GenMed Formative Flashcards
Which statement regarding hypoglycaemia is correct?
B. Insulin-dependent patients may lose warning symptoms of hypoglycaemia after many years of diabetes
When considering the presentation of renal cell cancer, which is incorrect?
- A. Commonly causes hypertension
- B. Haematuria is the most frequent presenting symptom
- C. May present as a pyrexia of unknown origin (PUO)
- D. May present with pulmonary metastases
- E. May involve both kidneys
A. Commonly causes hypertension = INCORRECT
Which is not a cause of acute pancreatitis?
= E. Hypocalcaemia
- A. Diffusing capacity of lung for carbon monoxide (DLCO) normal
- B. FEV1 100% of predicted
- C. FEV1:FVC <70%
- D. FEV1 improves 30% post bronchodilator
- E. Total lung capacity (TLC) decreased
= C. FEV1:FVC <70%
Which medication is contraindicated in heart failure?
- A. Amlopidine
- B. Aspirin
- C. Bisoprolol
- D. Diltiazem
- E. Ramipril
= D. Diltiazem
A. Corticosteroids
B. Gentamicin
C. Immunoglobulin
D. Metronidazole
E. NSAIDs
A. Corticosteroids
A patient with shortness of breath is diagnosed with pulmonary fibrosis. What medication could be responsible?
A. Amiodarone
A patient presents with central crushing chest pain. Their ECG shows ST elevation in leads V2-V4. Which coronary artery is most likely to be occluded?
C. Left anterior descending
Which clotting factor is synthesised by the liver?
= VII
Which feature of spider naevi help to distinguish them from other skin lesions?
= Spider naevi blanche with pressure
Why is it important to know if a patient with haematemesis is on a beta blocker?
A. Chest Xray
B. Clinical assessment of volume status
C. CT scan head
D. Serum and urine osmolality
E. Serum BNP (B type naturetic peptide)
= B. Clinical assessment of volume status
An 80 year old male is referred with a stroke. On examination he has receptive dysphagia. Damage to which area of the brain is most likely to cause this?
= Wernicke’s area
A. Erythrocyte sedimentation rate
B. Rheumatoid factor
C. Serum alkaline phophatase level
D. Serum calcium and phosphorus levels
E. Xray of the pelvis and shoulder girdle
= A. Erythrocyte sedimentation rate
A. Anterior cerebral artery
B. Bridging veins
C. Middle cerebral artery
D. Middle meningeal artery
E. Superficial temporal artery
= D. Middle meningeal artery
A patient presents with unilateral ptosis and mydriases. What is the cause?
= Third nerve palsy
Which pathogen does not typically produce bloody diarrhoea?
= Giardia
A patient with coeliac disease is found to be folate deficient. In which part of the intestine is folate absorbed?
= Jejunum
A patient produces a stool that is pale in colour, foul-smelling, and floats. What is the correct term for this type of stool?
steatorrhea
Which finding is most suggestive of raised intracranial pressure?
= papillodema
What is a reported side effect of thiazide diuretics?
A. Coagulation profile
B. Cytomegalovirus antibody titre
C. Direct and indirect antiglobulin (Coombs) tests
D. Hepatitis serology
E. Ultrasound of the liver and gallbladder
C. Direct and indirect antiglobulin (Coombs) tests
Which drug is least likely to cause constipation?
= Colchicine
All of the following blood results could be associated with metabolic acidosis except:
= Raised serum bicarbonate
A. Anti-embolic stockings
B. Continue low-molecular weight heparin for three months
C. Intravenous heparin infusion for 10-14 days
D. Warfarin for 3 months
E. Warfarin lifelong
= Warfarin for 3 months
A. Amoxycillin, gentamicin, metronidazole
B. Ciprofloxacin
C. Clindamycin and metronidazole
D. Meropenem
E. Vancomycin and metronidazole
= A. Amoxycillin, gentamicin, metronidazole
A. Acute glomerulonephritis
B. Bacterial cystitis
C. Renal cell carcinoma
D. Urinary tract tuberculosis
E. Urothiliasis
= E. Urothiliasis
Which statement about the jugular venous pulse is most correct?
= May be undetected if the jugular venous pressure is extremely high
Which bacteria produce multiple toxins causing toxic shock syndrome associated with tampon usage?
= Staphyloccus aureus
A 34 year old female comes for a review of her type I diabetes mellitus. She has not been regularly monitoring her blood sugar levels and her HbA1c was recently 8.5%. She is considering pregnancy. What advice is most correct?
= She needs to improve her blood sugar control prior to becoming pregnant.
A 74 year old female presents with a haemoglobin of 89 g/L (RI 117-135) and a mean corpuscular volume of 105fL (RI 80-95). What is the least likely diagnosis?
= Gastrointestinal bleeding
Regarding hepatitis, which statement is most correct?
Which statement regarding classical Hodgkin’s disease is most correct?
= It is characterised by the presence of Reed-Sternberg cells.
A. Decreased sensation
B. Extensor plantar responses
C. Increased tone
D. Ipsilateral neurological signs
E. Resting tremor
= Ipsilateral neurological signs
A. Follicular carcinoma
B. Granulomatous thyroiditis
C. Grave’s disease
D. Hashimoto’s thryoiditis
E. Multinodular goitre
= Grave’s disease
A. Chronic Epstein-barr virus infection
B. Chronic fatigue syndrome
C. Narcolepsy
D. Polycyythemia rubra vera
E. Sleep apnoea
= Sleep apnoea
You are deciding whether to believe the findings of a qualitative research paper. You would be more confident that the findings were valid if the methods involved:
= Triangulation of more than one data source.
The Pharmaceutical Benefits Advisory Committee has estimated that quadrivalent human papilloma virus vaccine (Gardasil) reduces lifetime risk of cervical cancer from 0.78% to 0.38% in girls vaccinated at 12 years of age. People who are not eligible for National immunisation program-funded vaccination pay $460 for a complete 3-dose course. Based on this information, is it correct to conclude that:
A 24 year old pregnant female is admitted to hospital with sudden onset of right-sided hemiplegia and depressed concious state. She died 24 hours later without regaining conciousness. Her past history includes severe mitral stenosis and atrial fibrillation due to childhood rhuematic fever. If you were the intern who admitted her and were then asked to complete her death certificate, you should:
= Report her death to the Coroner and the Executive Director of Public Health.
Acupuncture for persistent allergic rhinitis: a randomised sham-controlled trial (Xue et al, MJA 2007; 187: 337-41) concludes that acupuncture is effective. You would be less confident that the findings are valid if the study design or analysis included:
= Analysis of patients based on the actual treatment they received if this was not what they were randomised to.
A 65 year old Indigenous male with long standing bronchiectasis. On examination of his hands, what is the most likely finding?
= Clubbing
An 80 year old Italian market gardener with osteoarthritis. On examination of this patient’s hands, what is the most likely finding?
= Herberden’s nodes
A 55 year old secretary with thyrotoxicosis. On examination of her hands, what is the most likely finding?
= Palmar erythema
A 48 year old accountant with carcinoma of the caecum. On examination of his hands, what is the most likely finding?
= Koilonychia
A 70 year old retired engineer with an old fracture of the medial epicondyle of the elbow. On examination of his hands, what is the most likely finding?
= H. Wasting of the hypothenar eminence
Referring to the ECG shown, what is the most appropriate finding?
A. Anterior myocardial infarction
B. Atrial fibrillation
C. Atrial flutter
D. Complete heart block
E. First degree heart block
F. Hyperkaliemia
G. Inferior myocardial infarction
H. Left bundle branch block
I. Pericarditis
J. Right bundle branch block
K. Second degree heart block
L. Sinus bradycardia
M. Supraventricular tachycardia
N. Ventricular tachycardia
G. Inferior myocardial infarction
Referring to the ECG shown, what is the most appropriate finding?
A. Anterior myocardial infarction
B. Atrial fibrillation
C. Atrial flutter
D. Complete heart block
E. First degree heart block
F. Hyperkaliemia
G. Inferior myocardial infarction
H. Left bundle branch block
I. Pericarditis
J. Right bundle branch block
K. Second degree heart block
L. Sinus bradycardia
M. Supraventricular tachycardia
N. Ventricular tachycardia
D. Complete heart block
Referring to the ECG shown, what is the most appropriate finding?
A. Anterior myocardial infarction
B. Atrial fibrillation
C. Atrial flutter
D. Complete heart block
E. First degree heart block
F. Hyperkaliemia
G. Inferior myocardial infarction
H. Left bundle branch block
I. Pericarditis
J. Right bundle branch block
K. Second degree heart block
L. Sinus bradycardia
M. Supraventricular tachycardia
N. Ventricular tachycardia
M. Supraventricular tachycardia
Referring to the ECG shown, what is the most appropriate finding?
A. Anterior myocardial infarction
B. Atrial fibrillation
C. Atrial flutter
D. Complete heart block
E. First degree heart block
F. Hyperkaliemia
G. Inferior myocardial infarction
H. Left bundle branch block
I. Pericarditis
J. Right bundle branch block
K. Second degree heart block
L. Sinus bradycardia
M. Supraventricular tachycardia
N. Ventricular tachycardia
B. Atrial fibrillation
Referring to the ECG shown, what is the most appropriate finding?
A. Anterior myocardial infarction
B. Atrial fibrillation
C. Atrial flutter
D. Complete heart block
E. First degree heart block
F. Hyperkaliemia
G. Inferior myocardial infarction
H. Left bundle branch block
I. Pericarditis
J. Right bundle branch block
K. Second degree heart block
L. Sinus bradycardia
M. Supraventricular tachycardia
N. Ventricular tachycardia
J. Right bundle branch block
What is the reason that some patients with atrial fibrillation require anti-coagulation? (1 mark)
List four circumstances where a patient would be advised against anti-coagulation? (2 marks)
If a patient is placed on warfarin, what advice should be given to them about taking it? Include information about control, lifestyle factors and risks of warfarin therapy. (4 marks)
List 2 important drug interactions with warfarin. (1 mark)
A soft tissue mass visible on the thoracic inlet views and displacing the trachea. What is the most likely cause for this chest x-ray abnormality?
A. Aortic aneurysm
B. Dermoid cyst
C. Ectopic parathyroid
D. Foramen of Morgagni hernia
E. Hiatus hernia
F. Lymphoma
G. Retrosternal goiter
H. Sarcoidosis
I. Thymic tumor
= G. Retrosternal goiter
Bilateral hilar lymphadenopathy and diffuse fibrosis in both lung fields. What is the most likley cause for this chest x-ray abnormality?
= Sarcoidosis
Bilateral hilar lymphandenopathy in a young male with pruritis, and multiple painless swellings in the neck. What is the most likley cause for this chest x-ray abnormality?
Mediastinal widening in a tall, thin patient with a high-arched palate. What is the most likley cause for this chest x-ray abnormality?
There is an anterior mediastinal mass on the CXR of a patient with myasenthia gravis. What is most likely cause for this chest xray abnormality?
= Thymic tumour
A 54 year old male who has been a heavy smoker since a teenager presents with a seizure. On recovery, he indicates he has been well apart from a headache which is worse on waking in the morning and is relieved by paracetamol. The headache has been gradually getting worse over the last four weeks. What is the most likely diagnosis?
= Brain metastases
A 49 year old plumber is brought to the Emergency Department having had a brief loss of conciousness. Prior to the event, he had a sudden onset of “the worst headache in his life”. On examination he is afebrile, has neck stiffness but no focal neurological signs. What is the most likely diagnosis?
= Subarachnoid haemorrhage
A 23 year old medical student presents with several headaches over the previous six months. These are unilateral, throbbing, and associated with nausea and photophobia. On each occasion, she has woken with the headache on a Sunday morning at the end of a week when she had multiple assignments due. What is the most likely diagnosis?
A 19 year old student who has recently represented her university college at a rowing regatta, presents with headache, fever, and rash. What is the most likely diagnosis?
= Meningitis
A 75 year old male presents with excruciating paroxysms of pain in the cheek and lip. These only last a few seconds but have been recurring frequently for several weeks. They are sometimes triggered by touching the face. What is the most likely diagnosis?
= Trigeminal neuralgia
