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Recall paper

October 2004

Adelaide

1 Mother and daughter who came from Indonesia present with thyroid gland enlargement. Pictures of the thyroid goitre in the new AMC book pp281. What is the diagnosis. A Multinodular Goitre B 2 Picture of skin rashes in a child in AMC 600Qs ( question PA-18). What is the diagnosis ? A Henoch- Schonlein 3 Which nerve is most likely injured if the middle of the humerus is fractured ? 4 A patient present with headache and vomiting. No obvious sign of cranial nerve inury CT image provided. What is the possible diagnosis ? A Subarachnoid hemorrhage B C D 5.Hyperkalamia which of following treatment reduces the blood k+ 6.Treatment for the pneumonia in the middle lobe. A small consolidation in the right middle lobe with reduced density in the surrounding area. X-ray picture provided. What antibiotic should be used ? a. Amoxicillin b. Penicillin c. Erythromycin 7. Premenstrual syndrome. the best diagnosis method is A Chart plotting B HCG 8. The treatment for IIB cervical cancer is A Hysterectomy B Hysterectomy + C. Radiotherapy D. Chemotherapy 9 The best method to diagnose pancreatic cancer ? A.CT B.X-ray

C. BUG D. ERCP 10.the age of the child ? 7 month 13 A child presents with urinary tract infection, the best diagnosis method ? 15 Multiple thembosis and DVT. Treatment with Asprin is not effective Which of the following disease is most likely ? A. Ovarian cancer B. Pancreas cancer C. Small cell Cancer D. 16. A child with Funny turning and otherwise is normal ? What is the diagnosis ? 18. Most common complication of ERCP a. Pancreatitis (acute) b. Haemorrhage c. Ruptured duodenum 19. Young woman on OCP, has a headache 5 days per week, less noticeable when busy, worse in the afternoon. What is the management ? a. Relaxation course b. Cease OCP c. Change to other OCP 20. Septic osteomyelitis, blood borne, which is the most likely organism? a. staphy. aureus b. E. Coli 21. Most likely organism for acute cholecystitis A E Coli B Staph C Streptocci 22. Young man post-appendicectomy 5 days. developed tachycardia with fever. What is the most likely cause? a. Wound infection b. Lung infection 23. Middle aged patient with knee pain a. Slipped disc L4/L5 b. Slipped disc L5/S1 c. Osteoarthritis of the hip

24. Strawberry haematoma a. Reassure b. Initiate chemotherapy c. Surgical remove 25. 2-month child with abdominal mass with osteolytic lesion. Diagnosis a. Wilms tumor b. Neuroblastoma 26. Man with acute abdominal pain a. Perforated gastric ulcer b. Perforated duodenal ulcer 27. A man recently returned from Hong Kong with cough, pleuritic pain haemoptysis , further investigation a. V/Q scan b. CXR 28. Rugby player with repetitive anterior dislocation of the shoulder. patient tried to take something out of the shelf and dislocated again. What is the treatment? a. Open reduction b. Close reduction c. Early reduction, later fixation with pin? 29. Combined fracture of tibia and fibula. Best treatment? a. Open reduction b. Closed reduction c. Open reduction with internal fixation a. b. c. d.

30. Child with clean wound. What should be done? (not vaccination) Tetanus toxoid IgG Penicillin DTP

31. Cervical dysplasia spreading into the internal OS. What is the MX? a. Cone biopsy 32. Chronic urinary retention in woman with irregular periods every 8 months. Which of the following could not be the cause for the urinary retention. a. Retroverted uterus b. Herpes simplex c. Genital wart

33. Pregnant woman, no previous check up, claims to be 39 weeks. what is the management? a. Total physiological profile b. U/S 34. In hepatocellular carcinoma, which is elevated? a. Alpha feto protein(AFP) 35. Chronic diarrhoea, weight loss 3 kg. mass in the R lower quadrant a. Crohn’s disease 36. 4 months old child has cough for 2 weeks. Cough is accompanied with vomiting? Which of the following is true? a. The cough will last for another 4 weeks 37. Pethidine was used in labour, foetal heart rate was reduced what is the explanation? a. Pethidine side effect 38. Infant with burns. what is the most likely cause of death after 2 weeks. a. Infection –septicaemia b. Renal failure c. Dehydration 39. Young woman, changes job frequently, often injures herself, has unstable social relationship a. Borderline personality disorder 40. Young man sets fire to bush (arson, a big problem in Australia). What are the motifs? a. b. c. d.

41. Which of the following is not transmitted during labor HIV Hep B Syphilis GBS 42. Multiple sclerosis is frequently misdiagnosed for which of the following? a. Hysteria, conversion disorder b. Somatic disorder

43. Patient with proteinuria, oedema, around eye, hypertension, swelling face, developing SOBS which is correct? a. he is in immediate danger and risk of death from APO b. haematuria will be diagnostic 44. Anaphylactic reaction after food intake. what is the management?

a. s/c adrenalin b. iv hydrocortisone c. manage airway (ET tube) 45. Group of people went out to a restaurant, 6 hours later diarrhoea, vomiting dehydration. most people recovered quickly most likely organism? a. staphy. aureus b. E. Coli c. Salmonella 46. Patient with psychiatric medications, involuntary mouth movements. Possible cause a. tardive dyskinesia 47. Inguinal scrotal swelling, disappearing, when lying down. Most likely cause a. Inguinal hernia b. Varicocele 48. Vaginal cyst a remnant of wolffian duct 49. patient unconscious, some response GCS? a. 7-9? 50. 10yo girl has a history of repeated brief hemiplegia with complete recover a. Seizure b. Migraine c. TIA 51. Young child stealing little things at school: a. Report to police b. Watch and see c. Report to teacher and give formal behavioral correction program 52. Nauseated 8 hours after birth, dyspnoea. which of the following needs urgent intervention a. Diaphragmatic hernia b. Hyaline membrane disease 53. Repeated DVT What is the possible cause ? a. Pancreatic cancer 54. Acute attack of gout. which of the following cannot be used a. Allopurinol 55. Patient with anovulation has high risk of developing which type of cancer

a. Ovarian b. Endometrial cancer 56. A child presents with non-projective vomiting, not bile stained, 1-2 cm olive shaped mass in the upper epigastric. What is most likely DX ? a. Pyloric stenosis b. Intussuseption 57 Picture ( P7 annorated AMC questions) Skin lesion ( Ceraloacauthena) What is the management ? a. Surgical excision b. Wilder excision 58 Excision of skin lesion . Pathology shows a malignant melanoma.What is the management ? a. wide excision b. no further treatment. Reassure Pt c. Wide excision plus the excision of lymphy nodes. 59 Pt with sedative overdose with unconsciousness. What is typical blood gas picture ? A pH 7.35 PO2 70 p CO2 80 B pH 7.1g PO2 70 PCO2 80 60. Type I Diabetes. what is the indicator for the worst prognosis A HbA1c 4 B.Occasional mild hypoglycemia C Occasional hypoglycemia during sports. 61.Diabetic patients with hypotension which of the following is the worst prognostic factors A. Bp/14090 B Alcoholic C depression 62.What is the common complication of the epidural anaesthetics A. hypertension B,. Neonatal bradycardia C Prolonged labor 63.Which of the following chromosomal can be seen in a child with normal genitalia A. Kline felter/47 xxy B. congentital adrenal hypertrophy 47 XX

64. Mildly intellectually disabled lady IQ 77 washing in supermarket throw milk bottles at patient A. Acute stress reaction B. Delusion C. Illusion 65. Taxi driver with an arranged marriage suspects wife to be unfaithful hired private investigator which proved that he is wrong and he spend too much money for it. But he still believes she is unfaithful. What is the possible diagnosis ? A. paranoid delusion B. over valued idea 66. Which of the following medications will not cause the rennin level to increase A ACE inhibitor B B-blocker C a receptors blocker D diuretic 67.Young male 30 yo has back pain stiffen in the mico and right hip pain. A ANCYLOSING OPANDYLITIS B Osteoarthritis. C Reiter’s disease P Psoriasis 68. Characteristics of aortic stenosis A. Collapsing pulse B asymmetry of the left and right pulses C Syncope on excretion D 69. 5 month old child ‘funny turn’ draw up les no fever and otherwise is normal what is the most likely reason ? A intussuception B colic C seizure 70. Child ca stand with some support, grasp toy and place it in her plam. What is the age A 5 months B7 months C 10 months C. 2 years. 71. Opioid use in pain management in cancer patient A physical tolerance B Psychological tolerance

C Physical dependence 72. Most common death for Schizophrenic patient A Depression B Coronary heart disease C Respiratory disease D.Suicide 73. BUI for a lady of 150 cm and 45Kg bodyweight A 13 B15 C 20 D25 E 30 74. A lady with bronchiectasis, What is the management ? A Penicillin B Erythromycin C.Flucloxacillin 75. Old lady in nursing home developed a red area on her leg (Cellulitis ) allergic to penicillin what is the best medication ? A Roxithromycin Peicillin C Cefherasan 76. A patient is suspected of premenstrual sydrome. What is the best diagnosis method ? A. plotting chart B. estrogen level C Progesterone level D Serum hcg level 77. Precelampsia, cervical is not favourable, dilated 2-3 cm, Bishop score is 2 What is the next management ? A PGE pessait B.artificial membrane rupture C .Oxitocin infusion D Caesarian section 78. Pregnant woman of 17 weeks presents with hypertension with protein urine ++ What is the possible cause ? a. Preexisting renal disease b. She will proceed to the term normal delivery c. Pre-eclampsia

79. Lump in the neck in a mild age man growing up with swalling What is the likely cause ? A. Thyroglossal cyst B.Thyroid node Schenoprenoid patient admitted several times because he does not take medication does not feel he is sick What is the diagnosis A lack of insight B Delusion 80. Placebo is most useful in what kind of patient A Hysteria syndrome B Physical symptoms 81. 32 weeks came with pain. What will indicate that she will have her delivery prematurely presence of fibronectin in the virginal secretion 82. Pregnant lady came with transverse lie at 39/week she has not visited the antenatal clinic for last 8 weeks. What is your initial management A Do scan B. Do LSCS C.External version E. Do PV F. 83. What is the most likely organism, causing infection of the Bartholia gland infection. A, E coli B, Strep. C, Staphy 84, Renal artery stenosis

85, What is the characteristics of anal fissure? A, Purulent discharged on toilet paper 86, Nearly post appendicectomy patient with a history of diabetes, developed urinary frequency, fever and abdominal pain. The most likely cause would be A, Pelvic abscess

87, Stool examination shows fatty globules and crystals in a malabsorption patient. Which test below has most important diagnostic benefit? A, Small bowel biopsy B, Quantity measure of fate in stool 88, Elderly man presented himself in your clinics after came back from Bali. He complained nausea, vomiting and jaundice. Blood test showed abnormal LFT ( ALP increased significantly, but others just mildly increased). What is the most likely cause ? A, Hepatitis A B, Acute cholecystitis C, Acute cholangitis 89, 50 y/o lady developed sudden onset of epigastric pain, radiaing to the back with fever, jaundice and passing dark colour urine. Next day she went to see her doctor. Blood examination showed significantly elevated Amylase and abnormal LFT. What is her most likely diagnosis ? A, Biliary colic B, acute pancreatitis C, gallstone impacted in common bile duct 90, In prenatal clinical, a 20 weeks asymptotical pregnant women has been found GBS swab positive with intact membrane. What is the correct management? A, Give Penicillin during the labour B, Give Penicillin now, C. review the women in 2 weeks, 91, Which of the following is the most likely indication of malabsorption ? A, Iron deficiency B, Vit B 12 deficiency C. Undigested food in stool D, Folic acid defeciency E, Pale bowel action for one week 92, A patient suffered from Glande's disease, presented sudden shock. Which of the following is the most likely cause ? A, Ruptured spleen 93, ECT treatment can be used for which of the following condition ? A, Borderline personality disorder B, Schizophrenia C, Sever depression 94, Which of the following is the most likely cause of dementia for the person under 65 y/o ? A, Alzheimer's disease

B, Vascular cerebral ischaemic disease 95, Under the condition of hyperkalaemia, which of the following medication can not decrease potassium level ? A, Resonium A B, Insulin with glucose C, Calcium D, Dialysis E, Sodium Bicarb 96, Which of the following coagulation disorder is not hereditary ? A, Antiphospholipid syndrome B, Protein C deficiency C , antithromotic deficiency D, Factor Leiden deficiency 97, The most common cause of findings of undigested food in stool from children between age of 18 to 21 months old ? A, Toddler diarrhoea 98, Middle aged man developed non productive cough recently, worsening at night. What is the most likely cause ? A, exacerbation of COAD B, chronic cardiac failure C. sleep apnea 99, Middle aged lady complained of difficulty of swollening food recently, especially solid ones. She has 20 years history of heartburn, indigestion , cough and dyspnoea ? Which of the following investigation is most important ? A, UGI endoscopy B, no further investigation C, CXR 100, During yearly check up, a 53 y/o lady was found hypercalamia with elevated ESR and ALP. Which of following indicates malignancy instead of primary hyperparathyroidism ? A, low PTH 101, Which of the following is the most correct method to determine the pregnant period ? A, U/S at 8 weeks B, Bimanual examination at 12 weeks. C, U/S at 20 weeks.

102, In Polycythaemia rubra vera , which of the following is the most common sign ? A, Splenomegaly 103, Which nerve root will be compensated in a L4/5 slipped disc ? A, L4 B, L5 C, S 1 104, A lady suffers from S1 nerve compression. Which of following task she can not do ? A can not pick up child for floor B, 105, Anaemia of chronic disease : chronic renal failure 106, A 2 y/o, boy complains of smelly diarrhoea. Not able to strive (increase weight ). Which of the following test is best for investigation ? A, Duodenal biopsy B, sweat test C, stool test D, reassure mother 107, Which of the following is the best diagnostic method for pancreatic cancer ? A, CT B, U/S C, ERCP D. ABO X RAY