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Recalls lubi > Feb Part 2 2024 > Flashcards

Feb Part 2 2024 Flashcards

1
Q

Post-op patient on PCA fentanyl, feels nauseated but no pain, next step?

A

Reduce dose

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2
Q

Labour progressing normally, multiparous, pulsating cord felt in vagina at full dilation, station +2, next step?

A

Commence active pushing

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3
Q

Informed consent taken for laparoscopic removal of gallstones, surgery done by consultant, next step?

A

Proceed with surgery as planned

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4
Q

Woman tearful a week after 2-year anniversary of mother’s death, sees mother in dreams, diagnosis?

A

Bereavement

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5
Q

Patient with blunt trauma to eye, severe pain, hyphema present, next step while waiting for ophthalmology?

A

Eye patch

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6
Q

22-year-old man with dysphagia worse with solids than liquids, regurgitation at night, history of eczema?

A

Esophagoscopy

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7
Q

Patient in ED after home destroyed by fire, calms down after 2 hours, can’t remember past few hours, diagnosis?

A

Transient global amnesia

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8
Q

Best study design to assess drug efficacy by intern?

A

Randomized Controlled Trial (RCT)

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9
Q

Obese female with cellulitis on abdomen, best antibiotics?

A

Ampicillin + Clavulanate

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10
Q

Right mastitis, advises feeding every 4-6 hours, next step?

A

Increase frequency of feeding

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11
Q

Patient on oxycodone for back pain, using heroin for better pain control, next step?

A

Tail off oxycodone, prescribe benzodiazepines, and perform urine drug test

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12
Q

Aboriginal girl with recurrent sore throats and hematuria, next investigation?

A

ASO titre

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13
Q

8-week pregnant woman with severe vomiting, dehydration, ketones +++, treatment?

A

IV fluids and antiemetics; consider steroids

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14
Q

Medical student caught taking pictures of patient records, you are an intern, next step?

A

Confront the student and report the incident

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15
Q

25-year-old female post-laparotomy for appendicular mass, started TPN, low magnesium and phosphate, cause?

A

Refeeding syndrome

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16
Q

Patient with rhinorrhea, sneezing, allergic to carpet mites, treatment?

A

Fluticasone nasal spray

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17
Q

U/S shows small kidneys, indicating chronic kidney disease, what confirms chronicity?

A

Ultrasound finding

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18
Q

72-year-old woman with bilateral knee pain and effusion, controlled on PCM, appropriate management?

A

Progressive resistance training

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19
Q

10-year-old girl with dysphagia for chicken nuggets, complaint for 7 months, diagnosis?

A

Psychological feeling

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20
Q

Elderly patient with bowing of legs, diagnosis?

A

Paget’s disease

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21
Q

6-month-old baby with 1 cm umbilical hernia, color changes, next step?

A

Refer to emergency

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22
Q

Chronic HCV positive mother at 20 weeks POA, asking about breastfeeding?

A

It is safe to breastfeed

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23
Q

Soccer player with head impact, brief LOC, wants to play again, next step?

A

Need observation for 24 hours

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24
Q

18-year-old girl with recurrent UTIs, last culture E. coli, best step before treatment?

A

Partner penile swab

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25
Q

Woman with psychosis, refuses ECT, believes intestines disappear, what to do?

A

Seek husband’s consent and tribunal permission for ECT

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26
Q

16-month-old with vomiting, diarrhea, seizure, Na 119, Cl 79, next investigation?

A

Urine osmolality and Na

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27
Q

DM patient on metformin 2g, BMI 30, poor control, HbA1c 8.3, wants to lose weight, frequent UTIs?

A

Exenatide

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28
Q

HIV patient started ART, husband present, best safety option for husband?

A

Start on HIV prophylaxis

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29
Q

Chinese mother with English-speaking son, memory loss, MMSE 22/30, next step?

A

Chinese MMSE

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30
Q

24-year-old healthy male with hemoptysis, mild SOB, no travel, normal exam, next step?

A

D-dimer

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31
Q

35-year-old male with flank pain, macroscopic hematuria, 2cm radiolucent stone, no hydronephrosis, next step?

A

Extracorporeal shock wave lithotripsy (ECSW)

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32
Q

58-year-old woman with perimenopausal symptoms on HRT for 8 years, no symptoms now, next step?

A

Cease HRT

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33
Q

Woman with occipital headache, nausea, vomiting for 3 months, positive pass pointing test, next investigation?

A

CT brain

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34
Q

Elderly woman with COPD, acute confusion post-party, fever, basal crackles, cause?

A

UTI

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35
Q

Hemorrhoid with bluish anal verge, pain post 48 hours, treatment?

A

GTN surgery

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36
Q

Man in CHF, initial management?

A

ACE inhibitor

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37
Q

Man with claudication pain only in calf, absent pulses, affected artery?

A

Popliteal artery

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38
Q

Intern assessing diet in arthritis patients, strongest study design?

A

Meta-analysis

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39
Q

18-year-old female with PMS, irritability, insomnia, most appropriate treatment?

A

Fluoxetine

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40
Q

Impetigo case, when to report to school?

A

After initiating treatment

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41
Q

Young girl with bee sting, urticaria rash, severe itchiness, treatment?

A

Oral promethazine

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42
Q

Male working in animal center with fever, chills, discharge from axillary lump, diagnosis?

A

Hidradenitis suppurativa

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43
Q

Treatment of pancreatic pseudocyst, 3mm thin wall, presents with abdominal discomfort?

A

Observe

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44
Q

Woman in labor, how to determine if labor is established?

A

More frequent contractions and cervical dilation

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45
Q

Ankle sprain in pregnancy, treatment?

A

Ice

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46
Q

Postpartum woman with depression, constantly checking baby, previous depression history, needs management?

A

Previous history of depression

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47
Q

16-year-old girl with Factor V Leiden heterozygous, best contraceptive apart from condom?

A

Progestin-only pill (POP)

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48
Q

Man concerned about prostate cancer, father diagnosed at old age, next step?

A

PSA test

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49
Q

40-year-old male with C4-5 injury, MDD, on opioids, flushed face, sweating, BP 170/95, PR 50, cause?

A

Autonomic dysreflexia

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50
Q

64-year-old male with lung cancer post-radiation, SOB, inflammatory shadow on CXR, next treatment?

A

Prednisolone

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51
Q

32-year-old obese female, stopped previous drug due to nausea, BMI 32, already has dietician, next step?

A

Liraglutide

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52
Q

16-year-old girl starting sodium valproate, likely side effect to stop treatment?

A

Weight gain

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53
Q

Schizophrenia patient on risperidone, bilateral breast galactorrhea, prolactin 1120, cause?

A

Risperidone

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54
Q

Radiation exposure comparison, X-ray to CT?

A

20%

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55
Q

Feeling disturbed in mall, needs to start drug, what to ask in history?

A

Cannabis use

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56
Q

Teen girl with ataxia, sensory loss, upward plantar reflexes, diagnosis?

A

Friedreich’s ataxia

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57
Q

Truck driver with sleep apnea, day somnolence, financial problems, wants to drive, next step?

A

Drive after sleep specialist consultation

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58
Q

68-year-old man with right-left confusion, apraxia, can’t write or do math, likely lesion?

A

Left parietal glioblastoma

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59
Q

Elderly man with hearing loss, audiogram shows decreased hearing at high frequencies, cause?

A

Age-related hearing loss

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60
Q

Post-menopausal woman on denosumab with T-score -2.5 (sacral) and -3 (femoral), next step?

A

Alendronate

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61
Q

ECG shows digoxin toxicity, no cardiac arrest, next step?

A

stop digoxin Administer digibind (digoxin-specific antibody)

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62
Q
  1. MVA, 31yr female, USS 2.2 cm splenic artery aneurysm, other parameters ok, other injuries excluded
A

Splenic artery embolization

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63
Q
  1. Boy, 7 years old, bitten by a bat. Management?
A

Post-exposure rabies vaccine

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64
Q
  1. Girl comes to collect prescription for Risperidone for her boyfriend with schizophrenia, unable to visit due to work
A

Provide the prescription after obtaining verbal consent from him via a phone call

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65
Q
  1. 6-week baby, cough while feeding and mild increased work of breathing when breastfeeding. Next?
A

Referral to cardiology

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66
Q
  1. Crescendo-decrescendo murmur - cause?
A

Aortic stenosis

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67
Q
  1. 50-year-old lady, no significant medical history, not on HRT, breast lump 2 cm, mammogram shows dense breast tissue, USG shows cystic lesion. Management?
A

FNAC

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68
Q
  1. Action if a doctor wants to enter a relationship with a current patient?
A

Unethical

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69
Q
  1. URTI not responding to antibiotics, bronchoscopy shows Masson body. Treatment?
A

Steroid

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70
Q
  1. 16-year-old girl with depressive symptoms, self-injury behavior, denies suicidal thoughts, multiple antidepressant use, asks not to inform parents
A

Voluntary admission

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71
Q
  1. Elderly with AF, ECG HR 88, multiple comorbidities, asymptomatic, BP 145/90, eGFR 35, on aspirin, atorvastatin, and metformin
A

Rivaroxaban

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72
Q
  1. 50-year-old lady admitted for uncomplicated Colles fracture, after 3 days of admission, agitated, sweaty, confused with visual hallucinations. Cause?
A

Alcohol withdrawal

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73
Q
  1. Substance used in pregnancy associated with decreased risk of congenital birth defects?
A

Iodine

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74
Q
  1. Patient with gambling issue, initial treatment?
A

CBT

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75
Q
  1. 32-year-old female considering Mirena, currently using condoms, no medical history, heavy menses, prefers Mirena over pills due to forgetfulness
A

Pregnancy rate is less than 0.1%

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76
Q
  1. Depuytren contracture of hand, next investigation needed to diagnose?
A

No investigation

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77
Q
  1. 18-month-old child, URTI with clear nasal discharge, red enlarged tonsils, multiple cervical lymph nodes enlarged. Cause of infection?
A

Normal childhood URTI

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78
Q
  1. Newly diagnosed HIV patient, CD4 150, management?
A

TMP-SMX prophylaxis

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79
Q
  1. Patient with RA on MTX develops pneumonia and rash, COVID negative, precaution type?
A

Droplet

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80
Q
  1. 14-year-old female with MDD on fluoxetine, mother concerned about SSRI addiction
A

Reassure the mother about fluoxetine safety for long-term use

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81
Q
  1. Elderly female, confusion after learning about a fire, later improves but can’t remember event details, aware of husband, date, and day but not time
A

Transient global amnesia

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82
Q
  1. Elderly female, urine exam shows 20 WBC, culture E. coli, no symptoms
A

No treatment

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83
Q
  1. 50-year-old male with right shoulder pain, restriction of abduction, partial benefit from intraarticular steroid, next recommendation?
A

Arrange physiotherapy

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84
Q
  1. Child with swelling, pain in left eye, high fever, cannot open eye
A

IV flucloxacillin

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85
Q
  1. Child with URTI, symptoms of rheumatic heart disease, arthritis, murmur, fever, confirmation test?
A

ASO titre

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86
Q
  1. Manager with work delay, study postponement, organizational difficulties, poor concentration, symptoms after an event 3 months ago, diagnosis support?
A

Anxious and fidgeting appearance

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87
Q
  1. Elderly female with colicky abdominal pain, distension, now constant pain, vitals stable
A

Sigmoid volvulus

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88
Q
  1. Elderly female with persecutory delusions towards neighbors
A

Persecutory delusions

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89
Q
  1. Somalian patient, cough, hemoptysis, SOB for 3 months, heavy smoker, weight loss, X-ray shows right upper lobe haziness, sputum culture and AFB sent
A

Mantoux test

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90
Q
  1. Postpartum mother, anorexia, not feeding baby much, lack of sleep, baby sleeping 6 hours at a time
A

Postpartum depression

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91
Q
  1. 22-year-old man with strange behavior, speech, isolation, aggression, failure in school, shouts at family
A

Schizophrenia

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92
Q
  1. Photo of eye with matted lashes, discharge, normal cornea, no hyphema, management?
A

Cleaning and antibiotics

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93
Q
  1. 4-year-old boy with nocturnal enuresis, no constipation, eats well, next step?
A

Fasting blood sugar and urinalysis

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94
Q
  1. 45-year-old man with bilateral tender breast swelling, alcoholic, on Ranitidine, bilateral parotid swelling, leukoplakia, scrotal swelling
A

Alcoholic liver disease

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95
Q
  1. Elderly patient with dizziness, multiple drugs (metoprolol, ramipril, indapamide), HR 56, BP 90/60, cause?
A

Metoprolol

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96
Q
  1. Elderly female with type 1 DM, recent hypoglycemic attack, advice on driving?
A

Don’t drive for 6 weeks

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97
Q
  1. 18-week period of amenorrhea, tremor, palpitations, high TSH, next step?
A

Check thyroxin level

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98
Q
  1. Patient with vomiting, abnormal behavior, staring at ceiling, dystonia
A

Benztropine

99
Q
  1. Aged patient in residential care, post-menopausal bleeding, dislikes vaginal examination
A

Abdominal ultrasound

100
Q
  1. Post-menopausal female on HRT for 8 years, no complaints, initially started for hot flushes
A

Cease HRT

101
Q
  1. P3C2 mother in 3rd pregnancy, 12 weeks, previous large babies, all uncomplicated, next check?
A

Glucose tolerance test

102
Q
  1. Female, routine antenatal visit, Hb 9, MCV 70, not vegetarian, next step?
A

Hb electrophoresis

103
Q
  1. Waldenstrom macroglobulinemia with myelodysplastic syndrome, develops rash on ampicillin for pneumonia
A

Stop ampicillin

104
Q
  1. 33-week pregnant lady with vaginal bleeding, abdominal pain, BP 145/90, urine dipstick +prot, +RBC, previous preterm labor due to preeclampsia, preclude tocolysis?
A

Vaginal bleeding

105
Q
  1. Skin mass excised with clear margins, biopsy shows melanoma 0.6mm thickness, next step?
A

Further excision

106
Q
  1. Child with fever, irritability, cough, dyspnea, crepitations, CXR with 2 lesions showing fluid level
A

Clindamycin + Ceftriaxone

107
Q
  1. 55-year-old DM female with recurrent cellulitis in left leg, healed now, varicosities, tinea infections between toes, major factor causing problem?
A

DM

108
Q
  1. RTA patient with GCS 6/15, heavy beard, BP 100/75, RR 9, SaO2 88, initial step?
A

Shaving the beard to ensure mask ventilation

109
Q
  1. Patient with BP 90/60, PR 105, next step?
A

Put on left lateral position

110
Q
  1. Midline neck mass 1cm, important step for diagnosis?
A

Tongue extrusion

111
Q
  1. Patient with cellulitis treated with cefazolin, develops macular drug reaction, future avoidance?
A

All penicillins and cephalosporins

112
Q
  1. 8-year-old child with isolation, tantrums, normal language, good eye contact, aligns dolls, screams occasionally
A

Autism spectrum disorder

113
Q
  1. Female with gradual loss of superior quadrants of visual fields
A

Temporal lobe tumor

114
Q
  1. 4-month-old baby not gaining weight, dusky mouth, systolic murmur
A

TOF

115
Q
  1. 24-year-old post-laparoscopic cholecystectomy, severe shoulder tip pain
A

Ultrasound abdomen

116
Q
  1. Female in labor, slow progression, oxytocin started, deceleration on CTG, 6cm dilation with caput and molding, baby’s part 1cm above pelvic rim
A

Stop oxytocin

117
Q
  1. Labor case with ROM, meconium stained, no deceleration on CTG, +1 station, good contraction and effacement, 7cm dilation
A

Continue CTG

118
Q
  1. Crusty hyperpigmented lesion over earlobe
A

SCC

119
Q
  1. 10-year-old aboriginal boy, ear discharge, tympanic membrane dull and retracted, greenish nasal discharge
A

Cholesteatoma

120
Q
  1. Patient on oxycodone for back pain, recently started heroin for uncontrolled pain
A

Check urine drug level

121
Q
  1. Boy worried about body image, thinks shoulders are too narrow, joined gym, still dissatisfied
A

Body dysmorphic disorder

122
Q
  1. 12-year-old girl with head lice, visible eggs, permethrin given but still lice present
A

Use lice comb, repeat permethrin

123
Q
  1. Chronic schizophrenic patient not listening to questions
A

IM haloperidol

124
Q
  1. 12-year-old child, shortest in class, height at 3rd percentile, weight at 10th percentile, TSH elevated, low FT4
A

Thyroxine

125
Q
  1. Child with vomiting and diarrhea, treated for UTI 3 months ago, weight 10th percentile, vitals stable, most likely diagnosis?
A

UTI

126
Q
  1. Patient on OCP, newly diagnosed with RA, suitable drug for RA treatment?
A

Sulfasalazine

127
Q
  1. Elderly with nausea and vomiting, visual hallucination, multiple medications including digoxin
A

Digoxin toxicity

128
Q
  1. Patient with exertional breathlessness, pulse rate 100, BP 150/90, eGFR 35, Hb 105, next step?
A

Blood transfusion

129
Q
  1. Elderly female with pain in breast after menopause, skin biopsy shows orange pigment around dermal blood vessels, dense lymphocytic infiltrate, next step?
A

Treatment with steroids

130
Q
  1. 3-week baby with jaundice, weight loss 8% after birth, HR 150, BP 60/40, jaundice not cleared after phototherapy, next step?
A

Review breastfeeding technique

131
Q
  1. 3-year-old child with high fever, rash after 3 days, red eyes, no coryza, conjunctivitis, red tongue
A

Kawasaki disease

132
Q
  1. Elderly male with advanced pancreatic cancer, requires pain control, best management?
A

Oral morphine

133
Q
  1. Asthma patient with multiple inhaler use, no control, next step?
A

Check adherence

134
Q
  1. Elderly patient with bilateral eye inflammation, treated for multiple allergic conditions, no improvement, on prednisolone 10 mg, multiple anti-histamines
A

Biopsy

135
Q
  1. Teenage girl with vaginal bleeding, one episode of heavy bleeding, no other bleeding disorder
A

Oral contraceptive pill

136
Q
  1. Pregnant lady in 3rd trimester with painful rash over upper chest, no vesicles
A

Pemphigoid gestationis

137
Q
  1. Man with difficulty seeing road signs at night, low vitamin A
A

Night blindness

138
Q
  1. Postmenopausal woman with endometrial thickness 3mm, high prolactin, galactorrhea
A

MRI brain

139
Q
  1. Elderly male with hip pain, right foot 4cm shorter, traumatic injury, no other significant history
A

Open reduction and internal fixation

140
Q
  1. Boy with swelling and fever, history of trauma
A

Osteomyelitis

141
Q
  1. Girl with irritability, constipation, abdominal pain, PICA, family member with similar symptoms
A

Lead poisoning

142
Q
  1. Patient in ICU with history of hemorrhagic stroke, develops sudden collapse
A

Subarachnoid hemorrhage

143
Q
  1. Patient with left-side weakness, anosognosia, constructional apraxia, preserved comprehension
A

Right MCA stroke

144
Q
  1. Elderly patient with colonoscopy showing adenocarcinoma, CT shows no metastasis, next step?
A

Surgery

145
Q
  1. Female with dizziness, difficulty walking, headache, vomiting, diplopia, vertical nystagmus, next step?
A

MRI brain

146
Q
  1. Elderly patient with aortic stenosis, significant pressure gradient, next step?
A

Valve replacement

147
Q
  1. Patient with chronic back pain, opioid dependence, next step?
A

Buprenorphine

148
Q
  1. Patient with COPD, worsening breathlessness, increased sputum, SaO2 88, PaO2 60, next step?
A

Low-dose oxygen therapy

149
Q
  1. Male with difficult-to-treat psoriasis, long-term alcohol use, new lesions on legs
A

Liver function test

150
Q
  1. Female patient with cough, dyspnea, high-pitched inspiratory noise, no fever, normal oxygen saturation
A

Vocal cord dysfunction

151
Q
  1. Patient with chronic kidney disease, recent increase in serum creatinine, new antihypertensive started
A

Stop antihypertensive

152
Q
  1. Teenage girl with abdominal pain, tender palpable mass in the right lower quadrant, fever, next step?
A

Laparoscopy

153
Q
  1. Elderly male with DVT, on warfarin, INR 4.5, no bleeding, next step?
A

Stop warfarin for 2 days

154
Q
  1. Pregnant lady with fever, rash, myalgia, conjunctivitis, lymphadenopathy, confirmed Zika infection
A

Ultrasound and amniocentesis

155
Q
  1. Elderly patient with T2DM, GFR 35, HbA1c 8%, on metformin, next step?
A

Add DPP-4 inhibitor

156
Q
  1. Young male with epigastric pain, radiating to back, elevated lipase, history of binge drinking
A

Pancreatitis

157
Q
  1. Young female with chronic fatigue, arthralgia, low-grade fever, positive ANA, next step?
A

Anti-dsDNA and C3/C4

158
Q
  1. Elderly male with progressive memory loss, urinary incontinence, gait disturbance
A

Normal pressure hydrocephalus

159
Q
  1. Middle-aged female with recurrent UTI, next step?
A

Postcoital voiding

160
Q
  1. Young female with recurrent vulvovaginal candidiasis, no diabetes, normal immune status
A

Antifungal therapy

161
Q
  1. Elderly male with chronic heart failure, ejection fraction 25%, not responding to medications, next step?
A

Cardiac resynchronization therapy

162
Q
  1. Middle-aged male with severe acne, failed multiple treatments, isotretinoin considered, next step?
A

LFT and lipid profile

163
Q
  1. Pregnant lady with history of venous thromboembolism, next step?
A

Low molecular weight heparin

164
Q
  1. Elderly female with frequent falls, dizziness, orthostatic hypotension, on multiple medications including antihypertensives
A

Review medication list

165
Q
  1. Middle-aged male with hypercalcemia, low PTH, history of lung mass, next step?
A

PTHrP assay

166
Q
  1. Female with headache, visual disturbances, elevated prolactin
A

MRI brain

167
Q
  1. Young male with sore throat, fever, splenomegaly, atypical lymphocytosis
A

EBV serology

168
Q
  1. Elderly patient with hypertension, hyperlipidemia, diabetes, low ankle-brachial index
A

Peripheral artery disease

169
Q
  1. Middle-aged male with new onset AF, stable vitals, next step?
A

Anticoagulation therapy

170
Q
  1. Young female with shortness of breath, pleuritic chest pain, D-dimer elevated
A

CT pulmonary angiography

171
Q
  1. Elderly male with dysphagia, weight loss, barium swallow shows filling defect
A

Esophagogastroduodenoscopy

172
Q
  1. Middle-aged female with pruritus, jaundice, elevated bilirubin, ALP, GGT
A

MRCP

173
Q
  1. 48-year-old man drinks 12 standard drinks daily after work, denies withdrawal symptoms. What are you going to do?
A

Motivational psychotherapy

174
Q
  1. Patient from Vietnam 72 hours ago now has fever, dyspnea, chest pain. Diagnosis?
A

Bacterial pneumonia

175
Q
  1. 40-year-old male with sudden severe chest pain radiating to back after 18-hour flight, normal ECG. Next step?
A

D-dimer

176
Q
  1. Woman post-pregnancy developed psychosis, started on SSRI, planning next pregnancy. Advice?
A

Continue the same dose

177
Q
  1. 35-year-old female with TAH+BSO, DEXA results -2.5 spine and -1.5 femoral BMD. Treatment?
A

Risedronate

178
Q
  1. 18-year-old female with multiple bruises, living with paternal uncle. Whom to call next?
A

Inform child protection services

179
Q
  1. Elderly man with swelling over submandibular region. What to examine next?
A

Salivary gland

180
Q
  1. 10-year-old child started on stimulants for ADHD, not complying, problems in school. Next step?
A

Talk to boy about advantages and disadvantages of the drug

181
Q
  1. 56-year-old truck driver had a minor stroke, now has left homonymous hemianopia, reluctant to stop driving. Advice?
A

After occupational therapist assessment

182
Q
  1. Old man post hip/knee surgery, feels dizzy, BP 80/60, HR 110, DTX 4mmol. Cause of dizziness?
A

Orthostatic hypotension

183
Q
  1. Postpartum hemorrhage, 1500ml blood loss, continuous fresh blood. Most likely cause?
A

Atonic uterus

184
Q
  1. 18-year-old female with PMS, irritability, insomnia. Most appropriate treatment?
A

Fluoxetine

185
Q
  1. 72-year-old lady with vulval itching, on clotrimazole cream, not settled. Examination shows adhesion of labia, shrunk skin, narrowed introitus. Management?
A

Oestriol cream

186
Q
  1. Serum creatinine high, eGFR low, ultrasound showed small kidney. Feature indicating chronic disease?
A

Ultrasound finding

187
Q
  1. Knee injury. Best method for examination findings?
A

Anterior drawer test positive, Posterior drawer test positive

188
Q
  1. BRCA 1 positive. Correct screening method?
A

(Answer not provided in prompt)

189
Q
  1. Na low, sugar high. Diagnosis?
A

Hyperosmolar hyperglycemic state

190
Q
  1. On clozapine, symptoms improved, weight gain up to 15 kg. Next step?
A

Dietitian referral

191
Q
  1. Perimenopausal woman on estrogen patch, now menopausal. Advice?
A

Continue same

192
Q
  1. Best study type for GP to see incidence of cancer among patients?
A

Cohort

193
Q
  1. Hepatitis A epidemic in school. Management?
A

Exclude children for 14 days

194
Q
  1. Patient on corticosteroids for polymyalgia rheumatica, now tapering dose, patient lethargic. Cause?
A

Addison crisis

195
Q
  1. Woman in 20s with progressing occipital headache, nausea, vomiting for 3 months. Next step?
A

CT

196
Q
  1. Elderly lady with COPD, acute onset confusion after party, had fever, normal RR, tachycardia, normal O2 sats. Possible cause?
A

Pneumonia

197
Q
  1. Commercial driver 4 months post-stroke, decreased vision. Advice?
A

After occupational review

198
Q
  1. External hemorrhoid with hematoma. Treatment?
A

Surgery

199
Q
  1. Man with back pain, raised ESR, normocytic anemia. Investigation to establish diagnosis?
A

Hb electrophoresis

200
Q
  1. Man in chronic renal failure, anemia, hypertension, scarring kidneys. Most indicator for chronic disease?
A

Ultrasound findings

201
Q
  1. Man with CHF, stable. Initial management?
A

ACE inhibitors

202
Q
  1. Mastitis case. Advice?
A

Frequent feeds

203
Q
  1. Man with claudication symptoms, weak femoral pulse, absent distal pulses. Possible diagnosis?
A

Superficial femoral artery disease

204
Q
  1. Intern wants to assess diet in arthritis patients. Strongest evidence study design?
A

Meta-analysis

205
Q
  1. Intern administered wrong drug, not harmful, stopped. Next step?
A

Apologize to patient

206
Q
  1. 18-year-old female with PMS, irritability, insomnia. Most appropriate treatment?
A

Fluoxetine

207
Q
  1. AF with ECG, renal failure, GFR 24, not 35.
A

(Incomplete prompt)

208
Q
  1. Impetigo case. When to report to school?
A

After initiating treatment

209
Q
  1. Young girl stung by bees, urticaria rash, severe itchiness. Treatment?
A

Oral promethazine

210
Q
  1. Girl collecting Risperidone for boyfriend with schizophrenia, unable to visit due to work. Most appropriate action?
A

Provide the prescription after obtaining verbal consent via phone call

211
Q
  1. First cousins planning to start a family, history of genetic problems and miscarriages. Advice?
A

Recommend genetic counseling

212
Q
  1. Man concerned about infertility, wife has child from previous marriage. Potential reason for infertility?
A

Past infection with mumps

213
Q
  1. Pregnant nurse changing job to work with children, last diphtheria vaccine 8 years ago. Advice?
A

Vaccinate at 20 weeks

214
Q
  1. Research evaluating new drug effectiveness. Characteristic ensuring reliability?
A

Double-blindness

215
Q
  1. Elderly Chinese man with forgetfulness, MMSE score 22. Next action?
A

Perform MMSE in Chinese

216
Q
  1. 12-year-old child, shortest in class, height 3rd percentile, weight 10th percentile, otherwise well. Next step?
A

Ask about parents’ heights

217
Q
  1. Man working in garden, thorn cut, red and swollen hand. Most appropriate management?
A

Antibiotics

218
Q
  1. Carpenter with shoulder pain, partially relieved by steroid injections. Most appropriate management?
A

Physiotherapy

219
Q
  1. Labour progressing normally, then at 5cm dilation, station +1, fetal HR 115, pulsating cord felt in vagina. Management?
A

Reduce the cord and progress with labour

220
Q
  1. 6-year-old child with hereditary spherocytosis, anemia, jaundice, Hb 80-90, reticulocytes <0.1%. Management?
A

Folic acid

221
Q
  1. Family migrated to Australia 1 year ago, daughter depressed now doing well on fluoxetine, mother concerned about addiction. Management?
A

Reassure mother

222
Q
  1. Junior doctor in tertiary hospital, colleague disheveled and drunk. Next step?
A

Keep record of how many times colleague came in drunk

223
Q
  1. Couple, wife pregnant, man has chlamydia, doesn’t want to tell wife but wants her tested. Management?
A

Encourage him to tell wife

224
Q
  1. Woman tearful a week after 2-year anniversary of mother’s death, sees mother in dreams, saw mother standing in doorway. Diagnosis?
A

Bereavement

225
Q
  1. Eye trauma, hyphema. What to do while waiting for ophthalmology referral?
A

Eye pad and bed rest

226
Q
  1. End-stage small cell lung cancer, on oxycodone for pain, increased thirst, dry mucous membranes. Diagnosis?
A

Hypercalcemia

227
Q
  1. Recurrent DVT. Which cancer is likely?
A

Lung cancer

228
Q
  1. Clinical features of lateral epicondylitis. Investigation?
A

No need to do anything

229
Q
  1. 8-year-old child with scrotal pain, testes non-tender, redness extending to perineum and groin. Most likely diagnosis?
A

Scrotal edema

230
Q
  1. Patient with recent MI and DM, optimize medications, BMI 26, HbA1c 7. Treatment?
A

Empagliflozin

231
Q
  1. Waldenstrom macroglobulinemia with myelodysplastic syndrome, left lower lobe pneumonia, rash on ampicillin. Next step?
A

Stop ampicillin

232
Q
  1. Patient with family history of breast cancer, unilateral painful gynecomastia, on spironolactone. Next step?
A

Ultrasound breast

233
Q
  1. Female, healthy, routine antenatal visit, Hb 9, MCV 70. Next step?
A

Hb electrophoresis

234
Q
  1. Young male with scrotal lump, testes separately palpable, no other symptoms. Next step?
A

Testicular tumor markers

235
Q
  1. Female admitted for fracture, given morphine, weird behavior after 12 hours, claims can’t control eye movement. Treatment?
A

Benztropine

236
Q
  1. Female with swollen lymph nodes, 2 months tiredness, lives with cats, right posterior cervical lymph node FNAC shows reactive cells, no malignancy. Diagnosis?
A

Cat scratch disease

237
Q
  1. Orthopedic surgery patient on multiple medications. What to change on morning of surgery?
A

Withhold aspirin

238
Q
  1. Patient with ST elevation anterior wall MI, alcohol use, smoker, T2DM. Risk factor to address?
A

Smoking

239
Q
  1. Ear pain, submandibular gland swelling, dull TM. What organ to examine?
A

Tongue

240
Q
  1. Postpartum hemorrhage, 1500ml blood loss, shortness of breath. Diagnosis?
A

Amniotic fluid embolus

241
Q
  1. 18-month-old child with recurrent respiratory infections, multiple ear infections, enlarged tonsils, clear nasal discharge, normal development.
A

(Incomplete prompt)

242
Q
  1. Schizophrenic patient agitated in ED, holding knife, refuses call to psychiatrist. What to do?
A

Overrule refusal and call psychiatrist

243
Q
  1. 18-year-old male with sleep difficulties, sad, declining grades, not suicidal. Treatment?
A

Mirtazapine

244
Q
  1. Patient came in for testosterone injection, noticed tampered. What to do?
A

Prescribe and reschedule appointment

Recalls lubi (4 decks)

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