the sight in his left eye "went out like a light" while reading; there was no pai…

Eyes, Ears, Nose and Throat · Clinical rotations · common

A 34-year-old man who injects heroin presents with two weeks of fevers, sweats, a cough and pleuritic chest pain on both sides. His temperature is 39.2 °C, puls…

Cardiovascular · Clinical rotations · middle twist

A 22-year-old woman is brought from a music festival by paramedics. She is agitated and confused, her temperature is 39.8 °C, pulse 132/min, blood pressure 158/…

Emergency and Toxicology · Clinical rotations · middle twist

A 34-year-old man started lamotrigine 16 days ago for newly diagnosed epilepsy. For three days he has had fever, sore eyes and painful mouth ulcers that make sw…

Dermatology · Clinical rotations · middle twist

A 44-year-old man who works on the kill floor of an abattoir in central Queensland presents with six days of high fevers, drenching night sweats, severe headach…

Infectious Diseases · Clinical rotations · middle twist

A 24-year-old man presents with dark brown urine that began the day after the onset of a sore throat. He recalls two similar episodes in the past two years, eac…

Renal, Urology and Electrolytes · Clinical rotations · middle twist

A 34-year-old woman describes 18 months of intermittent difficulty swallowing. From the beginning both liquids and solids have been affected, and it is worse wh…

Gastroenterology and Hepatology · Clinical rotations · common

A 68-year-old man is brought in by his wife after his third collapse in a month. Each time he has been sitting watching television, has suddenly gone grey and s…

Cardiovascular · Clinical rotations · middle twist

A 78-year-old man presents with a lesion on the sun-exposed forearm that has enlarged from a pinpoint mark to 18 mm over seven weeks. It is a firm, smooth, red-…

Dermatology · Clinical rotations · middle twist

A 24-year-old woman presents with 12 hours of abdominal pain, nausea and anorexia. The pain began around the umbilicus and is now most severe in the right iliac…

Surgery and Perioperative Care · Clinical rotations · common

A 31-year-old woman with chronic hypertension was taking labetalol before conception. At 30 weeks, her blood pressure has risen from 132/82 to 154/98 mmHg. A ur…

Obstetrics and Gynaecology · Clinical rotations · common

A 26-year-old man with schizophrenia stopped taking lorazepam prescribed for recurrent episodes of immobility and mutism. Two days later he is mute, alternates…

Psychiatry and Mental Health · Clinical rotations · niche