Preparations are underway for a celestial extravaganza as the southern lights, known as the aurora australis, are poised to illuminate the night skies over southern Australia this Sunday. The eagerly awaited event, fueled by charged solar particles interacting with Earth’s magnetic field, promises a breathtaking display of colorful ribbons dancing across the heavens. Enthusiasts and astronomers alike are gearing up for prime viewing spots, with Tasmania, Victoria, and South Australia expected to offer optimal conditions away from city lights.
Photographers are advised to seize the moment, capturing the ethereal beauty of the aurora australis against the backdrop of the Australian landscape. Social media platforms are abuzz with anticipation, as Australians eagerly await the opportunity to share their experiences under the hashtag #AuroraAustralis.
Beyond the spectacle itself, the event holds cultural significance for indigenous communities, who have long revered the southern lights as a connection to their ancestral heritage. As preparations unfold, excitement mounts for an unforgettable night of celestial wonder, reminding us of the profound beauty and mystery of the universe we inhabit.
Australian Medical Council (AMC) MCQ Recalls MAY 2024 compilation
23lady pre-travel consult for Uganda trip in 6 wks. Planning to volunteer, explore, and trek. Discussed travel vaccinations, travelers’ diarrhea, and food safety. Highest risk of death?
a/ Advise highest risk of death is from road traffic accidents.
b/ Advise highest risk of death is from terrorism.
34woman w/ skin concern: small brown patches on nose, cheeks, upper lip. Darkening over 4 months, no other rash. Works as a chef, etonogestrel implant 2 yrs ago. Next step for her condition?
a/ Start topical hydroquinone 2% cream twice daily.
b/ Refer for dermatologist for IPL laser treatment.
78 old man collapses in waiting room, unresponsive, abnormal breathing. ALS measures, AED records non-shockable rhythm. Intravenous Adrenaline stage?
a/ Once AED finds non-shockable rhythm, repeat every 2nd CPR loop.
b/ Once AED finds non-shockable rhythm, repeat every CPR loop.
Research paper on a new screening test, calculating negative predictive value. Table included with test characteristics. Negative predictive value calculation?
a/ [D / (C + D)] x 10
b/ [A / (A + B)] x 100
c/ [A / (A + C)] x 100
Patient asymptomatic with popliteal artery aneurysm, pulse ok. Next step?
a/ CT
b/ duplex
c/ abdominal US
89 lady advanced breast cancer w/ metastatic disease. In terminal phase, started on dexamethasone and morphine for pain. Rapid deterioration, agitation, possible chest infection.
a/ Haloperidol 0.5mg subcutaneously 4-hourly in evening.
b/ Oral escitalopram solution 10mg nocte.
59man w/ erectile dysfunction. Results normal, no anxiety/depression. Past MI, active lifestyle, meds include atenolol, perindopril. Contraindication to PDE5 inhibitor?
a/ His current use of glyceryl trinitrate patches
b/ His past history of myocardial infarction
c/ His current use of oral atenolol
68 lady w/ irregular pulse and AFib. Past hypertension, aortic stenosis. CHA2DS2-VASc score 3, HAS-BLED score 1. Next step for AFib management?
a/ Commence her on rivaroxaban 20mg orally daily
b/ Commence her on 100mg oral aspirin daily
C / Commence her on clopidogrel 75mg orally daily
An elderly man presents with hematemesis. Has 1 litre of blood and 2 episodes of melena. After resuscitation next management?
a/ omeprazole
b/ gastroscopy
c/ h pylori eradication
d/ surgery
e/ cimetidine
A 42yo male with 2 days history of right sided pleuritic chest pain, fever, tachypnea, cxr shows right base consolidation and moderate pleural effusion. Needle aspiration showing empyema. Culture was negative. Apart from starting antibiotics what is the next best step?
a/ intercostal drainage
b/interpleural fibrinolysis with pa
c/ video-assisted thoracoscopy drainage
d/ repeat cxr in 3 days
23lady w/ concern about spicy foods on Thailand trip. Local Thai food makes tongue sting and rash changes daily. likely diagnosis?
a/ Geographic tongue
b/ Oral candidiasis
c/ Oral psoriasis
15-month-old girl w/ choking episode earlier in the day. No recent illness or medical history. Normal exam. Correct statement about paediatric airway foreign bodies?
a/ 50% of children w/ airway foreign body have no symptoms.
b/ Normal chest x-ray does not exclude airway foreign body.
41gentleman w/ concern about tongue appearance: brown, furry, and bad breath. Tried treating w/ antibacterial mouthwash, no improvement. Takes lansoprazole daily, smokes 20 cigs/day.
a/ Diagnosis can be made on clinical grounds, no investigation needed.
b/ Swab tongue for bacterial microscopy, culture, sensitivity.
c/ Perform punch biopsy of tongue.
58 guy w/ T2DM, on metformin and atorvastatin. Concerned about statin myopathy, urine normal color. Symptoms most concerning for myopathy?
a/ Muscle soreness in both of his shoulders
b/ Pain in both of his knees when walking
c/ Intermittent twitching of the right side of his face
66 woman w/ history of chickenpox and shingles, requests zoster vaccine. Up-to-date on other vaccines, PMH includes osteoporosis and hypertension. Advice regarding Shingrix vaccine?
a/ Vaccination will be funded by Australian gov’t under National Immunisation Program.
b/ Serology needed before vaccination.
76 man w/ burning, itchy rash on L flank, similar to previous shingles episodes. Third presentation w/ herpes zoster in 6 mos. Lymphocytosis noted in recent blood tests. Approach?
a/ Refer for further pathology tests: full blood count, LFTs, flow cytometry, urea, electrolytes, creatinine.
b/ Refer for skeletal survey, serum paraprotein.
6yo boy w/ hyperactivity, poor attention at school, and snoring. Mouth breathing during sleep, wakes up a few times at night. cause?
a/ Adenotonsillar hypertrophy
b/ Overweight / obesity
c/ Allergic rhinitis
32 female returned from travel. Developed febrile illness w/ headache, myalgia, arthralgia, and rash. Temp 39.5°C, generalized maculopapular rash. diagnosis?
a/ Dengue fever
b/ Chikungunya virus
c/ Influenza
55 male presents w/ high temp, shivering, upper abdo pain, and jaundice. Most likely diagnosis?
a/ Acute cholangitis
b/ Biliary colic
c/ Acute Hepatitis C infection
55 man w/ painful R great toe, hx of HTN, renal impairment, on ramipril. Acute gout diagnosed. Safest first-line treatment?
a/ Oral prednisolone 30mg once daily for 3-5 days
b/ Oral celecoxib 200mg twice daily for 5 days
45 lady discloses husband pushed her against a wall after dinner was late. She’s frequent patient, feels safe going home. Appropriate action?
a/ Speak to your colleague about taking over husband’s care, while continuing to see wife.
b/ Ask wife to bring husband in for another appointment to discuss their relationship.
3yo child w/ 2-day hx of fevers, rhinorrhea, and R ear pain. Temp 38.1C, red, inflamed, bulging R tympanic membrane w/ perforation. Correct statement?
a/ Smoking in household contacts is a modifiable risk factor.
b/ Topical 2% lignocaine is safe for short-term analgesia in child.
28 lady requests repeat OCP prescription. Asks if she needs cervical screening, never had one before, Gardasil vaccination in high school. Advice based on screening guidelines?
a/ Advise she is eligible for self-collected sample.
b/ Advise she can self-collect sample at 35yo or older.
2yo w/ hay seed in R ear canal, no occlusion. Appropriate way to manage?
a/ Swaddle baby tightly, attempt removal w/ torch and Alligator forceps.
b/ Flush ear canal w/ saline using butterfly tubing and syringe.
40 male w/ 1 wk hx of thick yellow urethral discharge after sex w/ sex worker in Thailand. Purulent urethral discharge seen. Suspected diagnosis?
a/ Gonorrhoea
b/ Chancroid
c/ Chlamydia
26 lady wants Depo-Provera repeat, last shot 4 months ago, negative pregnancy test. Counseling on injection, true statement?
a/ Next Depo-Provera injection today, use condoms for 7 days.
b/ Amenorrhoeic, assume Depo-Provera is still effective.
10yo boy w/ recent coeliac dx. Most likely food to exacerbate?
a/ Barley
b/ Corn
c/ Rice
7yo girl w/ 3-day fever, sore throat, headache, red rash except on face. Strawberry tongue, red and pus-covered tonsils. Likely diagnosis?
a/ Scarlet fever
b/ Roseola
c/ Epstein-Barr virus infection
61 female w/ T2DM on metformin for 6 months. Advice on self-monitoring of blood glucose?
a/ No need to test blood sugars at home.
b/ Check blood sugar four times a day (waking, pre/post meals, bedtime).
78 male w/ advanced SCC neck, too ill to travel, wants to die at home. Fam educated on meds. Advice for handling catastrophic hemorrhage?
a/ Use dark towels to help disguise blood; double morphine and 10mg midazolam if catastrophic hemorrhage occurs.
b/ Call 000 for immediate hospital transfer in case of catastrophic hemorrhage.
24 man w/ epilepsy dx, event described: stiff limbs, jerking, wet pants, confusion. Medically fit to drive, seizure-free period?
a/ 6 months
b/ 2 months
c/ 3 months
64 lady new patient w/ box of verapamil, unsure why she’s taking it. Screening for contraindications. Non-dihydropyridine CCB contraindication?
a/ Hypertensive patients with heart failure with reduced ejection fraction
b/ Hypertensive patients with diabetes mellitus
7yo boy fell off bike, abrasions, lost tooth brought in tissue. Immediate advice?
a/ Avulsed tooth should be in dairy milk, saliva, or saline for re-implantation.
b/ Antibiotic cover: doxycycline 5mg/kg up to 200mg first dose, then 2.5mg/kg up to 100mg daily for 7 days.
24 female dx w/ epilepsy, recent seizures, started on 2 anti-convulsants. Epilepsy statement correct?
a/ Anti-epileptic drugs may cause low bone mineral density.
b/ Mandatory therapeutic drug monitoring for anti-epileptic drugs in all patients.
3yo girl w/ fever, dry cough, barking cough, temp 37.3C, SpO2 99%. Appropriate management?
a/ Prednisolone 24mg orally stat
b/ Encourage use of a humidifier at night
25male on olanzapine 15mg daily post-psychosis, concerned about side effects. Most common side effect of olanzapine?
a/ Hypersalivation
b/ Insomnia
c/ Narrow angle glaucoma
19 lady w/ fatigue, tingling in extremities, hx of anorexia nervosa, BMI 18. Referral to ED?
a/ Temperature <36 degrees celsius
b/ Blood pressure < 95/60 mmHg
47male w/ MDD, referred for psychotherapy, starting antidepressants. True statement regarding side effects?
a/ SSRIs with diclofenac may increase risk of bleeding from peptic ulcers.
b/ Hypernatraemia induced by tricyclic antidepressants and SSRIs.
25 lady planning trip to rural Kenya, working at wildlife sanctuary for 2 months. Considering rabies vaccine; companion already advised. Rabies vaccine advice?
a/ Rabies pre-exposure requires both post-exposure prophylaxis and HRIG if exposed.
b/ Rabies pre-exposure involves four vaccinations.
Surgical registrar w/ Hepatitis B dx, possibly from his father in Vietnam. Back in Australia, requesting further tests, may start antiviral treatment. Reporting requirements for Hep B?
a/ Notify AHPRA of his diagnosis of Hepatitis B.
b/ Notify his employer of his diagnosis of Hepatitis B.
71 male w/ food bolus stuck at sternum, rural ED w/ wife. 600km from tertiary hospital, struggling with strained voice. Next step?
a/ Urgent air transfer to tertiary hospital for endoscopic retrieval.
b/ Administer 5mg oral diazepam STAT.
9yo boy w/ foreskin issue, foreskin retracted, mild swelling. Rural practice, 4hr away from tertiary center. Next step?
a/ Urgent air retrieval to tertiary hospital for surgery by paediatric urologist.
b/ Try manual reduction with compression bandage.
Statements about SGLT2 inhibitors true?
a/ No additional risk of hypoglycaemia with agents added to insulin/sulfonylurea.
b/ Empagliflozin may reduce cardiovascular death in T2DM patients w/ CVD.