Q1-Man presents with central chest pain that radiates to the back. On transit to hospital his BP was elevated and tachycardia. On arrival he became unresponsive, pulseless and cyanosed. Had distended neck veins and ECG showed nonspecific ST and T wave abnormalities.

Dx

2. Rupture of descending aorta 3. Supra ventricular congestion

Q2-As an intern you find out that a medical student is getting information about a patient through the patient’s medical records. When asked, he said the patient’s relative who lives overseas wants to know about it. What will you do?

B-Inform the medical Board C-Inform the Medical University

Q3- CT Question. 32 year old women who is known case of uncontrolled hypertension and taking warfarin for 6 months is presented with sharp pain in abdomen. Diagnosis?
A rectus sheet hematoma

Hemoperitoneum

B.

Depending on CT

Q4-female pregnant 32 weeks after MVA in emergency fundal height 36. fetal heart sound audible. But was raised. Mother vitals borderline, What next?

A) cross match 4 unit

B) usg C)amniotomy D)c/section E)2L NS in 2hr

Q5. 39 yo woman presents x Pap smear, 2 years ago her last pap was normal. She has not had sexual partner over the last 2 years but asks if she should have a check for

C Chlamydia is uncommon in her age group

STI. What is the best reason for advising against testing x chlamydia? A The test x chlamydia is unreliable
B she should have had symptoms by now if infection were present

D First catch PCR is more sensitive E She has had not recent partners

Q6. Couple with husband with HIV he accepts he is having unprotected sex with wife and he said is not going say anything to his wife. what to do? his wife your patient a test wife
b Notify to public health

d tell his wife

Q7. 3 year old with croup was improving. A day before discharge developed stridor, chest retraction, fever 39 chest auscultation normal . Cause
A) Epiglottitis

B) Bacterial tracheitis

C) Pneumonia D) Croup

Q8. Patients with acquired immune deficiency syndrome (AIDS) are prone to infections with a variety of infecting organisms, some of which constitute AIDS- defining illnesses. Which one of the following infections is least likely to be associated with AIDS?

A. Haemophilus influenzae meningitis.

B. Cytomegalovirus retinitis.
C. Pneumocystis carinii pneumonia. D. Candida oesophagitis.
E. Cryptosporidial enteritis.

Q9. A five-year-old presents with a rash on his back and trunk over one week, as shown. His general health is excellent, and the remainder of his examination is normal. Which one of the following is the most likely diagnosis?

A. Impetigo.
B. Varicella.
C. Herpes simplex.

D. Molluscum contagiosum.

E. Papilloma virus.

Q10. A 65-year-old woman had a course of amoxycillin for seven days for an upper respiratory infection. She developed severe watery diarrhoea after two days of treatment and these symptoms persist along with cramping abdominal pain associated with urgent call to stool, fever and nausea with intermittent vomiting. In addition to cessation of amoxycillin, which one of the following is the most appropriate initial treatment?

A. Monitor progress without further antibiotics.

B. Commence metronidazole.

C. Commence vancomycin.
D. Commence chloramphenicol. E. Commence ciprafloxacin.

Q11. A five -year-old presents with a rash on his back and trunk over one week as shown. His general health si excellent and the remainder of hsi examination si normal. Which one of the following is the most appropriate next step in his care?

A. Swab a lesion for virus culture. B. Apply aciclovir ointment.
C. Reassure and await resolution. D. Apply diathermy to each lesion. E. Surgically debride.

Q12. Ischaemic strangulation is an important complication associated with hernias. Which one of the following types of hernia is most often associated with strangulation of its contents?

A. Indirect inguinal hernia. B. Direct inguinal hernia.
C. Femoral hernia.
D. Paraumbilical hernia.
E. Oesophageal hiatus hernia.

Q13. A32-year-old man has a four-day history of progressive weakness in his extremities. He has been healthy except for an upper respiratory tract infection ten days ago. Hsi temperature is 37.8°C, BP is 130/80mmg, pulse is 94/min, and respirations are 42/min and shallow. He has symmetric weakness of both sides of the face and the proximal and distal muscles of the extremities. Sensation is intact. No deep tendon reflexes can be elicited; the plantar responses are flexor. Which one of the following is the most likely diagnosis?

A. Acute disseminated encephalomyelitis.

B. Guillain-Barré syndrome.

C. Myasthenia gravis. D. Poliomyelitis.
E. Polymyositis.

Q14. A 38-year-old builder had acute back pain which subsided over 24 hours. He now complains of increasing numbness and tingling in both legs and poor bladder and bowel control. Which one of the following should be the first step in management?

A. Physiotherapy.
B. Strict b e d rest with pelvic traction. C. Epidural local anesthesia.
D. Spinal manipulation.
E. Magnetic resonance imaging (MRI)

Q15. Which one of the following is the most usual mode of transmission of hepatitis C in Australia?

A. Intravenous drug use.

B. Heterosexual intercourse. C. Faecal-oral route.
D. Blood transfusion.
E. Homosexual intercourse.

Q16. A65-year-old woman in a nursing home had a course of amoxycillin for seven days for an upper respiratory infection. She developed severe watery and mucoid diarrhea after two days of treatment and these symptoms persist along with cramping abdominal pain associated with frequent urgent call to stool, fever and nausea with intermittent vomiting. Which one of the following si the most likely diagnosis?

A. Ischemic colitis.
B. Necrotizing enterocolitis. C. Pseudomembranous colitis. D. Ulcerative colitis.

E. Shigellosis

Q17. A 65-year-old woman had a course of amoxycillin for seven days for an upper respiratory infection. She developed severe watery diarrhoea after two days of treatment and these symptoms persist along with cramping abdominal pain associated with urgent call to stool, fever and nausea with intermittent vomiting. Which one of the following gut organisms is most likely to be responsible for her symptoms?

A. Salmonella typhi. B. Shigella Rexneri.

C. Clostridium difficile.

D. Entamoeba coli. E. Vibrio cholera.

Q18. Pt 65 yr old, Another Gout q on rx – Other comorbidities – DM, HTN, Hypercholesterolemia, Metformin, Allopurinol, Perindopril, INC Lipids all – Cause?

Q19. -Traveler to New Zealand with bloody diarrhea, investigations to make a diagnosis MCS ( Microscopy Culture Sensitivity ) of Stool
Fecal calprotectin

Q20. -Registrar confined in intern on
Intern saw Registrar take Temazepam from the cupboard. Next? Inform Intern Supervisor
Inform AHPRA
Confront the Registrar
If colleague – Confront

Q21. -Labour case with meconium stain at 7cm dilatation What to do next
Continuous CTG
Oxytocin

CS

Q22-Adopted child from a prostitute foster parents noticed child displaying sexual behavior in the playground what to do in managing the child. Foster parents are worried

Refer child to child psychiatrist Counseling for parents
Look for other foster parents etc.

Q23-Penis bends during sex , but he can pass urine, no hematuria, has had an erection after wards. Now having swelling and pain. Investigations

Retrograde uretrocystogram

Penile US

Penile MRI

Q24. -UTI in pregnancy (had reaction to flucloxacillin) Nitrofurantoin (cannot be given after 34 weeks ) Amoxicillin

Go for Cephalexin – First line
Trimethoprim cant be given in first trimester Treat even if asymptomatic bacteria in pregnancy

Q25. -Colon cancer screening (read up thoroughly)

Q26. -Pregnant woman with barrel shaped cervix bleeding PV, diagnosis

Q27. Molar pregnancy and management

1)Suction Evacuation

2)Methotrexate

Q28. Parathyroid gland surgery with surgery fever in day 1 possible causes

Atelectasis

Etc

Q29. Patient with symptoms like restless leg syndrome (worse at night) on metformin, ace inhibitors, atorvastatin and one other drug. asking for the drug causing it
SSRIs was the other drug

Antidepressants Antipsychotics

Q30. 52 years old Woman has post-menopausal symptoms, flushing, increased pain on sexual intercourse etc. she has undergone hysterectomy what would you prescribe her?
1. cops
2. topical estrogen

3. transdermal estrogen patch

4. Estradiol (like

they don’t pose a risk for VTE in a patient with thrombophilia SSRIs – for mood swings

Q31. A young female with a history of cocaine use presents with a seizure attack and is diagnosed with an intracerebral hemorrhage (ICH). What could be the likely cause of the intracerebral hemorrhage?
A) Hypertensive encephalopathy
B) Cerebral amyloid angiopathy

C) Arteriovenous malformation
D) Coagulopathy due to chronic liver disease E) Ruptured aneurysm

Q32. Elderly gentleman came with pain over knees. Synovial fluid analysis sent. Pictures given. The question mentioned the presence of negative birefringence. (A case of gout). Then got lists of blood tests. CRP WCC all raised. Creatinine on the high side (CKD perhaps). Best management for this patient?
a. Colchicine
b. Indomethacin
c. Intra Articular steroid
d. Allopurinol
e. antibiotics

Q33. A neonate 12 hours, after normal vaginal delivery is noticed to be jaundiced the blood film shows microcytic hyperchromic cells. The best investigation is

1. Osmotic fragility test
2. Pyruvate kinase level
3. G6PD enzyme level
4. EMA ( eosin – 5’ – maelide TEST)

Q34. Groin inguinal lymph nodes has malignant cells and is a smoker. Primary site?

a. anus

b. lungs
c. testicles

d. stomach e. rectum

Q35. A 48 years old farmer presented to you complaining of pain in his right arm with pain in different joints. On examination he appears to have motor neuropathy affecting his right arm, with foot drop and skin lesions in different parts of his body. On investigation you found haematuria, increase urea and creatinine. What will you do to confirm the diagnosis?

a) Sural nerve biopsy

b) Renal biopsy c) ANCA
d) Anti dsDNA

e) MRI spine

Q36. Farmer presenting with thenar eminence of hand muscle wasting with sensory loss of first and second digits. Pain on lifting above head, shaving and on wrenching movements. Loss of brachioradialis reflex… causes ?
a. Carpal tunnel syndrome

b. Cervical spondylosis

c. Compression t1 d. cervical rib
e. ulnar paradox

Q37. A patient with a non pigmented skin lesion about 1 cm with a red border and white area in the middle who has this lesion for some time. Best management ?
1.wide excision
2.local excision

3.cryotherapy 4.punch biopsy

Q38. Ankylosing spondylitis. Patient was having a stomach problem, 57 years and complained of mild pain from 20 years in joints. What will you choose as a medication for this patient?
A. Paracetamol
B. Naproxen

C. Methotrexate D. Infliximab
E. sulfasalazine

Q39. Couple with husband with HIV he accept he is having unprotected sex with wife and he said is not going say anything to his wife. what to do? his wife your patient
a test wife
b Notify to public health

c try to persuade him to tell his wife

d tell his wife

Q40. Management of sustained monomorphic VT (stable, with pulse)

Amiodarone

Adenosine

Q41. 52 years old Woman has post-menopausal symptoms, flushing, increased pain on sexual intercourse etc. she has undergone hysterectomy what would you prescribe her?
1.⁠ ⁠cops
2.⁠ ⁠topical estrogen

3.⁠ ⁠transdermal estrogen patch 4.⁠ ⁠estradoil (like)

Q42. Adopted child from a prostitute foster parents noticed child displaying sexual behavior in the play ground what to do in managing the child. Foster parents are worried
a. Refer child to child psychiatrist
b. Counselling for parents

c. Look for other foster parents etc

d. Report child protection organization

Q43-pregnant mid trimester with condylomata acuminata , all on the left labia majora , she did cryo but it increased in number spreading more , what should you do?

A. Topical antiviral
B. Surgical excision of the whole left labia majora C. Operative cryotherapy
D. Ignore till after delivery

Q44 -there was a question about haemorrhoid, especially with anal bleeding, The scenario was: Young lady constipated because of the use of Panadeine, she noted slight rectal bleeding and it aches. The question was with picture1 – Internal prolapsed haemorrhoids 2 – Perianal hematoma
3- pilonidal cyst
4 – Perianal abscess

Ans acc to picture

Q45. -A patient riding a horse in the rural area fell off the horse and sustain fracture of the ribs femoral and humeral fracture. X-ray shows small pneumothorax. Vitals stable and saturation 96%. She is to be air lifted to a tertiary hospital. Before lifting her to the hospital after stabilizing the femoral and humeral fractures, what should you do?�

a.Needle aspiration
b. chest tube insertion
c. oxygen therapy d. strap the chest

Q46-Best diagnostic test for Henoch púrpúra ? 1. Ultrasoúnd
2. úrine contrast.
3. Fbc

4. Skin biopsy

Q47-34 year old primi came at term with rupture membranes and meconium stained liquor , you did a CTG , in review of the CTG, whats the next best step ?
a. CS
b. Fetal scalp ph

c. Induce labour at once with cintocynon d. Wait for normal delivery
e. High forceps
Depending on the CTG

Q48-A 65yr old nulliparous came to you with blood stained discharge from nipple. Her cousin has breast cancer . What is the commonest possible cause of discharge in her ? a. Benign duct papilloma
b. Invasive ductal carcinoma

c. Paget disease of nipple d. Fibroadenoma

Q49. -A 45 year old presents with bloody discharge from nipple. On examination, when nipple was squeezed blood was expressed from only one duct. What is the most appropriate diagnostic tool? a. ENAC
b. USG

D. DUCTOGRAM

c. Mammogram
e. Cytology of discharge

Q50. -Boy with hand-foot-mouth disease asking when he can return to school: a. after 7 days,
b. when lesions are crusted,
c. when lesions have disappeared,

d. tomorrow

Q51. -2 yr child seen in GP with a 2 day Hx of Low grade fever and Moúth úlcer ! Appropriate to set the diagnosis ??!
A Blood Cúltúre
B CBC

C CSF Exam
D Urine Protein
E Examine Finger & Feet Rash

Q52. -Haemorroids- management , picture of 4degree haemorrhoid- management

A. ligation
B. Cricotherapy

C. Band ligation

D.Sclerotherapy

Q53-Lesion at the back of the ear like BCC. Management Surgery
Excision
Radiation therapy

Q54. -Chlamydia diagnosis and management
Q55. – Registrar surgeon did some injury to pat’s liver during surgery …he took this matter to surgeon

supervisor. now who has to break the news Supervisor surgeon

Nurse supervisor
Intern
Head of surgery department

Q56. -Pictures of ECG of VT, VF, pericarditis

Q57. -An ecg with diffuse ST elevation in multiple leads and chest pain after a heavy meal: A. Posterior wall MI
B. Unstable angina

D. Oesophagitis

Registrar surgeon

C. Acute pericarditis

Q58. -non-progressing labour scenario, but on auscultation no fetal Heartbeat and confirmed by USG. How to mx?

a)CS
b) wait for natural delivery

c) amniotomy

Q59. -A scenario of labour that had to have CS- indication for CS in the scenario

Q60. –Labour case with meconium stain at 7cm What to do next
Continuous CTG

Oxytocin CS

Q61. -Adopted child from a prostitute foster parents noticed child displaying sexual behavior in the playground what to do in managing the child. Foster parents are worried

Refer child to child psychiatrist Counselling for parents
Look for other foster parents etc

CPS Referral

Q62. -Penis bends during sex , but he can pass urine, no hematuria, has had an erection after wards. Now having swelling and pain. Investigations

Retrograde uretrocystogram

Penile US

Penile MRI

Q63. GBS prophylaxis 36PoA. Oral penicillin now
IV penicillin during delivery HB

Q64. . About Autosomal dominant inheritance

Q65. Colorectal cancer screening

Q66. Pregnancy anaemia. Currently taking Iron and Folate. What else to add a.Vit b12

b.Vitc

c.Vita
d.B6

Q67. Hysterosalpingography – done in Tubal Patency in infertility b/l fluid filled salpinges – indicates patent tubes

Q68. USS pancreas – pancreatitis
Initial test – Sr Lipase
Chronic Pancreatitis – CT without contrast Best

Q69. Chest Xray with widened mediastinum Hilar lymphadenopathy

Sarcoidosis

Other features – Hypercalcemia, Skin lesions on shin – Erythema Nodosum , ACE enzymes increased Lupus Pernio – poor prognosis ass with hair loss

Q70. slipped capital femoral epiphysis

Hip is flexed, and limited internal rotation and abduction, shortened
Treatment – first – cease weight bearing and refer – Definitive – reduction f/b Pin Fixation

Q71. Bell’s palsy treatment
No antiviral given
Prednisolone ( within 72 hrs ideally )
Ramsay Hunt Syndrome – look for ICPs, Vesicles on ear drum, pain – give both predni and acyclovir

Q72. Baby born and after half an hour. decreasing lung sounds on left side. Apical beat shift to right

Incomplete scenario – CDH – bowel sounds heard in the chest Pneumothorax – Prematurity,

Q73. Cx 3cm, decreased contractions, FHs normal. Station +1 Assisted delivery
Oxytocin
CS

Q74. schizotypal personality – odd beliefs , magical thinking,

Q75. Paranoia – suspicious, cluster A type

Q76-Prophylaxis in 36wk AOG —>? Order penG now? During labour?

Q77-Genetic diagram AD – Hemochromatosis, Huntington’s, PCKD, Male Pattern Baldness, Achondroplasia, FH, Peutz – Jegher’s, FAP

Q78-Pregnant woman has urine culture positive for GBS at 12 wk and is given antibiotics for treatment. What is the appropriate option for her?
A. Give penicillin until labour

B. Give penicillin during labour

C. vaginal swab for GBS at 34-37 wk

Q79. 38yrs.Lady presents with amenorrhea for 8 weeks after dilation & curettage for menorrhagia what is the initial investigation you would do?
A.USS-Pelvis
B. uterine sound

C. hysterosalpingography D. Hysteroscopy

Q80-Celiac and cystic fibrosis differentiation question was there

with diarrhoea and 6 episode of infection in a year and diarrhea non-mucous. And growth retardation, diarrhea for 3/4 months.