Hope this helps. Sorry I know most of the questions are rather incomplete but the best I can do. All the best!!
- 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?
6 weeks ampicillin
- Post MI on enoxaparin develop left abdominal pain (CT scan given: looks like hematoma?)
- Middle aged lady on atypical antipsychotic (mirtazapine) took her husbands tramadol and now having dizziness. What other information necessary to complete diagnosis
- 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
- 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?
- Post trauma patient now got deviation of trachea to the right with reduced breath sound over left lung. Diagnosis?
- Patient with flail chest after chest tube insertion. Next plan?
Positive pressure ventilation
- 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
- 25 year old lady presents with abdominal pain when she wears tight clothes and (something else) and relieved when drink something hot. Diagnosis?
- During an appendicectomy, surgeon discovers a 2mm carcinoid tumour. What to do? Nothing
- 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
- Image given of a young boy with swollen erythematous left ear. Child appears well and active. What is the diagnosis?
- 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
- 6 month baby present with fever, lethargy and mild jaundice. The urinalysis came back 105 unit/colony. Plan?
Check electrolytes and urea
Administer antibiotic amoxicillin 6 weeks
- Nurse with needle prick injury and patient has hepatitis B. What to do?
Give immunoglobulin and vaccine
Check nurse HbsAg
Check nurse HbsAb
- 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
- 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
- Middle age lady with fever 12 hours post laparascopic cholecystectomy. What to do?
- 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?
Fracture of humerus
- 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
- 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
- 39 week pregnant lady present with PV bleed of 1000ml. Fetal heart absent. Next?
- 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…
- 38 week pregnant lady present with painless bleed of about 800ml. Which physical examination correlates?
High fetal head…
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
Lady with pancytopenia and hemoglobin is macrocytic. What investigation to do?
- 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.
- 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)
- 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?
- 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
- (Image of erythematous calf) what is the management?
- Young man with underlying asthma now present with dyspnea. CXR shows 15% pneumothorax. Symptom resolved. What to do?
Repeat CXR tomorrow
Chest tube insertion
- 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
- Patient has symptoms of OCD. What treatment to start with?
Young lady with bulimia, conduct disorder. Which is most likely risk factor as a kid
- Cervical cone biopsy done and now develop PID. Treatment with metronidazole and ampicillin. Now what to give
- Young lady has Graves disease and has hyperthyroid sx despite on carbimazole. What next?
Change to propylthiouracil
- Young lady with normal T3/T4 but low TSH. What examination to do next?
T3/T4 in 2 weeks
- 50 year old male (image given shown erythematous and swollen palm and 2/3rdfinger. What is the diagnosis?
- middle age lady with swelling of left parotid gland. What investigation to do?
Fine needle cytology
- Elderly gentleman done TURP. Shows 5% low grade dysplasia with grade of T3bN0M0 and invading to seminal vesicle. Next plan of management?
- Patient with sigmoid carcinoma with 3 lymph node involvement. What will help increase his life span for next 5 years?
- Child with lower abdominal pain and fever. CXR shows patch at right lower lobe. What is most likely organism?
- Mother of 5 year old with measles rash after 5 days. Asking when can go back to school
- Young lady with secondary amenorrhea. USG shows 3-4 ovarian cyst bilaterally with size 3-5mm. Also has some hirsutism. Diagnosis?
- Elderly gentleman with pain and swelling over right lower leg. Pulse is absent. Diagnosis?
Popliteal cyst rupture
- Elderly lady with lower limb non pitting edema till groin. What investigation to do?
- Elderly lady with stress incontinence. Initial management?
- 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.
Stones in the CBD