SAQ Questions

Note: Questions are compiled in random order.

1. A man with a diabetic foot ulcer is at home and has been unable to seek treatment. List 4
social/cultural factors that might be causing this.
2. A patient recently had tonsillitis, was prescribed antibiotics and it settled down. He returns later
with macroscopic haematuria. What investigations would you do?
3. What is the difference between leukaemia and lymphoma?
4. What are the end-organ effects for hypertension? What are the implications for patient
management when these manifest?
5. Appendicitis presents with a pain history of central/umbilical pain that later migrates to the right
iliac fossa. Discuss why this happens.
6. A patient presents with worsening breathlessness and 12-month history of constipation. His
bloods show low haemoglobin, low MCV and low MCH.
● What could be causing the breathlessness, and describe the underlying mechanism of this
(unsure as to whether question asks you to describe mechanism of anaemia development, or
anaemia causing breathlessness mechanism).
● What 3 further tests could you do to further investigate the anaemia?
● What tests could you do for his overall management?
7. List 4 causes of fever on post-op day 3.
8. You are called to the ward to see a postoperative patient. He is 8 hours post-op and his urinary
catheter output has dropped to 0. It was functioning/flowing on insertion during the operation.
- What would be your next steps/approach in managing this?
9. A 30-something female patient presents to you having had recurrent upper respiratory tract
infections. She is a long-term smoker. She asks you if there’s anything you think could be done
to stop the infections/any way to stop the infections.
- Describe how you would use motivational interviewing, with specific reference to the 5 A’s, to
help her consider quitting smoking.
10. What are 10 features to look for when assessing a skin ‘lump’?
11. You are called to review a patient whose heart rate has gone up to 130 beats/minute a few
hours after surgery. Her heart rate was 80 beats/minute in the immediate recovery period.
- What could be causing the tachycardia?
- What would be your approach to management?
12. Describe the principles underlying gallstone formation (3 marks).
13. A 37-year-old woman who is asymptomatic comes in asking you for breast cancer screening.
Her characteristics/history indicate a low-risk for breast cancer.
- What are the disadvantages of screening someone who has a low-risk for breast cancer?
14. A female patient presents with an incisional hernia through a wound from a surgery 9 months
prior.
- What features of the hernia would indicate that it is a surgical emergency?
- What 3 signs would you elicit on physical examination of the hernia?
- List 4 symptoms that you would advise her to return to hospital upon experiencing?
15. You are provided with 3 images of various skin lesions/lumps and asked to identify what they are
and your justification for that diagnosis. The pictures are taken from LAMS modules.
16. Discuss the potential disadvantages for screening for hypertension amongst 12-18 year olds.
17. Discuss DVT prevention in the perioperative period. Give examples of measures you can take
pre-operatively, intra-operatively, and post-operatively. (6 or 8 marks)
18. A patient presents with abdominal distension/pain. A chest X-ray is provided showing free gas
under the diaphragm. You are asked to identify it, and list 3 potential causes of this.
- You decide to do a laparotomy. Prior to the operation, what treatment would you initiate?
 19. What signs would you look for on examination of a patient with a perforated duodenal ulcer?
20. What are 3 common bacteria causing gastroenteritis in Australia?
21. List 3 patient factors that would impact on an adverse outcome for an inguinal hernia repair.
22. A 20 year old male presents with a warm, red, painful, fluctuant lump with indurated edges in
his natal cleft region. He has a mild fever.
- What is the diagnosis likely to be? (1 mark)
- What is the pathophysiology of this condition? (1 mark)
- What the treatment? (1 mark)
- What prophylactic measures, if any, may need to be taken? (1 mark)
23. A patient with atrial fibrillation presents with an arterial occlusion of their left common femoral
artery.
- What signs/features will you see on physical examination?
24. A patient presents with a suspected stroke, he has right hand weakness and loss of speech.
- Discuss the relevant vascular anatomy to identify the most likely area of occlusion and infarct.
25. A 15 year old boy gets recurrent cold sores on his lips.
- What is the diagnosis?
- What is the immunological mechanism of recurrence?
26. List three groups who commonly experience social exclusion.
27. Describe the ways in which social inclusion can be of benefit, using the example of a 58-year
old male recovering from a stroke.
28. What is the Murri Grapevine?
29. Describe the key components of the ‘recovery model’ for mental health.
30. How do ACCHS reflect their community?
31. How is aged care funded? Who are the ‘gatekeepers’ to aged care funding?

MEQ Questions
Stem 1. Patient has chronic renal failure and is undergoing peritoneal dialysis
● Q1: Principles of Continuous ambulatory peritoneal dialysis
● Q2: Patient has abdominal tenderness at the site, fever? Likely infection at the site (you need to
identify this) and mechanism for this occurring
● Q3: Priorities of treatment for him
● Q4: Principles of haemodialysis and hot it works

Stem 2. Man presents with viral infection, GP told him to go home and rest but he has malaise, fevers and
generalised myalgias
● Q1: What are 5 elements of the history that would help confirm viral infection?
● Q2: What 5 signs on physical examination would help to confirm viral infection?
● Q3: What are the cellular and molecular mechanisms that the body uses to prevent/eradicate
viruses? (this is from the LAMS wiki task)
● Q4: His blood pressure drops to ?90/50, although you still suspect he is febrile what further
investigations could you do?
Stem 3. Patient with recurrent falls and pain on walking. Hx of Parkinson’s Disease, peptic ulcer disease,
hypertension

● Q1: List 3 mechanisms which may have caused the fall in this patient
● Q2: List 3 potential causes of falls and justify your answers
 ● Q3: What 3 medications for hypertension can cause falls
● Q4: Given her pain on walking, what investigation would you perform and what are you looking
for?
● Q5: What will you prescribe for her pain?
● Q6: The patient and her husband wish to stay at home as long as possible. You contact allied
health services to assist with arranging this. Which two in-hospital allied health services would
you refer them to and why? (E.g. social worker, occupational therapist, physio, dietician).
●
Stem 4. A man is playing rugby, gets tackled and feels intense pain + has his leg bent in the middle of
the lower leg. The trainer assesses it and diagnoses a tibia and fibula fracture.

● Q1: What investigation would you do? What type of fracture will it be?
● Q2: What kind of splint would you use?
● Q3: What factors should you use to determine whether the fracture needs internal reduction?
● Q4: What advice and information would you give him on discharge from the hospital?

Stem 5. Man diagnosed with diabetes, BMI 26, his characteristics and blood pressure etc aren’t overly
abnormal (he is RELATIVELY healthy)
● Q1: What are the initial steps in diabetes management?