AMC MCQS MAY 2005 RECALLS MCQ MAY 2005, Version Linsey , 05B1 1.

4-6 week old baby comes for a routine check up. Scrotal swelling is disco vered. Swelling is soft, transluminate. Testes are normal size after palpation. What is the management? review at 1-2 years elective surgery refer urgent surgical appointment ultrasound reassure parent 2. Which of the following is not associated with vomiting in infants a) a) a) a) a) gastroesophageal reflux pyloric stenosis congenital adrenal hyperplasia intersusseption galactosaemia

3. A Pregnant lady - 26 weeks, has a dilated cervix 2-3cm and is experiencin g regular contractions. Which of the following will you do except a) a) a) a) cervical suture give tocolytic drug give celestone give salbutimol

4. Female with acne and hirsutism. What is the treatment (recall question!) a) a) a) a) anti androgens isotretinion tetracycline OCP

5. Picture of scalp with a round crusty hairless lesion with some bloody pat ches. What is the diagnosis a) a) a) a) a) psorisis tinea eczema alopecia areata

6. New born baby with 1 week history of yellow discharge from umbilical stum p. A red fleshy lump can be seen on examination. What is the treatment? a) reassure parent a) povidone iodine (Betadine) a) silver nitrate a) ultrasound a) surgical removal 7. Patient with black pigmented skin lesion. What would be the most likely a ssociation to suggest malignancy a) ulceration a) greater than 5cm a) located on upper back

a) 2 or more of the same lesion else where on the body a) hair seen growing out of it 8. Picture of groin with lump shown. Patient came with complaint of swelling in groin for last 1-2 years. It is growing slowly and is soft and lateral to pu bic tubercle. What is the diagnosis a) a) a) a) a) female hernia lymph nodes lipoma inguinal hernia pre-vascular hernia

9. Antenatal checkup chart given. The last checkup was at 28 with normal fun dal height for dates. At 32 weeks the fundal height is still the same as 28 week s. Fetal heart rate is normal. What should you do? a) Instruct patient to come back in one week a) Perform a CTG a) Check to see if patient is developing preeclampsia a) 10. How will you detect increase ICP a) a) a) a) rise in BP papilloedema papillary reflex level of consciousness

11. A boxer comes to hospital after a fight in which he was knocked out. His right pupil is dilated but otherwise he feels ok and everything else is normal. What would you do? a) give manitol IV a) CT head a) 12. A 26 week pregnant lady has developed facial palsy. What do you advise? a) a) a) a) a) surgical decompression Prednisolone 75mg for 2 weeks Hydrochlorothiazide Advise it will resolve in 6-8 weeks

13 How do you calculate the diameter of the endotracheal tube for paediatric intubation? a) a) a) a) a) (age + 4) /4 (weight+4) /4 (weight + 4) /2 (height + 4)/4 (height + 4) /2

14. A 14 year old pregnant girl comes to you to request a termination. Her b oyfriend who is 21 left her when she discovered she was pregnant. She is living away from home. What do you do? a) ring parents for consent a) ring child care protection agency

a) inform police because of difference in age of male a) take her informed consent and terminate pregnancy 15. A photo of skin tags on eyelids of a small child. What is the diagnosis? a) Molluscum contagiousum a) Warts a) Skin tags a) 16. A 15 year old with a perforated appendix comes to hospital with his 18 y ear old sister. Parents at home. What do you do to obtain consent? a) a) a) a) obtain from sister ring parents get informed consent from 2 doctors take advice from witness/another doctor

17. Breast enlargement in an 18 month old girl. The most likely cause? (reca ll qu) a) idiopathic premature theliarche a) precoscious puberty a) adrenal hyperplasia a) 18. Staghorn calculi (recall qu) are found in all of the following except: a) a) a) a) UTI Immobilization Hyperuricaemia Hyperparathyroidism

19. What is a characteristic of fibrosing alveolitis a) reduced FEV a) reduced FEV/VC a) increased CO2 concentration 20. Tension pneumothorax (recall qu). What is the first thing you do? a) a) a) a) a) endotracheal intubation insert large bore needle into 2nd intercostal space insert tube into 4th intercostal space tracheostomy

21. Photo of buttock (recall qu) showing a large red area with elevated marg ins. Spread to both buttocks. What is the treatment? a) a) a) a) a) tar corticosteroids UV Imidazol Emoliant

22. Irish girl living in Sydney for 10 months. Has had diarrhoea and weight loss for 10 months. Blood test shows low folate and IGA, iron and B12 normal, en

omisial and anti gladyn antibodies negative. What do you do? a) colonoscopy biopsy a) small bowel biopsy a) it s not caeliac diseas because of negative findings a) 23. 3 year old with 10 brown spots on body (recall qu) He could have all the following associated except a) a) a) a) hypothyroidisn mental retardation deafness hypertension

24. An Aboriginal woman 57 years old. Lives in a remote community. Has never been to a doctor before. She has swelling in the legs plus difficultly breathin g. Bilateral basal creps. Non smoker. Drinks a lot of alcohol. You do all of the following except a) a) a) a) chest Xray ECG Echocardiogram CT pulmonary angiogram

25. An Aboriginal woman 57 years old. Lives in a remote community. Has never been to a doctor before. She has swelling in the legs plus difficultly breathin g. Bilateral basal creps. Non smoker. Drinks a lot of alcohol. What is the diagn osis? a) heart failure a) alcoholic cardiomyopathy 26. A 50 year old woman who had a CT scan abdomen. CT shows 1.5cm mass on th e R) adrenal gland. Non symptomatic, no electrolyte imbalance. No hormonal imbal ance. What do you do next? a) a) a) a) a) do MRI PET scan Biopsy Repeat CT in 6 months Ultrasound

27. A 19 year old woman with pelvic pain. Ultrasound shows a 4x6cm cyst on h er ovary. What do you do? a) a) a) a) reassure repeat ultrasound in 6 weeks laparotomy laparoscopy

28. Which one of the following is the least effective contraceptive? a) a) a) a) condom diaphram & spermicidal cream progesterone only pill IUD

29. What is the most common way of transmitting Hepatitis B in South East As ia? (recall qu)

a) perinatal a) sexual contact a) blood transfusion 30. In which of the following diseases does a person have a distorted percep tion of their body except a) a) a) a) amputation acromegally anorexia nervosa hyperchondria

31. A man attends hospital after being pinned to wall by forklift at work. H e has epigastric discomfort and mild pain. He is haemodynamically stable. What i s the indication for urgent laparascopic exploration a) a) a) a) liver heamatoma splenic heamatoma heamorrhagic fluid in peritoneum retroperitonial gas

32. Multiple red inflamed lesions with discharege in auxilla of left groin. What is the diagnosis a) pyelenodeal sinus a) infected epidermoid cyst a) hydroadenitis 33. A 42 weeks old baby weighs 2.5kg. What is the least likely association? a) mother with diabetes a) chance of hypoglyceamia is low a) length, head circumference and weight not same percentile 34. A lady with a hisotry of psychosis says she needs to contact you after h ours. What should you do? a) a) a) a) give give give give your home number the number of emergency telephone counseling number of nearest psychiatric hospital number of general hospital

25. A 17 year old girl who had a seizure with loss of consciousness for 1 mi nute. She says that for 1 year she has been experiencing jerks in her hands. What is the treatment? a) a) a) a) a) phenitonin carbamazepine gabapentin itho suxximide sodium valporate

36. A 19 year old woman who has been to you before for sleeping pills. Has a past history of occasional drug use. Mother who is also your patient has called to tell you the daughter is skipping school. Mother wants to know what the daug hter came to see you about. What should you do?

a) a) a) a) a)

tell her what tell her that tell her that interview the interview the

the daughter said her daughter is depressed her daughter is a drug addict daughter mother and the daughter

37. All are typical findings in acute asthma in a young adult except: a) pneumothorax a) right heart failure a) atelextasis 38. An x-ray of 67 year old woman with abdominal pain in left IF and some lo ose occasional diarrhoea. On x-ray there are some stones. What is most likely? a) a) a) a) renal stones gall stone ileous appendicular obstruction by faecolith previous Hx of TB

39. A couple who wanted advice regarding contraception using rhythm method. Her period in one year varied between 26 and 29 days. What stage do you advise a bstinence? (recall qu) a) a) a) a) a) 8-19 days 10-19 days 12-19 days 6-16 days 4-21 days

40. Without a previous history of any operation what is the most common caus e of small bowel obstruction? a) a) a) a) hiatus hernia groin hernia sigmoid volvulos gall stone illeus

41. A baby born at term. Normal appearance. 6 hours after birth develops tac hypnea and cyanosis and was corrected with 45% O2. What is the diagnosis? a) transient tachypnia of infant a) merconium aspiration a) hyaline membrane disease 42. A 65 year old lady with rheumatoid arthritis has developed a swollen and painful knee and fever. Pulse 120. She also has stiffness of hands in the morni ng. What do you do? a) a) a) a) take blood and cynovial fluid for tests take fluid from knee, test for gout and give allopurinol NSAIDs paracetamol

43. CT scan at L1 level. Patient has had epigastirc pain 2 months ago. What is the diagnosis a) pancreatic pseudocyst a) hyadatic cyst

a) splenic cyst a) gastric leiomyome a) gastric obstruction 44. Pregnant lady previously has caesarian and wants to have a vaginal deliv er. What will you say about risk of rupture and wound dehiscence? a) a) a) a) 0.5% risk increased increased increased of rupture risk if continues after 41 weeks risk if labour induced if difficult or laborious labour

45. Male with heart failure and AF. What is the risk of him having a stroke? On echocardiogram you see some shadow in atrium a) a) a) a) 0.5% /year increased risk of stroke 25% increased risk of stroke treat with warfrin treat with aspirin

46. A 60 year old Pacific Islander who is a heavy smoker. Has bloating and o edema of ankles. What is the likely diagnosis? a) lung cancer with vena cava superior obstruction a) ischaemic heart disease a) pulmonary emboli with hepatic metastisis 47. Coagulation deficit in obstetrics in all except: a) a) a) a) prolonged dead fetus in utero protein C deficit amniotic fluid embolism placenta previa

48. A menopausal lady comes for HRT to treat hot flushes. No other medical h istory. You do all of the following except: a) a) a) a) FSH Oestradiol Mammogram if not done in last 2 years Lipid profile

49. Patient with right sides sciatica and lower limb pain. He was hospitaliz ed and given narcotic analgesia and bed rest. After 8 hours he cannot pass urine . What is the reason? a) narcotic analgesic side effect a) prostetic bladder outflow obstruction a) central cord disc prolapse 50. A 12 year old girl with anorexia. Has lost 5kg over last few months. She has abdominal pain and anal pruritis. The diagnosis is: a) giardia a) Chrohns disease

a) Amoebiec parasite 51. An 87 year old man that you are going to do a colonic operation on. His daughter has had a 3 hour meeting with the anaesthetist and she is very anxious and agitated about the operation. Now she wants to see you to discuss her father s surgery. What do you do? a) a) a) a) speak to her choose not to see her see her only if she has power of attorney see her only with her father present

52. Lady on OCP has missed one pill. Had mid cycle intercourse and took morn ing after pill post intercourse and continues with daily of usual OCP. She is no w experiencing spotting after 3 days. What should you do? a) reassure and tell to continue taking OCP a) pregnancy test HCG a) tell her to stop, have a normal periods and then continue taking OCP 53. What is true except: a) a) a) a) a) gestational sac can be seen after 51/2 weeks of last menstruation at 7 weeks head, trunk and limbs can be identified at 8 weeks fetal heart can be seen on ultrasound fetal bradycardia indicates poor prognosis Ultrasound at 6-11 weeks can be correct plus minus three days

54. Inappropriate use of diuretics frequent in the following: a) a) a) a) football players bulimia anorexia obese people

55. Shown a fluid balalnce chart for a 5 days post op for rectal cancer man. He has received 2.5L IV fluids fluids. His output was colostomy 1500ml and urin e 2.3L. Which of the following may be the cause? a) a) a) a) a) diabetes insipid osmotic diuresis since operation wrong figures in fluid chart due to resolve of the ileus

56. A 41 weeks gestation baby. Normal delivery of 6 hours duration. Baby wei ghed 3kg. While delivering placenta the woman became suddenly shocked. What is t he cause a) a) a) a) pulmonary embolism uterine inversion amniotic fluid embolism uterine rupture

57. Which CTG reading shows fetal hypoxia except (recall) a) baseline 180 and variable moderate deceleration a) baseline 110 and increased by 20 beats twice in 20 minutes a)

58. In psychiatric evaluation which shows the least lack of insight and prop er judgment? a) a) a) a) altruism denial projection splitting

59. Lady with nausea and sudden onset of abdominal pain. LMP 3 weeks ago. Te nderness in RIF. What is the diagnosis? BP systolic 100 and Pulse 100 a) a) a) a) perforated appendix hemorrhaging ovarian cyst torsion of ovarian cyst ruptured ectopic pregnancy

60. A 21 month old baby with occasional diarrhoea that contains undigested v egetables. Normal development otherwise. What is diagnosis? a) a) a) a) toddlers diarrhoea giardia galactosaemia lactose/inulose deficiency

61. ADHD in children. Which of the following is most common: a) develops frequently in 5-7 year olds a) reading difficulties 62. Least likely to be primary hypothyroidism a) a) a) a) a) 6 year old child with less bone age 35 year old lady with menorrhagia 70 year old lady with goiter 10 year old boy with mental retardation lady with anaemia that didn t respond to folic acid, iron and B12

63. Elderly lady with large goiter. For which of the following would you adv ise her to have it removed. a) hoarse voice at end of day a) difficultly breathing when lying down 64. 60 year old man attends with his wife. He has lost 10kg in last year. Li ght smoker for last 30 years. Lately he has lost interest in activities of daily living. On examination all is normal. What do you think is the problem? a) chronic fatigue syndrome a) occult malignancy 65. Corticosteroids and psychosis a) if no previous psychosis before commencement of Tx there is no increased risk of developing psychosis a) prior psychosis menas a high risk a) low dose treatment can cause depression a) delirium can occur after abrupt withdrawal

66. Naltrexone given for opiod poisoning is: a) short acting a) has good absorption orally a) only efficient 3 days after heroine intoxication 67. 40 nulliperous woman with post coital bleeding. All of the following are possible except: a) a) a) a) enometrial carcinoma cervical polyp submucous fibroid intramural fibroid

68.CVS and amniocentesis except: a) a) a) a) CVS done earlier than amniocentisis Both good for detecting chromosomal abnormalities Both good for spinal bifida Risk of abortion higher in CVS

69. O negative Rh negative woman delivers an A negative Rh negative child wh o is jaundiced at 24 hours. What is the most likely cause of the jaundice? a) ABO incompatibility a) Breast milk jaundice a) Rh incompatiblity 70. A lady who is 26 weeks pregnant. Fundal height normal at 26 weeks with C oombes test mild positive. At 28 weeks fundal height is 38cm. What is the likely cause? a) a) a) a) polyhydramnios hydrops fetalis diabetes UTI

71. Mother Rh negative, baby Rh negative, Coombes test negative, Kleinhower test ok. What do you do? a) still give anti D at 72 hours 72. A 40 year old nurse threatening suicide. Has had previous episodes but n o associated risk of crisis. States she has a syringe in her bag and will kill h erself. What is the diagnosis? a) a) a) a) depression bipolar disorder borderline personality disorder schizophrenia

73. Venous ulcer on leg. Treat with all of the following except: a) a) a) a) topical antibiotics enzymes for debridement compression stocking bed rest

74. An olive shaped abdominal mass in a 6 week old infant. Has non projectil

e, non bile stained vomiting. What is the diagnosis a) malrotation a) volvolus a) pyloric stenosis 75. All of the following drugs cause gynocomastia except: a) a) a) a) digoxin simetidine labetolol alphmethyldopa

76. All of the following drugs cause gynocomastia except a) a) a) a) digoxin simetidine fruesemide alphmethyldopa

77. Endometrial cancer. All of the following can cause except a) obesity a) raloxifin a) oestragen therapy a) 78. Which of the following can cause osteoporosis except: a) early menopause a) smoking a) chemotherapy in a 60 year old lady for cancer 79. A 35 year old woman with menorrhagia. Bleeding for 8 days and having to change tampon every 2 hours. Mother had colonic cancer. Hb was 115. Is being tre ated with iron tablets. Should you a) do colonoscopy a) hysteroscopy and D&C a) give norethisterone 80. Treatment for cluster headache a) methyseigite a) sumotryptine a) ergotimine 81. Lady with headache for 3 days. Located in temporal and frontal region. O therwise well. Has been off work for 3 days because of pain. What do you do? a) CT a) Give ergotimine a) Reassure 82. A 40 year old man who is anxious about traveling to other places for bus iness. Uncomfortable outside his home. What is the likely diagnosis (recall qu) a) social phobia a) panic disorder with agoraphobia

83. 5 year old child with contaminated abrasion. Had vaccinations at 2 month s and 4 months, but missed the 6 month dose. What do you do? a) a) a) a) give give DTPa DTPa tetanus plus penicillin tetanus plus immunoglobulin plus penicillin and immunoglobulin and booster after 2 months

84. Radio opaque stone in renal pelvis, 2cm in diameter. What is the treatme nt? a) a) a) a) ECLT Advise the stone will pass The stone being there will cause cancer He has a urate calculi

85. Daughter brings in father who is confused. CT scan is given. What does i t show (recall qu) a) cerebral hemorrhage a) cerebral infarct a) cerebral tumor 86. For the past few days woman who has weakness in right hand. She can t use it properly. Look at CT scan. What is the diagnosis? a) cerebral hemorrhage a) cerebral infarct a) cerebral tumor 87. Haemolytic anaemia (recall qu) what do you find? a) increased lymphoblasts a) target cells a) reduced reticulocytes 88. Maculopapular rash in a 35 year old lady. 1 week prior had malaise, head ache and fever. Do all of the following screens except a) a) a) a) HIV EBV Rubella Varicella

89. Tonsil ulceration with exudates. Malaise, fever. Monospot test negative a) measles a) EBV a) Rubella 90. Av 25 year old student with fever, malaise and headache for 2-3 weeks. E xudative tonsils. Perianal soft lesions. Diagnosis? a) Yaws a) EBV a) Secondary syphilis a)

91. A 1 week old baby with neck stiffness, vomiting and fever. Lumbar punctu re shows raised protein. What do you give? a) acyclovir a) ceftriexone a) vancomycin 92. A 2-3 week old baby with tachypnea and distress. Chest x-ray shows shado w on lower left a) pneumonia a) congenital diphramatic hernia a) 93. Child with expiratory wheezing after exercise. Presents in Autumn. Bilat eral expiratory wheezes on auscultation. What is the diagnosis? a) asthma 94. Child was at birthday party. Came to hospital with sudden onset of wheez e on one side. What do you do? a) inspiratory and expiratory x-ray a) bronchoscopy a) allergy test a) 95. Which of the following has the most severe outcome for a child (recall) a) with a bruise on the cheek a) bluish discoloration on buttocks a) diamond shaped lesion on scalp a) 96. Patient delirious due to multiple factors - hepatic failure and alcohol withdrawal. What is the least likely associated issue? a) asterixes a) unable to give consent a) sundowning effect a)

97. LFT elevated, billirubin elevated, ALP and gama GT high. ALT 600 and AST 500. Igg for Hepatitis A and he drinks 60g alcohol daily. IGM core antigen posi tive. Diagnosis? a) a) a) a) Hepatitis B Cirrhosis for Hepatitis B Acutem alcohol hepatitis Acute Hepatitis A

98. Which of the following is true regarding haemocromatosis? a) you don t do venesection if the pacient is asymptomatic a) 1: 50.000 Australians have the disease

a) The gene implicated is C28CY 99. A 4 yo girl wakes up every night complaining of cramps( not related to d aily sports and activities) and wants her parents to massage her legs, then fall s asleep. Wof is not true? a) she has abnormal calcium and electrolites b) her parents used to do the same as kids c) reasurre that she only wants attention 100. A 3 yo girl gets apnoeic and cyanosed and falls to the ground when upse t or the parents are not doing what she wants. What do you tell the parents? a) reassure that it is a benign condition b) 101. Lady with BMI 28 she drinks heavily and also has high cholesterol (some other asso features). Mxa) Advice to loose weight. a) Tell her to maintain a well balanced protein diet. a) Tell her to stop drinking. 102.Pt with tremor, heartrate , TSHlow(.2),T3 and T4 high. Mx a) Necarmazole a) b) Radioactive iodine. a) c)Suppress with thyroxine 103. Pt had fever and neck pain for 2 days, came with slightly enlarged thyr oid gland, tender. Mx a) Aspirin and atenolol . 104. School teacher anxious and at class keen to do everything perfectly. Go es over things of the day in his mind at the end of the day Tries to stop doing it but can t. Mx a)SSRI b)Antidepressants 105. All of the following will give increased pulmonary vascular evidence ex cept a)ASD b)VSD c)Anomalous pulmonary vein d)Overriding of aorta. 106.Child 10 yrs cough for 2 weeks, fever. Bilateral hilar diffuse shadows. Likely organism a) Bordetella a) Mycoplasma 107.Woman after 3 days of laparotomic operation during shower became cyanose d, tachypnoec, breathless. Dx a) Myocardial Infarction. b)Pulmonary embolism c)Vasodilatation due to hot shower 108.Daughter lost father 6 months ago. Can t get over it.Lost weight 6-10 kg. What will you enquire about a)Eating pattern b)Suicidal ideas c)Menstruation regularity

109.In senile dementia what pt most likely to forget last a)Recent events b)Vocubulary c)People s faces d)Where they are (get lost) 110.Pt with aortic aneurysm repair after 3 days developed distention of abdo men(other features). Cause a)Hypokaelimia b)Dissecting aortic aneurysm 111.Haemochromatosis indication for venesection except a)Asymptomatic patient b)Genetic pattern given 112.Iron deficiency anaemia, which is true a)Ferritin increased b)Premature babies more prone 113. Haemolytic anaemia what does not occur a)Increased urine urobilinogen b)Increased unconjugated bilirubin c)Reticulocytosis

114.1 hr after difficult urethral instrumentation under GA pt developed swea ting, pale, breathless. Cause a)Concealed hge b)PE c)Gram ve bacteraemia 115.Before cardioversion to see progress what do you do a)Adrenaline IV every 10 min b)Put ECG monitor 116. Regarding IUCD use what is true except a)Excellent form of contraception b)Risk of ectopic pregnancy 117.Which of the following is true about depression presentation in a GP pra ctice a) It affects all age groups a) Both sexes are affected equally a) It is the commonest psychiatric disorder to present to a GP 118. X-ray of suprachondylar fracture(anthology book), pt s limb is pulseless. First step of management 119.Mammogram and USG of breast given what is it (Anthology book pg 104) a) breast cyst a) 120.Pt came from warzone area,what he might suffer from most likely 121.Man has fear of flying. Avoids flying and staying away from home. Dx

122.Most likely cause of wasting of small muscles of hand is due to which ne rve lesion a) ulnar a) median a) digital a) radial 123.Pt can do planter flexion and inversion but dorsiflexion and eversion we akly. Knee jerk and ankle jerk okay. Where is the lesion. a)Common peroneal nerve b) L4 c)L5 d)Sciatic nerve 124.Seamstress came with needle prick on finger. Can t extend it. Dx 125.Child came acyanotic, when feeding cries. Systolic murmer at left sterna l border, loud S2. apex beat not shifted but tapping in 5th intercostals space. Dx a)ASD b)VSD c)Disposition of great vessels. 126. Commonest form of epilepsy that occurs between ages 4-10years a) Petit mal a) Generalised tonic-clonic a) Myoclonic a) Infantile spasms 127.In Polycythaemia rubra vera is associated except a)Anaemia persistent b)Normal lifespan of RBC c)Osmotic fragility d)Persistent spherocyte 128. Photo of skin lesion (from Anthology of Medical Illnesses pg 396). Dx a) melanoma a) psoriasis a) Bowen s disease a) SCC (invasive) 129.Girl wants to have umbilical ring but on examination splenomegaly. What to do. 130.Keratin scaling does not occur in which one a)SCC b)BCC 131.What is NOT true about Australian snake bites? a) most are not poisonous a) cranial nerves are usually affected a) you should apply a torniquet immediately a) observe for symptoms before administering antivenom 132.Lady can t see outside in bright light. Dx 133. Lady with tremor at rest and when she reaches for phone but not when sh

e looks at her hand. Treatment a) propanolol a) carbidopa and l.dopa a) benzehexol 134.Child with signs of pneumonia and in X-Ray consolidation of lower lobe. Rx a)Penicillin b)Erythromycin c)Flucloxacillin d)Roxithromycin 135.Paracetamol overdose. 136.Pt with left sided scrotal hydrocele growing fast, what is likely cause a) left renal cancer b) left testicular cancer 137. Unilateral nasal discharge foul smelling and child not allowing you to examine nose. What to do. 138.Boy with knee pain, worse after exercise. Dx 139.Mother came with son 12yrs old who had limp. Dx a) slipped femoral epiphysis a) Perth s disease a) Osteomyelitis a) 140.Child crying and vomiting due to intussucception. a) surgery a) air contrast enema a) N/G tube 141.Common cause of bleeding from nipple in 50 Yr old woman. 142. Cause of toothpaste like discharge from nipple. 143. 80 Kg man came with 15% burn how much IVF needed? a) 3L Hartmanns + 2L 5% D/W a) 3L N/S + 2? 5% D/W a) 3L Hartmanns + 2 L blood a) 144.Man came with vomiting, eyes sunken, dehydrated what type of fluid does he need? 145. What is true about febrile convulsion. a) recur in 3% of children a) the majority will develop epilepsy a) commonly occur between 6 months and 4 years a) associated with focal seizures a) last less than 15 minutes 146.Pt came in labour with PV bleeding about 1000 ml. How to know it was pla centa praevia. 147.Infant with urine in bag culture 105. Next what to do?

148.Second commonest cause of death in Australia after cardiovascular diseas e. a) motor vehicle accident a) malignancy a) respiratory illness a) 149. Which tumour does not metastasise to brain. a) breast a) lung a) kidney a) melanoma a) prostate 150.Lady with DVT and superficial thrombophlebitis taken medication but stil l it occurs. Reason. 151. An old man who has difficulty reading the telephone book. The Dx is a) myopia a) cataract a) hypermytropia a) presbyopia 152. A butcher presents with fever, myalgia, jaundice, maculopapular skin ra sh and hepatosplenomegaly. What is the most likely Dx a) leptospirosis a) brucellosis a) Q fever 153. WOF is true about iron deficiency anaemia in infancy a) malabsorption is the commonest cause a) peak time is around 2 months a) blood loss is the commonest cause 154. What is the first sign of puberty inm males? a) increased penile shaft size a) increased testicular size a) increased breast size a) presence of pubic hair 155. A young adult from Fiji presents with fatigue, ascites, hepatomegaly, i ncreased JVP. What is the most likely Dx a) Tuberculosis pericarditis 156. Which of the following is not the first investigation of an infertile c ouple a) semen analysis a) karyotype a) hormone profile a) laparoscopy and hystersalpinogram 157. Methotrexate is effective in the treatment of ectopic pregnancy in all except a) unruptured gestational sac a) live fetus a) HCG level low a) The gestational sac is small on U/S 158. The best method for imaging bile ducts

a) a) a) a)

CT U/S ERCP Oral cholecystography

159. Most common manifestation of pyloric stenosis in adults a) frequent vomiting a) abdominal distension a) one or two large vomits per day 160. The commonest form of cancer in non smokers a) SCC a) Small cell ca a) Adenocarcinoma 161. WOF is not true about amniocentisis and chorionic villus sampling a) both can detect chromosomal abnormalities a) CVS is done at earlier gestation a) Amnio is slightly less accurate 162. WOF does not get transmitted to baby during delivery a) herpes a) syphilis a) B. Streptococci a) CMV 163. WOF is less likely to be a manifestation of first degree hypothyroidism a) an 8 year old child with retarded growth a) a 65 year old woman with multi nodule goiter a) a 35 year old woman with depression a) a woman with menorrhagia 164. In WOF is anaerobic bacteria growth most likely a) lung absess a) brain absess a) hip prosthesis a) GI tract 165. WOF is not true about emphysema a) decreased FEV a) decreased VC a) increased TLC 166. Management of a breast cyst a) fine needle aspiration a) biopsy a) mammectomy 167. A lady immediately post partum develops shortness of breath and increas ed JVP a) conjestive heart failure a) PE 168. Drug of choice for myoclonic seizures a) carbamazepine a) sodium valproate a) phenytoin a) phenobarbitone 169. In a patient with a loss of dorsiflexion and eversion but has intact in version, plantar flexion, ankle and knew reflex. WOF nerves is injured

a) a) a) a)

L4 L5 S1 S 2 or 3

170. WOF is contraindicated in a child with ALL in remission a) MMR vaccination a) DPT vacc a) Polio vacc 171. An elderly man 10 days post op from a hemicolectomy collapses following a hot bath. Reason for collapse a) vasodilation due to hot bath a) bleeding a) anastomosis leak 172. In a patient who is agitated and depressed, with suicidal threats, appr opriate management is a) haloperidol a) contact the police a) try to convince him to take medication a) involuntary admission 173. A pregnant lady delivers at 34 weeks gestation. The neonate develops re spiratory distress. What is the cause? a) hyaline membrane disease a) transient tachypneoea of the newborn a) congenital pneumonia 174. A lady with avenous ulcer. WOF is not the appropriate management a) elevation of the leg a) sustemic antibiotics a) local antibiotics a) debridement 175. A group of people at a banquet present with GI symptoms within 6 hours. Some recover spontaneously, others develop diarrhoea and are admitted to local hospital. WOF is the most likely causative agent a) salmonella a) staph aureas a) clotridium a) E. Coli 176. WOF is not found in pulmonary embolis a) synope a) pleuritic pain a) SOB a) Bronchial breath sounds 177. In subacute bacterial endocarditis, prophylaxix antibiotics is appropri ate in all except a) appendisectomy a) cystoscopy a) reduction of simple # a) dental filling 178. WOF is not a side effect of Depoprovera a) mild hypertension a) prolonged ammenorrheoa a) thromboembolism

a) hypelipidemia 179. WOF won t decrease potassium level in a patient with hyperkalemia a) glucose + insulin a) calcium a) resonium a) sodium bicarbonate 180. In a diabetic foot WOF isn t true a) unlikely in the presence of intact pulses a) neuropathy plays a significant role a) major presenting problem in hospital a) 3 year survival rate after amputation is around 50% 181. A young man is brought to hospital by his girlfriend. He is angry and r epeatedly shouting I love you, drive to Timbuctu . Most likely DX a) mania a) thought disorder a) faetitious disorder a) drug abuse 182. Evaluation of an acute head injury a) change in level of consciousness a) pupil reaction change a) BP a) Pulse rate 183. Varicocele is associated with a) left testicular cancer a) left renal cancer 184. Tension pneumothorax management a) wide bore needle 2nd intercostal space a) chest tube 185 Diagnosis of gout arthritis is best made by a) serum uric acid b) x-ray c) joint aspiration

OTHER INFORMATION: ? ? ? ? 4 2 3 6 ECG s were given for diagnosis X-rays for mastery questions CT scans of head for diagnosis photos of lesions also given 3 or 4 were Mastery questions