5 day evening- Part 3
( Mostly are recall , just find the new question) but, I have attached all
questions that come in group. Thanks
Brindan Sept:
Women, Hairly Vulval pic given burning sensation +ve. Regular menses,
heavy recently. Rest Normal.
Clotrimazol
Top steroids
Vulval hygiene
Pressary
B/L shoulder pain, Neurology Normal, I think she was on Cohlchicine, can’t
remember.Dx??
B/L rotator cuff tear
Fibromyalgia
PMR
Polymyositis
Missed pill. Regularly took at 11Pm. Came to gp nxt day evening. On 7th day.
No sex in a week. What to do??
Take the missed pill now and nxt on 11pm
Take the pill and use condom for nxt 7days
Emergency contraceptives pills
Erythema nodusum in shin. Vietnam immigrants. Chest issues
Tb
Sarcoidosis
Naproxen induced AIN
One 15yr child had lots of problems in school,used drugs, smokes marijuana.
What to give?
Risoeridone
Haloperidol
Methylphenidate
Inf wall mi bp85/65 - iv fluids
Buergers disz amputated fingers
ecg looked like Heart block / long qt
Methadone 80 mg taking daily.
Now Bp 85/65 pso2 82% many other thinks mentioned. Oxygen,iv given. Nxt
best??
Iv fluids
Naloxone
Naltrexone
Agricultural has higher CFR
68 F stress incontinence. Has omentocoel and rectocoel. What nxt??
Urodynamic studies
Vagunal pessary
Estrogen cream
Intermittent displasia to solid and liquid. Normal ugd
Achalsia
DOS
PUD
Oeso Ca
Female no symptoms coeliac negative , brother diagnosed with coelic dis.
Reassure
Hladq8/2
No endoscopy and biopsy in option
Recurrent uti. Fever dysuria cause??
Vcug
Cystoscopey
Ct urography
No usg kub in option
Thyroid mass 25mm on right lower thyroid?? Psammoma bodies +nt
Rt lobectomy
Total thyroidectomy
One male who had cuts on neck and hands. His male partner recently
abused him and threatened him.He came to you. What to do?
Report to police
Mange alternative for him
Bipolar lady went to er, er staffs gave her allergic drugs. Called them maddie
wakiiee something like that. She came to gp. Nxt?
Inform police
Support on behalf of er team
Help her guide to complain
Legal adviser
Child playing football in sun. Temp 39.8, gcs 12.Heat storke scenario. What
inv?
Electrolytes
Ct
Cbc
28 preg female rh -ve
Check the parthner
Alzimers pt. Wanted advance directives no ressursitatiin no surgery. Mmse
22/30
Psychiatrist evaluation
Respect his will
Geriatric physician consult
Do surgey
72 years old man , 3 day total constipation , anemia, and pain , rectum
empty . CT - caecum 11 cm, stenosis of sigmoid colon ( like malignancy). Tx:
Colonoscopy
Colostomy
Sigmoidstomy
Boy was kicked in his abdomen. After 2minths still pain persists.
Investiin?
Ct abd
Usg
Xray
Colonoscopy
Child 15 kg irritable decreased feeding, CRT 3sec. Mx??
0.9ns +5%dex @33ml/hr
0.45ns bolus initial and send him
0.9ns 150mlbolus and observe
Women want to conceive on sod valproate *15yrs??
Stop Valprote and switch to carbamazipine
Reduce valprote
Stop valprote and start phenytoin
Stop all meds
Uss given. Post aucustic shadow? Bil 60 Alp inc?
Lap choli
Handbook lady with swellin in front of ear. Parotid swellin
Nxt inv?
Uss
Mri head and nexk
My questions
Manish September:
ECG picture of : QT prolonagtion diagnosis
Pic of Rash of mIlia and ETN: reassurance
Pic of Atheroma to go for Hyperlipidemia
Pic of Impetigo Back: Stap Aureus No pyogens in option.
Pic of Eczema Rash in 8 year child
Case of OCD what features will be seen?
1. Argumentiveness
2. Miserly Spending
3. Other can be rule out
Patient was on clozapine started having akathesia what to do next?
1. Check serum clozapine
2. Propanolol
3. Baclofen
4. Benzos
Patient was on amisulpride for Schizo have adverse effect of TD and EPS.
Want to change medicine. What to give?
1. Risperidone
2. Clozapine
3. Haloperidol
4. Triphenazine
5. Queitepine
Patient started on Anti psy. Later got T2DM. what to check next?
1. Lipid
2. TSH
Day 3 of OT. Patient confused, shouting, Used to drink 4 can of beer /day
what next?
1. Haloperido
2. Abs
3. Midaz
Picture of diastasis recti. How to diagnose?
1. Asking to stand up
2. Rasing leg from bed
3. Asking to cough
Women, Hairly Vulval pic given burning sensation +ve not itchye. Regular
menses, heavy recently. Rest Normal.
1. Clotrimazole
2. Top steroids
3. Vulval hygiene
4. Pressary
5. Douching
B/L shoulder pain, Neurology Normal, She was on Cohlchicine for Gout , can’t
remember.Dx??
1. B/L adhesive capsulitis
2. Fibromyalgia
3. PMR
4. Polymyositis
Missed pill. Regularly took at 11Pm. Came to gp nxt day evening. On 7th day.
No sex in a week. What to do??
1. Take the missed pill now and nxt on 11pm
2. Take the pill and use condom for nxt 7days
3. Emergency contraceptives pills
Erythema nodusum in shin. Vietnam immigrants. Chest issues
1. Tb
2. Sarcoidosis
Buergers disz amputated fingers
Methadone 80 mg taking daily. Now Bp 85/65 pso2 82% many other thinks
mentioned. Oxygen,iv given. Nxt best??
1. Iv fluids
2. Naloxone
3. Naltrexone
Another similar question where need to give naloxone
Agricultural has higher CFR,
Chest pain, Intermittent dysphagia to solid and liquid. Normal ugd
1. Achalsia
2. DOS
3. PUD
4. Oeso Ca
Female no symptoms coeliac negative , brother diagnosed with coelic dis.
1. Reassure
2. Gentic testing
No endoscopy and biopsy in option
Recurrent uti. Fever dysuria cause??
1. Vcug
2. Cystoscopey
3. Ct urography
4. Xray KUB
No usg kub in option
Child with LOC after playing football in sun. Temp 40.2, gcs 12.Heat storke
scenario. What inv to do next?
1. Electrolytes
2. Ct
3. Cbc
4. Echocardiogram
Alzimers pt. Wanted advance directives no ressursitatiin no surgery. Mmse
22/30
1. Psychiatrist evaluation
2. Respect his will
3. Geriatric physician consult
4. Legal adviser
Boy was kicked in his abdomen. After 2minths still pain persists.
Investiin?
1. Ct abd
2. Usg
3. Xray
4. Colonoscopy
Child 15 kg, moderate dehydration, irritable decreased feeding, CRT 3sec.
Mx??
1. 0.9ns +5%dex @33ml/hr
2. 0.9ns +5%dex @50ml/hr
3. 0.45ns bolus initial and send him
4. 0.9ns 150mlbolus and observe (Mainly mixed 0.9 vs 0.5 and dextrose at
rate of 50/33 mm.hr)
Women want to conceive on sod valproate *15yrs. Clinically stable. Epilepsy
under control??
1. Stop Valprote and switch to carbamazipine
2. Reduce valprote
3. Stop valprote and start phenytoin
4. Stop all meds
Uss given. Post aucustic shadow? Bil 60 Alp inc mildly?
1. Lap choli
2. Ercp
3. Mrcp
Another case of NTD using TMp for Recurrent UTI for which she had rashes
initially. Underwent surgery where she had sudden hypotension and stridor.
Asked cause?
1. Latex
2. Isoflurane
3. Antibiotics
Case of LGI bleed. Bp 98/52. Endo done normal. After Resus what to do
1. Colonoscopy after bowel prep
2. Angio
54yr old girl underwent a Hysterectomy for UV prolapse. 3 days later pt
presented with tem 37.6 lower abdominal pain and vomitting. Abdomen pain
on deep palpation. cannular removed 2days back.cannular site pain
present.but no features of infection.most probable diagnosis
1. 1.cannular site infection
2. Vaginal vault hematoma
3. 3.Pelvic venous thrombosis
4. Atelectasis
Farmer with Picture of back given. Multiple dark lesion ?SK ? Nevus
1. reassurance and R/V
2. excision biosy
3. punch biopsy
4. Cryotherapy
5. Wide excision
Lump anterior to the L/ear noted.Increse in size before meal.bleeding noted
in inbetween teeth.diagnosis
1. parotid duct obstruction
2. Parotid gland tumour
3. Abscess
PCOS future risk of
1. Osteoporosis
2. OSAS
Female with fatigue and constipation. H/O multiple renal stone. What to
check?
1. S calcium
2. S Uric Acid
3. TSH
Female partner is planning to conceive.she wanted to know the exact date of
ovulation.her cycles are 28-36days.what is the best method
1. early morning body temperature
2. cervical mucus ph monitoring
3. Cervical mucous thickness
4. day 14follicular scan
5. Day21serum progesteron
Question on a lady who came with concern about her fasting sugars, she's
got HTN, IHD stable, also has had CABG 5 years ago and completely well,
and drugs given - perindopril-indapamide, atorvastatin 20mg, Aspirin 100mg,
labs given -
Na normal, K 3.6 ( cut off given was 3.8 for normal ) , all LFTs normal except
inc in GGT, BGL - 5.2, asking what is most appropriate thing to do for her ?
1. Continue her therapy
2. Switch atorva to rosuvas
3. Reduce atorva
4. Switch perindo-indap with perindo-amlo
5. Start Metformin
Pregnant lady 22 yrs old, had only one antenatal visit at 12 months now calls
you to tell you that she delivered at home, a still born baby, and was late by
3 weeks, what is the next most appropriate thing to do -
1. Notify the coroner
2. Bring mother and child to the hospital
3. Send midwife home
4. Doesn't need to notify anyone as stillborn
Pregnant lady first pregnancy, religious beliefs against blood transfusions, Rh
neg, 6 weeks, has had PV bleeding since 3 days, no Intrauterine GS, BHCG
was 3630, on PV, adnexal mass present, what's the best advice to give about
Anti D
1. Check for partner's RH status
2. Check for feto maternal hhg
3. Counsel her about Anti D immunoglobulin not being a blood product
Intern gets to know about Student who checked patient files for a relative
who is abroad, what to do next -
1. Talk to AHPRA,
2. Suspend intern's access to records
3. Check the records to see if intern actually accessed
4. Inform clinical director of services
5. inform patient that his records have been accessed
Son comes with concerns about his 82 yr old mother who has been well until
recently where she's forgetful, is irritated and despite the son's insistence,
she won't get herself assessed. He wants you to assess her at the earliest,
what's the next appropriate thing for you to do ?
1. Arrange an appt with both son and mother
2. tell son you cannot check mother
3. Assess for a home dementia assessment
question about the man on Olanzapine well controlled, for Schizophrenia and
BMI 27 and increased day time sleepiness and snoring, whatnot, wife
threatens to leave him because of the same, sleeps in a separate room, he
comes to you asking for help with the sleep issues
1. Reduce Olanzapine
2. Weight loss program
3. Do nothing
Elderly patient came with agitation, irritability, confusion, brought by son
who noticed symptoms since 3 days. Patient lives alone. On exam, febrile
high, BP normal, urine analysis shows infection I think. She allows you to
examine her. Vitally patient was stable, after giving antibiotics what will you
do for her agitation ?
1. Keep her in a quiet dark room
2. Physically restrain her
3. Give antipsychotics
4. Encourage more family meetings
Women in 41 WOG. What is indication to do CS withoud doing Fetal scalp
test?
1. Fetal Bradycardia
2. Meconium stain
3. One of the position of head given
Renal stone size 0.5 cm in the upper renal calyx , incidentally found during
investigations of another surgery, otherwise patient completely okay, no
symptoms, labs were given, there was slightly increased uric acid in serum,
increase urine calcium and normal serum calcium
1. Allopurinol
2. HCZ
3. ESWL
4. Ureterolithotomy
Case of Behcet disease. Uveitis seen. What to give?
1. Oral Pred
2. Topical Pred
One patient after accident..came to ER..tongue is bleeding..maxill and
mandibles fracture on both side and can't open mouth and already
orophygreal tube inserted but still breathlessness Spo2 92 , what next thing
you do immediately ?
1. endotrache incubation
2. naso incubation
3. tracheostomy
4. Cicrothyridotomy
5. Percutaneou treostomy with oxygen
3 month old baby picture on abdomen given...maybe haemangioma...three
portions..propanolol given 3 days after birth. Mother does not want to
continue medicine anymore. Appropriate mx..
1. Review 3 months.
2. Surgery.
3. Topical b blocker.
Female with pain abdomen and PV bleed. Fetal heart not ascualtate- next
management following IV resus- option
1. amniotomy
2. ultrasound
3. prostaglandin
Apical lung tumour size 14mm investigation option
1. video assisted biopsy
2. bronchoscopy
3cm lumb in the right upper quadrant of the right breast noticed after a
tennis ball trauma with right axial lymphadenopathy and at 37.5
1. fat necrosis
2. fibroadenoma
3. Fibrocystic change
4. Breast ca
Child jaundice for 6 weeks, most important in History to come up with dx
1. Stool color
2. Family history of liver
Spinal # what to give? Calcium and vit d normal
Alendronate
Another Spinal # what next?
Rest and Analgesia
Analgesia and Mobilize
Aortic aneurysms size 3.5 to 3.7 cm
1. Biannual
2. Annual
3. 6 month
4. 5 year
