Hope this helps. Sorry I know most of the questions are rather incomplete but the best I can do. All the best!


#1

Hope this helps. Sorry I know most of the questions are rather incomplete but the best I can do. All the best!!

  1. 8 year old boy with reduced concentration in school. Weight and height 75thcentile. Snores when asleep and difficult to wake up for school. Tonsil moderately enlarged but no inflammation. Nose mildly inflamed.Management?

Intranasal steroid

oral loratadine

amphetamine

6 weeks ampicillin

  1. Post MI on enoxaparin develop left abdominal pain (CT scan given: looks like hematoma?)

Management?

Laparotomy

platelet transfusion

  1. Middle aged lady on atypical antipsychotic (mirtazapine) took her husbands tramadol and now having dizziness. What other information necessary to complete diagnosis

Symtpoms?

Ataxia

diplopia

  1. 56 year old male present with (forget symptom) but he has history of multiple visits to hospital for multiple reasons but all normal. Diagnosis?

somatic delusion disorder

  1. 7 year old boy with multiple history of URTI. Now present with bilateral knee pain/swelling and well demarcated macular rash over abdomen. What examination to do?

dsDNA

ASOT

  1. Post trauma patient now got deviation of trachea to the right with reduced breath sound over left lung. Diagnosis?

Tension pneumothorax

  1. Patient with flail chest after chest tube insertion. Next plan?

Positive pressure ventilation

  1. Registrar confides in intern that he has lost interest in work and is taking drugs. What should the intern do?

Inform supervisor in charge of intern training

  1. 25 year old lady presents with abdominal pain when she wears tight clothes and (something else) and relieved when drink something hot. Diagnosis?

Crohn

Diverticulosis

  1. During an appendicectomy, surgeon discovers a 2mm carcinoid tumour. What to do? Nothing

Hemicolectomy

Chemotherapy

Radiotherapy

  1. Young man with grand mal seizure (first onset) and is a bus driver. He is asking regarding when he may drive the bus again. Plan?

advise him wait 6 months

inform his employer

inform the driving board

  1. Image given of a young boy with swollen erythematous left ear. Child appears well and active. What is the diagnosis?

Erysipelas

Perichondritis

Cellulitis

  1. Young lady with dog phobia but fiancé has a dog. She wants to overcome her phobia. Initial step?

Show picture of dog everyday

Play recording of dog barking everyday

Volunteer at dog shelter

Talk about dogs at least once per day

  1. 6 month baby present with fever, lethargy and mild jaundice. The urinalysis came back 105 unit/colony. Plan?

Check bilirubin

Check electrolytes and urea

Administer antibiotic amoxicillin 6 weeks

  1. Nurse with needle prick injury and patient has hepatitis B. What to do?

Give vaccine

Give immunoglobulin and vaccine

Check nurse HbsAg

Check nurse HbsAb

  1. Elderly gentleman with laceration wound over calf while farming. He last took tetanus booster 6 years ago.

No need to give tetanus toxoid

Give tetanus toxoid and tetanus vaccine

Give tetanus toxoid only

  1. Elderly gentleman fell from tractor 6 years ago and now present with dyspnea. (CXR given shows ?bowel in thorax) what is your plan?

Laparatomy and repair

Chest tube

Biopsy

  1. Middle age lady with fever 12 hours post laparascopic cholecystectomy. What to do?

Chest physiotherapy

Give antibiotic

  1. Elderly lady with recent fall over right shoulder. Currently have difficult to dress,lift up her hands. On examination no tenderness over bilateraly shoulder but pain on passive and active movement of bilateral shoulders. Why?

Adhesive capsulitis

Fracture of humerus

Osteoarthritis

  1. 50+ year old lady with pain over right hip. Straight leg test is negative.Pain on external and internal rotation. Pain extending from right high to lateral thigh. What is your diagnosis?

Lateral cutaneous nerve

Gluteal tendinopathy

  1. Mid 20s male present with alopecia and rash over palm. He was in Darwin for 3 months but previously was on a trip around Asia. Initial investigation

EBV serology

HIV

  1. 39 week pregnant lady present with PV bleed of 1000ml. Fetal heart absent. Next?

Caesarean section

Amniotomy

  1. 8 week pregnant wants to assess if baby may have Down syndrome and request for non invasive testing

Nuchal translucency at 12 weeks

Maternal screening at first trimester and USG at 18 weeks

Choriovillous biopsy something…

  1. 38 week pregnant lady present with painless bleed of about 800ml. Which physical examination correlates?

High fetal head…

  1. Middle yr old man recently arrived from Africa with complaint of haematuria and splenomegaly Hb is 8 . He tested malaria that was negative 3 days before he left from Africa
    recheck malaria immunoassay
    schistosomiasis
    giardiasis

  2. Lady with pancytopenia and hemoglobin is macrocytic. What investigation to do?

Bone biopsy

Serum b12

Hemoglobin electrophoresis

  1. Obese man with underlying hypertension, diabetes and gastric reflux. HbA1c is 9.1 and already on insulin.How to best manage his diabetes, obesity and gastric reflux?

Surgery gastric banding

Lifestyle modification and aggressive medical therapy

Roux en y op.

  1. Elderly gentleman with pneumonia doesn’t want antibiotics or admission to ICU. But children want. What to do?

Follow children wishes

Discuss with hospital legal team

Refer to neuropsychologist

(no option to follow patient decision)

  1. Elderly gentleman with underlying diabetes, now present with 1cm ulcer over 5thtoe and erythematous over sole of foot. Otherwise patient is well and vital signs are stable.What to do?

Oral antibiotics

Amputate toe

  1. Elderly gentleman with underlying GERD.Endoscopy image shown*. Biopsy shows low grade metaplasia of distal esophagus, with no dysplasia. Plan?

Repeat endoscope in 24 months

Double the dose of PPI

  1. (Image of erythematous calf) what is the management?

Fluclolaxilin/penicillin

Metronidazole/penicillin

  1. Young man with underlying asthma now present with dyspnea. CXR shows 15% pneumothorax. Symptom resolved. What to do?

Repeat CXR tomorrow

Chest tube insertion

Bronchoscopy

  1. Young boy doesnt have friends. Arranges toys in his room and doesn’t respond to parents when they punish or reward him. Has good eye contact when you talk to him. Diagnosis?

Autism spectrum disorder

ADHD

  1. Patient has symptoms of OCD. What treatment to start with?

Risperidone

  1. Frontotemporal dementia

  2. Young lady with bulimia, conduct disorder. Which is most likely risk factor as a kid

Sexual abuse

  1. Cervical cone biopsy done and now develop PID. Treatment with metronidazole and ampicillin. Now what to give

Doxycyclin

Azithromycin

Ceftriaxone

  1. Young lady has Graves disease and has hyperthyroid sx despite on carbimazole. What next?

Change to propylthiouracil

Radioactive iodine

  1. Young lady with normal T3/T4 but low TSH. What examination to do next?

USG

T3/T4 in 2 weeks

Antithyroglobulin

  1. 50 year old male (image given shown erythematous and swollen palm and 2/3rdfinger. What is the diagnosis?

Tendon synovitis

  1. middle age lady with swelling of left parotid gland. What investigation to do?

Fine needle cytology

Core biopsy

Sialogram

  1. Elderly gentleman done TURP. Shows 5% low grade dysplasia with grade of T3bN0M0 and invading to seminal vesicle. Next plan of management?

Radical prostatectomy

Radiation

Hormone deprivation

  1. Patient with sigmoid carcinoma with 3 lymph node involvement. What will help increase his life span for next 5 years?

Total colectomy

Chemotherapy

Radiotherapy

  1. Child with lower abdominal pain and fever. CXR shows patch at right lower lobe. What is most likely organism?

Strep pneumonia

H. Influenza

Klebsiella pneumonia

  1. Mother of 5 year old with measles rash after 5 days. Asking when can go back to school

Now

2 days

4 days

7 days

  1. Young lady with secondary amenorrhea. USG shows 3-4 ovarian cyst bilaterally with size 3-5mm. Also has some hirsutism. Diagnosis?

PCOS

  1. Elderly gentleman with pain and swelling over right lower leg. Pulse is absent. Diagnosis?

DVT

Popliteal embolus

Popliteal cyst rupture

  1. Elderly lady with lower limb non pitting edema till groin. What investigation to do?

Echocardiography

  1. Elderly lady with stress incontinence. Initial management?

Kegel exercise

  1. Young lady with RUQ pain and jaundice for past 1 week. 2 days ago took 10 tablets PCM for migraine. Blood investigation shows raised GGT, AST and ALT.

PCM intoxication

Acute cholangitis

Stones in the CBD