Medical education

A 59- year- old woman with carbimazolerefractory Graves disease presented with fever and extensive necrotising rash 2 weeks after commencing propylthiouracil therapy

Brian Lam · Alexander Yuile · Suran L Fernando

Evidence suggests that appropriate hepatitis B virus (HBV) screening before B cell-depleting therapy is frequently not performed

Sanjivan Mudaliar · Ken Liu · Simone I Strasser

The gait, arms, legs and spine (GALS) screen improves confidence and competence in the examination of the joints

Jane Dacre

A 77-year-old woman with a background of hypertension, diet-controlled type 2 diabetes and bilateral cataract surgery was referred by her GP to the emergency department

Stuart Campbell · Emma Hack · Babu Philip

A 26-year-old refugee from Myanmar was referred to the infectious diseases unit of an Australian teaching hospital

David WJ Griffin · G Khai Lin Huang · Philippe Lachapelle · Steven YC Tong · Siddhartha Mahanty

A 30-year-old woman was admitted for pancreatitis

Anthony Yao · Bob Wang

A 68- year- old man presented with hyperacute stroke one hour after symptom onset

Amy Ting · Abhay R Venkat · Yash Gawarikar · Ronak Patel

The basic premise of a stepped wedge cluster randomised trial (SW- CRT) is that all clusters start in the control condition

Michael J Campbell · Karla Hemming · Monica Taljaard

Lessons from practice

Anthony M Whitfield · Ai Van B Tran Nguyen · Kashif Sheikh

55- year- old otherwise healthy woman presented with the first episode of syncope

Vahid Moosavi · Mohammad Paymard

A 56-year-old man presented with a 2-month history of continuous occipital pain that progressed to aching neck movements

Tsung‐Han Ho · Yaw‐Don Hsu

A 64-year-old woman was referred to the glaucoma clinic at a tertiary eye hospital with elevated intraocular pressures

Helen HL Chan · John F Salmon

A 12-year-old boy was at a family gathering when he threw a deodorant can on a barbecue with exposed flames

Varun Chandra · Lei Liu · Jonathan B Ruddle

Cluster randomised trials randomise groups of individuals rather than individuals themselves to interventions. The groups might be communities, schools, workplaces, hospitals, or patients treated by a particular doctor. There are a number of reasons for the use of cluster trials as opposed to individually randomised trials. They may be the only available choice, as when a city is randomised to a mass intervention.

Michael J Campbell

Biases and assumptions often arise from past experiences and, when unquestioned, can negatively influence the development of effective educational strategies

Ruth M Sladek · Sue McAllister · Kieran M Walsh

ANA by indirect immunofluorescence remains the method of choice for screening patients suspected of having SARDs. A positive ANA test should be followed by further testing for ENA and dsDNA antibody testing for defining the ANA specificities and disease associations. The presence of anti‐DFS70 antibody in absence of ENA and dsDNA antibodies effectively excludes a diagnosis of SARD.

Pravin Hissaria · Andrew Broadfoot · Karl W Baumgart

A 42-year-old man presented to our emergency department with sudden bilateral visual loss

Tanya Kowalski · Jitin Verma · Shaun L Greene · Jeremy Curtin

A 52-year-old woman presented with symptomatic iron deficiency anaemia …

Varitsara Mangkorntongsakul · Cecily J Forsyth

The Timed Up and Go test provides a quick and valid way to estimate an older person's risk of falls, as well as other adverse outcomes

William Browne · Balakrishnan (Kichu) R Nair

Informed use of digital learning technologies can contribute to effective learning experiences

Helen Wozniak · Rachel H Ellaway · Peter GM de Jong

Clinicians should be mindful about the potential renal effects of cefepime

Luke Vlismas · Hannah Coleman · Tom N Lea-Henry · Bobby Chacko

A previously healthy 12-year-old girl presented to a rural hospital with 10 days of intermittent fevers

Fumitaka Nonaka · Susan M Carden · Coen Butters · Christine Chen

Programmatic assessment is a holistic approach to assessment that promotes a feedback and learning culture by removing decision making from individual assessment and focusing on meaningful feedback to the learner instead

Cees van der Vleuten · Iris Lindemann · Lisa Schmidt

A 40-year-old female Australian rules football player presented to a rural emergency department with a 3-hour history of swelling and pain in her right upper limb

John WP Wong · Fiona WY Lai · Ian Wilson