Just finish the test in Melbourne today. As I take it just for fun for some personal reasons (Am I crazy?), I was over relaxed in the exam. Hope my recall may help someone. I will keep you posted when I get the feedback.
- A primigravida come after MVA, only slightly tummy pain, no unconsciousness, no headache, no pv bleeding, can feel baby movement, blood group O –ve, concern about baby,
Task: take further Hx, ask for Ex, tell the Mx
Everything fine, so US/CTG and anti-D
- A truck driver have right ear pain when having an interstate trip 2 days ago. With hearing loss, no fever, similar episode 2 months ago.
Task: take further Hx, do the Ex, tell the Mx
I made the most stupid mistake in this station. When pick up the sound fork, I told examiner loud and clear that I am using the 128Hz sound fork to check the hearing and actually went for it. 
The otoscope finding is given in a picture, The quality is so poor that I have no idea what it is. What I can see is a shining mass and redish ear drum without cone of light. I told the examiner that it is abnormal, but don’t know what’s the diagnosis, and I will refer him to the specialist.
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a lady with typical tension headache worry about brain tumor. Handbook P167
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4 yo girl discharged from ED 2 days ago, follow up in your clinic.
Task: take history, Mx
Asthma 2+ yr, 3 admission before, no ICU admission, On ventolin and steroid tablelet, using spacer, poor control, trigger include cold/exertion, past eczema, dog in house, partner smoke outside, Talk about action plan, skin allergic test, commence preventor
- 74 yo male with urine retention 12 hours,
Task: Hx, ask for Ex, Mx
Has history of BPH, no fever, normal sexual Hx, I am not quit sure it is from BPH or UTI. Eventually I chose BPH and talk about catheterization, and refer to specialist. The role player want to hear about TURP in very detail.
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Hip examination, I try to be systematic and organized in this station, then I don’t have time to talk to patient about DDX and Mx.
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a somatoform disorder lady (10 yr hx of migraine etc) refuse any suggestion about psychiatry. Persuaded her from different angle till bell rang. It is funny that I noticed there were bandage on her wrist, and asked what happen, trying to rude out suicide. The examiner said that’s for her arthritis, ignore it.
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A business man going to have long distant air travel to Thailand and LA,
Task: take focused hx and councelling
Past DVT Hx, talk about keep mobile on the plane, drink water. No plan for prostitute, skip safe sex. Always stay in hotel, then no malaria risk. Talk about vaccine, warned about street food. Was asked will you put him on Warfarin? No.
- A mid age lady with history of anorexia, weight loss, constipation, all tests normal.
Task: Hx focus on psychiatry, DDx,
Clearly nervous, several panic attacks before, no depression. No drug use. I have no idea what’s wrong apart from anxiety.
- a girl fall from horse and unconscious in rural area 100+km away from you, no doctor available there, local nurse call you.
Task: ask Ex from the nurse, give order
After asking Ex, and the routine IV line, monitor, oxygen, blood sample. I don’t know what to do, can she do the intubation? Should I arrange a chopper? I don’t know.
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A repeat case (Mel Sep 07 retest), a busy man found duodenal ulcer in endoscopy and H Pylori +ve,
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ED setting, video showing whooping cough
task: Hx, Mx
in Hx father have URTI recently, immunization up to date, I gave antibiotic to baby and contacts, and keep her in observation for a while.
- 20+ yo lady has sore throat, came for antibiotics
Task: Hx, ask for Ex, Mx
Several similar episodes in past 2 yrs, PE suggest viral infection, I refuse antibiotic request and refer to specialist to find out the reason behind the recurrent infection.
- 45 yo lady want to switch from OCP to HRT, your colleague had run some test on her
Task: further history, ask for Ex, ask for the test result you guess had been done, Mx
I totally got lost in this station. No headache, no HT, no blood clotting problem, no breast lump, no family Hx, no smoking, mammography and pap smear all normal. The most important is I had no idea what my colleague might have done for her.
- 40 wk primigravida fetus not engage
Task: Hx, Ex, counseling
Everything is normal, so I told her don’t worried, it is common in first preganancy.
- Recurrent UTI in 30+ lady. Repeat case from Mel Sep 08 retest.