AMC MCQ Recalls APRIL 2023

ANZAC DAY 2023! Today marks the 108th anniversary of the Gallipoli landings in 1915 and it commemorates Australians who have served and made the ultimate sacrifice for their nation.

The solemnity of the services is reflected in the fact some 8700 brave Australians lost their lives and 18,000 were wounded during the campaign.

We would like to extend a huge thank you to those who have provided us with these recalls. It is now our turn to do our part and help solve them for you. You can obtain them from here.  

Australian Medical Council (AMC) MCQ Recalls APRIL 2023 compilation

37yo man with sudden-onset right arm weakness, headaches, nausea, and dizziness for 2 weeks. No medical history or medication use. Faint rash present. Brain imaging shows acute left frontal infarction with meningitis. Cause?

a/ Blood cultures

b/ CSF cytology for malignant cells

c/ CSF VDRL testing

42 non australian man chased by police then the stolen car he was driving turned upon killing a passenger citizen & he came with multiple fractures in ortho department with multiple ribs &limbs fractures days later he became aggressive shouting accusing staff ..threatening ..and want to smoke now what appropriate act u will do

a/ discharge immediately to police station

b/ refer to nearby psy clinic or behavioral institute to rehabilitate

c/ allow him to smoke in special area for smokingz

d/ insist on him to take nicotine patch or gum

e/ refer to immigration institute to turn him into (some authority to send him home

35yo man with skin lesions 3 wks after kidney transplant for glomerulonephritis & high-dose corticosteroids. Multiple red, nontender lesions on trunk & lower extremities. dx?

a/ Hemangioma

b/ Kaposi sarcoma

35 female presented with persistent rhinorrhea, clear drainage on R nostril, worsens w/ bowel movement/bending. External nose normal, pink turbinates, straight septum. Clear fluid on R nostril. Important history for diagnosis?

a/ Family history

b/ Prior seasonal allergies

c/ Recent head trauma

• yr-old woman with dull, aching RUQ pain for wks. Takes oral contraceptive for 12 yrs, drinks 1-2 glasses of wine on social occasions, no tobacco or illicit drug use. Exam shows hepatomegaly with moderate discomfort. Abdominal ultrasonogram reveals 7-cm lesion in the right lobe of the liver. Diagnosis?

a/ Hepatic adenoma

b/ Hepatocellular carcinoma

4 days old baby comes with jaundice. Baby is born normally, No features other than jaundice. Total bilirubin is 380, conjugated bilirubin is 12. What is the most appropriate mx for this child.?

a/ Repeated bilirubin after 2 weeks

b/ Phototherapy

c/ Exchange transfusion

d/ Stop breast feeding

42 F w/ fatigue, hot flashes, crankiness, bloating, missed work. LMP 3wks ago, cycles every 30d, 2d heavy, 4d mod flow. 2 vaginal deliveries, stopped OCPs 1yr post-bilateral tubal ligation. Social smoker, no alcohol/illicit drugs/meds/drg allergies. Normal vitals/exam. Next step?

a/ Restart COCP

b/ Symptom diary

36 male hospitalized after motor accident w/ concussion and right femur fracture. No medical history, no chronic meds. Finger-stick glucose 8.6mmol/L, HbA1c 5.5%. Next step in glucose management?

a/ Calorie-restricted diet

b/ Metformin

c/ No treatment

Case of 12mos infertility. What to measure for ovulation?

a/ FSH

b/ LH

c/ progesterone

d/ Estrogen

6yo boy w/ learning difficulties since starting school 6 mo ago, IQ=68. Adopted from overseas orphanage w/ unknown hx. Mild conductive hearing loss on R ear. Flat nasal bridge, grade 3 holosystolic murmur at L lower sternal border. diagnosis?

a/ ????FMR1 DNA analysis (fragile x)

b/ Karyotype analysis

26 male w/ wife unable to conceive for 1 yr. Decreased libido, gynecomastia, sparse facial/body hair. Normal penis, small firm testes. Which is the most likely cause of infertility?

a/ Complete androgen receptor insensitivity

b/ Congenital gonadotropin-releasing hormone deficiency

c/ Dysgenesis of the seminiferous tubules

You’re assisting doctor with a surgeon performing colonoscopy and he ruptures the bowel. The patient after surgery asks you what he can do. What is your advice?

a/ Ask the patient to go talk to hospital management

b/ Talk to him as if this could happen during these procedures

7yo girl w/ cat bite on R arm from picking up cat by tail. Mom cleaned wound w/ H2O2. Vaccinations up to date. Deep puncture wound on R forearm, no debris/bleeding. Wound irrigated w/ saline & cleaned w/ povidone-iodine. next step?

a/ Administer tetanus booster

b/ Prescribe amoxicillin/clavulanate

14yo boy w/ midthoracic spine pain for 12 wks, worse at night, not activity-related, no injury. Relieved by ibuprofen. No spasm or tenderness, normal range of motion, strength, sensation, reflexes, and pulses. No abnormality on straight-leg raising test. Cause?

a/ Ankylosing spondylitis

b/ Disc herniation

c/ Osteoid osteoma

24F w/ severe R hand pain after hydrofluoric acid exposure. Erythema, edema, mild blistering. Sensation and perfusion intact, can move fingers w/ pain. Initial therapy?

a/ Calcium gluconate gel

b/ Hydrocortisone cream

Bilateral lower limb petechiae picture of elderly women and asked for next best investigation.

a/ Ct angiogram,

b/ doppler,

c/ carotid angiogram

24yo man w/ ankylosing spondylitis hx, had acute anterior uveitis w/ prednisolone drops. Blurry vision w/ need for more light to read, glare while driving at night. Normal funduscopic exam. Next step?

a/ Fluorescein eye stain

b/ Lumbar puncture

c/ Tonometry

23F primigravid w/ decr fetal movement, some regular, nonpainful uterine contractions, no vaginal bleeding/leakage. 38 wks gestation, fatigue/joint stiffness for past month. Confluent facial rash, supple neck. Likely cause of fetal heart rate tracing?

a/ Congenital hypothyroidism

b/ Fetal atrioventricular block

32F, G2P1 at 16wks, came for prenatal care. 2mos ago, had cramping & vaginal bleeding; ultrasound showed 8wk fetal pole w/ cardiac motion. No pain/bleeding since. unable to take prenatal vitamins consistently due to nausea/vomiting. BMI 38 kg/m2. Cause?

a/ Complete hydatidiform mole

b/ Incorrect gestational age dating

c/ Trisomy 21

23 female w/ milky nipple discharge x1mo, erratic cycles x3mo, poor libido. hx of depression/nervous breakdown, fam hx of breast cancer, occasional alcohol/half-pack/day smoking. neg urine preg test. cause of symptoms?

a/ Polycystic ovary syndrome

b/ Risperidone

60 male w/ work disability, dyspnea worsening past 2yr. Worked in factory w/ granite. RA, took methotrexate but stopped. Coarse inspiratory crackles, squawks in upper lung fields. caused respiratory disease?

a/ Adverse drug reaction

b/ Occupational dust exposure

52F w/ R upper-quadrant pain, nausea, h/o obesity & gallstones, underwent cholecystectomy 1 yr ago. Pain lasts 30-60 mins, similar to pre-surgery pain. Abdominal ultrasound shows mild common bile duct dilation, normal pancreas. next step?

a/ Antimitochondrial antibodies

b/ Endoscopic retrograde cholangiopancreatography

2D boy, born 39 wks to 17yo primigravida w/o prenatal care. Uncomplicated delivery, Apgar 9 at 1 & 5 min. Formula-feeding well, stooled twice, single wet diaper in 48 hrs. Weight 2.89 kg, down 3%. Unremarkable exam. next step?

a/ Abdominal radiograph

b/ Bladder catheterization

c/ Renal and bladder ultrasound

A 54 yr old woman presents with a swelling in the neck which has progressively enlarged for the past few months .Investigations reveal mass to be goiter. Which one of the following symptoms ,if present, should make you think of urgent surgery?

a/ Retrosternal extension

b/ Hoarseness

c/ Dysphagia

d/ Dyspepsia

e/ Puffiness of her face on raising her arms above shoulder

53 female w/ progressive exertional dyspnea, increased abdominal girth w/ discomfort and early satiety. Hx of bacterial endocarditis due to IV drug use. No JVD or hepatojugular reflux. Clear chest, distended abdomen w/ shifting dullness and fluid wave.

a/ Chronic liver disease

b/ Constrictive pericarditis

67 female w/ right hand pain, thumb base pain worsens w/ gardening, hand stiffness in morning. Tenderness on palmar and dorsal base of thumb w/ hard enlargement at carpometacarpal junction. diagnosis?

a/ Chronic osteomyelitis

b/ Osteoarthritis

59M w/ hx acute MI, subtotal occlusion mid-LAD, treated w/ DES. Asymptomatic, w/ HTN, fam hx MI. Takes aspirin, ticagrelor, metoprolol, lisinopril, stopped rosuvastatin 1 mo ago due to muscle aches. lipid management?

a/ Advise fish oil supplement

b/ Offer fenofibrate therapy

c/ Offer moderate-intensity statin therapy

55 female w/ insomnia, fatigue, wine use, worry, occasional sadness, hypothyroidism, and GERD. Used to sleep 7-8hrs, now difficulty falling asleep, drinks 2-3 glasses of wine before bedtime.Mild tremor on exam. Diagnosis?

a/ Adjustment disorder

b/ Alcohol use disorder

Man came to u for a medical certificate as his employer asked him To take a break. He has started taking a lot of holidays, was ambitious previously but now demotivated. What will help u diagnose

A. Collateral history from employer

B. Drug alcohol history

C. Employment history

D. Finance history

A 26-year old pregnant woman went for antenatal check up. Sonogram revealed a 27- week old fetus with erythroblastosis fetalis. Doctor recommended intrauterine fetal blood transfusion. She refused the procedure. Social worker discussed the case with the mother. But she refused.

Next step ?

A: follow mother wishes

B:get court permission

Dr after night shift from emergency department went to bar.he found his colleagues there and some are having illicit drugs.they have to go to hospital for duty 2hrs later.what will you do?

A.Inform APHRA

B. Leave n said nothing

C. Report to director of ED

D. Tell directly to those colleagues

A16 year old girl with anorexia nervosa. She is now refusing NG tube feeding . What would allow NG tube feeding against her wish ?

A.Consent from parents

B.Agreement between 2 psychiatrists

C.Order from ethics committee

D.Order from court

Son comes to your practise regarding his 82 year old mother saying that the nurse from your practise is using his mother for financial purpose as she has been giving her expensive gifts and recently added her to her will as a beneficiary. What will you do?

a/ Ask son to speak to nurse

b/ Arrange appointment with the mother

c/ Raise issue with the nurse

d/ Report her to APHRA

55 female w/ ovarian cancer, chemo, R leg swelling/tenderness. Ultrasound: R popliteal vein thrombosis. Rx: subcutaneous enoxaparin. Follow-up. Predisposition?

a/ Acute interstitial nephritis

b/ Arterial thrombosis

Aboriginal woman comes to you with 5 month history of insomnia, anxiety and depression. You want to start her on escitalopram but she refuses. She wants to see a traditional healer within her community instead.

a/ involve indigenous officer

b/ provide her leave to go see transitional healer (dunno wtf the mean but exact words)

c/ involuntarily detain her

d/ inform the police

A 50-year old woman is diagnosed with severe aortic stenosis. She collapsed in a doctor’s office and is required resuscitation. She is waiting for valve replacement surgery.

What should a physician do in this situation?

a/ Resuscitation

b/ Refrain from resuscitation

70M w/ weakness, dizziness, back pain. PMH: DM, diabetic nephropathy & retinopathy, HTN, AFib, chronic leg cellulitis, on warfarin. diagnosis?

a/ Renal cell carcinoma

b/ Retroperitoneal hematoma

54F w/ 1d R-sided weakness, 6wks headaches, generalized weakness, hx of smoking. MRI shows infarction in L internal capsule. No abnormalities in cardiopulmonary exam, abdomen, extremities, ECG. Diagnosis?

a/ Bone marrow aspiration

b/ CT scan of the abdomen

Schizophrenia pt long time on medication. come to you for some reason. ultimately you find a larger ulcers on rt arm; you said to pt that u need antibiotics but refused. what should you do?

A.just ignore it (exact words)

B.take a swab now

C. go to mental tribunal for permission to start rx

D. give him a course of amoxicillin

CTG with decelerations which comes with the contractions not before or after them. Beat to beat variability was ok. Heart rate and others were nl . I couldn’t find enough accelerations.

a/ Continue CTG monitoring

b/ Fetal blood sampling

c/ C section

22M “weird behavior” after father’s death. Sleeping poorly, eating minimally. Treated for depressive episode after parents’ divorce. Hypervigilant, short and unrelated responses on MSE. diagnosis?

a/ Acute stress disorder

b/ Brief psychotic disorder

57 year old woman presents to you complainjng of low back pain. she has hx of breast cancer successfully treated 4 years ago. She doesnt go out much bcz she is afraid of developing melanoma. Dexa T score of -2.8. Xray reveals 2 vertebral fractures. Most appropriate next step in management?

A. Alendronate

B. Raloxifene

C. Vitamin D

D. Calcium

E. Strontium ranelate

Chest x ray with diffuse opacites and high hemidiaphragm on

one side with chronic cough with 2 weeks history of rusty

sputum. What is the diagnosis?

A. Bronchiectasis

B. Copd

C. Pul fibrosis…if no lung ca in option

D. Lung ca

E. Bronchitis

3yoF w/ hx asthma, choking episode 5d ago, persistent cough/wheeze despite nebulized albuterol & oral corticosteroids. Symmetric chest expansion, faint wheeze R middle lobe, no crackles, L lung clear. Next step?

a/ Allergy testing

b/ Antibiotic therapy

c/ Bronchoscopy

67M w/ lightheadedness and weakness for 2 days. Chronic stable angina w/ exertion, chest discomfort at rest. HTN, asthma, no SOB, cough, or edema. Meds: aspirin, isosorbide dinitrate. next step?

a/ Adenosine

b/ Cardiac pacing

A patient came to your practice because of sore throat. The nurse informed you that she hasn’t paid for the last three consultations. What should you do?

a. Ask patient to go to public hospital

b. Leave a prescription for amoxicillin

c. Book her for the next available appointment

d. See her after she paid the previous bills

e. Refuse to see her

A man with severe depression treated with Venlafaxine now presents with speech euphoria and mania. Asking the most appropriate next step?

a/ Add sodium valproate.

b/ Add Clozapine

c/ Add Olanzapine

d/ Withdraw Venlafaxine

e/ Add Risperidone

2hr-old boy w/ minimal R arm movement after complicated vaginal delivery at 37wks gestation, 4.6kg birth weight. Edema in scalp. R UE held in adduction and internal rotation, elbow extended, forearm pronated, wrist/fingers flexed. Next step?

a/ Botulinum toxin injections

b/ MRI of the brain

c/ Observation only

Patient comes to you who has been visiting you and in the last three appointments he has not paid his bills. What will you do now?

A) Ask receptionist to talk to him

B)Ask him to pay bills first and then seen him

C) See him between appointments

D) Refer him to hospital

11M w/ irritability, poor fluid intake. Fevers 7 days, half of usual formula volume w/ sweating while feeding. Conjunctivae injection, perianal peeling. S3 gallop, diffuse, fine lung crackles. Liver 3cm below costal margin, bilateral lower extremity edema, pulmonary edema. etiology?

a/ Arteriovenous malformation

b/ Eosinophilic myocarditis

c/ Lymphocytic myocarditis

46M w/ fall during race, loss of consciousness, severe back and abdominal pain. no intracranial bleeding. abdomen: small retroperitoneal hemorrhage, renal laceration. day 3: diffuse abdominal pain, distended abdomen, tympanic, absent bowel sounds. Diagnosis?

a/ Cecal volvulus

b/ Paralytic ileus

16M w/ high fever, sore throat, severe leg pain, pale appearance. Diffuse erythema of posterior pharynx, enlarged bilateral tonsils, supple neck w/o adenopathy. Bilateral lower extremities diffusely tender w/ skin mottling. Negative streptococcal & influenza tests. Next step?

a/ CT scan of the neck

b/ Heterophile antibody test

c/ Lumbar puncture

38F R-handed w/ brief seizure, hx of headaches for wks, acting strange for months. Socially withdrawn, impaired memory, no med/psych history. Somnolent, pupils equal/reactive, papilledema on funduscopy, normal extremity strength.

a/ Frontotemporal lobe atrophy

b/ Solitary mass in the frontal lobe

You are intern. Patient wishes you to witness her will in the presence of lawyer?

a. Witness will

b. Refuse to witness

c. Ask surgical registrar if he can do it

d. Ask the patient if he is happy with intern witnessing his will

e. seek legal advice

65M w/ obesity, aortic stenosis, and coronary artery disease undergoing valve repair and coronary artery bypass grafting. Complications prolong surgery, surgical suction catheter tip missing. Catheter tip found on postoperative film, requiring retrieval. How to prevent this error?

a/ Creating anonymous incident reporting systems

b/ Simulation training in team-based safety communication

A medical student was assaulted during his rotation in the psychiatry unit. He shares this with you and tells you (the registrar) that he is feeling anxious and stressed out about returning to the ward. What should you suggest?

A. Encourage him to return to the ward and complete his rotation B. Tell him to write a letter and change his ward.

C. Send for PTSD treatment

D. Suggest him to join a student support group

6yo girl w/ hyperactivity, impulsivity x4mo. Energy calms down w/ TV. Takes siblings’ toys, runs off at store. No behavioral concerns at school. No abnormalities on physical exam. Next step?

a/ Advise the father to discontinue screen time

b/ Obtain a blood lead level

c/ Recommend parent management training

48F w/ breast cancer, hospitalized for hemoptysis, SOB, severe back pain, lost 2kg in 2 wks, BMI 17kg/m2, wants to stop treatment and go home. Hospice care requirement?

a/ Lack of family or other caregivers to assist the patient

b/ Patient has a prognosis of ≤6 months

A patient was planned to have an elective hip replacement surgery and you referred her to the surgeon. The patient asked the surgeon about the complications of the surgery to which the surgeon got irritated and told her an extensive list of complications including the risk that she could die while she is under anesthesia. The patient now returns to you (the GP) and tells you that she is scared and no longer wishes to get her surgery done. What will you do?

A. Refer her to a different orthopaedic surgeon

B. Refer her to the anesthetist to discuss the complications of anaesthesia C. Report the surgeon to AHPRA

D. Call the surgeon and ask him to apologise to the patient

A female after delivery is awake all night and not letting anyone hold her child as she is afraid someone might steal her baby. She is continuously checking everything in the room and is cautious of the hospital environment. She wants to be discharged and return home. What will you do?

A/ Admit her in psychiatry ward

B/ Discharge her

C/ Give her diazepam

D/ Give her olanzapine

E/ Prescribe sertraline

32 yo domestic violent’s victim, is telling you that she lives in constant fear/stress because of her husband aggression. OE has several bruises all over her body. She doesn’t want you to call the police. What to do next:

a Inform the police anyway.

b tell her to inform the police.

c offer a number of a safe shelter for her.

d offer counselling about domestic violence. e take pictures of the bruises.

A 65 year old farmer presents with 2 year history of progressive cough. Patient is known to be a 30 pack year smoker but ceased 5 years ago. On examination patient had clear breath sounds, but you noticed clubbing of his fingers. What’s the most likely diagnosis?

A. Sarcoidosis

B. Lung CA

C. COPd

D. Pneumonia

E. CVS disorder

What is the most likely primary source of metastasis to the lungs

Thyroid

Breast

Stomach

Renal

Colon

There is a polytrauma patient with bladder distended on palpation and u noticed blood in urethra. How will you proceed

A. Suprapubic catheter

B. Pass urtheral catheter

C. Percutaneous nephrostomy

66M w/ low back and L hip pain after falling at work. BP: 148/90, pulse: 105/min, resp: 18/min. L paraspinal lumbar area and L hip tender to palpation. Neurovascular exam intact. X-ray obtained. Next step?

a/ Admit for nonoperative pain control and physical therapy

b/ Admit for surgical repair

65M in hospital w/ altered mental and fever. Admitted 10 days ago for acute pancreatitis 2/2 alcohol use, now has pancreatic edema/necrosis. Fever, low BP, tachycardia, decreased bowel sounds, tenderness to palpation in epigastrium. next step?

a/ Administration of naloxone

b/ CT scan of the abdomen

2yo boy hosp after drowning w/ no pulse but restored after CPR. Now intubated and on mech vent w/ persistently high BP and bradycardia. No response to stimulation, normal JVP, bilateral crackles in lungs. Cause of hemodynamic?

a/ Cervical spinal cord injury

b/ Increased intracranial pressure

Girlfriend came for filling prescription for BF who is known pt with schizophrenia couldnt come bcz of new job…he z usually well compliant with rx ..asking wt to do?

a. Ring the patient to confirm if u should give medicine to gf

b.Refuse

c. Give a few days medicine and arrange early consult

Gp works in the remote aboriginal community where incidence of std is increasing.What is the most appropriate?

a.tv campaign

b.lectures in community health centre regarding effect of STD

c.community wide program focused on behavior and knowledge

d.education programs in school

e. Arrange peer education for aboriginal males

35-year old woman is diagnosed to have chronic throat infection. She is frustrated with the conventional medicine. She told her doctor that she is using an alternative homeopathic medicine. She is feeling much better and she has no other complications.

What should a doctor suggest to this patient?

A. Continue alternative treatment

B. Discontinue alternative treatment

21 yr old male, Stable, Height:170 cm Wt: 60 Kg, took 14 or 16(not sure)

PCM tablets of 500 mg, present at your place after 10 hours, what is your most

appropriate next step?

a) PCM level

b) N-Acetyl Cystine

c) Charcoal

d) Reassure

A patient present with headache , prominent supra orbital ridges , prognathism, wide teeth spacing , thick spade like hands and seborrheic,  coarse and oily skin. Which of the following is the best to establish a diagnosis ?

A)Insulin +glucose test

B)Xray of the pituitary fossa

C)Cranial CT or MRI scans

D)Serum T4+PRL+ GH test

E)Oral glucose tolerance test

Mother presented with a newborn who had a difficult vaginal delivery with assisted forcep/vacuum extraction. Newborn had a cephalohaematoma.he was jaundiced.and on D5 they did Investigations which showed Total Bilirubin content 384.and conjugated level was given as 4.

What is the most appropriate management plan.

a.Phototherapy

b.Exchange Transfusion.

c.Increase hydration of the newborn

Patient presented with severe lower cramping abdominal pain and distressed.she had loose bowel motions with mucous but she didn’t have any bloody stool.BP Normal.PR tachycardic.She has presented to the ED.what is the initial management?

a. I/V Fluids

b. I/V paracetamol

c. I/V Hyosine

Patient calls you for a telehealth appointment and complains of lower abdominal pain.shes has no vomiting and shes had regular motions.Shes not on any medications but she had COVID 19 viral vector vaccine last week.As the GP what would you do?

a/ ask her to come to surgery if the pain doesn’t subside.

b/ reassure her as its because of the covid vaccination.

CXR given with right sided Hilar and middle lobe opacity.

Scenario 65yr old patient presented following nocturnal cough worsening over two weeks which is bothersome to the patients.he is a smoker.but he doesn’t have SOB.

What is the most likely Diagnosis?

a/ Bronchitis

b/ Mucous Plug

c/ sarcoidosis

d/ Bronchogenic Carcinoma

14yr old boy presented brought in by the patients as he argues with parents all the time and he is aggressive that last time he used a weapon to threaten them.and last week he went away from home after and Argumaent.the parent had strict upbringing and there is a history that his father has a mood disorder.

a. oppositional defiant disorder

b. Bipolar disorder

c. Conduct Disorder

17 yr old boy was brought in by Father as he was acting stange.He thinks theat he is under surveillance of cameras by the police.other day he was looking for something in his room.and when father asked he said he is looking for Cameras hidden in his room.

What is the probable diagnosis?

a/ Paranoia

b/ Delusional Disorder.

c/ schizophrenia

65yr old patient had a PCI for a MI.post stenting he was started on ASPRIN and CLOPIDOGREL.On Day 2 he developed a 6cm pulsating mass over the catheter insertion site.

What is the most appropriate management.

a.put compression over the mass.

b.Inject Thrombin into the Mass.

c.some surgery

CT given it looked like a pneumothorax.But the Scenario given 30 tr old was in a MVA and had chest injury and having chest pain on palapation.Haemodynamically stable.Saturation is 94%.Percussion note is Dull.What is the appropriate Management?

a.Intubation and Ventillation

b.Needle Thoracotomy

c.under water seal drainage.

65 yr old lady with pevous history of IHD and impaired renal function presented following Angina.and ECG shows lateral ST depressions relating with past MI.what is the suitable investigation for her.Echo was done but her EF reduced to 45%.sitable investigation for her.

a.stress ECG

b.Dobutamine nucleotide scan update

c.CT angiogram

d.Coronary angiogram.

Patient was brought in with dark tarr coloured stool.and his Hb was low 7 was transfused blood.and endoscopy and colonoscopy didn’t reveal the cause of bleed.Also mentioned that he is rapidly loosing blood needing two transfusions .most appropriate investigation.

a. Capsule Endoscopy

b.CT angiography

4 yr old patient in 9 wks of her 2nd pregnancy came for routine check up.She is RH negative.her first baby had a history needing to admit to NICU and needing Transfusions.

Her maternal Antibody level titre was(1:2)

What would you do?

a.monitor maternal antibody

b.refer to specialist

there were some other options but most striking was this two.

17 yr old patient presented asking for contraception.she has recently to be sexually active.she has migrated from US.Her BMI is 32.what other screening you would do?

a.Human Papilloma Virus

b.DM

c.Hyercholesterolemia

32yr old presented for Pap screening.it has not detected HPV 16 18.LSIL positive.

a.colposcopy

b.take samples for smear in 6 to 12 weeks.

c.Repeat HPV DNA in 1 year

20 yr old complaing of food getting stuck in mid sternum.she had the same like episode last year.she also has eczema on examination.most likely Diagnosis.

a.achalasia

b.oesophageal web.

c.esoinophillic oesophagitis

4 yr old known asthmatic child was brought to ED following SOB not resolving with bronchodilators on examination her right side air entry was reduced .Rhonchi was present.what is most appropriate investigation

a.CXR

b.ABG

they are doing A survery on Primary prevention on DM.what is the best indicator of its success?

a.Morbidity

b.Mortality

c.incidence

d.life expectancy

CXR given with left pleural effusion and was given the history that he developed it after severe vomiting bout after eating a large Pizza.what is the next investigation?

a.Ic tube drain

b.CT

c.pleural aspiration

Another CXR with diffuse infiltrates in the chest.they have done pleural or pericardical aspiration (cant remember properly)and it shows malignant cells.what is the next best investigations?

a.CT Chest

im sorry I cant remember other options

A receptionist comes to you complaining of low pay grade at her job and the person who she is working at is your friend. what should you do?

a.tell her that you can speak to the other GP to help her with her pay

b.show conflict of interest.

c.refer her to a different GP

d.Tell the other GP regarding the low pay complaint of her

a patient comes to you and complain of chest pain.and she tells you that she requested a different doctor than her usual as she knew that the doctor needs to do a chest exam when you complain of chest painand she wasn’t comfortable last time when her doctor did it.what should you do?

a.tell her that touching is a usual way to do the chest exam

b.give her information how to report to APHRA

c.ask her if she is comfortable discussing what made her feel uncomfortable

d.Talk to the other doctor regarding the complaint.