The government of Western Australia has allocated nearly a million Australian dollars ($590,000) to fund 19 projects exploring generative AI applications in healthcare. These projects aim to address challenges within health and medical research, innovation, service delivery, and education and training, with specific focuses on diagnosing Alzheimer’s disease and ear conditions using generative AI. WA Medical Research Minister Stephen Dawson highlighted the technology’s potential to enhance efficiency, care quality, and value for healthcare organizations, despite acknowledging the uncertainties and risks associated with generative AI.
Australian Medical Council (AMC) MCQ Recalls FEBRUARY 2024 compilation
Patient had abdominal pain and liver enzymes elevated. Diagnosed with pancreatitis and treated. Now she is normal. On USS, she had multiple gallstones and CBD is 10mm. Next step of management?
a. ERCP
b. MRCP
c. Elective cholecystectomy in current admission
d. Elective cholecystectomy after 3 months
10 year old aborginal boy.Discharge coming from both ears .Right side tympanic membrane dull and retracted Also with yellowish greenish discharge from nostrils What is the most likely sequelae of this diagnosis
Cholesteatoma
Sinusitis
Hearing loss
Myringitis
60 year old man brought by his wife for hearing loss With a graph of his audiogram with increasing frequency showed lower hearing ability He had wax removal from his ear every 5 years on examination right side had a small soft cerumen
age related hearing loss
One was a primigravida woman in labour given syntocin but then 4 hrs later no progression with positive caput and molding what to do next Next..
stop syntocin
Definite.. C.S
Meconium staining with ctg showing slow fetal hr What to do next?
If CTG normal… go for continue CTG Have to do fetal blood sampling 1st and then go for CS.
But if the fetal compromise is severe go for CS directly
Pregnant lady with obstructed labor and vasa previa and i think what to do next?
CS
Pregnant lady with vasa previa but no operation theatre available So what maneuvers can you do after manual manipulation something like that
Left lateral position..
With dexa scan reading given and then what to do
Elderly pts with fractures admitted in the hospital and then delirium scenarios
Asking what to give
what is the cause
Middle age patient was a known chronic schizophrenic pt not listening to our questions What to give next Im haloperidol Iv diazepam
With the ecg given and asking what to do next stop digoxin given digibind
Another similar of an old man with a lot of meds with dizziness and syncope what should be stopped first in their medications digoxin, spironolactone, b blocker, ace inhibitors
52 year old lady come with elevated BP, states ‘White Coat Syndrome’. Correct statement regarding BP measurement?
A Wrist monitors OK for home BP checks.
B Clinic vs. ambulatory BP readings: different criteria for hypertension.
39 year old lady returned from Nigeria 2 months ago, lost 12kg, night sweats, productive cough. Suspect pulmonary tuberculosis. True regarding tuberculosis?
a 90% of M. TB won’t get active.
b Half of Aussie TB isolates are Isoniazid-resistant.
A 4 yo boy fell on head, brief loss of consciousness, vomiting, headache. Advise mother?
a. ER monitoring for 4 hours advised after injury.
b. Home okay, but hourly wake-ups needed tonight.
A 3yo girl with fever, maculopapular rash, parents opted against childhood immunisations. True statement regarding exanthems in childhood?
a Measles = sandpaper rash & ‘strawberry tongue’.
b Rubella = swollen lymph nodes, especially neck, behind ears & at back of head.
A 55 yr old DM female BMI 31 presented for control visit regarding Her cellulitis in It leg.. she mentioned that thus is her 4th cellulitis Event in same leg..she is well now healed cellulitis ,both legs with Varicosities but no chronic venous insufficiency signs but betw toes There is tenia infections.. asking what is the major factor causing her Problem?
Obesity
varicose veins
dm
alcohol
46yo with schizophrenia, 6 wks lip smacking. Medication causing adverse effect?
a Clozapine
b Risperidone
c Haloperidol
elderly female with delusions accusing neighbours of trying to break in to her house, spraying poisonous gas and wearing gas masks at home
Paranoid mood
Refractory psychosis
Paranoid delusions.
elderly female with abdomen pain, afib,no altered bowel movements. Presenting with normal bp, no fever however other features of shock
a AA rupture
b Mesenteric ischemia
c Pelvic abscess
25 year female came for asthma follow up. Taking short acting beta 2 agonists 7 days a weeks. Still complaints iof breathlessness at night.
a long acting beta agonists
b corticosteroid inhaled
c montelukast
same questions regarding father bringing his child after bat bite – abt post rabies prophylaxis
pulsatile painless mass in the groin. found in middle aged woman. Next best step
USG
I&D
rectal hematoma diagram – remember from old recall – think drainage and deroofing
Aboriginal child with weeks of history of sore throat, came with difficulty in breathing, reduced breath sounds and X rays showed patchy opacities. Further supportive Ix?
antisteptolysin O
CT chest
sputum cytology
Child came with only difficulty in drinking water. Has no other symptoms. Urticaria or eczema (don’t remember) on both Elbow flexures
globus hystericus
eosinophilic esophagitis
x-ray complicated fracture of shaft of humerus (picture) first step –
x-ray
debridement
reduction in the casualty
middle aged refugee shown cxr, no fever, just chiils, rigors and wt loss. What is the diagnosis procedure
Branchoalveolar lavage
sputum cytology
interferon gamma assay
39 lady with suprapubic pain, dysuria, vulval pain, and itching, w/ white vaginal discharge. Soft abdomen with mild suprapubic tenderness. Initial investigations?
a Urine MC&S, vaginal swab & pelvic ultrasound
b Pregnancy test, urine MC&S, vaginal swab, blood sugar level
32 yr old female come to you for Mirena she is on regular condom she has no any medical history, just sometimes heavy menses of 30-35days cycles..not wants pills bec of forgetfullnes, which one is true regarding mirena.
Pregn rate is less than %1
mirena can correct irregular cycles
she cannot use mirena bec she is nulliparous
Mirena should be replaced after 3years Stop bleeding not correct it as regular cycle
30 male with 2-day constant sharp chest pain, worse on deep breathing and coughing. Active, training for triathlon. ECG shows widespread ST elevation and PR segment depression. Diagnosis?
a Hyperkalaemia
b Rhabdomyolysis
c Pericarditis
12month baby with 2-month fatigue, decreased appetite, abdominal cramps, nausea, low BP, dehydration, hyperpigmentation. Likely diagnosis?
a High early morning cortisol; low adrenocorticotropic hormone (ACTH); hypernatraemia
b Low early morning cortisol; elevated adrenocorticotropic hormone (ACTH); hyponatraemia
7month baby with 24h fever, bloody diarrhea, vomiting, abdominal pain. Most likely cause?
a Campylobacter
b Entamoeba histolytica
c Adenovirus
49yo man w/ +ve HBsAg, -ve HBsAb, +ve HBcAb, HIV-negative, HCV-negative. Next step?
a More blood tests: Hep B e Ag, Ab & DNA load.
b Hepatologist referral for possible anti-virals.
65F w/ rapidly growing 15mm lesion on L forearm. No palpable lymphadenopathy. Likely diagnosis?
a Acne
b Folliculitis
c Keratoacanthoma
78M, 3d rhinorrhea, green sputum, fever, pleuritic pain. Left-sided crepitations, chest x-ray confirms left lower lobe pneumonia. Empiric treatment?
a/ Clarithromycin 500 mg orally, 12-hourly for 5-7 days
b/ Amoxicillin 1g orally 8 hourly for five to seven days
12-mo boy w/ fever, rash, lethargy, decreased appetite. MMR vaccine given 1 wk ago. Likely vaccine reaction?
13-a/ Previnar 13
b/ M-M-R II
c/ Fluarix Tetra
15yo netball player w/ knee injury after twisting her knee. Unable to fully extend knee. Father wants MRI. MRI referral for knee injury?
a/ Medicare covers knee MRI for 16+ with suspected meniscal tear (GP referral needed), but not always if diagnosis is clear.
b/ Knee MRIs can lead to more diagnostic knee arthroscopies.
Middle age man with pain on swallowing for 2 months, no fever, no weight loss, initial investigation ?
Barium meal
Endoscopy
Stool occult blood
Nanometer
Urea breath test
32yr,female with 8 month amenorrhea, had twins by IVF, bmi 32 , on resperidone and thyroxin. complain of milk discharge. Cause?
PCOS
Risperidone
Prolactinoma
Pituitary denim’s
Hypothyroidism
Aboriginal agitated known psychiatric patient, long waiting for telephone operated, best thing to do?
Ask aboriginal ED security to attend
Ask other ward aboriginal nurse to come
Waiting for tel interpreter
Man with painful swelling “over” the ingunal ligament after weekend heavy exercises. can’t reduce, possible dx?
Inguinalhernia
Femoral hernia
Torsion
Lymph node
Carcinomatous lesion over pinnacle with lots of crusts
Basal cell ca
SSCA
Bowens disease
Keratokanthoma
60yo man w/ hypothyroidism on thyroxine 100mcg daily. Chemist out of stock of Eltroxin. Advice on managing thyroxine?
a/ Switch directly from Eltroxin 100mcg to Eutroxig 100mcg, retest thyroid in 12 months.
b/ Switch from Eltroxin 100mcg to Eutroxsig 125mcg, retest thyroid in 4 months.
13yo Aboriginal and Torres Strait Islander girl. Discuss preventative health. Appropriate checks?
a/ Check smoking status; check body mass index using centile charts; ask about gambling
b/ Recommend syphilis serology; ask about gambling; check fasting blood sugar level
82yo female collapsed in waiting room, unresponsive, abnormal breathing. Shockable rhythm on defibrillator. Medications to administer while waiting for ambulance?
a/ After 2nd shock: 1mg Adrenaline (every 2nd loop), 300mg Amiodarone after 3 shocks.
b/ After 2nd shock: 2mg Adrenaline (every 2nd loop), 0.5mg Atropine after 3 shocks.
15yo girl recently became interested in animal rights and commenced a vegan diet. Which is true regarding dietary sources of essential nutrients?
a/ Vegan diets contain plentiful amounts of omega-3
b/ Non-haem iron is found in eggs and plant foods
Calculation of specificity in new screening test?
a) [A / (A + B)] x 100
b) [D / (B + D)] x 100
2yrs child w Umbilical hernia,iritable parents concerning what to do 1.refer to emergency 2.refer to paediatric surgeon 3.reassure
18yo female, treated for chlamydia 1 wk ago. Wants to know when can resume sex. Boyfriend the only partner, no sex in past 2 wks, has been notified. Advice?
a/ Test of cure required 4 weeks after treatment completion.
b/ Boyfriend needs NAAT test and to avoid sex until his results are negative, or for 7 days after his treatment.
28yo female, 8 wks pregnant, asking about vaccinations during pregnancy. Advice?
a/ Unvaccinated close contacts of infants under 6 months need Pertussis vaccine
b/ If not exposed to Varicella before, get 2 doses of vaccine (now & second trimester).
58yo female, no significant PMH, no smoking, wants to book in for ABI screening. Advice?
a) Consider PVD screening (age > 50), but ABI not needed (low risk).
B) No screening for her – insufficient evidence for low risk.
19 lady w/ swollen, painful left arm. No trauma, recent shelf stacking. Left arm swelling, slightly mottled. Radiology & pathology delayed. Weekend management?
a. Start heparin for DVT suspicion.
b. Rest, ice, compression, elevation for sprain.
37 lady with 2 wk change in vision of left eye. Eye painful with movement, decreased clarity of coloured objects. Visual acuity 6/18 in left eye, red-green confusion with colour testing. Likely cause?
a/ Conjunctivitis
b/ Scleritis
c/ Optic neuritis
Dm patient with sudden painless loss of vision before 3days asking Most probably cause? 1.Retinal detachment 2.vitreous hemorrhage 3.CRAO
73yo male with bilateral hip prostheses scheduled for dental work. Dentist requests antibiotic prophylaxis. Recommendations?
a Advise to proceed with the dental work without any specific prophylaxis
b Advise taking 2g amoxicillin orally one hour prior to the dental procedure
65yo male with new pigmented skin lesion on left scapula, enlarging for 3 months. Melanoma confirmed with Breslow thickness 1.2mm. Referred urgently for wide local excision and SLNB.
a High complication rates for sentinel lymph node biopsy.
b Staging, not just diagnosis, with sentinel biopsy.
83yo male newly incontinent of urine. Urine microscopy, culture and sensitivities unremarkable. Other basic investigations?
a Repeat urine microscopy, culture and sensitivity and a renal ultrasound
b A portable bladder scan to assess post-residual volume and a 3 day bladder chart
When the nappy changes, the patient doesn’t like it and is irritated. On examination, there is a mild swelling in the vertebra and thoracic region with no point tenderness. What is the initial investigation? US Thoracolumbar Xray MRI
15yo boy with acute onset left-sided scrotal pain, radiating to left lower abdomen, nausea, vomiting. Temp 36.7. Negative urine dipstick. Next step?
a. Arrange an urgent Doppler scrotal ultrasound with review later today
b. Recommend urgent referral to the emergency department for surgical review
Patient for cellulitis treated with cefazolin, then picture given after 3days of treatment macular drug reaction on trunk, asking the Cefazolin stopped which one not good for patient for future? 1.all cephalosporins 2.all penicillins and cephalosporins 3. just cefazolin 4.clindamycin
20yo new patient with first psychotic episode 3 wks ago, discharged on quetiapine. Wants regular GP. Recommended baseline investigations/health checks?
a. Fasting bloods, prolactin, eye check (cataracts).
b. Fasting lipids, liver, electrolytes, urea/creatinine, prolactin.
34yo male with 6 mo of fatigue, polyarthritis, family hx of diabetes and iron overload disorder. Normal pattern of inheritance for hereditary haemochromatosis?
a. Autosomal Dominant
b. X-Linked Dominant
c. Autosomal Recessive
7yo boy with BP 145/90, likely primary or essential hypertension. Feature most likely to fit with essential hypertension?
a/ Abdominal bruit
b/ Ambiguous genitalia
c/ Family history of hypertension
25yo female traveling to Bali in 2 months. Wants to prevent travellers’ diarrhoea. Advice?
a/ Norfloxacin 400mg daily for trip.
b/ No antibiotics, but azithromycin script for severe traveler’s diarrhea
7yo boy with 4mo of severe periumbilical abdominal pain, no vomiting, fever, bowel changes, normal appetite and examination. Wnl urinalysis. Likely diagnosis?
a/ Acute glomerulonephritis
b/ Appendicitis
c/ Non-specific abdominal pain
55yo plumber with sudden onset floaters, flashes, and blurred vision in left eye. Fundoscopy shows grey shadow in lower fundus. Likely diagnosis?
a/ Acute glaucoma
b/ Amaurosis fugax
c/ Retinal detachment
51yo woman with pruritic rash under breasts for 2 months. Screening mammogram and FOBT done at 50. Important investigation for rash?
a/ Fasting blood glucose level
b/ Bilateral mammogram
A man with RTA Gsc 6/15, has long heavy bearded bp 100/75, RR 9 , sa02 88 asking initial step to do 1.shaving the beard to ensure mask ventilation 2.9%6100 02 mask ventilation immediately 3.CT 4IV fluid
13yo boy with 3mo of knee pain, worse after basketball. Tender lump on right knee, pain better with rest, worse with stairs. Likely diagnosis?
a/ Osgood Schlatters disease
b/ Synovial plica pain
4wo girl with excessive crying for the past week, lasting 1-3 hours. Normal physical examination. Appropriate next step?
4-a/ Commence a trial of antacid and reassess
b/ Organise urine microscopy, culture and sensitivities and review
73yo man with SOB and productive morning cough for 6 months. Extensive smoking hx. Spirometry?
a/ Fully reversible airflow limitation on spirometry testing
b/ A ratio of FEV1 to FVC of < 70% and FEV1 < 80% of predicted after bronchodilator therapy
32yo male with 2x blood in semen, no pain, frequency, anorexia, bone pain, weight loss. No hx or risk factors for prostate cancer. Initial investigations?
a/ Urine tests, cytology, PSA, CT, chlamydia/gonorrhea PCR.
b/ Urine tests, blood count, cytology, ultrasound, cystoscopy.
5-week-old baby with impalpable left testis. Next step?
a/ Urgent pediatric surgery referral.
b/ Re-examine in 3 months, surgery if left testis still not palpable.