SEPTEMBER 2026 Recalls Compilation
87F, new in RACF 2wks, c/o persistent loose watery diarrhoea x days w/ faecal incontinence, largely bedbound. DRE shows significant hard faecal loading. Stool neg for blood/mucus.
a/ DRE/disimpaction
b/ Stool cx/C. diff testing
7-wk-old F w/ 4 episodes non-bilious emesis since AM. Irritable, but feeding ok, 5 wet nappies. Temp 38.4C, HR 158, RR 42. Mildly dry mucous membranes, otherwise nml exam. What next?
a/ Refer to ED.
b/ Oral rehydration advice.
34F w/ 5wk hx R lower leg pain, worse w/ running. Pt increased mileage significantly. Pain ant tibia, point tender distal 3rd, normal X-ray. No trauma, swelling, neuro sx. Hx I/D, hypoT.
a/ Relative rest for 2 wks
b/ MRI scan of R lower leg
65M c/o acute onset dizziness, SOB, palpitations x40 min while gardening. Reports rapid, irregular pulse, lightheaded. Denies CP/syncope/focal neuro sx. PMH HTN, DM2, OSA.
a/ Oral flecainide
b/ IV verapamil
75M w/ acute onset dysphagia after steak meal. Can’t eat solids/liquids. Central retrosternal discomfort. W/o emesis, dyspnea, aspiration. Hx GERD, HTN. IV access, NPO, urgent EGD.
a/ Glucagon 1mg IV
b/ Glyceryl trinitrate 800mcg SL
13M w/ new onset motor tics (grimacing, shrugging) & vocal tics (throat clearing, humming) over 16 mos. Urge to perform, difficult to suppress when stressed. No sig impact on school/social. Exam confirmed tics. Pts anxious.
a/ CBT
b/ Psychoed & reassurance
76F w/ 8d vomiting/diarrhoea, now weak, lethargic, abdo pain. Min urine output. Daughter notes pt confused/shaky. PMH HTN, CKD3. Exam: tachy irregular, hypotension, dry mucous membranes.
a/ Calcium gluconate IV
b/ Discont perindopril
69F w/ progressive bilateral knee pain, worse w/ stairs/sitting, better w/ rest. Tried paracetamol/heat, minimal relief; cane helps some. Exam shows crepitus bilat, mild L effusion, reduced flexion. XR shows JSN & osteophytes. Cause?
a/ Initiate meloxicam 15mg daily
57M c/o chest tightness for 6 wks, triggered by exertion, relieved by rest. Feels diff from heartburn. PMH HTN/HLD/obesity. On olmesartan/rosuvastatin. Resting ECG non-specific. Still feels diff w/ exertion.
a/ Esomeprazole 40mg daily
b/ Exercise stress ECG
20F student w/ 3mo epigastric gnawing/burning pain, worse at night, relieved by food. Reports assoc n/v, bloating. Exam shows mild epigastric tenderness. Labs unremarkable. What’s the most appropriate next diagnostic step?
a/ Barium swallow
b/ Urea breath test
51M c/o generalized urticaria, nasal congestion, wheezing w/ aspirin use for last few mos. Sx resolve w/o ASA, recur w/ RE-start. Had DES x2 post-STEMI 14 mos ago, off DAPT now. Wants alternative to ASA.
a/ Clopidogrel 75 mg daily
b/ Reassurance, no antiplatelet needed
15M w/ ASD lvl 3 presented w/ rash on UEs & LEs for 1 wk. Parents noted inc irritability & beh regression over last mo. Diet severely restricted: refined carbs only, refusal of F&V, meat.
a/ Zinc deficiency
b/ Vitamin C deficiency
40F w/ several yrs of nocturnal noisy breathing, episodic wheezing, chest tightness, & SOB esp at night/early AM. Sx worse w/ spring & dust. Also has nasal congestion, rhinorrhea. Hx of allergic rhinitis.
a/ Asthma
b/ Obstructive sleep apnoea
19yoM w/ acute onset L chest pain x 3d, pleuritic, radiates L shoulder. Mild SOB. Exam showed tachypnea, tachycardia, diminished L upper breath sounds. Dx?
a/ ECG
b/ Chest X-ray
c/ CTPA
19yoF w/ chronic inflammatory acne on face, chest, back; papules, pustules, nodules, scarring. Failed OTV tx, doxy 50mg daily + topical retinoid for 4 mo no improvement. BMI 35. Pt distressed. Next step?
a/ Refer for isotretinoin
b/ Add spironolactone 50mg
30F w/ 3mo malaise, fatigue, ↓ energy, ↓ stamina. Working 3d/wk < full capacity, exhausted by midday. Intx nausea, ↓ appetite, dizzy on standing. No GI sx. Labs below.
a/ Short Synacthen test
b/ Dexamethasone suppression test
29 yo G1P0, 13wks preg w/ mild N/V, fatigue. UA sent at booking. Pt denies dysuria, freq, flank pain, fever. PMH unremarkable, taking prenatal vitamin. UA results pending. Next step?
a/ Repeat urine microscopy, C&S
b/ Await sensitivity results
44F w/ 3wk R index finger discomfort, swelling, morning stiffness ~30min, decr flexion. Exam shows diffuse swelling, tenderness, restricted MCP/PIP jts w/o erythema/warmth.
a/ Rheumatoid arthritis
b/ Psoriatic arthritis
2yoM presents w/ audible breathing, nightly wheezing, yellow rhinorrhea, productive cough & low-grade fevers x3 nights. No prev asthma/atopy hx, attends daycare. Exam shows mild tachypnea. Dx?
a/ Asthma
b/ Bronchiolitis
c/ Viral-induced wheeze
46M re advice re dental filling re prophylactic abx. Pt had childhood RF w/ RHD teen yrs, regular cardio f/u. Last echo 12 mo ago showed normal LV fx & valves. No prior endocarditis hx. Otherwise well, no meds.
a/ Amoxicillin 2g PO 60m pre-proc.
b/ Cephalexin 2g PO 60m pre-proc.
49F w/ paresthesias (fingers/perioral), intermittent cramps, muscle stiffness, anhedonia, irritability x 7-10 days. Hx total thyroidectomy 3 mos ago for FTC, on thyroxine 200mcg daily.
a/ Measure serum calcium levels.
b/ Measure parathyroid hormone levels.
74M w/ long-standing HTN, no CAD/HF/DM/CKD/CVA hx. On candesartan-HCTZ 32/12.5 QD, atorva 20 QD. Home BP avg 164/72, PND 50. Echo 6mo ago showed LVH, EF preserved, no LVOTO.
a/ Add amlodipine 5mg QD
b/ Commence bisoprolol 2.5mg QD
9-wk-old M inf w/ persistent non-bilious emesis post-feeds x 3 wks, despite eager feeding. Passes loose stools, mild irritability. No dehydration, tracking 50th percentile. Management?
a/ Switch to lactose-free FORM
b/ Trial thickened feeds FORM
20M w/ 8d malaise, fevers, fatigue, night sweats, myalgias/arthralgias. Noted new thin dark linear marks under nails past 24h. Admits IV meth use, sharing needles. Suspect bacterial endocarditis.
a/ Transthoracic echocardiogram
b/ HIV serology
4yo M w/ elbow injury to mouth, avulsed primary tooth. Tooth brought in dry tissue, intact. Clot noted at ALVEOLAR socket L central incisor. No other oral trauma.
a/ Replant tooth
b/ Store tooth in milk
45M w/ 5d productive cough, yellow-green sputum. No fever, fatigue mild. Hx childhood asthma, quit smoking >20yrs ago. Che P/E nl, SpO2 98% RA. COVID neg.
a/ Chest X-ray.
b/ symptomatic management.
39F w/ 2yr hx of hirsutism on face/abd. PMH PCOS w/ oligomenorrhea. No meds. BMI 34.
a/ Ethinyloestradiol-cyproterone acetate
b/ Metformin modified release
62F w/ 8mo worsening vulval pruritus, esp. at night, + occasional spotting post-scratching. Postmenopausal 7 yrs. Exam shows thin, pale, atrophic vulval skin w/ excoriations.
a/ Topical estrogen
b/ Vulval bx
c/ Topical steroids
7yoM presented w/ 10d worsening L ear pain, high fevers, irritability. Refuses feeding, pain on palpation L mastoid. Exam showed marked mastoid swelling, erythema, L EAC oedema w/ purulent discharge.
a/ Oral amox 25mg/kg TID x 5d
b/ IV antibiotics stat
57M presents w/ L knee pain, swelling, bruising after trauma. Limited active flexion ~40 deg, can SLR. Pt able to ambulate short distances, but increased swelling overnight. No anticoagulatns.
a/ Immobilise L knee in full extension w/ hinged brace.
b/ Strict NWB, f/u X-ray in 1 wk.