Case library
Browse every case in the library
Filter by category or specialty to find the case you need, or search by keyword. Each case runs as a case-grounded patient encounter with OSCE-style feedback at the end.
203 of 203 cases
- Emergency & Acute AssessmentRespiratory Medicine
20-Year-Old With Acute Wheeze After Allergen Exposure
A college student presents with acute-onset wheezing and shortness of breath after visiting a friend's cat-owning apartment. Known asthmatic with incomplete adherence to preventer therapy.
Start this case - Data InterpretationCardiology
52-Year-Old Man With Fatigue and Mild Jaw Discomfort After Exertion
A middle-aged man presents with vague exertional fatigue and atypical jaw discomfort — learners must integrate ECG and troponin findings to reach a time-critical cardiac diagnosis.
Start this case - Emergency & Acute AssessmentRespiratory Medicine
52-Year-Old With Severe Dyspnea and Known COPD-Asthma Overlap
A middle-aged office manager with asthma-COPD overlap syndrome presents with worsening breathlessness over 48 hours following a respiratory tract infection, now unable to complete sentences.
Start this case - Clinical ReasoningRespiratory Medicine
68-Year-Old With Unexplained Breathlessness and No Audible Wheeze
An elderly woman with known asthma presents with progressive breathlessness and chest tightness but no audible wheeze. She was recently started on a beta-blocker for newly diagnosed atrial fibrillation.
Start this case - Communication & CounsellingPaediatrics
8-Year-Old With Nocturnal Cough and Exercise-Induced Wheeze
A child is brought to the ED by her mother with persistent nocturnal cough and wheeze after PE class. Mild-moderate exacerbation in a newly diagnosed asthmatic. Atypical presentation dominated by cough rather than wheeze.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Abdominal Injury and Deteriorating Vitals Following Road Traffic Accident
A 17-year-old male cyclist struck by a car presents with right-sided abdominal pain, tachycardia, and pallor. He appears initially stable but rapidly deteriorates due to splenic laceration.
Start this case - Emergency & Acute AssessmentPaediatrics
Abdominal Pain and Fever in a 9-Year-Old Girl
A 9-year-old girl presents with 30-hour history of worsening central abdominal pain now localised to the right side, vomiting, and fever, with high risk of imminent perforation.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Acute Abdominal Pain in a 28-Week Pregnant Woman
A 28-year-old woman at 28 weeks gestation presents with right-sided abdominal pain and nausea, requiring careful differentiation of appendicitis from obstetric causes in pregnancy.
Start this case - Emergency & Acute AssessmentCardiology
Acute Chest Pain
Classic ACS teaching case with vitals and focused exam.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Acute Confusion and Breathlessness in an Elderly Man
A 78-year-old retired farmer with COPD and type 2 diabetes presents via ambulance with acute confusion, high fever, and severe dyspnoea. CURB-65 score indicates high-risk requiring immediate hospital admission.
Start this case - Emergency & Acute AssessmentCardiology
Acute Palpitations and Hypotension on Post-Op Day 2 After CABG
A 67-year-old man develops sudden palpitations, hypotension, and dyspnoea on post-operative day 2 following coronary artery bypass grafting. Monitoring confirms AF with RVR requiring urgent intervention.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Acute Paraplegia After a Road Traffic Accident
A 28-year-old male motorcyclist is brought to the ED after a high-speed collision, unable to move his legs, with a suspected thoracic spinal injury and haemodynamic instability.
Start this case - Communication & CounsellingObstetrics & Gynaecology
Acute Pelvic Pain in a Transgender Male Patient
A 27-year-old transgender male on testosterone therapy presents with severe left pelvic pain and nausea. Ovarian torsion is easily missed due to assumed anatomy, highlighting importance of inclusive history-taking and avoiding anchoring bias.
Start this case - Clinical ReasoningInfectious Disease
Afebrile Chemotherapy Patient with Fatigue and Low-Grade Confusion
A 54-year-old woman on chemotherapy for breast cancer presents with fatigue and mild confusion but no fever. This atypical sepsis case challenges learners to recognize immunosuppression-masked presentation.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Agitated and Hallucinating Post-Operative Patient
A 55-year-old female accountant develops acute agitation, visual hallucinations, and autonomic instability on post-operative day 2 following elective hip replacement, revealing concealed heavy alcohol use.
Start this case - Emergency & Acute AssessmentCare of the Elderly
Altered Mental Status in Elderly Diabetic
An 82-year-old nursing home resident with type 2 diabetes presents with 3 days of progressive confusion, decreased oral intake, and no urine output for 12 hours.
Start this case - Clinical ReasoningGeneral Practice
Anxious Executive with Vague Symptoms
A 38-year-old male marketing executive presents to a general practice clinic with insomnia, palpitations, and mild anxiety two days after a 'health kick' during which he stopped drinking without informing his doctor.
Start this case - Communication & CounsellingDentistry
Anxious Patient — Wisdom Tooth Extraction Consultation — Guided Demo
A dental-anxious patient before a planned wisdom tooth extraction — consent and communication practice.
Start this case - Clinical ReasoningEndocrinology
Apathetic Confusion and Weight Loss in an Elderly Woman
A 72-year-old woman presents with unexplained weight loss, new heart failure, and quiet confusion without the classic hyperadrenergic features, representing apathetic thyroid storm.
Start this case - Communication & CounsellingInfectious Disease
Arm Swelling and Systemic Infection in a Person Who Injects Drugs
A 34-year-old man who injects drugs presents with a 2-day history of right arm swelling, redness, and fever. He is reluctant to disclose his drug use and has had multiple prior skin infections.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Atypical Flank Discomfort and Nausea in a Third-Trimester Pregnant Woman
A 31-year-old woman at 32 weeks gestation presents with vague right-sided flank discomfort, nausea, and mild urinary frequency. Presentation is subtle and diagnosis is easily attributed to normal pregnancy.
Start this case - Clinical ReasoningNeurology
Atypical Presentation: Dizziness, Vomiting, and Ataxia Misdiagnosed as Vertigo
A 67-year-old woman with hypertension and diabetes presents with sudden severe dizziness, vomiting, and inability to walk straight – an atypical ICH in the cerebellum initially mistaken for benign vertigo.
Start this case - Clinical ReasoningCardiology
Back Pain and Hypertension in a Tall Young Woman
A 29-year-old tall woman with Marfan syndrome features presents with sudden severe back pain radiating to the flank, mild hypertension, and no prior cardiac history, representing a Type B aortic dissection.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Bee Sting Anaphylaxis in a Middle-Aged Farmer
A 45-year-old farmer presents minutes after a bee sting with diffuse urticaria, throat tightness, and rapidly falling blood pressure requiring immediate intervention.
Start this case - Clinical ReasoningRheumatology
Bilateral Hand Swelling and Morning Stiffness in a Middle-Aged Woman
A 48-year-old teacher presents with 3 weeks of worsening bilateral hand and wrist swelling, prolonged morning stiffness, fatigue, and low-grade fever, representing a typical RA flare.
Start this case - Clinical ReasoningCare of the Elderly
Bilateral Leg Swelling in an Elderly Care Home Resident
An 82-year-old care home resident with heart failure and limited mobility presents with worsening bilateral leg oedema, where unilateral DVT is hidden within a background of chronic bilateral swelling.
Start this case - Data InterpretationNeurology
Breakthrough Seizure in Elderly Woman on Thiazide Diuretic
An elderly woman with longstanding partial epilepsy presents with a new seizure; investigation reveals severe hyponatremia likely precipitated by her thiazide diuretic.
Start this case - Emergency & Acute AssessmentCardiology
Breathless at Midnight
An elderly man with known ischemic cardiomyopathy presents with acute onset orthopnea, bilateral leg swelling, and worsening dyspnea after running out of furosemide for five days.
Start this case - History TakingRespiratory Medicine
Breathless Young Woman with Undiagnosed Obstructive Lung Disease
A 44-year-old woman with a 20-year smoking history presents with 4 days of worsening dyspnea, wheeze, and a barking cough. No formal COPD diagnosis. History complicated by homelessness and irregular healthcare access.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Breathlessness and Leg Swelling in the Third Trimester
A 32-year-old woman at 34 weeks gestation presents with acute onset breathlessness and unilateral leg swelling. She is haemodynamically stable but at high risk for PE given pregnancy and limited mobility due to pelvic girdle pain.
Start this case - History TakingPsychiatry
Businessman with Fatigue and Chest Pain Masking Suicidal Intent
A 48-year-old male executive presents to the ED with two months of fatigue, chest tightness, and insomnia, initially appearing to be a cardiac workup, but screening reveals profound depression and concealed suicidal planning.
Start this case - Clinical ReasoningRheumatology
Butterfly Rash and Joint Pain in a 24-Year-Old Woman
A young woman presents with a facial rash, bilateral joint pain, and fatigue following sun exposure, consistent with a classic SLE flare requiring urgent workup and management.
Start this case - Clinical ReasoningHaematology
Calf Swelling After Hip Replacement
A 68-year-old retired teacher presents with unilateral left calf swelling and pain five days after elective hip replacement surgery, a classic high-risk DVT scenario.
Start this case - Clinical ReasoningCardiology
Chest Pain and Palpitations in a Young Woman on OCP
A 34-year-old woman on combined oral contraceptive pill and a smoker presents with sharp chest pain, palpitations, and near-syncope. Initial ECG shows ST elevation in V1–V3, concerning for spontaneous coronary artery dissection or vasospasm.
Start this case - History TakingPaediatrics
Child with Periumbilical Pain, Fever, and Behavioural Change
A 9-year-old girl presents with 2-day history of central abdominal pain, fever, and refusal to eat. Diagnostic uncertainty and inability to clearly localise pain in a paediatric patient create a challenging scenario.
Start this case - History TakingPsychiatry
College Student with Hopelessness and Suicidal Ideation
A 21-year-old female university student presents to student health clinic after a friend reports she has been giving away possessions and expressing hopelessness for the past three weeks.
Start this case - Emergency & Acute AssessmentInfectious Disease
College Student with Sudden Fever and Neck Stiffness
A 20-year-old university student living in a dormitory presents with sudden-onset severe headache, high fever, neck stiffness, and a non-blanching petechial rash, raising concern for meningococcal meningitis.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Colorectal Cancer Causing Acute Large Bowel Obstruction
A 74-year-old man presents with progressive constipation over 3 weeks culminating in absolute obstipation, marked abdominal distension, and new-onset vomiting, found to have a sigmoid colon mass causing large bowel obstruction.
Start this case - Clinical ReasoningCare of the Elderly
Confused and Unsteady: Not Just 'Old Age'
An 82-year-old woman with dementia and hypertension is brought in by her carer for confusion and two falls. Subtle signs on exam reveal decompensated heart failure as the underlying cause rather than primary neurological event.
Start this case - Clinical ReasoningCare of the Elderly
Confused Elderly Man on Glibenclamide After Poor Oral Intake
A 74-year-old retired farmer with Type 2 diabetes on a sulfonylurea presents with subacute confusion and falls. His daughter reports he has barely eaten for two days due to a viral illness. Risk of prolonged hypoglycemia.
Start this case - Emergency & Acute AssessmentRheumatology
Confused Elderly Man with Joint Pain and Fever on Biologics
A 74-year-old retired engineer on etanercept presents with a 5-day history of polyarthralgia, fever, and new-onset confusion, raising urgent concern for serious infection versus severe RA flare with systemic features.
Start this case - Clinical ReasoningCare of the Elderly
Confused Elderly Woman After Pain Medication Change
A 72-year-old woman with chronic back pain presents with excessive sedation and slowed breathing after her opioid dose was recently increased. Subtle presentation of iatrogenic opioid toxicity in an elderly patient on polypharmacy.
Start this case - Communication & CounsellingRespiratory Medicine
Confused Elderly Woman with Acute Respiratory Distress
An 82-year-old woman with severe COPD is brought by her daughter with acute confusion, severe dyspnea, and cyanosis. She is unable to complete sentences and has not improved with home nebulisers.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Confused Elderly Woman with Fever and Hypotension
An 82-year-old woman presents with acute confusion, fever, and low blood pressure. No obvious infection source is initially apparent, requiring systematic evaluation and urgent sepsis management.
Start this case - Emergency & Acute AssessmentNeurology
Confused Elderly Woman with Right Arm Weakness
An 82-year-old woman with known atrial fibrillation presents with acute onset confusion, right arm weakness, and expressive aphasia after missing her anticoagulant dose.
Start this case - Emergency & Acute AssessmentNeurology
Confusion and Hemiplegia After Elective Hip Surgery
A 71-year-old man develops acute right-sided weakness and confusion on post-operative day 2 following elective hip arthroplasty, with anticoagulation held perioperatively.
Start this case - Emergency & Acute AssessmentCare of the Elderly
Confusion and Malaise in an Elderly Man
An 82-year-old retired farmer presents with 3 days of confusion, reduced appetite, and falls. Family reports he has been 'not himself'. Minimal urinary symptoms reported.
Start this case - Emergency & Acute AssessmentNeurology
Confusion and Seizure in a 29-Year-Old Male with Known SLE
A 29-year-old male with SLE presents after a witnessed seizure with post-ictal confusion and behavioral changes, prompting evaluation for neuropsychiatric lupus as a life-threatening flare manifestation.
Start this case - Clinical ReasoningCare of the Elderly
Confusion and Vague Abdominal Discomfort in an Elderly Man
A 78-year-old man with type 2 diabetes presents with mild central abdominal discomfort, reduced appetite, and new-onset confusion — an atypical presentation of acute pancreatitis masking underlying severity.
Start this case - Emergency & Acute AssessmentCardiology
Crushing Chest Pain in a Middle-Aged Smoker
A 54-year-old male construction worker presents with sudden-onset severe crushing chest pain radiating to the left arm and jaw, diaphoresis, and nausea for 40 minutes. ECG shows ST elevation in leads II, III, aVF.
Start this case - Communication & CounsellingDentistry
Dental Implant Consultation — Guided Demo
New-patient consultation weighing implant risk factors against a missing molar.
Start this case - Clinical ReasoningEndocrinology
Deterioration After Emergency Appendectomy in a Middle-Aged Man
A 45-year-old male with undiagnosed hyperthyroidism develops fever, confusion, and atrial fibrillation 12 hours after emergency appendectomy, revealing an unsuspected thyroid storm.
Start this case - Emergency & Acute AssessmentRenal Medicine
Elderly Diabetic Man with Fatigue, Nausea, and Leg Swelling
A 72-year-old retired farmer with longstanding type 2 diabetes and hypertension presents with worsening fatigue, nausea, bilateral leg edema, and decreased urine output over 3 weeks.
Start this case - Clinical ReasoningEndocrinology
Elderly Diabetic with Confusion and Weakness
A 74-year-old man with T2DM on SGLT2 inhibitor presents with 3 days of weakness, confusion, and poor oral intake. Euglycemic DKA precipitated by urinary tract infection – an atypical and easily missed presentation.
Start this case - Clinical ReasoningInfectious Disease
Elderly Diabetic with Subacute Confusion and Low-Grade Fever
A 72-year-old diabetic woman with recent dental procedure presents with 3 days of progressive confusion, low-grade fever, and mild neck discomfort, representing an atypical meningitis presentation requiring high clinical suspicion.
Start this case - Emergency & Acute AssessmentUrology
Elderly Diabetic Woman with Flank Pain, Fever, and Rigors
A 67-year-old diabetic woman presents with left flank pain, high fever, chills, and costovertebral angle tenderness. She was treated for a UTI one week ago without improvement.
Start this case - Clinical ReasoningCare of the Elderly
Elderly Man with Acute Paranoid Psychosis and Delirium Overlap
A 72-year-old retired farmer presenting with acute onset paranoid delusions and agitation, with background dementia and recent urinary tract infection, requiring careful differentiation of delirium from psychosis.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Elderly Man with Fever, Hypotension, and Altered Mentation
A 74-year-old retired teacher presents with high fever, confusion, and hypotension following three days of dysuria and flank pain, consistent with urosepsis progressing to septic shock.
Start this case - Data InterpretationEmergency Medicine
Elderly Man With Vague Malaise and Reassuring-Looking Vitals
A 67-year-old man presents to the emergency department with non-specific fatigue and mild confusion, challenging learners to look beyond reassuring initial observations and identify occult hypoperfusion.
Start this case - Emergency & Acute AssessmentRenal Medicine
Elderly Man with Vomiting, Diarrhea, and Decreased Urine Output
A 78-year-old retired farmer presents with 3 days of vomiting and diarrhea, confusion, and markedly reduced urine output, consistent with severe volume-depleted pre-renal AKI.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Elderly Widow with Confusion After Bereavement
A 72-year-old retired nurse presents with subacute confusion, unsteady gait, and insomnia three days after her daughter removed alcohol from her home following her husband's funeral.
Start this case - Emergency & Acute AssessmentEndocrinology
Elderly Woman Found Unresponsive in Winter
An 80-year-old woman with known hypothyroidism found obtunded at home during cold weather, presenting with hypothermia, bradycardia, and periorbital edema. Classic precipitant: cold exposure and medication non-compliance.
Start this case - Communication & CounsellingPsychiatry
Elderly Woman with 'Not Caring to Live' After Bereavement
A 74-year-old retired schoolteacher is brought by her daughter due to progressive weight loss, medication non-compliance, and stating 'I wouldn't mind if the Lord took me soon' following her husband's death six months ago.
Start this case - Data InterpretationEndocrinology
Elderly Woman With New Confusion and Unsteady Gait After Prescription Change
An 82-year-old woman presents with subacute confusion and falls one week after a new medication was started, challenging learners to identify and interpret a critical electrolyte abnormality.
Start this case - Clinical ReasoningCare of the Elderly
Elderly Woman with Vague Abdominal Discomfort and Confusion
A 78-year-old woman with diabetes and hypertension presents with 3 days of vague lower abdominal discomfort, mild confusion, and low-grade fever — an atypical appendicitis masked by age and comorbidities.
Start this case - History TakingCardiology
Epigastric Pain and Fatigue in an Elderly Man
A 78-year-old man with dementia presents with epigastric pain, fatigue, and vomiting for six hours. Family reports he seems 'not himself.' ECG subtle; troponin mildly elevated. Risk of dismissal as GI cause is high.
Start this case - Clinical ReasoningGastroenterology
Epigastric Pain with Lipid Disorder and Gestational History
A 38-year-old woman with known hypertriglyceridaemia presents with acute epigastric pain and vomiting. This case highlights a less common but important aetiology of acute pancreatitis requiring specific metabolic management.
Start this case - Clinical ReasoningCardiology
Escalating Chest Tightness in a Diabetic Woman
A 67-year-old woman with type 2 diabetes and CKD presents with chest tightness and breathlessness on minimal exertion for two days, worsening tonight. ECG shows dynamic T-wave inversions in V4–V6. Troponin is elevated.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Excessive Bleeding Following Vaginal Delivery
A 29-year-old woman develops heavy vaginal bleeding and tachycardia one hour after an uncomplicated vaginal delivery, with fundal atony identified on examination.
Start this case - Emergency & Acute AssessmentInfectious Disease
Facial Swelling and Fever in a University Athlete
A 22-year-old female university swimmer presents with progressive left eye swelling, facial redness, and fever for 2 days following a minor facial abrasion sustained during training.
Start this case - Emergency & Acute AssessmentCardiology
Fatigue and Breathlessness in a Young Father
A 34-year-old man presents with progressive fatigue, dyspnea, and leg swelling over six weeks. He is found to have a new diagnosis of dilated cardiomyopathy with severely reduced EF, likely viral in origin.
Start this case - Emergency & Acute AssessmentPaediatrics
Febrile Infant with Bulging Fontanelle and Irritability
A 7-month-old boy presents with high fever, inconsolable crying, poor feeding, and a bulging fontanelle for 12 hours, raising urgent concern for bacterial meningitis in an infant where classic signs are absent.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Fever and Abdominal Distension in a Post-Operative ICU Patient
A 55-year-old male in the ICU on day 7 post-major vascular surgery develops fever, rising WBC, and abdominal distension without a clear source, representing acalculous cholecystitis.
Start this case - Emergency & Acute AssessmentUrology
Fever and Flank Pain in a Young Woman
A 24-year-old female university student presents with 2 days of right flank pain, high fever, and urinary frequency following a recent UTI treated incompletely.
Start this case - Emergency & Acute AssessmentEndocrinology
Fever, Agitation, and Racing Heart in a Young Woman
A 28-year-old woman with known Graves' disease presents with high fever, severe palpitations, agitation, and vomiting after stopping her carbimazole two weeks ago.
Start this case - Clinical ReasoningInfectious Disease
Fever, Back Pain and Leg Weakness in an IV Drug User
A 41-year-old woman with a history of intravenous drug use presents with severe thoracic back pain, fever, and new-onset lower limb weakness, raising concern for spinal epidural abscess.
Start this case - Data InterpretationHaematology
Feverish and Fatigued Days After Her Last Chemotherapy Cycle
A 34-year-old woman on active chemotherapy presents with low-grade fever and vague malaise, challenging learners to recognise a time-critical haematological emergency through systematic investigation and blood count interpretation.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Flank Pain and Fever in Second Trimester Pregnancy
A 28-year-old woman at 22 weeks gestation presents with left flank pain, fever, and rigors. She reports untreated asymptomatic bacteriuria diagnosed at her antenatal visit 3 weeks ago.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Healthy Adult Woman with Perforated Appendix and Septic Shock
A 38-year-old fitness instructor presents with 48 hours of worsening abdominal pain. She is found to have a perforated appendix with peritonitis and hemodynamic instability requiring urgent source control.
Start this case - Emergency & Acute AssessmentGastroenterology
Hematemesis and Dizziness in a Middle-Aged Man
A 52-year-old male with known alcohol use and NSAID use presents with multiple episodes of coffee-ground vomiting, lightheadedness, and dark stools over 24 hours.
Start this case - Emergency & Acute AssessmentGastroenterology
Hematemesis in an NSAID User
A 58-year-old male with a history of osteoarthritis on long-term NSAIDs presents with sudden-onset hematemesis and epigastric pain, representing a classic upper GI bleed from peptic ulcer disease.
Start this case - Clinical ReasoningCare of the Elderly
HHS Precipitated by Urinary Tract Infection in Diabetic Elder
A 74-year-old man with type 2 diabetes and heart failure is brought in by his son with 4 days of confusion, reduced urine output, and foul-smelling urine. Temperature is 38.3°C.
Start this case - Clinical ReasoningRheumatology
Homeless Middle-Aged Man with RA Flare, Nonadherence, and Suspected Infection
A 55-year-old homeless man with known RA presents via emergency services with severe bilateral knee swelling, fever, and multiple missed rheumatology appointments, raising complex diagnostic and social management challenges.
Start this case - Emergency & Acute AssessmentRenal Medicine
Homeless Older Man with Advanced Uremia and Social Barriers to Care
A 61-year-old unhoused man brought in by shelter staff presents with profound weakness, vomiting, and altered mental status. He has no known medical history but is found to have severely advanced CKD with uremia on workup.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Hypertensive Emergency Presenting as Flash Pulmonary Edema in an Elderly Woman
A 74-year-old woman with hypertension and CKD presents with sudden onset severe dyspnea, orthopnea, and frothy pink sputum. Markedly elevated BP is driving acute left ventricular failure and flash pulmonary edema.
Start this case - Emergency & Acute AssessmentCardiology
Hypertensive Emergency Presenting as Tearing Chest Pain Radiating to the Back
A 67-year-old woman with longstanding uncontrolled hypertension presents with sudden tearing chest pain radiating to the interscapular region, unequal blood pressure in both arms, and markedly elevated BP. Aortic dissection must be excluded urgently.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Intermittent Abdominal Pain in a Teenage Girl
A 14-year-old girl presents with a 2-day history of intermittent left lower abdominal pain and nausea. Pain has waxed and waned, making the presentation subtle. Represents an atypical, easy-to-miss case of ovarian torsion.
Start this case - Clinical ReasoningHaematology
Leg Swelling in a Patient Undergoing Chemotherapy
A 58-year-old man with metastatic colorectal cancer on active chemotherapy presents with right lower leg swelling and pain, highlighting DVT in the context of malignancy-associated thrombosis.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Lower Abdominal Pain and Vomiting in an Older Woman
A 58-year-old postmenopausal woman presents with acute right lower abdominal pain and persistent vomiting. Ovarian torsion is often not considered in this age group, creating a diagnostic pitfall and delay risk.
Start this case - Data InterpretationEmergency Medicine
Man Found Confused Hours After Clinic Visit
A 45-year-old male on methadone maintenance therapy presents with delayed-onset somnolence and QTc prolongation. Atypical, insidious presentation of methadone toxicity with cardiac involvement, hours after a dose change.
Start this case - Emergency & Acute AssessmentGastroenterology
Massive Haematemesis in a Cirrhotic Patient
A 44-year-old woman with known liver cirrhosis secondary to alcohol misuse presents with massive haematemesis and signs of decompensated liver disease, requiring urgent variceal bleed management.
Start this case - Clinical ReasoningEndocrinology
Middle-Aged Man with Fatigue and Confusion After Surgery
A 58-year-old man with undiagnosed hypothyroidism develops increasing confusion and hemodynamic instability 48 hours post-elective hernia repair. Subtle presentation masked by post-operative state.
Start this case - Emergency & Acute AssessmentHaematology
Middle-Aged Man with Neutropenic Fever and Septic Shock
A 52-year-old man with AML on induction chemotherapy presents with fever, rigors, and rapid hemodynamic deterioration – classic neutropenic sepsis evolving to septic shock.
Start this case - Emergency & Acute AssessmentUrology
Middle-Aged Man with Suprapubic Pain and Inability to Urinate
A 62-year-old accountant presents with acute urinary retention, suprapubic distension, and rising creatinine, representing post-renal AKI secondary to bladder outlet obstruction from benign prostatic hyperplasia.
Start this case - Data InterpretationCardiology
Middle-Aged Woman With Epigastric Pain and Nausea After Lunch
A 58-year-old woman with type 2 diabetes presents with indigestion-like epigastric discomfort and nausea, challenging learners to recognise an atypical cardiac presentation and interpret a critical ECG finding.
Start this case - Clinical ReasoningRenal Medicine
Middle-Aged Woman with Fatigue and Mild Rash After Starting a New Anti-Inflammatory
A 47-year-old teacher presents with 3 weeks of fatigue, low-grade fever, and a subtle maculopapular rash after starting naproxen for osteoarthritis, representing a subtle presentation of NSAID-induced acute interstitial nephritis.
Start this case - Emergency & Acute AssessmentRenal Medicine
Middle-Aged Woman with Pruritus, Confusion, and Pericarditic Chest Pain
A 45-year-old teacher with systemic lupus erythematosus and known lupus nephritis presents with intractable itching, new confusion, and pleuritic chest pain. She has been non-adherent to nephrology follow-up.
Start this case - Emergency & Acute AssessmentUrology
Middle-Aged Woman with Recurrent Stones, Neurogenic Bladder, and Urosepsis Risk
A 45-year-old woman with spinal cord injury, neurogenic bladder, and recurrent urinary tract infections presents with increasing spasticity, autonomic dysreflexia symptoms, and cloudy urine – her atypical 'pain equivalent' for obstruction.
Start this case - Emergency & Acute AssessmentNeurology
Middle-Aged Woman with Subacute Psychosis and Seizure
A 38-year-old teacher presenting with two weeks of rapidly progressive paranoia, visual hallucinations, and a witnessed generalized tonic-clonic seizure, raising concern for an organic aetiology.
Start this case - Clinical ReasoningInfectious Disease
Mild Cough and Fatigue in an HIV-Positive Patient
A 45-year-old HIV-positive man with a CD4 count of 180 presents with a 10-day history of mild dry cough, night sweats, and progressive exertional dyspnoea, requiring a broad differential including PCP and TB alongside CAP.
Start this case - Emergency & Acute AssessmentEmergency Medicine
New Diagnosis HHS in Undiagnosed Diabetic
A 54-year-old obese man presents to the ED via ambulance with extreme thirst, confusion, and weight loss over 2 weeks. No prior diabetes diagnosis.
Start this case - Emergency & Acute AssessmentPsychiatry
New Mother with Rapidly Escalating Postpartum Psychosis
A 29-year-old woman, eight days postpartum, presenting with insomnia, disorganised behaviour, and beliefs that her baby has been 'switched', initially dismissed as postnatal mood changes.
Start this case - Emergency & Acute AssessmentEmergency Medicine
New-Onset Rapid AF in a Middle-Aged Man with Pneumonia
A 58-year-old male construction manager presents with 2 days of fever, productive cough, and sudden-onset palpitations. ECG confirms new AF with RVR in the context of community-acquired pneumonia.
Start this case - Clinical ReasoningEndocrinology
Nursing Home Resident Sedated After Medication Change
A 72-year-old male nursing home resident with treated hypothyroidism becomes profoundly obtunded after starting amiodarone for new atrial fibrillation, revealing drug-precipitated myxedema coma in the context of polypharmacy.
Start this case - Clinical ReasoningHaematology
Older Man with Mild Sickle Cell Disease and Vague Abdominal Pain
A 58-year-old man with HbSC disease and multiple comorbidities presents with vague abdominal and hip pain subtly consistent with vaso-occlusive crisis, initially mistaken for other diagnoses.
Start this case - Emergency & Acute AssessmentPaediatrics
Peanut-Induced Anaphylaxis in a School-Age Child
An 8-year-old girl with known peanut allergy develops vomiting, urticaria, and respiratory distress at school after accidentally ingesting a peanut-containing cookie.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Penicillin Anaphylaxis During Outpatient IV Antibiotic Infusion
A 67-year-old woman with hypertension and diabetes develops flushing, hypotension, and collapse 10 minutes into IV co-amoxiclav infusion at an outpatient clinic.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Perineal Pain and Sepsis in an Elderly Immunocompromised Man
An elderly man on immunosuppressants for rheumatoid arthritis presents with perineal pain, swelling, and foul smell following a minor anorectal procedure, representing Fournier's gangrene.
Start this case - Clinical ReasoningRenal Medicine
Peripheral Oedema and Hypertension in a 38-Year-Old with SLE
A 38-year-old woman with SLE presents with new-onset leg swelling, frothy urine, and hypertension, raising urgent concern for lupus nephritis requiring immediate investigation and nephrology referral.
Start this case - Clinical ReasoningEmergency Medicine
Persistent Back Pain After a Fall in an Elderly Woman
An 82-year-old woman presents with persistent back pain following a minor fall, attributed initially to musculoskeletal injury, but subtle clues including resistant hypertension and pulse deficits reveal an underlying Type B aortic dissection.
Start this case - History TakingRespiratory Medicine
Persistent Dry Cough in a Teenage Athlete
A 17-year-old competitive swimmer presents with a 2-week history of gradually worsening dry cough, low-grade fever, and fatigue misattributed to overtraining, representing classic atypical walking pneumonia.
Start this case - Clinical ReasoningRespiratory Medicine
Pleuritic Chest Pain and Haemoptysis in a Young Traveller
A 27-year-old nurse presents with two days of right-sided pleuritic chest pain and small-volume haemoptysis after returning from a 14-hour flight, while taking the combined oral contraceptive pill.
Start this case - History TakingInfectious Disease
Post-Dental Procedure Young Man with Rigors and Tachycardia
A 28-year-old man presents with chills, rigors, and tachycardia three days after a dental extraction. The source is not initially obvious and requires a thorough history to uncover the procedural link.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Post-Op Adhesion SBO in Middle-Aged Woman
A 52-year-old woman with prior appendectomy presents with crampy periumbilical pain, bilious vomiting, and inability to pass gas or stool for 24 hours, consistent with adhesive small bowel obstruction.
Start this case - Emergency & Acute AssessmentDentistry
Post-Op Dental Implant Complication — Guided Demo
Worsening pain and swelling five days after implant placement — a red-flag screening case.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Post-Operative Acute Dyspnea
Post-operative patient with worsening breathlessness; prioritize oxygenation and differential breadth.
Start this case - Clinical ReasoningInfectious Disease
Post-Operative Neurosurgery Patient with Healthcare-Associated Meningitis
A 55-year-old man who underwent elective VP shunt revision 5 days ago presents with new fever, headache, and altered consciousness, requiring evaluation for nosocomial bacterial meningitis with gram-negative and Staphylococcal coverage.
Start this case - Data InterpretationRespiratory Medicine
Post-Operative Woman With Sudden Breathlessness and Chest Tightness
A 29-year-old woman develops unexplained breathlessness and chest tightness two days after elective surgery, challenging learners to systematically investigate beyond an obvious post-operative diagnosis.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Pregnant Woman with Right-Sided Abdominal Pain at 22 Weeks
A 28-year-old woman at 22 weeks gestation presents with right-sided abdominal pain and nausea. Displaced appendix position and pregnancy make diagnosis and management particularly challenging.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Pregnant Woman with Vomiting and Shortness of Breath
A 28-year-old woman at 26 weeks gestation with T1DM presents with vomiting, reduced fetal movement, and dyspnoea. DKA in pregnancy occurs at lower glucose levels and is a fetal emergency requiring urgent multidisciplinary management.
Start this case - Clinical ReasoningRespiratory Medicine
Productive Cough and Fever in a College Student
A 22-year-old university student presents with 4 days of high fever, productive cough with rusty sputum, and right-sided pleuritic chest pain following a recent campus outbreak.
Start this case - Emergency & Acute AssessmentNeurology
Progressive Confusion and Fall in an Anticoagulated Elderly Woman
An 82-year-old woman on warfarin for atrial fibrillation presents with progressive confusion, right-sided weakness, and a minor fall, representing anticoagulant-related ICH requiring urgent reversal.
Start this case - Emergency & Acute AssessmentNeurology
Progressive Leg Weakness in a Cancer Patient
A 62-year-old man with known prostate cancer presents with worsening back pain and bilateral leg weakness over two weeks, now unable to walk independently.
Start this case - Emergency & Acute AssessmentPaediatrics
Prolonged Seizure in Child with Epilepsy and Fever
A 9-year-old girl with Dravet syndrome presents with a prolonged febrile seizure lasting over 5 minutes, raising concern for status epilepticus requiring urgent benzodiazepine treatment.
Start this case - Emergency & Acute AssessmentCardiology
Rapid Palpitations and Shortness of Breath in an Elderly Woman
A 74-year-old woman with known AF presents with worsening palpitations and dyspnea after missing several doses of her rate-control medications over the past 3 days.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Rapidly Deteriorating Trauma Patient After MVA
A 35-year-old female restrained driver involved in a high-speed MVA presents with respiratory distress and hemodynamic instability. Tension pneumothorax requires immediate needle decompression without waiting for imaging.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Rapidly Spreading Leg Infection in a Diabetic Man
A middle-aged diabetic man presents with severe left leg pain, erythema, and swelling after a minor scratch, with disproportionate pain and early systemic toxicity suggesting NSTI.
Start this case - Clinical ReasoningUrology
Recurrent Groin Pain in a Young Adult Male
A 28-year-old male presents with intermittent right groin and scrotal discomfort over two weeks, now with acute worsening. Atypical history risks misdiagnosis as musculoskeletal or epididymitis.
Start this case - Clinical ReasoningGeneral Surgery
Recurrent RUQ Pain in a Young Woman on Oral Contraceptives
A 28-year-old woman on oral contraceptives presents with recurrent right upper quadrant pain and nausea. Initial labs are near-normal, creating a diagnostic challenge requiring careful imaging.
Start this case - Emergency & Acute AssessmentGastroenterology
Recurrent Vomiting and Abdominal Pain After Weekend Binge
A 28-year-old man with heavy alcohol use presents with epigastric pain, persistent vomiting, and inability to tolerate fluids following a weekend of heavy drinking, representing alcohol-induced acute pancreatitis.
Start this case - Emergency & Acute AssessmentNeurology
Repeated Episodes of Vertigo and Double Vision in a Middle-Aged Diabetic Man
A 58-year-old lorry driver presents with three episodes over 48 hours of sudden-onset vertigo, diplopia, and unsteadiness each lasting 10–20 minutes. Symptoms are attributed to inner ear problems by the patient. He has poorly controlled type 2 diabetes and hypertension.
Start this case - Data InterpretationRenal Medicine
Retired Engineer With Fatigue and Palpitations After Medication Change
A 71-year-old man with chronic kidney disease presents with vague fatigue and palpitations days after his GP adjusted his antihypertensive regimen, requiring careful investigation to identify a life-threatening electrolyte disturbance.
Start this case - Clinical ReasoningGeneral Surgery
RIF Pain in a 22-Year-Old University Student
A 22-year-old male presents with 18-hour history of periumbilical pain migrating to the right iliac fossa, nausea, and low-grade fever – a textbook acute appendicitis case.
Start this case - Communication & CounsellingUrology
Scrotal Pain in a Transgender Male with Delayed Presentation
A 19-year-old transgender male (assigned female at birth, no gonadal surgery) presents via a different route — this case instead features a 19-year-old transgender woman (assigned male at birth) with undescended testis and acute inguinal pain.
Start this case - Emergency & Acute AssessmentPaediatrics
Scrotal Swelling in a Newborn Male
A 2-day-old male neonate presents with right scrotal swelling noted at birth. Neonatal testicular torsion is a rare but must-not-miss diagnosis requiring urgent surgical assessment.
Start this case - Emergency & Acute AssessmentGastroenterology
Severe Epigastric Pain After Fatty Meal
A 52-year-old obese woman presents with sudden severe epigastric pain radiating to the back after a large meal, with nausea and vomiting, consistent with gallstone-induced acute pancreatitis.
Start this case - Emergency & Acute AssessmentUrology
Severe Flank Pain in a Dehydrated Young Construction Worker
A 28-year-old male presents with sudden-onset right flank pain radiating to the groin, nausea, and gross hematuria after a long day working outdoors in the heat.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Severe Headache and Confusion in a Middle-Aged Man with Known Hypertension
A 52-year-old man with poorly controlled hypertension presents with thunderclap-onset headache, blurred vision, and new confusion. BP is critically elevated with papilledema on fundoscopy.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Severe RUQ Pain After Fatty Meal
A 45-year-old obese woman presents with acute right upper quadrant pain radiating to her right shoulder after eating a large meal, associated with nausea and low-grade fever.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Sigmoid Volvulus in a Frail Nursing Home Resident
An 82-year-old woman with chronic constipation and psychiatric illness from a nursing home presents with acute massive abdominal distension and obstipation, diagnosed with sigmoid volvulus requiring urgent endoscopic or surgical decompression.
Start this case - Clinical ReasoningGastroenterology
Small-Volume Haematemesis After Alcohol Binge
A 27-year-old male presents with streaks of blood in vomit after prolonged retching following a heavy alcohol session, representing a Mallory-Weiss tear – a common but often underrecognised cause of UGIB.
Start this case - Emergency & Acute AssessmentInfectious Disease
Spreading Leg Redness with Fever in a Diabetic Patient
A 58-year-old man with poorly controlled type 2 diabetes presents with a 3-day history of spreading redness, swelling, and pain in his right lower leg, accompanied by fever and chills.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Stroke-Like Symptoms and Mild Chest Discomfort in an Elderly Man
A 72-year-old male with atrial fibrillation presents with sudden left arm weakness and slurred speech with only mild chest discomfort, masking an underlying Type A aortic dissection involving the carotid artery.
Start this case - Clinical ReasoningObstetrics & Gynaecology
Subtle Abdominal Wall Pain and Low-Grade Fever After Caesarean Section
A young post-partum woman presents with worsening abdominal wound pain and low-grade fever 5 days after C-section, with minimal visible skin changes initially concealing a rapidly progressive NSTI.
Start this case - Clinical ReasoningEmergency Medicine
Subtle Anaphylaxis Presenting as Near-Syncope in a Young Adult After NSAID Use
A 22-year-old woman presents to urgent care feeling faint and unwell 30 minutes after taking ibuprofen, with only subtle skin changes and persistent hypotension initially attributed to vasovagal episode.
Start this case - Clinical ReasoningGeneral Surgery
Subtle Closed-Loop Small Bowel Obstruction in a Young Man
A 28-year-old man with no prior surgery presents with vague constant abdominal pain and mild nausea, initially appearing benign, but found to have a closed-loop small bowel obstruction from an internal hernia – a must-not-miss diagnosis.
Start this case - Clinical ReasoningRespiratory Medicine
Subtle Exacerbation Disguised as General Deterioration
A 61-year-old man with known but undertreated COPD presents with 1 week of increasing fatigue, reduced appetite, and mild breathlessness on exertion. No wheeze reported. Primary care referral for 'general decline'.
Start this case - Clinical ReasoningPsychiatry
Subtle HHS Mimicking Psychosis in Young Adult
A 31-year-old woman with schizophrenia on atypical antipsychotics is brought in by her case worker for worsening disorganized behavior and not drinking enough fluids over 5 days.
Start this case - Clinical ReasoningInfectious Disease
Subtle Lower Limb Cellulitis in an Elderly Woman on Steroids
A 76-year-old woman on long-term prednisolone for rheumatoid arthritis presents with mild leg warmth and low-grade fever. Her subtle presentation masks significant systemic illness requiring careful assessment.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Subtle Presentation of Severe Pre-Eclampsia Progressing to Hypertensive Emergency in a Young Pregnant Woman
A 28-year-old primiparous woman at 34 weeks gestation presents with epigastric pain and headache, initially attributed to heartburn. Markedly elevated BP and proteinuria signal severe pre-eclampsia with eclamptic risk.
Start this case - Clinical ReasoningNeurology
Subtle Staring Episodes Mistaken for Inattention
A middle-aged woman with childhood-onset epilepsy, believed to be in remission, presents with recurrent brief staring episodes at work, initially dismissed as stress or distraction.
Start this case - Clinical ReasoningEndocrinology
Subtle Tachycardia and Fatigue in a Young Woman with Undiagnosed Thyroid Disease
A 32-year-old woman presents with 6 weeks of progressive fatigue, weight loss, heat intolerance, and mild palpitations. Examination reveals an irregular tachycardia and enlarged thyroid; ECG confirms AF with RVR.
Start this case - History TakingHaematology
Subtle Thigh Heaviness in a Young Traveller
A 26-year-old flight attendant on combined oral contraceptive pill presents with vague left thigh heaviness and mild swelling after a 14-hour flight, representing an atypical and easily dismissed DVT.
Start this case - Emergency & Acute AssessmentRespiratory Medicine
Sudden Chest Pain in a Tall Young Man
A tall, thin 22-year-old male with no prior lung disease presents with acute left-sided pleuritic chest pain and mild dyspnea after lifting weights. Classic primary spontaneous pneumothorax presentation.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Sudden Collapse and Hypoxia After Hip Replacement
A 68-year-old retired man develops acute dyspnoea, hypotension, and tachycardia 5 days after elective right total hip replacement, presenting with haemodynamic instability consistent with massive PE.
Start this case - Emergency & Acute AssessmentNeurology
Sudden Left-Sided Weakness and Slurred Speech
A 58-year-old hypertensive male presents with acute onset right MCA territory stroke featuring facial droop, arm weakness, and dysarthria of 90-minute duration.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Sudden Pelvic Pain in a Young Woman
A 24-year-old woman presents to the ED with acute onset right lower quadrant pain, nausea, and vomiting. Known ovarian cyst on prior ultrasound. Classic high-risk presentation requiring urgent surgical evaluation.
Start this case - Clinical ReasoningCare of the Elderly
Sudden Right-Sided Facial Droop and Confusion in a Frail Elderly Woman with Dementia
An 82-year-old care home resident with moderate vascular dementia is brought in after a 30-minute episode of right facial droop and increased confusion. Baseline cognitive impairment makes history unreliable and complicates assessment.
Start this case - Emergency & Acute AssessmentNeurology
Sudden Seizure and Headache in a Young Woman with No Prior Medical History
A 26-year-old previously healthy woman presents after a witnessed tonic-clonic seizure followed by severe headache and transient left arm weakness, suggesting ICH from an undiagnosed arteriovenous malformation.
Start this case - Emergency & Acute AssessmentNeurology
Sudden Severe Headache with Hemiplegia in a Hypertensive Middle-Aged Man
A 58-year-old hypertensive man presents with sudden-onset severe headache, left-sided weakness, and vomiting after exertion, representing classic hypertensive basal ganglia hemorrhage.
Start this case - Emergency & Acute AssessmentUrology
Sudden Severe Scrotal Pain in a Teenage Boy
A 15-year-old male presents with acute onset left scrotal pain awakening him from sleep, associated with nausea and vomiting. Classic high-riding testis with absent cremasteric reflex.
Start this case - Clinical ReasoningNeurology
Sudden Slurred Speech and Arm Weakness in an Elderly Man
A 74-year-old retired engineer presents with sudden onset slurred speech and right arm weakness lasting 25 minutes that fully resolved before arrival. He has hypertension, hyperlipidemia, and atrial fibrillation.
Start this case - Emergency & Acute AssessmentCardiology
Sudden Tearing Chest Pain in a Middle-Aged Man
A 58-year-old hypertensive male presents with abrupt onset severe tearing chest pain radiating to the back, with unequal blood pressures in both arms and a widened mediastinum on CXR.
Start this case - Emergency & Acute AssessmentGeneral Surgery
Sudden Thigh Pain and Fever in a Young Marathon Runner
A young athletic woman develops acute onset severe thigh pain and fever after a minor muscle strain, with minimal skin findings initially masking a rapidly progressive streptococcal NSTI.
Start this case - Communication & CounsellingCardiology
Swollen Legs and Shortness of Breath
A middle-aged obese woman with poorly controlled hypertension and preserved EF presents with two weeks of worsening leg oedema and dyspnea on minimal exertion, initially attributed to venous insufficiency.
Start this case - Data InterpretationEndocrinology
Teen With Vague Abdominal Pain and Repeated Vomiting
A 19-year-old man presents with two days of diffuse abdominal cramping and persistent vomiting, challenging learners to move beyond a surgical or gastroenterological diagnosis and correctly interpret key metabolic data.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Teenage Athlete with Worsening Myalgia, Rash, and Hemodynamic Instability
A 16-year-old male soccer player presents with three days of worsening flu-like symptoms, new petechial rash, and tachycardia. The presentation mimics viral illness but escalates to septic shock requiring urgent recognition.
Start this case - Emergency & Acute AssessmentHaematology
Teenage Boy with Bilateral Leg Pain and Sickle Cell Disease
A 16-year-old male with known HbSS disease presents with severe bilateral lower extremity pain after a cold exposure, consistent with a typical vaso-occlusive crisis requiring urgent analgesia.
Start this case - Emergency & Acute AssessmentPaediatrics
Teenage Girl Collapsed at School After Deliberate Insulin Overdose
A 16-year-old girl with known Type 1 diabetes collapses at school. A witness saw her inject extra insulin before gym class. Safeguarding and mental health concerns are prominent alongside the acute management.
Start this case - History TakingPsychiatry
Teenage Male with Anger, School Refusal, and Concealed Suicidal Thoughts
A 16-year-old male is brought reluctantly by his mother to the GP after three months of irritability, school refusal, and social withdrawal. He initially denies depression but discloses suicidal thoughts when seen alone.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Teenager Collapsed at House Party
A 16-year-old female collapses at a party after unknowingly ingesting a pill containing fentanyl. Rapid onset of profound respiratory depression in a patient with no opioid tolerance. Friends are present but withhold information initially.
Start this case - Emergency & Acute AssessmentPaediatrics
Teenager with Weight Loss and Breathing Difficulty
A 15-year-old boy presents with 3 weeks of polydipsia, polyuria, and weight loss culminating in rapid breathing and vomiting – first presentation of T1DM in DKA, a common but high-stakes scenario.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Thyroid Storm in a Pregnant Woman After Hyperemesis Gravidarum
A 32-year-old pregnant woman at 14 weeks gestation presents with uncontrolled vomiting, fever, palpitations, and agitation, with hyperemesis gravidarum masking an underlying thyroid storm.
Start this case - Data InterpretationCardiology
Tired and Nauseous: Elderly Woman With Vague Chest Discomfort
A 76-year-old woman presents with two days of unexplained fatigue, nausea, and mild upper chest heaviness — a case that challenges learners to recognise and investigate an atypical acute coronary syndrome.
Start this case - Data InterpretationGastroenterology
Tired Man With Dizziness and No Obvious Cause
A 44-year-old man presents with weeks of progressive fatigue and exertional dizziness, challenging learners to pursue a systematic investigation strategy and interpret key laboratory findings.
Start this case - Clinical ReasoningPaediatrics
Toddler with Swollen Hands and Inconsolable Crying – First VOC Presentation
A 2-year-old girl with newly suspected sickle cell disease presents with bilateral hand swelling and severe irritability consistent with dactylitis, potentially her first vaso-occlusive crisis.
Start this case - Communication & CounsellingNeurology
Tonic-Clonic Seizure After Missing Doses
A young adult male with known epilepsy presents post-ictally after a witnessed generalized tonic-clonic seizure, admitting he ran out of levetiracetam three days ago.
Start this case - Clinical ReasoningNeurology
Transient Confusion and Visual Disturbance in a Young Woman on OCP
A 34-year-old marketing manager presents with a 15-minute episode of left visual field loss and word-finding difficulty. She is on the combined oral contraceptive pill and is a smoker. Initial assessment may suggest migraine with aura.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Tremulous and Agitated Middle-Aged Drinker
A 48-year-old male construction worker presents with tremor, diaphoresis, and anxiety 24 hours after his last drink following a 15-year history of heavy daily alcohol use.
Start this case - Clinical ReasoningRespiratory Medicine
Unexplained Confusion and Worsening Fatigue in an Oncology Patient
A 74-year-old woman with metastatic lung cancer presents with a two-week history of progressive fatigue, mild confusion, and non-specific breathlessness without classic PE symptoms, representing a diagnostic challenge.
Start this case - History TakingRheumatology
Unexplained Fatigue and Anaemia in a 55-Year-Old Woman
A 55-year-old woman presents with progressive fatigue, mild dyspnoea on exertion, and incidentally found pancytopenia, with an atypical and delayed presentation of SLE flare mimicking haematological malignancy.
Start this case - History TakingGastroenterology
Unexplained Syncope Concealing a Silent Upper GI Bleed
A 72-year-old woman on anticoagulation presents with a fainting episode and fatigue, with no overt GI symptoms. Investigation reveals significant occult upper GI haemorrhage – an atypical and easily missed presentation.
Start this case - Emergency & Acute AssessmentEndocrinology
Unresponsive Diabetic Patient After Missed Meal
A 22-year-old woman with Type 1 diabetes is brought in unresponsive by her roommate after skipping lunch and taking her usual insulin dose. Classic autonomic and neuroglycopenic features present.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Unresponsive Young Man Found in Alley
A 24-year-old male found unresponsive by bystanders with pinpoint pupils, slow breathing, and track marks on arms. Classic presentation of illicit opioid overdose requiring immediate airway management and naloxone.
Start this case - Clinical ReasoningCare of the Elderly
Vague Abdominal Discomfort and Confusion in an Elderly Man
A 78-year-old man with diabetes and heart failure presents with two days of mild epigastric discomfort and new-onset confusion, with minimal pain complaint and low-grade fever.
Start this case - History TakingGeneral Surgery
Vague Abdominal Discomfort in a 78-Year-Old Nursing Home Resident
A 78-year-old woman with dementia presents with two days of reduced appetite, vague right-sided abdominal discomfort, and new confusion – masking a perforating appendicitis.
Start this case - Clinical ReasoningCare of the Elderly
Vague Abdominal Pain After a Fall in an Elderly Woman
An 82-year-old woman on anticoagulation presents with progressive fatigue and vague left-sided abdominal pain two days after a minor fall, initially without overt bleeding signs.
Start this case - Clinical ReasoningNeurology
Vague Leg Tingling and Unsteady Gait in an Older Woman
A 74-year-old woman presents with six weeks of bilateral leg tingling and a feeling of unsteadiness when walking, initially attributed to peripheral neuropathy by her GP.
Start this case - Clinical ReasoningRenal Medicine
Vague Malaise and Low-Grade Fever in an Immunosuppressed Man
A 45-year-old male renal transplant recipient presents with 5 days of vague malaise, low-grade fevers, and mild flank discomfort. He minimises symptoms and has no classic urinary complaints.
Start this case - Clinical ReasoningRespiratory Medicine
Vague Shoulder Tip Pain and Mild Dyspnea in a Runner
A 28-year-old female marathon runner presents with right shoulder tip pain and subtle exertional dyspnea. Small right apical pneumothorax is the unexpected finding in this atypical presentation without classic chest pain.
Start this case - Emergency & Acute AssessmentRespiratory Medicine
Worsening Breathlessness in a Retired Smoker
A 68-year-old retired miner presents with 3 days of increasing dyspnea, productive cough with yellow sputum, and reduced exercise tolerance. Known COPD on inhalers.
Start this case - Emergency & Acute AssessmentRespiratory Medicine
Worsening Breathlessness in an Elderly COPD Patient
A 67-year-old male with severe COPD presents with acute worsening of dyspnea and right-sided chest pain, initially attributed to a COPD exacerbation. Secondary spontaneous pneumothorax must not be missed.
Start this case - History TakingRenal Medicine
Young Adult with Fatigue and 'Feeling Off' – Subtle Uremic Symptoms
A 28-year-old graduate student presents with months of vague fatigue, difficulty concentrating, restless legs at night, and occasional nausea. She appears well and symptoms are easily dismissed as stress-related.
Start this case - Clinical ReasoningPsychiatry
Young Adult with First-Episode Psychosis
A 22-year-old university student presenting with auditory hallucinations, paranoid delusions, and social withdrawal over six weeks, with no prior psychiatric history.
Start this case - Emergency & Acute AssessmentRenal Medicine
Young Athlete with Dark Urine and Muscle Pain After Extreme Exercise
A 24-year-old male personal trainer presents with severe myalgia, cola-colored urine, and oliguria 24 hours after completing a military-style obstacle race, suggestive of rhabdomyolysis-induced ATN.
Start this case - Emergency & Acute AssessmentEndocrinology
Young Diabetic with Nausea, Vomiting, and Polyuria
A 22-year-old woman with known T1DM presents with 2 days of nausea, vomiting, polyuria, and abdominal pain after running out of insulin. Classic DKA with clear precipitant.
Start this case - Clinical ReasoningGeneral Surgery
Young Male with Migrating Right Iliac Fossa Pain
A 19-year-old male university student presents with 24-hour history of central abdominal pain migrating to the right iliac fossa, anorexia, and low-grade fever consistent with classic acute appendicitis.
Start this case - Emergency & Acute AssessmentEmergency Medicine
Young Man Found Drowsy After Binge Drinking
A 31-year-old bartender is brought in by ambulance after being found unrousable at a party. Initially assumed to be alcohol intoxication, but blood glucose reveals severe hypoglycemia. No known diabetes.
Start this case - Clinical ReasoningRheumatology
Young Woman with Fatigue, Anaemia, and Vague Joint Aches — Subtle RA Flare
A 29-year-old office administrator presents with 6 weeks of fatigue, diffuse joint achiness, and pallor. Subtle early RA flare is disguised by the absence of overt joint swelling, posing a diagnostic challenge.
Start this case - Emergency & Acute AssessmentEndocrinology
Young Woman with Hashimoto's Disease in Septic Crisis
A 34-year-old woman with known Hashimoto's thyroiditis presents with severe obtundation and hypothermia following a urinary tract infection, highlighting infection as a precipitant of myxedema coma in younger patients.
Start this case - Emergency & Acute AssessmentObstetrics & Gynaecology
Young Woman with Postpartum Fatigue and Mild Fever
A 28-year-old woman, 10 days postpartum, presents with fatigue, low-grade fever, and tachycardia. Initial presentation appears benign but masks evolving endometritis progressing to septic shock.
Start this case - Clinical ReasoningHaematology
Young Woman with Sickle Cell Crisis and Evolving Respiratory Symptoms
A 28-year-old woman with HbSS disease presents with chest and back pain, low-grade fever, and mild hypoxia raising concern for acute chest syndrome superimposed on vaso-occlusive crisis.
Start this case - Clinical ReasoningNeurology
Young Woman with Sudden Headache and Mild Arm Tingling
A 34-year-old woman on oral contraceptives presents with sudden headache, left arm numbness, and subtle hand clumsiness that could easily be dismissed as migraine or anxiety.
Start this case