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MARCH 2021 PAST RECALLS

1) 6yrs old girl Jelly fish sting in QLD beach, she has resp distress, what to do next

/
-Antivenom

m
-Wash with water
-wash with Vinegar
-O2

co
-Remove the tentacles

2) Pedestrian with gunshot by a gang comes with distended abdomen , low bp, gcs is good what will u

x.
do
Ct
Fast

us
Laporotomy

3) young lady return from thailand.fever ,maculopapular rash,red eye, myalgia,low wbc,plt normal,UE

pl
normal,CORONA virus negative.next step?
throat swab
blood culture
r.m
urine culture
isolation
cxr
be

4) depressed patient has the highest risk of attempting suicide?

When the depression deteriorates
After discharge from the hospital
em

5) In a urine dipstick test, a 26-yr-old man is only positive for 1+ proteinuria. no significant medical
history. next step?
a/ Serum electrolytes, urea, and creatinine
b/ 24 hour urinary protein assay
//m

6) An ecg with pt on multiple drug taken with history of dm,hypertension asking cause of AF
a.dehydration
b.ischaemic heart disease
c.hypertensive heart disease
s:

d.high cholesterol
tp

7) woman with …. OCP for 10 yrs comes, what’s the cancer risk increasing for her, her BMI is >30
Ovarian Ca
Endometrial Ca
ht

Breast Ca
Colorectal Ca
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8) 40-yr-old patient with heart burn & chest pain started developing difficulty swallowing food in the last
12 mths. Has regurgitation when lying down but eases when raising arms. Diagnosis?
1. Esophageal cancer

/
2. Esophageal strictures

m
9) Woman, BMI>30, on COCP, grandma with ovarian ca at 65 years old, what can reduce the risk of
ovarian ca?

co
A. Weight loss
B. BRCA screening
C. Stop OCPs

x.
D. Ca-125 yearly
E. Breast ultrasound?

us
10) WPW with AF treatment
adenosine
verapamil

pl
lignocaine
digoxin r.m
11) most common adverse effect of aripiprazole?
a Light-headedness
b Dizziness

12) Mentally retarded child brought by caretaker as he threatened his roommate with knife what to do
be

next
Inform police
Refer to ED
em

13) Gross hematuria next investigation

CT urography
Cystoscopy
//m

14) Lecture on sex education has been given to 13-yr-old school girls. Next most important topic to be
covered?
Sunscreening
s:

Regular cancer screening

15) 23-year-old woman presents to your clinic with amenorrhea for 6 weeks. Which one of the
tp

following, if found on history or exam, will make you decide to proceed to emergency intervention?
a Vaginal bleeding
ht

b Lower abdominal pain

16) Ankylosing spondylitis bamboo spine , what’s the tx?

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-Inflaximab
- paracertamol
-Nsaids

/
- prednisolone

m
17) IV drug abuser guy come with symp of pul abscess, CX ray is given fluid level with the cavity after 2
weeks antibiotic tx, he is not good, what will be your next?

co
- CXR
-bronchoscopy
- Refer to the surgeon

x.
- Continue the treatment

18) 24-yr-old woman with BMI of 25 is extremely worried about her weight & body size. Exam & lab

us
values are all within normal range. Diagnosis?
i. Bulimia nervosa
ii. Body dysmorphic disorder

pl
19) 30-yr-old woman complains of episodes of headache, sweating, palpitation, tingling sensation in her
hands, shortness of breath & severe anxiety. Medical workup reveals no pathological finding. Causes?
- Increased free plasma epinephrine
r.m
- Decreased serum glucose

20) 60 yrs old man with the history with hep C, he got cirrhosis, abd distension and sepsis? What inx will
you do for him?
be

There is no paracentesis in options , only Ammonia in option

21) a man with fever, fatigue, rusty sputum , pic of his left foot is given , multiple brownish red spot,
em

with wt loss what is the diagnosis?

TB
Cancer
Sarcoidosis
Cellulitis
//m

melanoma

22) Melanoma on the eyelid

- refer to surgeon
s:

23) Man wants to travel by airplane distance is 5000 kilometres he is concerned about Dvt what would
be your advice??
tp

prophylactic LMWH
therapeuticlmwh
ht

compression stockings
fluids
tell him to get up and walk where every can find the path
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24) 8-yr-old boy with red swelling behind the right ear complains of right ear pain & purulent discharge
since yesterday. He has the history of chronic bilateral otitis media for which he underwent bilateral

/
grommet procedure. Next step?

m
a/ Take samples for culture
b/ Hearing assessment

co
25) 67-yr-old woman complains of headaches for the past 2 weeks. Headache is worse in the morning &
associated with vomiting but no nausea. Painkillers doesn’t work. Diagnosis?
a/ Migraine headache

x.
b/ Cluster headache

27) 36-yr-old man underwent splenectomy 2 yrs ago seeks for advice about vaccination before he goes

us
on a business trip to Cambodia. Infection most susceptible during this trip?
a/ Dengue fever
b/ Hepatitis B

pl
28) Mobitx type 2 ecg with very slow HR, options for
- amiodarone
- pul pacemaker
r.m
29) Old man after prostactectomy comes with fever and chills, what is the casue?
- wound infection
-peritonitis
be

- inf with gram negative bacteria

30) 25 yrs old female came with history of her grandmother having ovarian ca . What we do for her ?
em

A) ca125
B)sonography
C) mammography
D) nothing
//m

31) Prostate ca, underwent surgery. After prostactomy PSA rising too quick. What to do next ?
A) Pet scan
B) Mri
C) Abd ct
s:

32) RTA with seat belt , abd pain , shock despite of 3L colloid . Next step ?
A) laparotomy
tp

B) FAST
C) CTAP
ht

D) abd tap.
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33) 67-yr-old presents with a firm & non-mobile left breast mass. There is no lymphadenopathy. An
ultrasound scan found a 2x3 cm hypoechoic mass with irregular borders. Next step?
a- Excisional biopsy

/
b- Mastectomy

m
34) 72-yr-old man has been treated several times for depression. He smokes 15-20 cigarettes a day &
wants to quit smoking. Most important option for him to assist his quitting?

co
a- Cognitive behavioral therapy (CBT)
b- Nicotine replacement therapy (NRT)

x.
35) Lab test results for Jane confirmed systemic lupus erythematosus (SLE). You write a referral letter to
a local rheumatologist for consultation. She wants to know for how long this referral letter is valid?
a- Three months from the date of issue

us
b- Three months from the first visit by the specialist

36) menopausal woman come with post coital bleeding what is the best inx to do

pl
a- Endometrial biopsy
b- Only that rem r.m
37) 55 yrs old woman with sexually active, greeny brown discharger
a- Chlamydia
b- endometria ca

38) woman with Hbs Ag positive , male partner had vaccine, he wants to check it ? What will you check?
be

- Hbs Ab
- HbeAg
em

39) A boy has come back from Correctional center , he is aggressive he doesn’t want to go back to that
place, what will you do for his tx?
-Anger mx
-CBT
//m

40) correct statements about Perthes disease?

- Hip mobility is reduced especially abduction and external rotation
- Ultrasound is the modality of choice to make a diagnosis
s:

41) You are a hospital medical officer & an intern on rotation approaches for a prescription of
benzodiazepine. He complains of stress, lack of sleep & irritation most of the time. Response?
- Report him to the coordinator of interns program
tp

- Report him to the medical board

ht

42) 48-yr-old painter falls from a height of 3 meters & lands on his both heels. He suffered a minor
wound on the forehead. There is severe swelling below the left ankle and moderate tenderness over the
lumbar area. Next step?
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- CT scan of the head to exclude intracranial hemorrhage

- AP and lateral x-ray films of the left and right foot

/
43) 40-yr-old heavy alcohol drinker complains of vertigo and shaky hands. He says: "like I am floating,

m
and my head is light". He denies any sensation of spinning or moving around. Diagnosis?
- Temporal lobe epilepsy
- Anxiety

co
44) PAD Q, lower limb pulses are palable, the best inx?
- Doppler

x.
- Angiography

45) what the tx of DVT>?

us
- Heparin
- Wafarin

pl
46) pt on warfarin, takes amoxillicin, massive bleeding in inf fossa, no ct
- Rectus shealth haematoma r.m
47) man with chronic constipation, what will you lead to dx?
- colonoscopy
- stool exam & culture

48) 25-yr-old woman with a history of greenish-yellow vaginal discharge is tested positive for chlamydia
be

infection. She has multiple sex partners in the past 6 months. Advice?
a Trace all her sexual contacts in the past six months and treat them
b Ask her to bring her most recent sexual contacts for testing and treatment
em

49) woman at emergency with vomiting, abdominal pain and distention. has congestive heart failure.
Her abdomen is distended but not tender. cause of abdominal distention?
- Hypokalemia
- Digoxin toxicity
//m

50) old man believe is vertigo. when stood up from a sitting, felt dizzy and nauseated. diabetes and
ischemic heart disease, currently on valsartan, metoprolol, atorvastatin, metformin and glimepinde.
diagnosis?
s:

- Stroke
- Myocardial infarction
tp

51) Woman at 37 weeks gestation. contractions started and painful every 5 minutes. no leakage of fluid
or vaginal bleeding. Fetal movement is normal. amniotic sac is tense and palpable. next step?
ht

a. Amniotomy
b. Cesarean delivery
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52) pic was given , child with mass on his umbilicus, no tender
- hernia
- lipoma

/
m
53) ECG was given, young male with dizziness, HR 150, brought to hospital by ambulance
- recaller couldn’t dx ecg ..
- SVT or something

co
54) Couple came - lady with heavy and prolonged menstruation with regular cycles.
They dont want to get pregnant for 1 more year . what to give?

x.
A. POP
B. COCP
C. Naproxen

us
D. Implanon
E. Mirena

pl
55) A 13-year-old girl presents to your practice asking for an abortion. Eight weeks ago, she is a raped in
party. After missing her due period, she performed a home pregnancy test which showed she is
pregnant. The girl had left home 2 years ago and lives by herself. Which one of the following is the most
appropriate next step in management?
r.m
A. Refer her for an abortion as she wishes.
B. Inform the police.
C. Inform the Child Protection Service.
D. Inform the Sexual Assault Services.
be

E. Inform her parents.

56) a Malaysian student,uni student ,his gf went back to attend dad’s funeral now this guy become
em

restless ,irritable and cant sleep and complains that his gf talking behind his back
Dx?
Suspicious cannabis (amphetamines would be best)
Grief reaction
Panic psychosis
//m

Reactive psychosis
Onset of schizo

57) woman progressive fatigue, myalgias, and muscle weakness in both lower extremities. difficulty
s:

getting up from a chair, cramping in the legs . normal erythrocyte sedimentation rate and elevated
serum creatine kinase level. next step ?
a/ ?Antinuclear antibody test
tp

b/ Discontinuation of lisinopril
ht

58) man accidentally amputated right thumb with bandsaw. picked up the amputated part in a plastic
bag. amputated part is in one piece without contamination. best way to transport the amputated?
a/ Directly covered by ice on all sides
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b/ Left open to air in a plastic bag over a bed of ice

59) man of traces of blood after bowel movements. abdomen soft and nontender with normal bowel

/
sounds. traces of red blood visible on the glove. next step?

m
a/ iFOBT
b/ Proctoscope (should be this)
c/ colonoscope

co
d/ sigmoidoscope

60) Woman 16 weeks gestation had nausea and vomiting. no vaginal bleeding or cramping. cold knife

x.
conization 2 years ago for cervical intraepithelial neoplasia. additional interventions?
a/ 24 hour urine protein collection
b/ Early glucose challenge test

us
61) A child with severe asthma was brought to emergency hospital by ambulance.
When measured spo2 level very low, the patient was very dyspnoeic with gasping,

pl
comatose, silent chest. The oxygen cylinder in ambulance not working. Child went
to apnea. The parents were distressed and aggressive and asked for compensation.
A. The hospital manager will be responsible and face criminal case
r.m
B. No court case but hospital has to pay compensation
C. The doctor is responsible to investigate the case and report parent
D. Its just an accident. So nobody is responsible
E. The ambulance driver would have to attend civil court
be

62) Woman, BMI>30, on COCP, grandma with ovarian ca at 65 years old, what can reduce the risk of
ovarian ca?
A. Weight loss
em

B. BRCA screening
C. Stop OCPs
D. Ca-125 yearly
E. Breast ultrasound?
//m

63) man painful swelling right lower eyelid. right eye shows localized swelling along the margin of the
lower eyelid with associated erythema and tenderness. appropriate management?
a Erythromycin ointment
b Incision and curettage
s:

64) back pain increases when straining and coughing. examination shows 2+ symmetrical knee and
ankle jerk reflexes. most likely underlying etiology?
tp

a/ Apophyseal joint arthritis

b/ Intervertebral disc degeneration
ht
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65) colon cancer screening. mother developed colon cancer at age 85. no hematochezia, melena, or
unexpected weight loss. does not use tobacco or alcohol. two small hyperplastic polyps are found and
removed. next step?

/
a/ Colonoscopy in 1 year

m
b/ Colonoscopy in 10 years
c/ iFOBT every 2 yearly

co
66) right shoulder and arm pain. examination shows spasm of the cervical paraspinal muscles. pain
improves when the patient lift the right arm and rest the hand on the top of his head. diagnosis?
a Cervical muscle strain

x.
b Cervical radiculopathy

67) blood pressure increases to 170/115 mm Hg and pulse is 54/min. 15 minutes later, blood pressure is

us
172/117 mm Hg and pulse is 53/min. severe headache and an episode of emesis. next step?
a/ Furosemide
b/ Hydralazine

pl
68) Older female from Indonesia, hasn’t been to Indonesia in many years, came with night sweats,
fever, o/e basal crackles otherwise all other examinations normal. What to test?
A. Mantoux
r.m
B. IGRA
C. Chest CT
D. CXR
E. Sputum AFB
be

69) Male complain of brown snake bite. o/e 5cm laceration wound but no bite mark. What to do?
A. Take swabs and pressure bandage
em

B. Tranfer to tertiary hospital 150KM away by ambulance

C. Venous torniquet
D. Administer anti-venom

70) Middle aged woman with hypertension on amlo, epigastric pain on fennel (?), schizoaffective on
//m

risperidone, and some other drugs complain of breast discharge milky no lumps etc. Cause?

A. Amlo
B. Fennel
s:

C. Risperidone

71) discharged after treatment for splenic rupture and intraabdominal bleeding following blunt
tp

abdominal trauma. vaccinations planned in 2 weeks. antibiotics should be prescribed?

a/ Amoxicillin-clavulanate
ht

b/ Clindamycin
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72) abdominal cramping, nausea, vomiting, and diarrhea. has common variable immunodeficiency.
episode of sinusitis a month prior that was treated with amoxicillin/clavulanate. most likely cause?
a. Contamination of treatment infusions

/
b. Drinking inadequately purified water

m
73) history of ischemic stroke causing right-sided weakness and uses a cane to ambulate. recently has
had dysuria and urinary urgency. Dysmetria is present on finger-nose testing, and the gait is wide-based.

co
cause?
a- Epidural abscess
b- Folate deficiency

x.
74) 1-month-old girl. Weight and length are stable at the 45th percentile. Pulse is 120/min, and
respirations are 35/min. chest x-ray reveals an enlarged left heart contour. cause of x-ray findings?

us
a/ Asymmetric septal hypertrophy
b/ Decreased left ventricular contractility

pl
75) commit suicide. pupils are 3 mm bilaterally. oropharynx is erythematous with some mild ulcerations.
heavy drooling. abdomen is benign with normal bowel sounds. explanation symptoms?
a/ Anticholinergic medication
b/ ???Caustic cleaning product
r.m
76) A woman 12 weeks gestation, O negative, done CVS for Down syndrome. Given a list of blood panels
including
HbsAG negative
be

HbSab postive
Hep C negative
Anti-D negative
em

77) What to do next?

A. Hep B vaccine
B. Administer anti-D
//m

78) Small smooth lump in the vaginal opening, what to do? (Can’t remember whether it was painful but
no discharge, not itchy, no systemic symptoms)
A. Marsupialization
B. Excision
s:

C. Electro cautery
D. Cryotherapy
tp

79) A 18/19 year old male with vomiting etc Glucose high, ABG metabolic acidosis, no ketone given
A. DKA
ht

B. Hyperosmolar Hyperglycemic State

C. Alcohol toxicity
D. Ethylene (?) toxicity
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80) A 10yo boy brought by parents because he was fat. Weight >98th percentile, height >90th
percentile. What could be potentially be found?

/
A. Reduced TSH

m
B. Increased Parathyroid hormone
C. Increased FBS

co
81) 6year old with ttttthey tttteaseeee meee
A. Stuttering, cant remember other options

x.
82) Boy on Sertraline for 21 days no effect yet, what to do?
A. Continue first
B. Increase dose

us
C. Change to others
D. Add another drug

pl
83) First Clostridium difficile infection treatment?
A. Metronidazole
B. Vanco
C. Others
r.m
84) Patient on Warfarin started on Roxi for infection, came with per rectal bleeding. INR 9, BP 90/60, PR
120, what to do first?
A. FFP
be

B. Vit K
C. Packed cell transfusion
D. Stop Warfarin
em

85) Older lady with lump in the supraclavicular fossa, otherwise no other symptoms, physical
examination normal. What to do next?
A. FNAC
B. CT-scan of chest
//m

C. Mammogram
D. Colonoscopy
E. CT brain
s:

86) Lady with heavy menstrual bleeding, no pelvic mass etc etc don’t plan to get pregnant soon?
A. OCP
B. COCP
tp

C. Implanon
D. Mirena
ht
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87) Male from prison (multiple jail time), history of Diazepam abuse, at ED because got laceration
wound after trying to rob someone. Tells the doctor he will commit suicide if he goes to jail again,
complains very painful although everything else normal except for the small laceration wound

/
A. Depression

m
B. Factititous disorder
C. Malingering
D. Bipolar

co
E. Drug withdrawal?

88) Teen hit with a tennis ball in the eye. Complain of floaters AND flashes, reduced viscual acuity, no

x.
other findings anteriorly,
A. Hyphema
B. Retinal detachment

us
C. Vitreous hemorrhage

89) Young lady back from Thailand (visited family). Didn’t take any prophylaxis whatsoever. Fever T 40,

pl
maculopapular rash, conjungtivitis, myalgi, WBC slightly decreased, otherwise all others normal
including normal platelet. BP was normal too. COVID negative. Next step?
A. Throat swab
B. Blood culture
r.m
C. Urine Culture
D. Isolation
E. CXR
be

90) Male account does not want anti-psychotics, complain of fatigue, unable to sleep at night
A. CBT
B. Sleep Hygiene
em

91) Older man with urinary incontinence, what to give?

A. Incontinence pads
B. Oxybutinin
C. Doneprazil
//m

92) Older woman, no symptoms but UA nitrates positive and WBC positive. What to do?
A. Ciproflox
B. Trimetrophim
s:

C. Amoxcilin
D. Urine alkaliniser?
tp

93) Patient writer to doctor saying she is unhappy with his treatment. What should the doctor do?
A. Inform medical board
ht

B. Make an appointment to talk to her

C. Inform Hospital
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94) Intern asking registrar for sleeping meds because studying for exam. What to do?
A. Inform intern supervisor
B. Prescribe

/
C. Ask to see GP

m
D. Report to AHPRA

95) Older menopausal women with itchy vagina, o/e white pale what to do?

co
A. Estriol cream
B. Gentamicin cream

x.
96) Food poisoning scenario list of food and the number of people who ate and didn’t ate and whether
they had symptoms

us
97) A table given and asked about incidence (not prevalence), town had 200 people, but asked per 1000
population or something like that

pl
98) Boy with pink rash on the face with tender lymphadenopathy. What is significant?
A. Mother is pregnant
B. Cat at home
C. Other children at home
r.m
D. Immunisation up to date

99) In labour, on syntocinon, VE 9cm, bradycardia for 30 seconds to 60 then recovered. What to do?
be

A. Stop syntocinon
B. Emergency C-sec
C. Scalp pH
em

100) Post vomiting, what the ABG, potassium, and sodium will be like? (it should be hypochloremic,
hypokalemic, hypernatremic, metabolic alkalosis)

101) Patient with asthma and SVT, didn’t want Adenosine made him sick, vagal manouver failed. What
//m

to give?
A. Digoxin
B. Sotalol
C. Verapamil
s:

D. Enalapril
E. Amiodarone
tp

102) 15 year old obese boy with hip pain (given X-ray), otherwise no swelling whatsoever
A. SCFE
ht

B. Perthes
C. DDH
D. Septic arthritis
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103) Older woman, knee pain, joint effusion (+), no inflammation, pain on pressure only, what to do?
A. Xray

/
B. CT

m
C. MRI

104) Person with reduced pinser grip and reduced sensation over 4th and 5th fingers, where is the

co
injury?
A. C8/T1
B. Brachial plexus

x.
C. Wrist
D. Elbow

us
105) Case of flexor tenosynovitis
A. Pain on flexion
B. Finger in flexion

pl
C. Fusiform swelling

106) Male, chronic smoke with cough etc etc, with Horner’s syndrome what to check?
A. Chest xray
r.m
107) Patient with Glesson score 4, on double antiplatelet following stent, what to do?
A. External beam radio
B. Radical protesctomy
be

C. Chemo

108) Patient with colon ca, with multiple lymph node involvement (I think it was 15?), what can improve
em

life-span?
A. Chemo
B. Radio

109) Woman with regular menstrual cycles, patent tubes, primary infertility 5 years what to check?
//m

A. Semen analysis
B. Hysterscopy
C. 21 day progesterone
s:

110) Patient on colchine and allopurinol for gout intermittently, photo given – pseudogout. Serum urate
elavated. What to do?
A. Stop allopurinol
tp

B. Stop both
C. Regular allopurinol
ht

111) Pregnant woman, RUQ pain, BP high, proteinuria ++ headache

A. HELLP syndrome
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B. Acute cholecystitis
C. Other irrelevant optiosn

/
112) Patient with GBS +ve treated during follow-up. What to do after?

m
A. Repeat swab at 37-38 weeks
B. Treat baby with IV penicilin
C. Intrapartum IV Penicilin

co
D. Intrapartum IV Erythromycin

113) MSM with three partners, protective sex, Hep A, Hep B vaccines taken. What to do next?

x.
A. Screening for STDs yearly
B. HIV three monthly testing
C. Vaccine for HPV

us
114) Child throws vase when angry with mother
A. Acting out

pl
B. Displacement
C. Regression
D. Reaction formation
E. Projection
r.m
115) Woman, drinking during pregnancy, what to monitor in baby?
A. Fetal movements
B. Fundal height
be

116) Boy 14 ADHD doesn’t want to take meds, what to do?

A. Tell parents it’s their responsibility
em

B. Speak to the boy

C. Tell parents it is mandatory he takes meds

117) 20year old male with ADHD not on meds for some time, now asking for meds again, what to check?
A. Level of hyperactivity?
//m

118) Childcare case of Hep A. What to do?

A. offer Hep A vaccine to everyone
B. Quarantine 4 weeks
s:

C. Test food workers Hep A IgM

D. Cater food
tp

119) Woman post-partum, suspicious of surrounding, hypervigilant, no fever or other complaints, what
to check?
ht

A. urine tox screen

B. ECG
C. CT-scan
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D. CXR
E. Blood culture

/
120) memory problems. frequently forgot grandchildren's names. difficulty finding words. never used

m
alcohol or illicit drugs. Moca score is 15 on a scale of 30. abnormalities?
a Diffuse cortical infarctions
b Enlarged lateral ventricles

co
cant remember the question

121) thyroidectomy for Grave's disease complains of anxiety, muscle cramps, and poor sleep.

x.
medications include daily multivitamin supplements and lansoprazole for acid reflux disease. diagnosis?
a Hyperkalemia
b Hypocalcemia

us
122) woman bizarre behavior has become increasingly paranoid. history of depression treated with
bupropion. drinks alcohol but do not uses drugs. Family history is significant for bipolar disorder in a

pl
maternal uncle. next step?
a Administer a mood stabilizer
b Administer an antipsychotic medication
r.m
123) 2 years of persistent cough. coughs up whitish sputum. complains of exertional shortness of breath.
smoked one pack of cigarettes daily for the past 40 years. Pulmonary function testing reveals a vital
capacity that is 65%.
a Alveolar capillary membrane thickning
be

b Decreas functional residual cpacity

em
//m
s:
tp
ht