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.
23-year-old lady pre-travel consult for Uganda trip in 6 weeks. 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
34-year-old woman with skin concern: small brown patches on nose, cheeks, upper lip. Darkening over 4 months, no other rash. Works as a chef, etonogestrel implant 2 years ago. Next step for her condition?
a. Start topical hydroquinone 2% cream twice daily
b. Refer for dermatologist for IPL laser treatment
78-year-old man collapses in the 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
Unlock AMC Solved Recalls & Qbank!
Patient asymptomatic with popliteal artery aneurysm, pulse ok. Next step?
a. CT
b. Duplex
c. Abdominal US
89-year-old lady with advanced breast cancer and metastatic disease. In the terminal phase, started on dexamethasone and morphine for pain. Rapid deterioration, agitation, possible chest infection.
a. Haloperidol 0.5mg subcutaneously 4-hourly in the evening
b. Oral escitalopram solution 10mg nocte
59-year-old man with 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-year-old lady with 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 42-year-old male with a 2-day 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
23-year-old lady with 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 with choking episode earlier in the day. No recent illness or medical history. Normal exam. Correct statement about pediatric airway foreign bodies?
a. 50% of children with airway foreign body have no symptoms.
b. Normal chest X-ray does not exclude airway foreign body.
41-year-old gentleman with concern about tongue appearance: brown, furry, and bad breath. Tried treating with 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-year-old man with 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-year-old woman with 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 government under National Immunisation Program.
b. Serology needed before vaccination.
76-year-old man with burning, itchy rash on left flank, similar to previous shingles episodes. Third presentation with herpes zoster in 6 months. 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.
6-year-old boy with 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-year-old female returned from travel. Developed febrile illness with headache, myalgia, arthralgia, and rash. Temp 39.5°C, generalized maculopapular rash. Diagnosis?
a. Dengue fever
b. Chikungunya virus
c. Influenza
Unlock AMC Solved Recalls & Qbank!
55-year-old male presents with high temp, shivering, upper abdominal pain, and jaundice. Most likely diagnosis?
a. Acute cholangitis
b. Biliary colic
c. Acute Hepatitis C infection
55-year-old man with painful right great toe, history of hypertension, 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-year-old lady discloses husband pushed her against a wall after dinner was late. She’s a frequent patient and 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.
3-year-old child with 2-day history of fevers, rhinorrhea, and right ear pain. Temp 38.1°C, red, inflamed, bulging right tympanic membrane with 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-year-old 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 35 years old or older.
2-year-old with hay seed in right ear canal, no occlusion. Appropriate way to manage?
a. Swaddle baby tightly, attempt removal with torch and Alligator forceps.
b. Flush ear canal with saline using butterfly tubing and syringe.
40-year-old male with 1-week history of thick yellow urethral discharge after sex with sex worker in Thailand. Purulent urethral discharge seen. Suspected diagnosis?
a. Gonorrhoea
b. Chancroid
c. Chlamydia
26-year-old lady wants repeat Depo-Provera injection, 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.
10-year-old boy with recent coeliac diagnosis. Most likely food to exacerbate?
a. Barley
b. Corn
c. Rice
7-year-old girl with 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-year-old female with 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-year-old male with advanced SCC neck, too ill to travel, wants to die at home. Family 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-year-old male with epilepsy diagnosis, 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-year-old lady new patient with 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
7-year-old 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-year-old female diagnosed with 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.
3-year-old girl with fever, dry cough, barking cough, temp 37.3°C, SpO2 99%. Appropriate management?
a. Prednisolone 24mg orally stat
b. Encourage use of a humidifier at night
25-year-old male 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-year-old lady with fatigue, tingling in extremities, history of anorexia nervosa, BMI 18. Referral to ED?
a. Temperature <36°C
b. Blood pressure < 95/60 mmHg
Unlock AMC Solved Recalls & Qbank!
47-year-old male with 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-year-old lady planning a trip to rural Kenya, working at a 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 with Hepatitis B diagnosis, 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-year-old male with food bolus stuck at sternum, rural ED with 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.
9-year-old boy with 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 pediatric 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 with CVD.
