APRIL 2025 Recalls Compilation
24 lady with worsening R eye ‘ache’ & reduced vision. Worse with eye movements, no redness or fluorescein uptake. 6/12 vision in R eye, 6/6 in L eye. RAPD on exam. Associated disease?
a Multiple sclerosis
b Graves’ disease
57 lady w chronic cough, 35 pack-yr smoking hx, breathless with daily tasks. Spirometry done. Interpretation?
a Mod OAD, no reversibility
b Mild OAD, no reversibility
45 male poorly controlled DM, IHD, living in rural Indigenous community. Fevers, cough, lethargy, night sweats, occasional hemoptysis. Additional test for TB?
a/ Try hypertonic saline to get sputum
b/ CT chest
25 gentleman with 3 days of rhinorrhoea, fever, cough, abdo pain. Temp 39.6°C, reduced breath sounds, enlarged spleen. Causative pathogen needing notification?
a/ Chlamydia psittaci
b/ Parainfluenzae
59 lady w/ 3 months of cough, blood-tinged sputum, night sweats, 5kg wt loss. Past hx of T2DM, HTN, no smoking. Initial investigations for likely dx?
a/ CXR + 3 AFB sputum samples
b/ IGRA
74 lady, 2 hrs nosebleed, pale & clammy, ongoing bleeding despite digital pressure. BP 120/80mmHg, HR 120/min. Next step?
a/ Ribbon gauze w/ chloramphenicol, review 2h
b/ Rapid Rhino + bloods for VWD
62F, high BP (162/97mmHg), not concerned. White coat HTN, declines 24hr BP monitoring. Correct statement about home BP readings?
a/ Check BP before daily meds
b/ Check BP after food & exercise
72 old man, fatigue, past MI at 55. Breathless on stairs, 3kg wt gain, ankle marks. NYHA functional class for chronic heart failure?
a/ NYHA Class 1
b/ NYHA Class 2
55 lady, painless unusual mouth appearance for weeks, feels well, no significant hx. Likely dx?
a/ Oral lichen planus
b/ Erythroplakia
35 man, 3 weeks of anal pain after defecation, blood on wiping, constipation (firm stool every 2-3 days). Likely dx?
a/ Anal fissure
b/ Anal skin tags
56 gentleman, gardener & cat owner, 24hrs of pain, swelling, redness on R index finger. Temp 38.1°C, pulse 72. Suspected gout, next step?
a/ Start diclofenac TDS + discuss allopurinol
b/ Urgent hosp referral for drainage + IV abx
65 lady, enlarging papule on R neck, 8mm, raised w/ keratotic horn. Suspected keratinocytic tumor. Max safe dose of 1% Lidocaine w/ adrenaline?
a/ 140 mg
b/ 210 mg
c/ 490 mg
72yo fatigue, past MI at 55, breathless on stairs, ankle marks. LVEF < 40% on echo. Meds that improve outcomes in HFrEF?
a/ Eplerenone
b/ Verapamil
c/ Frusemide
33 lady HNPCC gene mutation, 2 sisters w/ bowel cancer, no bowel habit change. Best surveillance for bowel cancer?
a/ Immediate colonoscopy, 5-yr repeat, 2-yr iFOBT, aspirin at 50
b/ Refer to bowel ca specialist
Refugee family from Iraq registering at your clinic. Settled 6 months ago. Health assessment needed for this family?
a/ No interpreter needed, father can translate
b/ Medicare rebate for refugee health check
5yo girl itchy bottom for nights, worse at night, possible threadworm infection. Best tx for her infection.
a/ Treat whole family w/ pyrantel, repeat in 2wks
b/ Reassure – common, low morbidity
18 teenage girl sudden change in behavior at music festival, confused & aggressive. 5-6 vodkas, unsure if illicit drugs. Next step?
a/ Calmly de-escalate in quiet room
b/ IV droperidol 10mg
55 old man prostate cancer w/ bony mets, severe pain, no strong analgesia. Reluctant to use NSAIDs. Next step?
a/ Oral IR morphine
b/ Buprenorphine patch
c/ SC morphine
31 man gradual onset lateral knee pain, worsens w/ running, no trauma. Pain localized above joint line, no swelling. Likely dx?
a/ Iliotibial band syndrome
b/ Quadriceps tendon tear
25 man painless testicular lump on L side, firm intratesticular mass. Likely dx?
a/ Testicular cancer
b/ Spermatocele
c/ Hydatid of Morgagni
10yo girl w/ 3-day hx of SOB, fever, headache. Dx pneumonia. What signs might be seen in severe pneumonia?
a/ Tachycardia
b/ Bilat lung creps
25yo & 23 lady newlyweds planning 3-wk trip to Sth America. She not on OCP, wants to conceive. Concerned re: Zika. Advice?
a/ Start OCP now + avoid unprotected sex, 6mo post-trip
b/ Get vax before holiday
66 old man smoker w/ mild COPD, on salbutamol & tiotropium, confused re: usage. Back for GPMP. Care plan?
a/ Recommend flu, COVID, pneumococcal vax
b/ Recommend zoster & pneumococcal vax
c/ Advise smoking cut
70 old man w/ vertebral # after minor fall. Reviewing osteoporosis RFs. Most likely RF?
a/ Type 2 diabetes.
b/ Hypothyroidism.
23 yo backpacker doing farm work, low-grade fever x4d. Concerned re: Q fever. Dx method?
a/ Serum PCR for C. burnetii
b/ Serial blood cultures
62yo w/ tiredness. Found to have B12 def. Likely assoc condition?
·a/ Newly arrived refugee
b/ Low vegetable, high meat diet
c/ Sulphonylurea use
29 lady w/ postpartum hair loss, hair sparse, +ve pull test, scalp normal. Dx?
a/ Telogen effluvium
b/ Alopecia areata
c/ Androgenic alopecia
59yo w/ recurrent gout, on multiple meds, started allopurinol & naproxen. Uric acid 0.58. Target uric acid?
a/ Less than 0.30mmol/L
b/ Less than 0.40mmol/L
c/ Less than 0.36mmol/L
66 man active, good diet, mother had # at 91. Wants to check OP risk. What RF prompts BMD?
a/ Rheumatoid arthritis
b/ Asthma
c/ Generalised anxiety disorder
22 lady wrongly given B12 script for another pt. Error noticed later at pharmacy. Next step?
a/ Apologise to pt for error
b/ Notify practice manager
Couple w/ 4yo daughter w/ CF, both CFTR gene carriers, want to try for another baby. Likelihood of 2nd baby w/ CF?
a/ 25% chance of CF in child
b/ 50% chance of CF in child
98 old lady w/ cognitive impairment, 2 episodes of acute delirium, pacing, vomiting blood. Immediate mgmt?
a/ SC line + give haloperidol, morphine, midazolam
b/ Call 000, transfer to regional hosp
22 female strange tongue appearance after brushing teeth, no pain, past pustular psoriasis. Next step?
a/ Reassure – no tx needed
b/ Daily AB mouthwash till tongue normal
Warts on L hand for 2 months, no tx yet. Best evidence-based tx for warts?
a/ Repeated topical sal acid
b/ Cryotherapy w/ LN
43yo unconscious w/ low BG (1.8 mmol/L), hx of insulin use & alcohol intake. Next step?
a/ 16G IV + 10% glucose 150–200ml over 15min
b/ Give 2nd IM glucagon 1mg
girl 8yo chronic night cough, wheezing, possible asthma. Minimum age for spirometry?
a/ 6 years old
b/ 5 years old
c/ 7 years old
72old man 4wks SOB, shoulder pain, weight loss, cervical lymphadenopathy, finger clubbing. Likely dx?
a/ Lung cancer
b/ Multiple myeloma
c/ Lymphoma
17teenage girl menorrhagia, family hx of heavy periods & hysterectomy. VWD, which statement is correct?
a/ 2 VWD patterns; most are AD
b/ Affects F > M, 2:1
20 female medical student, arrives late, parties, attentive in consultations. Next step?
a/ Discuss lateness + concerns
b/ Notify uni re: suspected EtOH on placement
37 lady sudden R-sided facial droop, no ear sx or dysphagia, 16wks pregnant. Likely dx?
a/ Bell’s palsy
b/ Ramsay Hunt syndrome
c/ Schwannoma