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Year 4 exams > 2019 summative > Flashcards

2019 summative Flashcards

1
Q

22yo M presents w. sores on penis. GF has hx of cold sores- what is most appropriate next step?

A

swab (of penile sore) for HSV PCR

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2
Q

23 year old female, itchy and burning sensation down below. Stable
partner for 10 years. External genitalia examination normal. Speculum
examination revealed a small amount of white, adherent discharge. What is
the most likely diagnosis
A. Bacterial vaginosis
B. Atrophic vaginitis
C. Candida vaginitis
D. Trichomoniasis

A

candida vaginitis
- white, adherent d/c “cottage cheese”

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3
Q

6yo M, 6hr hx n, v, abdo pain and scrotal pain
O/E: tender R scrotum, no erythema, skin changes or swelling
Most likely diagnosis?

A. Orchi-Epididymitis
B. Testicular torsion
C. Hydrocele
D. Testicular cancer
E. Appendicitis

A

testicular torsion

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4
Q

36 yo woman otherwise well complained of intermittent joint pain and
swelling in mcp, mtp, pip joints, for the last 6 months. Bilateral. She has no
erythema, joint swelling, rash or deformity on examination. 5 kg weight
loss.
A. Fibromyalgia
B. Gout
C. Psoriatic arthritis
D. Rheumatoid arthritis
E. Systemic lupeus erythymatosis

A

rheumatoid artyhritis

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5
Q

65 M with acute gout and settled with NSAID (diclofenac). Has a PMH
of T2DM, hypertension, ?CAD. Returned for review of gout. Current
medications include perindopril, hydrochlorothiazide, allopurinol. Blood test
result showed worsening of kidney function, with eGFR = 26, and also
HbA1C = 10.1%. Gout symptoms have settled but urea still high…
What changes to the medication should you make?
A. Cease Diclofenac and hydrochlorothiazide
B. Cease Diclofenac and increase allopurinol
C. Cease hydrochlorothiazide and start on low purine diet
D. Cease hydrochlorothiazide and start low dose metformin
E. Start metformin and increase allopurinol

A

cease diclofenac (NSAID) and hydrochlorothiazide

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6
Q

60 something lady with jaw pain when chewing, vision changes,
headache. What would you give to treat?

A

diagnosis: GCA for which the treatment is prednisolone/ high dose glucocorticoids (no cure but sx.s resolve) e.g. 40-60mg pred/ day

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7
Q

45 y/o male with L retroorbital pain a/w tearing and redness in eye. The
symptoms last for a few seconds /minutes. These episodes have happened
consecutively on most nights of the week for past 3 months.

A

cluster headache

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8
Q

31yo M, 2dat hx: photopobia, blurry vsision. Otherwise well. Corneal injection as seen in image. Constricted pupil.
most likely diagnosis?

A. Corneal foreign body
B. Dendritic ulcer
C. Anterior uveitis
D. Acute Glaucoma
E. Hemorrhagic conjunctivitis

A

anterior uveitis

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9
Q

17-year-old girl? presents with wheeze and SOB. FEV1 50% predicted ->
70% predicted post bronchodilator. Minimal change to FVC. What is the
likely pathology?
A. restrictive lung disease
B. anxiety
C. neuromuscular weakness
D. Foreign body
E. Reversible airways disease

A

reversible lung dx

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10
Q

Lady, thinks she is 12 weeks pregnant.
BP 150/100mmHg, otherwise normal examination. Normal urinalysis.
Most likely diagnosis:
A. Essential hypertension
B. Pregnancy induced hypertension
C. Preeclampsia

A

essential HTN

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11
Q

Middle aged man, HTN, smoking. On a business trip and when was
walking to lunch had left jaw pain. Has happened before. Comes to GP
what should you do?
A. Dental referral
B. Cardiology referral
C. ECG
D. dental xray
E. Analgesia

A

ECG
- due to HTN, smoking hx AND the fact that L jaw pain (like L shoulder pain I guess) occurs when walking with previous episodes

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12
Q

2 yo boy with recurrent otitis media treated w abx. Normal FM + GM +
S milestones but babbles/doesn’t speak well. He presents today w parents
suspecting developmental delay. Likely cause of his language delay?
Ans:
a) Serous otitis media
b) Autism
c) Sensorinerual hearing loss
d) Acute otitis media

A

serous OM

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13
Q

Elderly lady with dementia in nursing home. Recently completed a course
of oral antibiotics. Has recently started refusing food and had some
alterated behaviours, perhaps agitated

What is appropriate management?
a. Nasogastric tube feeding
b. Speech path review
c. Oral glucose tolerance test
d. Do nothing
e. Nystatin + mouth care

A

nystatin and mouth care

this looks like oral candidiasis (thrush) for which the preferred topical agents include
- clotrimoxazole
-miconazole
-nystatin (best option in this MCQ BUT not preferable; contains sucrose which can !dental carries which this patient has, may be less effective than clotrimoxazole and miconazole)

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14
Q

16 year old female, living on the street and womens shelters, wanting
contraception that didn’t require partner cooperation. Loves to occasionally
sniff solvents?
A. COCP
B. Condoms
C. Depot
D. Subcutaneous progesterone (the bar)
E. Mini pill

A

subcutaneous progesterone (the bar) because most permanent

-COCP and minipill requires too much remembering especially for this pt
-condoms requires partner cooperation
-depot is expensive and requires coming into GP

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15
Q

5 year old Thai tourist. Presents with fever, macular rash, conjunctivitis.
Now has white spots on buccal and pharyngeal mucosa. Parents have
been advised to not send her to daycare, when is she able to return?
A. 48 hours after penicillin
B. 5 days after onset of rash
C. When rash is gone
D. When rash has completely crusted over
E. When fever is gone

A

5 days after onset of rash

this is measles
- fever
- macular rash
- Koplick spots: white spots on buccal and pharyngeal mucosa

mx is wait 4-5 days after onset of rash to be in contact w/ ppl again

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16
Q

17 year old with cosmetically unpleasant acne. Currently doing daily
facial cleanses and topical benzyl peroxide. Has recently become sexually
active and uses condoms, but is interested in going on the “pill”.
Papulopustular acne on face, chest, neck, back. What is the most
appropriate next step in management?
A. COCP
B. Doxycycline
C. More intensive cleansing
D. Oral prednisolone
E. Refer to dermatologist for commencement of roaccutane

A

COCP

  • pt requested for it and it can also help with skin, already suing topical for acne and so this will supplement it and aid both her primary health concerns
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17
Q
  1. 60 y.o male was diagnosed with essential HTN, was already on beta
    blocker then had another med added for BP. Presented with SOB? showed
    ECG with bradycardia (no discernible p waves? - I thought I saw post-QRS
    inverted P-waves (junctional rhythm). what drug is most likely to have
    caused this:
    A. Verapamil
    B. Amlodipine
    C. Thiazide diuretic
    D. Nifedipine
    E. Enalapril
A

verapamil

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18
Q

30yo M, centrasl and L chest pain (pleuritic), mild fever, no SOB and ECG is shown

What’s the most likely diagnosis?
A. Acute pericarditis
B. Constrictive pericarditis
C. Acute myocardial infarction
D. Pulmonary embolism
E. Pneumonia

A

acute pericarditis

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19
Q
  1. 28 year old female presents to GP for first time requesting oxycodone.
    Reports congenital spondylolisthesis at L2/L3, normally takes oxycodone
    80mg BD but has forgotten script on holiday.
    O/E limping, lumbosacral tenderness on palpation. Muscle bulk
    symmetrical, normal tone, power, reflexes.
    What do you do? (class is unsure)
    A. Refer to emergency department
    B. Prescribe small quantity of drug until she sees her regular GP
    C. Prescribe smaller dose of drug
    D. Don’t prescribe drug
    E. Report to prescribing authority
A

B

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20
Q

Person on sertraline seeing lady dressed in white just before going to
sleep. No hallucinations during the day or any other things going on.
a. Hypnagogic hallucination
b. Sertraline side effect
c. Psychotic depression

A

HYPNAGOGIC HALLUCINATION

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21
Q

Vegan F pregnant, what additonal screening would you do during routine screening to ensure bub grows well?

A

B12

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22
Q

. Pregnant lady in first trimester, her child has chicken pox, she is IgG
negative for varicella. what do you do?
A. Reassure
B. Zoster immunoglobulin
C. Varicella immunisation
D. MMRV immunisation
E. Aciclovi

A

B??? WHY

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23
Q

. 70yo man, his wife is about to undergo CRTx for leukaemia. What
advice do you give him on which immunisation he should have to protect
his wife as she will be immunocompromised?
a. Rotavirus
b. zoster/varicella
c. Tetanus toxoid
d. Polio
e. Hepatitis A

A

zoster/ varicella

WHY

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24
Q

what is most appropriate mx?
Child, see image for rash, was from europe

A

diagnosis: impetigo

antibacterial cream

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25
Q

.Lady with headaches, frontotemporal and into neck, like a band across
the forehead sometimes radiating bilaterally to temples, having to take
panadol 2-3 times a week. otherwise well, no stressors mentioned but…
A. Tension headache
B. Migraine
C. Cluster headache
D. Haemorrhage
E. Medication overuse headache

A

tension headache

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26
Q

.Breastfeeding, painful left breast, red lump inner, upper quadrant.
Nurses told her to feed with both breasts, not getting better, non fluctuant
and has a fever of 38.5
What’s the next best initial step?
A. Empirical oral antibiotics (if just mastitis)
B. Feed with right breast only
C. Stop breastfeeding and give formula
D. U/S breast
E. Aspirate for culture (if abscess)

A

A (i don’t think it’s an abcess because the fever isn’t fluctuating but I’m not sure tbh)

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27
Q

Male who had unprotected sex 10 days ago with a random girl.
Small amount of yellow discharge. What do you give as empiric therapy?
a. Ceftriaxone IM
b. Azithromycin oral
c. Amoxicillin + Clavulanic acid
d. Ciprofloxacin

A

azithromycin oral

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28
Q

9-mo baby presents with distressing, tight cough associated with
vomiting, wheeze, widespread inspiratory crackles, fever, 91% sats
A. Asthma
B. Pertussis
C. Viral Bronchiolitis
D. Lobar Pneumonia

A

viral bronchiolitis

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29
Q

man comes back from malaysia- what is show on image? he is otherwise well

A

pityriasis versicolor

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30
Q

69 year old female who had 3 weeks of anorexia and weight loss.
Recently returned from travel in Bali . Was taking doxycycline for malaria
prophylaxis. 3 days ago developed jaundice, pale stool, dark urine.
LFTs
Elevated Bilirubin, ALP +GGT significantly elevated, ALT mildly elevated.
No AST result shown.
a. Pancreatic carcinoma
b. Viral hepatitis
c. Drug induced cholestasis
d. Choledocholithiasis
e. Liver abscess

A

pancreatic carcinoma

  • anorexia and weight loss= cancer
    -elevated bilirubin causing jaundice, pale stools and dark urine
  • only mildly elevated ALT meaning there is not much hepatocellular injury compared to …
    -… primary issue being elevated ALP and GGT indicating cholestasis
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31
Q

9.Old mate with knee OA waking him at night worse at end of day. What to
do
1. Paracetamol regular
2. NSAIDs regular
3. Corticosteroid injection

A

regular paracetamol

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32
Q

last year this pt had swollen 1st MTP which resolved slowly on its own. Now she presents to GP with same sx.s in wrist.
a. Gout
b. Reiters Syndrome
c. Rheumatoid arthritis
d. Psoriatic arthritis

A

GOUT

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33
Q

There was a question where a dude got bashed and underside of his
left eye was bruised and swollen and he had diplopia on upward gaze
Numbness over area beneath lower eyelid
Cause of diplopia?
a. Entrapment of inferior rectus with orbital floor fracture
b. superior oblique affected by haematoma
c. Damage to trochlear nerve with orbital fracture
d. Orbital swelling and bruising limiting eye movement

A

entrapment of inferior rectus w/ orbital floor #

Inferior rectus entrapment
- pts often present w/ vertical gaze diplopia and restriction of upward gaze

(makes sense that # is causing this because he got hit to underside of eye)

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34
Q

22yo F acute exacerbation of asthma. Previously well-controlled asthma on fluticasone and salbutamol. Self-ceased <1mnth due to minimal sx.s. Recently moved to new share house. Besides resuming puffers what else would you do in mx?
Management for this episode
a. Oral predisolone
b. LABA
c. LAMA
d. Montelukast
e. Dust-mite desensitisation injections

A

oral prednisolone

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35
Q

.Young guy on salbutamol, using multiple times a day, asthma not
affecting sleep, which extra medication would you put him on.
a. Low-dose ICS
b. High-dose ICS
c. LABA

A

low dose ICS

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36
Q

20 something year old girl, random abdo pain 2 weeks after first day of
LMP. Has like 3 partners. On COCP. Generally normal exam, no cervical
excitation, some adnexal tenderness on left. What is it
1. Mittelschmirtz
2. PID
3. Blagh
4. Red degeneration of fibroid
5. Early complication of follicular cyst

A

mittlescmrtz

37
Q

I think there was an ear question about a guy that had a bunch of
yellow discharge from his ear but could not visualise tympanic membrane ?
Tenderness on traction of pinna. Options were Abx drops, saline flush…?
Mastoiditis…?
a) Broad spectrum abx drops (pseudomonas)
b) Saline flush
c) Urgent referral to ENT surgeon

A

A

38
Q

21 year old medical student presents with fatigue and rubbery bilateral
lymphadenopathy. Abdo pain. 2 weeks ago had a sore throat. O/E has a
palpable spleen.

A

Infectious mononucleosis (EBV, kissing dx or glandular fever)

39
Q

.Dude comes back from business trip from N Africa. Profuse watery
diarrhea. Most likely organism?
a) Campylobacter
b) ETEC
c) Giardia
d) Schistosomiasis
e) Rotavirus

A

ETEC

40
Q

COPD pt, SOB deemed to have non-infective cause. On salbutamol. What else would you prescribe him?

A

LAMA/ LABA

41
Q

Oldish bloke with a past history of gout, gets a bit nervous with the doc
and has a BP measurement of 150/80ish and scores himself a pill, comes
back in with a swollen toe or something, which of the following
antihypertensive classes was the culprit.

a) ACEIs
b) Beta blockers
c) CCBs
d) L00p diuretics
e) Thiazide diuretics

A

thiazide diuretics

42
Q

14mo Boy come in for 12 months vaccination, failure to thrive (FTT) since birth
PC : fever 38.5, URTI 4 days, allergic to eggs
What is the most appropriate reason to not give vaccine today?
A. T of 38.5
B. Egg allergies
C. URTI
D. FTT

A

temp of 38.5

43
Q

39 yo F weighs 51 kg. Presents concerned about a lump in her left
breast and a lymph node in left axilla. Which of the following exam findings
are most suggestive of a breast cancer diagnosis?
A. Presence of two mobile 1 cm lymph nodes in the axilla
B. Dimpling of the skin over the lumps
C. Nipple inversion
D. Overlying redness
E. 2 cm elongated mass in the tail of the right breast

A

dimpling of skin overlying lumps

44
Q

A 70 year old female with a longstanding history of RA presents with a
2 days history of a swollen right knee. She is currently taking
hydroxychloroquinine, prednisolone and diclofenac. Her temp was 38.5 and
HR 112 beats per minute. The joint is warm, swollen and painful through all
movement. What is the most likely cause?

a. Exacerbation of RA
b. Gout
c. Osteoarthritis
d. Pseudogout
e. Septic Arthriti

A

septic arthritis (febrile, tachycardic and the jt warm, swollen and painful (isolated to one jt)

45
Q

After car collided with post, 27 yo male had a tibial fracture. Patient is
on the ortho ward and develops leg pain. This is worse on extension of big
toe. What is your initial management?
a. Elevate the leg
b. Review in 2 hours
c. Calf Fasciotomy
d. Increase analgesia
e. Compression bandage or something

A

this is describing compartment syndrome- calf faciotomy

46
Q

72yo, pianful swollen leg, previous DVT in same leg post tibia #, melanoma removed from same ankle few years ago

best initial mx?

A

looks like cellulitis: oral flucloxaccilin

47
Q

Abdominal x-ray, 1080p. Elderly lady with parkinson’s disease currently
taking L-dopa. PMHx appendicectomy age 20. DRE found firm faecal
matter in the rectum. Abdomen was distended
a. Sigmoid volvulus
b. Faecal impaction
c. Drug induced pseudo obstruction
d. Adhesion obstruction
e. Colorectal ca obstruction

A

faecal impaction??

48
Q

Male with back pain. Urea, creat and total protein HIGH, albumin and LOW, Hb not given, cCa 2.55, PSA 2

A

MM

(not met.s prostate cancer as this would affect bone= increased Ca and high PSA)

49
Q

5.What was that one about this old lady with a t score -2.5 something and
you had to decide what to give her? She had some vertebral fractures or
smth
Wedge fracture. Pain leaning forwards? Asking for most effective
therapeutic option
a. Calcium
b. Vitamin D
c. Bisphosphnates
d. Vertebroplasty
e. Smoking cessation

A

bisphosphonates

50
Q

F in 60s, PMHx of osteoA and osetoP, went buchwalk and presented to GP w. pain on lateral aspect of hip which radiated down lateral thigh. On palpation of this area: same pain was elicited. No hx of trauma. Full ROM active and passive.

a. Greater trochanteric syndrome
b. OA of hip
c. Regional pain syndrome
d. Hip fracture
e. Meralgia paraesthetica

A

greater trochanteric syndrome

51
Q

Something like most appropriate imaging for carpenter with 1 week of
back pain made worse by some movements. Pain with flex/extend/lateral
flex.
a. CT
b. MRI
c. Xray
d. No imaging
e. Reflexology

A

NO imaging

  • probably young healthy M, carpenter which makes it likely that it is a muscle strain or something most likely imaging would be waste.
52
Q

Older F, b/g bipolar on sertraline and Li
Diabetes
Last few days: ataxic w/ wide-based gait. Tremor when tryign tot ouch your finger. Confuse.
Urine: pale yellow and otherwise clear on dipstick

what is most likely?

  1. Lithium toxicity
  2. Hyponatraemia
  3. Parkinsonism
  4. Neuroleptic malignant syndrome
  5. Serotonin syndrome
A

Li toxicity

53
Q

Older M, headache, myalgia, weight loss, trying to eat and maintain weight. Can’t leave house, sleep disturbances: walking at night.
Slowness to initiate motor movements on instruction (slow to respond to instruction)

A. MDD
B. Polymyalgia rheumatica
C. Hypothyroidism
D. Parkinsons prodrome
E. Head injury

A

parkinson’s prodrome

54
Q

21 year old female, history of irregular periods (5-8wks),comes in to ED
with lower abdominal pain and PV bleeding, LMP 6 weeks ago. HR 130,
RR 20, BP 80/50.
What is the most appropriate next step?
A. Suction D+C
B. IV fluids
C. Quantitative beta HCG
D. Transvaginal Ultrasound
E. Speculum Examination

A

IV fluids

  • probably ectopic or miscarriage maybe?? regardless she is hypotensive and tachycardia so give IV fluids as initial mx
55
Q

26yo female, has always had irregular periods (2-8 weeks). Not
currently sexually active. Fine downy facial hair and dark arm hair. BMI 26.
a. PCOS
b. Anovulatory cycle
c. Hypothyroid
d. Androgen secreting tumour

A

PCOS

56
Q

Pain w/ should abduction 60-130 degrees- most likely cause?

A

rotator cuff injury

57
Q

Lady with a non healing wound after a scratch in the garden, burnt
same area as a child that didn’t require a graft. Cause of the wound
A. BCC
B. SCC
C. Kaposi sarcoma
D. Angiosarcoma

A

SCC

58
Q

22 year old female comes in asking for the “morning after pill”.
What is the most important thing you need to know for appropriate
prescribing?
a. History of atypical migraine
b. History of thrombosis
c. History of pregnancies
d. Last day of 1st menstrual period
e. Timing from last unprotected sexual intercourse

A

timing from last unprotected sexual intercourse

59
Q

21yo pregnant lady 30/40 has history of periumbilical pain for 12 hours
that has now localised to the right side above the umbilicus. Febrile (?37.8°
, fundal height 31cm, uterus soft,
foetal HR 160bpm. What’s the most likely diagnosis?
a. Acute appendicitis
b. Placental abruption
c. Pyelonephritis
d. Cholecystitis

A

acute appendicitis

60
Q

25 year old lady, has 3 children and last gave birth 6 months ago.
Presents for antenatal visit, currently 10/40. Microcytic anaemia, normal
WCC and platelets. What’s caused it.
a. Thalassaemia
b. Fe deficiency anaemia
c. Pernicious anaemia
d. Folate deficiency
e. Coeliac disease

A

Fe deficiency anaemia

61
Q

12 mo baby with easily reducible rectal prolapse. Fussy feeder. Hx of a
few chest infections requiring antibiotics. Intermittent loose stools.
Generalised lung crackles on auscultation
a. Crohns
b. Cystic fibrosis
c. Gastroenteritis
d. Coeliac

A

CF

more mucus production= loose stools maybe, chest ix (susceptible)

62
Q

52 year old lady, upon checking sugar book, number of episodes of BSL
down to 3.5. Does not recall any symptoms during these episodes.
Currently on metformin, ACE inhibitor, Beta blocker, spironolactone
Which of these drugs would you cease to make her aware of the
hypoglycaemic episodes?
A. Metformin
B. ACE Inhibitor
C. Beta blocker
D. Spironolactone

A

B blocker

why?

63
Q

Male w/ dizzy spells. (vertigo) worse when looking up in bed. What would you do to confirm diagnosis?

A

Hallpike manoeuver

Probably BPPV

64
Q

5yo M, 2day hx of n+v, thirsty yesterday and had little amounts of fluid today. Large amounts of diarrhoea this morning. Mum unsure about urine output. Appears irritable.
100vpm, RR30, BP 90/50, cap refill <2seconds and has midly reduced skin turgor.

What is the most appropriate management?
A. IV 0.9 Saline infusion
B. IV 0.45% Saline infusion +2.5%dextrose
C. Oral Loperamide
D. Oral Ondansetron
E. Oral rehydration sachets

A

Oral rehydration sachet

goal is rehydration and the child is not unwell enough for IV- remember unwell child. Irritabel is good in a way because it indicates child is not THAT unwell or too critical. Indication for IV might be something like: child looks tired/ sleepy, skin pale, cap refill >2 seconds, sig. reduced skin turgor

65
Q

6 y.o. girl with hereditary spherocytosis. Had an URTI+fever 6 weeks
ago which lasted for 3-4 days. Now presents with obvious pallor. Afebrile,
not jaundiced, spleen palpable, soft systolic murmur at left sternal edge. Hb
46, retics low (0.1), other parameters normal.
What should be the immediate management?
a. Ferrous gluconate
b. Folic acid+1
c. Packed cell transfusion
d. Prednisolone
e. Splenectomy

A

C

question says IMMEDIATE mx so C is what I went with
for hereditary spherocytosis
- folic acid supplements
- red cell tranfusion
-splenectomy for severe cases

66
Q

6 month old boy, presents with 2 weeks history of swollen groin. Nil
other symptoms. Unable to illicit any lumps during examination but
testicular cord on the right was thicker than left. What is your next
management.
1. arrange ultrasound of scrotum and testis
2. Surgical referral for hernia repair
3. Come back when lump reappears
4. Send home

A

arrange US

67
Q

26 year old female presents with 4 suicide attempts by pills in the last
12 months after a breakup from a relationship lasting 6 months. She had a
past history of unstable relationships, alcohol abuse, binge eating etc.
A. Borderline
B. Bulimia
C. dysthymia
D. factitious disorder
E. Schizophrenia

A

borderline

68
Q

32y/o pregnant lady (10/40) presented for routine serology etc. What
immunisations are appropriate to give in pregnancy
A. Influenza and pertussis
B. MMR + pertussis
C. MMR + varicella
D. Pertussis +varicella
E. Influenza + MMR

A

influenze and pertussis

69
Q

Middle aged lady present to GP with headaches, generalised aches,
and vague abdominal pain. All physical examinations and investigations
have been normal. She came from Bosnia as a refugee a few years ago.
Upon further questioning of her past, she did not want to share more
information and became guarded. What is the likely diagnosis ?
A. Trauma from her past
B. Language difficulties
C. Psychotic illness (emerging)
D. Depression

A

A

70
Q

41 year old married woman presents to GP for “easy bruising”. She has
depression and OA on sertraline and aspirin. On examination she has
multiple bruises on upper arm and thigh. she couldn’t explain the causes
other than “a few bumps here and there”. What is the most likely cause for
her bruising?
A. Domestic violence
B. myeloproliferative disorder
C. self injury
D. aspirin

A

A

71
Q

85 year old man, background of T2DM and HTN, BP 145/70, new
presentation of AF on ECG pulse 80bpm. Asymptomatic and doing well.
What do you do about his AF
A. Cardioversion
B. Aspirin
C. Rivaroxaban
D. Clopidogrel
E. Do nothing

A

rivaroxaban

Factor Xa inhibitor (anticoagulant)- inhibit clot formation and reduce risk of stroke ect.

72
Q

Women treated for 10 years for anxiety and distress thinking that her
neighbours were out to get her. Saw doctor and was given a medication.
Presented 6 months later with chest pains, palpitations, and shortness of
breath. What was the medication given?
a. Clozapine
b. Aripiprazole
c. Olanzapine
d. Quetiapine
e. Risperidone

A

clozapine

73
Q

21 Year old spent the WHOLE day at her 21st bday party in summer. she presents with acute confusion, 40C, HTN, tachycardic,
jerky eye movements, ataxia, ?hyperreflexia, many other things. what
caused her presentation.
A. MDMA toxicity
B. Heat stroke
C. Dehydration
D. hyponatremia
E. Pathological alcohol intoxication

A

MDMA toxicity

74
Q

Postpartum woman about to be discharged after a still-birth. She is
about to be discharged later today but the nurses report that she is teary
and feeling quite upset. What is the best initial management?
a. Delay discharge
b. Supportive counselling
c. Psych review
d. Supportive management

A

A and B????

75
Q

75F who was taking fluoxetine. The fluoxetine was ceased and after 10
days. She has been started on sertraline. She is also taking L-tryptophan
for sleep. She presents with confusion, dizziness, nausea, sweating …
A) Serotonin syndrome
B) Dehydration
C) Neuroleptic malignant syndrome
D) Antidepressant withdrawal syndrome
E) Alcohol intoxication

A

serotonin syndrome

76
Q

A previously well 60 y/o came in bought in by police during the middle
of the night. Agitated and whatnot. Saying that ‘this is a prison’, and ‘knows’
that you are going to kill him. Can see that the colours are moving into
shapes.
A. Delirium
B. Ischaemic stroke
C. Head injury
D. Delusional disorder
E. Schizophrenia

A

Delerium

77
Q

Lady presented to her GP requesting weight loss medication. Used to
be very boses. Had lost 30kg in the last 2 years, current BMI 23, cried
when she was being weighed. Avoided telling about her diet, but admitted
to using laxatives and exercising every day after work.
A. Bulimia nervosa
B. Depression
C. OCD
D. Body dysmorphic disorder
E. Eating disorder otherwise not-specified

A

bulimia ????

78
Q

A woman is concerned about her 19-year-old daughter who is a University
Student. She has an exam in 2 weeks and stopped studying 1 month ago.
She has recently become vegetarian. She has been having long showers
at night to drown out a tapping noise that she believed her neighbours are
deliberately making to keep her up at night.
A. Delusional disorder
B. Delirium
C. First episode of psychosis
D. Depressive episode
E. Tinnitus

A

first episode of psychosis

79
Q

44yo male previously diagnosed with schizophrenia. Complaining that his
neighbour is poisoning the water. Has raised this with the police who
dismissed the issue. Believes no one is listening to him. Wants to pay his
neighbour a visit today. Is agitated and angry when talking to him. What is
your management?
A. Anger management therapy
B. Liaise with police
C. Arrange hospital admission
D. Talk to the neighbour
E. Reassure patient

A

arrange hospital admission

80
Q

Mum concerned, brings in 14 yo son who’s in trouble at school for
swearing, disruptive, grunting, being a nuisance. Well-behaved at home.
Also gets bullied for blinking lots, doesn’t have any friends. Is fine at home,
kinda distressed by all this. Dad had similar issues when he was in school,
dropped out.
A. Autism
B. ADHD
C. Adjustment disorder
D. Tourettes
E. Conduct disorder

A

tourettes- (he would be doing this stuff at home if it were autism,
tourette’s can be triggered by social interaction)

81
Q

Head CT (concave bleed) 22yo man. Right pupil larger than the
left…fell of a first floor balcony, smells of alcohol.
a. Extradural haematoma
b. Subdural haematoma
c. Subarachnoid haemorrhage
d. Intracranial haemorrhage
e. Ventricular haemorrhage

and why

A

extradural haematoma

82
Q

57 y/o female with severe myopia. 4 day history of increased floaters in the
R eye. Describes them like ‘large house-flies flying in her vision’. On
fundoscopy, there was vitreous debris and white fibrous ring’. Current vision
6/18 and 6/6.
A. Acute uveitis
B. Idiopathic floaters
C. Retinal detachment
D. Vitreous haemorrhage
E. Acute angle glaucoma

why

A

vitreous haemorrhage

  • Painless, unilateral floaters +/- visual loss
    -early haemorrhage may be described as haze, red hue, floaters, cobwebs, shadows
  • boat-shaped haemorrhage can be seen on slit-lamp
83
Q

60 year old male, one month history of painless swelling in L tonsil region.
30 pack year history, 3 drinks daily.
O/E firm non tender mass in L tonsillar region.
A. Non-hodgkins lymphoma
B. Metastatic lymph node deposit
C. Primary squamous cell carcinoma
D. Nasopharyngeal Carcinoma
E. Carotid body tumour

A

primary SCC

84
Q

6wk boy presents with irritability, vomiting and reduced feeding. O/E
abdomen slightly distended and a tender lump in groin.
What is the most likely diagnosis?
A. Femoral hernia
B. Inguinal lymphadenitis
C. Strangulated inguinal hernia
D. Testicular torsion
E. Undescended testis

A

strangulated inguinal hernia

85
Q

Questions 91-93 Options:
● CMV
● Hep B
● HIV
● Parvovirus B19
● Rubella
● Syphilis
● Varicella
● Zika
91. Mother is infected at 16 weeks, baby is born with limb abnormalities and skin
scarring.
92. Foetal anemia and hydrops.
93. Congenital cataracts, congenital heart defects, hearing loss, microcephaly.

A
  1. varicella
  2. parvovirus B19
  3. rubella
86
Q

When to start investigating if they haven’t met these milestones
● 3 weeks
● 6 weeks
● 3 months
● 6 months
● 9 months
● 12 months
● 18 months
● 2 years
● 3 years
● 4 years
● 5 years

  1. Walking alone
  2. Running
  3. Sitting with support
  4. Smiling
  5. 3 word phrases
  6. Responds to own name
  7. Interactive play with peers
  8. Pull to stand
  9. Says ‘Mum’ and ‘Dad’ with meaning
  10. Pincer grip
A
  1. 18 months
  2. 3 years
  3. 9 motnhs
  4. 6 months??
  5. 4 years
  6. 9 months
  7. 5 years
  8. 12 months
  9. 2 years
  10. 12 months
87
Q

what salter harris classification is this?

A

2- above epiphyseal plate

88
Q
A

Year 4 exams (8 decks)

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