Cases

Each case walks the full reasoning arc: describe, localise, build the differential, decide on investigations, commit, and debrief. Diagnoses are never in the titles; wrong turns teach and rejoin the path.

Foundations
The itch that keeps coming back
A 19-year-old presents with an intensely itchy rash affecting both elbow creases.
6 decisions
Preclerkship
The ring that keeps growing
A 31-year-old presents with an expanding itchy ring on the forearm, worse despite a cream from the pharmacy.
5 decisions
Clerkship
Pain first, rash second
A 68-year-old presents with three days of burning left-sided chest pain, and now a rash.
6 decisions
Clerkship High acuity
The rash that hurts
A 45-year-old on a new medication presents with fever, sore eyes and mouth, and a painful spreading rash.
6 decisions
Clerkship
One red leg
A 58-year-old presents with two days of a painful, hot, swollen lower leg and a fever.
5 decisions
Preclerkship
The whole house is scratching
A 24-year-old presents with eight weeks of relentless itch, far worse at night, and now their partner itches too.
4 decisions
Foundations
Silver on the elbows
A 27-year-old presents with thick scaly patches on both elbows and knees, and something odd happening to their fingernails.
4 decisions
Foundations
Welts that will not sit still
A 31-year-old presents with two days of intensely itchy raised welts that seem to move around the body.
4 decisions
Clerkship
The spot that changed
A 52-year-old presents because a dark spot on their back has grown and darkened over the past few months.
4 decisions
Foundations
The classroom rash
A 6-year-old is brought in with crusted sores around the nose and mouth; two classmates have the same thing.
4 decisions
Foundations
Streaks after the weekend
A 34-year-old develops intensely itchy streaks of blisters on both forearms two days after clearing brush in the garden.
5 decisions
Foundations
Flakes that never leave
A 27-year-old asks about persistent flaking and redness beside the nose and in the eyebrows, worse in winter and with stress.
5 decisions
Foundations
The face before the photographs
A 16-year-old is upset by months of bumps and blackheads across the forehead and cheeks, some leaving dark marks behind.
5 decisions
Clerkship
One patch, then a hundred
A 23-year-old had a single oval scaly patch on the trunk; a week later many smaller ones followed the rib lines.
6 decisions
Clerkship
Purple, flat and furious
A 45-year-old has weeks of intensely itchy violet bumps on both wrists and the shins, and white streaks inside the cheeks.
6 decisions
Clerkship
Blisters that will not break
An 82-year-old develops weeks of itchy red patches and then large tense fluid-filled blisters on the trunk and thighs.
5 decisions
Clerkship
It started in the mouth
A 52-year-old has three months of painful mouth erosions and now flaccid blisters that rupture into raw areas on the chest.
5 decisions
Preclerkship
Day eight of the antibiotic
A 30-year-old on amoxicillin for a week develops a symmetrical pink rash that started on the trunk and is spreading to the limbs.
5 decisions
Preclerkship
The patches with no scale
A 24-year-old notices spreading milk-white patches on the backs of the hands and around the mouth over six months.
6 decisions
Preclerkship
A pimple that never healed
A 68-year-old retired farmer has a shiny bump on the side of the nose that bleeds when towelled and has been there eight months.
6 decisions
Clerkship
Growing fast on the temple
A 71-year-old kidney transplant recipient has a firm, crusted, tender lump on the temple that has doubled in size in six weeks.
5 decisions
Foundations
Stuck on, not grown in
A 63-year-old is worried by a dark, waxy, rough-topped plaque on the back that a partner noticed. It has slowly darkened over years.
5 decisions
Clerkship
Sore shins
A 24-year-old has a fortnight of hot, painful red lumps on both shins, with a low fever and aching joints. Nothing has ulcerated.
5 decisions
Clerkship High acuity
The leg that hurts more than it looks
A 58-year-old with diabetes has twelve hours of severe calf pain, a fever, and a faint blotchy redness that looks too mild for the agony.
5 decisions
Foundations
Crops of spots, three days apart
A 26-year-old teacher has a fever and an itchy rash spreading from the trunk in waves; new spots keep appearing beside crusted ones.
5 decisions
Foundations
Little domes with a dimple
A 6-year-old has three months of small shiny skin-coloured bumps in the armpit and on the flank, each with a tiny central pit.
4 decisions
Clerkship
Both legs, for the third time
A 74-year-old is on a third course of antibiotics this year for 'cellulitis' of both lower legs, which are swollen, itchy, brown and scaly.
6 decisions
Clerkship High acuity
Dots that do not blanch
A 34-year-old has four days of raised purple dots over both shins and ankles that stay put under a glass, plus joint pain after a recent chest infection.
5 decisions