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.
Patient with abdominal pain and elevated liver enzymes, diagnosed with pancreatitis, now normal. On USS, 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 Aboriginal boy with discharge from both ears, right tympanic membrane dull and retracted, yellow-green discharge from nostrils. Most likely sequelae?
a. Cholesteatoma
b. Sinusitis
c. Hearing loss
d. Myringitis
60-year-old man with hearing loss, audiogram shows decreased hearing with increasing frequency. Right ear has soft cerumen. Likely diagnosis?
Age-related hearing loss
Primigravida woman in labor, given syntocinon but no progression after 4 hours with positive caput and molding. What to do next?
a. Stop syntocin
b. Definite Cesarean section
Meconium staining with CTG showing slow fetal heart rate. What to do next?
a. If CTG normal, continue CTG and perform fetal blood sampling before considering cesarean section.
b. If fetal compromise is severe, go for cesarean section directly.
Pregnant lady with obstructed labor and vasa previa and i think what to do next?
a. CS
Pregnant lady with vasa previa but no operating theatre available. What maneuvers can you do after manual manipulation, like left lateral position?
a. Left lateral position
b. Manual manipulation
c. Oxygen administration
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With DEXA scan reading given, what to do?
a. Start bisphosphonates
b. Recommend weight-bearing exercise
c. Increase calcium and vitamin D intake
Elderly patient with fractures admitted to the hospital and then delirium scenario. What is the cause?
a. Medication side effects
b. Dehydration
c. Infection
Middle-aged patient, known chronic schizophrenic, not listening to our questions. What to give next?
a. Haloperidol
b. IV diazepam
c. Antipsychotic injection
With the ECG given, what to do next?
a. Stop digoxin
b. Administer digibind
c. Start anticoagulation
Another similar case of an old man with a lot of meds, dizziness, and syncope. What should be stopped first in their medications?
a. Digoxin
b. Spironolactone
c. Beta-blocker
d. ACE inhibitors
52-year-old lady comes with elevated BP, states ‘White Coat Syndrome.’ Correct statement regarding BP measurement?
a. Wrist monitors are okay 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-year-old 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 3-year-old girl with fever, maculopapular rash, parents opted against childhood immunizations. 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-year-old DM female BMI 31 presented for control visit regarding her cellulitis in left leg. She mentioned that this is her 4th cellulitis event in the same leg. She is well now, healed cellulitis, both legs with varicosities but no chronic venous insufficiency signs. Between toes, there is tinea infection. What is the major factor causing her problem?
a. Obesity
b. Varicose veins
c. DM
d. Alcohol
46-year-old with schizophrenia, 6 weeks lip smacking. Medication causing adverse effect?
a. Clozapine
b. Risperidone
c. Haloperidol
Elderly female with delusions accusing neighbors of trying to break into her house, spraying poisonous gas, and wearing gas masks at home.
a. Paranoid mood
b. Refractory psychosis
c. 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-old female came for asthma follow-up. Taking short-acting beta-2 agonists 7 days a week. Still complains of breathlessness at night.
a. Long-acting beta agonists
b. Corticosteroid inhaled
c. Montelukast
Same question regarding father bringing his child after bat bite – about post-rabies prophylaxis
Pulsatile painless mass in the groin, found in a middle-aged woman. Next best step:
a. USG
b. 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 investigation?
a. Anti-streptolysin O
b. CT chest
c. Sputum cytology
Child came with only difficulty in drinking water. Has no other symptoms. Urticaria or eczema (don’t remember) on both elbow flexures.
a. Globus hystericus
b. Eosinophilic esophagitis
X-ray complicated fracture of shaft of humerus (picture). First step?
a. X-ray
b. Debridement
c. Reduction in the casualty
Middle-aged refugee shown CXR, no fever, just chills, rigors, and weight loss. What is the diagnosis procedure?
a. Bronchoalveolar lavage
b. Sputum cytology
c. Interferon gamma assay
39-year-old lady with suprapubic pain, dysuria, vulval pain, and itching, with 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-year-old female comes to you for Mirena. She is on regular condom use, has no medical history, and experiences occasional heavy menses with 30-35 days cycles. She doesn’t want pills due to forgetfulness. Which one is true regarding Mirena?
a. Pregnancy rate is less than 1%
b. Mirena can correct irregular cycles
c. She cannot use Mirena because she is nulliparous
d. Mirena should be replaced after 3 years, but stop bleeding, not correct it as a regular cycle
30-year-old male with 2-day constant sharp chest pain, worse on deep breathing and coughing. Active, training for a triathlon. ECG shows widespread ST elevation and PR segment depression. Diagnosis?
a. Hyperkalaemia
b. Rhabdomyolysis
c. Pericarditis
12-month-old baby with 2-month fatigue, decreased appetite, abdominal cramps, nausea, low BP, dehydration, and hyperpigmentation. Likely diagnosis?
a. High early morning cortisol; low adrenocorticotropic hormone (ACTH); hypernatraemia
b. Low early morning cortisol; elevated adrenocorticotropic hormone (ACTH); hyponatraemia
7-month-old baby with 24-hour fever, bloody diarrhea, vomiting, and abdominal pain. Most likely cause?
a. Campylobacter
b. Entamoeba histolytica
c. Adenovirus
49-year-old man with positive HBsAg, negative HBsAb, positive 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.
65-year-old female with rapidly growing 15mm lesion on left forearm. No palpable lymphadenopathy. Likely diagnosis?
a. Acne
b. Folliculitis
c. Keratoacanthoma
78-year-old male, 3 days 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 5-7 days
12-month-old boy with fever, rash, lethargy, and decreased appetite. MMR vaccine given 1 week ago. Likely vaccine reaction?
a. Previnar 13
b. M-M-R II
c. Fluarix Tetra
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15-year-old netball player with 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-aged man with pain on swallowing for 2 months, no fever, no weight loss, initial investigation?
a. Barium meal
b. Endoscopy
c. Stool occult blood
d. Nanometer
e. Urea breath test
32-year-old female with 8 months amenorrhea, had twins by IVF, BMI 32, on risperidone and thyroxine. Complains of milk discharge. Cause?
a. PCOS
b. Risperidone
c. Prolactinoma
d. Pituitary adenoma
e. Hypothyroidism
Aboriginal agitated known psychiatric patient, long waiting for telephone interpreter, best thing to do?
a. Ask Aboriginal ED security to attend
b. Ask other ward Aboriginal nurse to come
c. Wait for telephone interpreter
Man with painful swelling “over” the inguinal ligament after weekend heavy exercises. Can’t reduce, possible diagnosis?
a. Inguinal hernia
b. Femoral hernia
c. Torsion
d. Lymph node
Carcinomatous lesion over the pinnacle with lots of crusts. Possible diagnosis?
a. Basal cell carcinoma
b. Squamous cell carcinoma
c. Bowen’s disease
d. Keratoacanthoma
60-year-old man with hypothyroidism on thyroxine 100mcg daily. Chemist out of stock of Eltroxin. Advice on managing thyroxine?
a. Switch directly from Eltroxin 100mcg to Eutroxin 100mcg, retest thyroid in 12 months.
b. Switch from Eltroxin 100mcg to Eutroxin 125mcg, retest thyroid in 4 months.
13-year-old 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
82-year-old 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.
15-year-old 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 a new screening test?
a) [A / (A + B)] x 100
b) [D / (B + D)] x 100
2-year-old child with umbilical hernia, irritable parents concerning what to do. What’s the next step?
a. Refer to emergency
b. Refer to pediatric surgeon
c. Reassure
18-year-old female, treated for chlamydia 1 week ago. Wants to know when she can resume sex. Boyfriend is the only partner, no sex in the past 2 weeks, and has been notified. What 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.
28-year-old female, 8 weeks pregnant, asking about vaccinations during pregnancy. What 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).
58-year-old female, no significant PMH, no smoking, wants to book in for ABI screening. What is the advice?
a. Consider PVD screening (age > 50), but ABI not needed (low risk).
b. No screening for her – insufficient evidence for low risk.
19-year-old lady with 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-year-old lady with a 2-week change in vision in the left eye. Eye painful with movement, decreased clarity of colored objects. Visual acuity 6/18 in left eye, red-green confusion with color testing. Likely cause?
a. Conjunctivitis
b. Scleritis
c. Optic neuritis
Diabetic patient with sudden painless loss of vision over the past 3 days. What is the most probable cause?
a. Retinal detachment
b. Vitreous hemorrhage
c. Central retinal artery occlusion (CRAO)
73-year-old male with bilateral hip prostheses scheduled for dental work. Dentist requests antibiotic prophylaxis. What is the recommendation?
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.
65-year-old male with a new pigmented skin lesion on the left scapula, enlarging for 3 months. Melanoma confirmed with Breslow thickness of 1.2mm. Referred urgently for wide local excision and SLNB. What is the consideration?
a. High complication rates for sentinel lymph node biopsy.
b. Staging, not just diagnosis, with sentinel lymph node biopsy.
83-year-old male newly incontinent of urine. Urine microscopy, culture, and sensitivities are unremarkable. What are the 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 is changed, the patient is irritated. On examination, there is a mild swelling in the vertebra and thoracic region with no point tenderness. What is the initial investigation?
a. US
b. Thoracolumbar X-ray
c. MRI
15-year-old boy with acute onset of left-sided scrotal pain, radiating to left lower abdomen, nausea, vomiting. Temp 36.7°C. Negative urine dipstick. What is the 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 treated for cellulitis with cefazolin. After 3 days of treatment, there is a macular drug reaction on the trunk. After stopping cefazolin, which of the following is not good for the patient in the future?
a. All cephalosporins
b. All penicillins and cephalosporins
c. Just cefazolin
d. Clindamycin
20-year-old new patient with first psychotic episode 3 weeks ago, discharged on quetiapine. Wants a regular GP. What baseline investigations/health checks are recommended?
a. Fasting bloods, prolactin, eye check (cataracts).
b. Fasting lipids, liver, electrolytes, urea/creatinine, prolactin.
34-year-old male with 6 months of fatigue, polyarthritis, family history of diabetes, and iron overload disorder. What is the normal pattern of inheritance for hereditary hemochromatosis?
a. Autosomal Dominant
b. X-Linked Dominant
c. Autosomal Recessive
7-year-old boy with BP of 145/90, likely primary or essential hypertension. Which feature is most likely to fit with essential hypertension?
a. Abdominal bruit
b. Ambiguous genitalia
c. Family history of hypertension
25-year-old female traveling to Bali in 2 months. Wants to prevent traveler’s diarrhea. What is the advice?
a. Norfloxacin 400mg daily for the trip.
b. No antibiotics, but azithromycin script for severe traveler’s diarrhea
7-year-old boy with 4 months of severe periumbilical abdominal pain, no vomiting, fever, bowel changes, normal appetite, and examination. WNL urinalysis. What is the likely diagnosis?
a. Acute glomerulonephritis
b. Appendicitis
c. Non-specific abdominal pain
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55-year-old plumber with sudden onset floaters, flashes, and blurred vision in the left eye. Fundoscopy shows a grey shadow in the lower fundus. What is the likely diagnosis?
a. Acute glaucoma
b. Amaurosis fugax
c. Retinal detachment
51-year-old woman with a pruritic rash under her breasts for 2 months. Screening mammogram and FOBT were done at 50. What is the most important investigation for the rash?
a. Fasting blood glucose level
b. Bilateral mammogram
A man with RTA, GCS 6/15, long heavy beard, BP 100/75, RR 9, SpO2 88%. What is the initial step to take?a. Shaving the beard to ensure mask ventilation
b. 9% O2 mask ventilation immediately
c. CT scan
d. IV fluid
13-year-old boy with 3 months of knee pain, worse after basketball. Tender lump on the right knee, pain better with rest, worse with stairs. What is the likely diagnosis?
a. Osgood-Schlatter’s disease
b. Synovial plica pain
4-week-old girl with excessive crying for the past week, lasting 1-3 hours. Normal physical examination. What is the appropriate next step?
a. Commence a trial of antacid and reassess
b. Organize urine microscopy, culture and sensitivities, and review
73-year-old man with SOB and productive morning cough for 6 months. Extensive smoking history. What is the likely spirometry result?
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
32-year-old male with blood in semen, no pain, frequency, anorexia, bone pain, or weight loss. No history or risk factors for prostate cancer. What are the initial investigations?
a. Urine tests, cytology, PSA, CT, chlamydia/gonorrhea PCR
b. Urine tests, blood count, cytology, ultrasound, cystoscopy
5-week-old baby with an impalpable left testis. What is the next step?
a. Urgent pediatric surgery referral
b. Re-examine in 3 months, surgery if left testis is still not palpable
