May 20th 2021

Question 1

6 week old baby with left inguinal lump, 2/7 ago immunisations, bulges when cries, 2 ddx

Answer 1

left inguinal lymphadenopathy
left inguinal hernia
left femoral hernia

Question 2

6 week old baby with left inguinal lump, 2/7 ago immunisations, bulges when cries, next mx?

Answer 2

early referral to paediatric general surgeon for repair within 2 weeks

Question 3

47F, rash on leg, pruritic last night after garden, hx asthma, 1 most likely dx?

Answer 3

allergic contact dermatitis leg lower leg

Question 4

47F, rash on leg, pruritic last night after garden, hx asthma, 4 mx

Answer 4

• 10mg, cetirizine, PO, daily
• wash skin with water
• identify and avoid trigger
• mometasone 0.1%, topical daily
• review in 1-2 days for signs of infection

Question 5

5 medications you can give through a syringe driver?

Answer 5

haloperidol
hydromorphone
metoclopramide
midazolam
hyoscine hydrobromide
clonazepam
fentanyl

Question 6

81F metastatic breast Ca, needs more pain relief, on patch and pro oxycodone, 2 med changes?

Answer 6

• 10/5mg, Targin, PO, BD
• cease patch (not good in pall care, can’t dose adjust)
• 10mg, oxycodone, TDS, PO, PRN

Question 7

24M acute onset SOB at gym, smoker 2.5py, crane operator, 4 hx

a,L, H

Answer 7

• chest pain?
• cough
• recent long haul flight or sitting
• recent fever?

Question 8

3 Ix for HOCM?

Answer 8

ECHO
ECG
24-hour holter

Question 9

19yo, 9/40 preg, painless bleeding this AM. 3 exam findings

F,p,w

Answer 9

speculum examination
blood pressure
abdominal exam

Question 10

Needle stick injury, 5 hx from patient

Answer 10

• hx of IV drug use
• hx of hep B immunisations
• any MSM?
• tattoos/piercings overseas
• transfusions/surgeries overseas?

Question 11

Needle stick injury, 5 immediate actions

Answer 11

• stop procedure
• wash my wound under water
• ask colleague to take over
• take patient blood-borne infection history
• explain accident to patient