The Australian government has accepted the recommendation of the Australian Technical Advisory Group on Immunisation (Atagi) and will offer a fifth Covid vaccine dose to all Australian adults who have not received a booster or had a confirmed case of Covid-19 in the past six months. Eligible individuals will be able to receive the additional dose from 20 February onwards, according to Health Minister Mark Butler.
According to a statement from Health Minister Mark Butler, the Australian government currently has 4 million booster doses specifically designed to combat the Omicron variant, with an additional 10 million expected to arrive this month. Minister for Aged Care Anika Wells and Butler plan to reach out to aged care providers and suggest that they involve local pharmacists and general practitioners to help distribute the extra booster doses within their facilities.
According to the minister, Atagi recommended that individuals aged 65 and over, as well as younger adults with medical comorbidities, disabilities, or complex health needs, should receive a booster dose in 2023. Children under 18 will not receive an additional booster dose, except if they have health conditions that put them at risk. This is due to the low incidence of severe illness and high level of hybrid immunity in this age group.
Reported cases have been on a steady decline since reaching a peak of 16,000 per week in December – the highest rate recorded since August – and now have a rolling seven-day average of 2,600 cases. However, there was a rise in deaths reported in aged care centers last month, which was caused by the surge in cases earlier in the summer.
Despite the need for booster doses, there has been a decline in demand for them, with Australia discarding almost 20% of its national Covid vaccine supply in September.
As a side note, 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 FEBRUARY 2023 compilation
Pregnant lady at 39 weeks present with painless bleeding of 1000ml fetal hr 155. Mother heart rate 100. Cervix dilated and 5cm effaced no contactions of uterus which of the option will help to assist in diagnosis?
A no contractions
B fetah hr
C mother hr
middle age presented to ER, complaining seizure. dx as cased of generalised tonic clonic seizure. hx of stroke and hypertension on warfarin and other drugs. what is best drug for him?
B sodium valproate
30yo painful knee. + painful urination before onset of painful knee. physical examination shows edematous knee and bilateral conjunctivitis with mucopulurent discharge
B rheumatoid arthritis
c osteochondritis dessicans
d pigmented vilonodular tenosynovitis
e gouty arhthritis
scenario of hoarding disorder. wife brings husband to gp complaining she can’t use her kitchen and toilet as her husband brings collects rubbish. sx are from past 20 years. when his wife asked about collection of rubbish, he replies nothing is waste it might be useful one day. underlying cause of the behaviour. SOCIAL ANXIETY or ALCOHOL not in option
A social avoidant
B childhood sexual abuse
homosexual man asking for pre exposure prophylaxis. HIV test negative
A daily tenofovir and emtricitabine
B tenofovir and emticitabine after exposure
C tenofovir and emtricitabine before high risk exposure
D do hiv test
4 yo boy brought to see you because of jaundice of eye and intermittent pallor with normal wbc and platelet. only anemia is present with hb 8.0
respiratory viral infection
patient marked pallor and splenomegaly. what is most appropriate management
B. oral iron
D. Folic acid and vitamin B12
45yo man sudden onset skin rash, oral lesion with fever. Not able to eat. Conjunctivae inflamed. Erosion at oral mucosa. Rash at trunk and thigh. Prescribed TMTSFX 5 days ago. Dx?
a/ Staphylococcal scalded skin syndrome
b/ Stevens-Johnson syndrome
1month boy poor feeding. Breathing hard and fast during feed. 4/6 holosystolic murmur at left sternal border with thrill. Lungs rales bibasal. Liver palpable. Cause?
a/ Increased left ventricular afterload
b/ Increased pulmonary blood flow
34yo lady fatigue become tired easily after walking short distance. Difficulty combing hair. Father die of stroke. Mother dm. she has tachycardia. Awkward drop into chair when ask to sit. Decreased shoulder muscle mass. Cause?
a/ Cerebellar dysfunction
b/ Neuromuscular junction disorder
c/ Thyroid disease
young woman. Panic attack. Severe anxiety. Trembling sweating chest tightness SOB when giving presentation. Concern lose job resulting poor asleep. Avoids eye contact. Dx?
a/ Generalized anxiety disorder
b/ Social anxiety disorder
4month girl. Fussiness and persistent fever 2 days. 1 episode of vomiting. Not finishing breastmilk. Still wet diapers but urine no smell or blood. Exam shows tired baby. Next step?
a/ Abdominal ultrasound
b/ Urinalysis and urine culture
5mth old, full-term boy is brought due to fever, runny nose & intermittent coughing. His 3yrold brother had an upper respiratory tract infection last wk. Takes vitamin D. Exam shows crusted rhinorrhea at the nares. Marked on chest radiograph?
a/ Right upper lobe atelectasis
b/ Right upper lobe infiltrate
25 yo woman comes due to chest pain that began 2 days ago. Unable to sleep prone because of pain. Last menstrual period was 3 wks ago. Takes a daily folic acid supplement. Palpation demonstrates bilateral, nonfocal chest tenderness & diffusely nodular, dense breasts. Diagnosis?
b/ Fibrocystic changes
teenage girl is brought for a preparticipation sports physical. She is planning to play lacrosse, which she had played the previous school yr. Posture seemed abnormal. Physical exam shows a right-sided lumbar prominence during forward bend test. Next step?
a/ MRI of the spine
b/ Surgical fixation
c/ X-ray of the spine
43yr old woman comes with abdominal pain & dark urine. Physical exam shows right upper-quadrant tenderness without guarding or rebound. Further workup, including MRI of the abdomen, shows hepatic vein thrombosis. Diagnosis?
a/ Acute intermittent porphyria
b/ Paroxysmal nocturnal hemoglobinuria
elderly woman is brought for lethargy & drowsiness. Medical history is significant for hypertension, chronic kidney disease, chronic low back pain & frequent constipation. Strength in the upper & lower extremities is 2/5 & deep tendon reflexes are absent. Serum creatinine 200. Diagnosis?
a/ Cerebellar infarction
21yrold man being stepped on the chest by a bull approx 30 min ago. BP 75/50. Bilateral chest tubes with 1.5 L of blood is returned from each side; Vital signs do not improve. 4 units of packed red blood cells are prepared for transfusion. Blood products to be administered?
a/ 4 units of cryoprecipitate only
b/ 4 units of fresh frozen plasma and 4 units of platelets
c/ 4 units of platelets only
56yold man comes due to an episode of transient right eye blindness that lasted an hr. Smoked a pack of cigarettes daily for 30 yrs. BP 160/94. BMI 32. Facial plethora is present. Abdominal exam reveals splenomegaly. Best therapy?
middle age car mechanic comes due to a 4-wk history of right elbow pain. Tenderness on palpation around the lateral distal humerus. Pain is reproduced when testing grip strength & with resisted wrist extension. Next step?
a/ Elbow counterforce brace
b/ Elbow x-ray
old man with severe difficulty speaking, right visual field defect & severe right lower facial droop. Weakness & sensory loss in right arm & leg. Has transient ischemic episode with 30% stenosis in carotid arteries. Has hypertension, hyperlipidemia, type 2 diabetes mellitus & ADPKD. Cause?
a/ Cardiogenic emboli
b/ Carotid artery atherosclerosis
man with intermittent right knee pain for the last few mths. Has type 2 diabetes mellitus. BMI 36. Right knee has bony enlargement & a small effusion. Synovial fluid shows a leukocyte count of 1,800/mm3 with no crystals. Medication for relief?
middle age man hx of travelling cruise to Indonesia. Presented to you now with fever, nonproductive cough & shortness of breath for the past 2 days. Also has headache, abdominal pain & diarrhea. History of type 2 diabetes mellitus & smoked a pack of cigarettes/day for 20 yrs. Lung crackles bilaterally; interstitial infiltrates. Sodium 128. Antibiotics? Legionella infection.
26yo woman comes due to pulsatile headaches associated with nausea over the past 6 wks. Has transient episodes of blindness lasting 2-3 secs. 16-kg weight gain over the past yr. BMI 43. Funduscopy shows bilateral papilledema. Feels better after the lumbar puncture. Treatment?
b/ Cerebral venous sinus stenting
20 yo woman comes due to hearing loss. Trouble with balancing poses during yoga. Her mother also developed hearing loss in her 20s. Standing on 1 foot is difficult, especially with closed eyes. Audiogram shows bilateral sensorineural hearing loss. Cause?
a/ Multiple sclerosis
51 yo old man comes due to frequent itching, especially after bathing. Occasional headaches & dizziness. His sister has bipolar disorder. BMI 30. Face has a ruddy cyanotic appearance. Spleen is palpable 4 cm below the left lower ribs. Likely seen on further workup?
a/ Low resting arterial oxygen saturation
b/ Low serum erythropoietin level
75 yo man in end-stage multiple myeloma. Severe pain due to pathologic vertebral compression fractures & osteolytic rib lesions. Continuous IV morphine infusion; infusion rate has been increased several times. Pulse oximetry 89%. Patient is drowsy but constantly moans in pain. Next step?
a/ Continue morphine at the same dosage and reevaluate in 48 hours
b/ Increase morphine until adequate pain control is achieved
young woman with sudden-onset blurry vision, numbness & tingling in the legs. Stressed at school & worried about her mother’s health. 2 episodes of urinary incontinence. MRI shows multifocal, white matter, hyperintense T2 lesions in corpus callosum & periventricular area. Likely to develop?
18 months old boy is brought due to developmental concerns. Does not walk independently. His older brother began walking at age 12 mths. Speaks in 2- to 3-word sentences & follow simple commands. Height, weight & head circumference track at the 20th percentile. Next step?
a/ Brain imaging
b/ Creatine kinase level
53yo man comes due to persistent fatigue. Started a therapeutic dose of fluoxetine 2 mths ago after being diagnosed with major depressive disorder. Medical history includes hypertension treated with enalapril. 4-kg weight gain over the past 2 mths. Appears depressed & speaks softly. Next step?
a/ Continue fluoxetine and add methylphenidate
b/ Discontinue fluoxetine and begin bupropion
34yo woman with worsening difficulty hearing, especially in the left ear. When environment is noisy, she can understand speech better than when in a quiet room. Hears ringing. Her mother had surgery for hearing loss in her 40s. A slight reddish hue behind the left tympanic membrane. Cause?
a/ Bony overgrowth of the ossicles
b/ Degeneration of neuronal cell bodies
30+ yo man comes due to lack of sexual desire & erectile dysfunction for 3 mths. Medical history is significant for opioid use disorder, for which he has been taking methadone for 2 yrs. Gained 4.5 kg over the past 6 mths. BMI is 24.5 kg/m2. Testes are small & soft. Cause?
a/ Klinefelter syndrome
b/ Medication adverse effect
teenage girl of short stature with height <3rd percentile & weight at 20th percentile. Not yet undergone menarche. A 2/6 systolic ejection murmur heard loudest in left infraclavicular area. Breast development is Tanner stage 1 & pubic hair development is Tanner stage 4. Present?
a/ High estrogen
b/ High FSH
c/ High inhibin A
middle age woman slipped & fell backward down half a flight of stairs. Has right-sided back & chest pain. X-ray reveals a minimally displaced, posterior fracture of the right sixth rib & bilateral basilar atelectasis. Essential for preventing pulmonary complications?
a/ Adequate analgesia
b/ Continuous positive airway pressure
middle woman is evaluated for fatigue & exertional dyspnea. Difficulty walking for more than 1 or 2 blocks without becoming short of breath. Significant for hyperlipidemia, hypertension & type 2 diabetes mellitus. BMI 55 . There is trace bilateral lower-extremity edema. Cause of dyspnea?
a/ Airway inflammation and bronchospasm
b/ Alveolar hypoventilation
4-yr-old boy is brought due to concerns about his vision. Born at 34 wks gestation & takes no daily medications. Visual acuity is 20/30 in the right eye. In the left eye, the patient is unable to see the visual acuity chart & is able to count fingers only at a close distance. Cause?
a/ Retinopathy of prematurity
b/ Uncorrected refractive error
middle age woman comes due to bloating, flatulence, abdominal cramps & explosive watery diarrhea. These symptoms occur after ingesting dairy products. Physical exam shows abdominal distention & borborygmi. Further investigation test results observed?
a/ Decreased stool osmotic gap
b/ Positive hydrogen breath test
man with history 6 mths ago, diagnosed with papillary thyroid cancer & underwent total thyroidectomy, followed by radioactive iodine treatment. Since then, takes levothyroxine. Significantly elevated serum thyroglobulin concentration compared with the previous level 6 mths ago. Explaination?
a/ Excessive thyroid hormone replacement
b/ Recurrence of the thyroid malignancy
5-mth-old girl is brought due to abnormal body movements started a mth ago.During exam, the patient suddenly flexes at the hips & elbows for approx 2 secs. Skin exam shows several hypopigmented, elliptical macules on the chest. The mother has similar lesions. Cause?
a/ Acoustic schwannoma
b/ Subependymal giant cell tumor
39-yr-old woman with worsening urinary symptoms. Diagnosed with multiple sclerosis 3 yrs ago. Has hypertension & glucocorticoid-induced hyperglycemia. Hyperreflexia of lower extremities & mild intention tremor. Scan reveals a contracted, small bladder. Cause?
a/ Obstruction of bladder outlet
b/ Overactivity of detrusor muscle
25-yr-old homeless man with a history of schizophrenia, destroyed a television set at a local electronics store & then became extremely agitated & violent. Given haloperidol, which calms him down. Physical exam shows a sustained contraction of his neck to the right side. Next step?
52-hr-old girl with abdominal distension. Loops of small bowel with paucity of air in large intestine & rectum. Left lateral decubitus view shows free air above liver & emergency laparotomy is performed. Thick, sticky stool evacuated from ileum & colon appears diffusely narrow. Risk?
a/ Bicuspid aortic valve
b/ Chronic rhinosinusitis
64-yr-old woman with a neck lump. Significant for obesity, type 2 diabetes mellitus & nonalcoholic fatty liver disease. 2-cm, hard, nontender cervical lymph node close to the right submandibular gland. Mild hepatomegaly. Fine-needle aspiration reveals squamous cell carcinoma. Most helpful?
a/ Abdominal CT scan
middle age presented to the ER, with complaint of seizure. diagnosed as a case of generalized tonic clonic seizures. He has a history of stroke and hypertension and takes warfarin and other drugs. What will be your best drug of choice for him?
b/ sodium valproate
elderly-old man is agitated & confused after surgery for a right hip fracture. History of mild cognitive impairment, hypertension, gout & benign prostatic hyperplasia. Faint mid-systolic murmur heard over the left sternal border. Lower abdomen is tender & palpation exacerbates the agitation. Next step?
a/ Abdominal x-rays
b/ Bladder ultrasound
boy is brought due to right knee swelling after a fall. Last wk he fell & developed a large bruise to his left hip. Pain with knee movement & limited range of motion. Scattered ecchymoses to the anterior shins. Radiograph of the right knee shows a large effusion. Next step?
a/ Bone marrow evaluation
b/ Coagulation studies
19yo gravida 2 para 1, at 38 wks gestation comes due to severe abdominal pain & vaginal bleeding. Prior pregnancy is cesarean delivery at 24 wks gestation for placental abruption. Uses cocaine multiple times a wk. FHT shows multiple prolonged decelerations to 100/min. Risk factors?
a/ Maternal age
b/ Prior uterine surgery
Oxycodie in prostrate cancer..side effect
man looking at Fan.sayig his neighbour is trying to poison water take..what to give
husband gambling but aware of his behaviour wife complainting to doctor.. management?
patient gives golden watch to doctor. Accept/return/politely refuse?
diabetic foot management?
Lot of psychiatry drugs.riseperidone..clozapine
fever after 7days in pueperium??causes?
colon cancer screening question
breast cancer screening
sigmoid colon xray given? managemenr?
Xray chest In a 18monrh child -management?
Another xray..diagnoses showing patchy infiltrate after travel..Tb?
Milky discharge urethra after return from Thailand..cause?
Right side tongue ulcer in a 40 pack smoking man..also he had gonnorhea 6month back..reason?
Jaundice 6hours after birth reason?