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Q1. Which of the following malignancy is not an AIDS-defining cancer?CorrectIncorrect
Q2. An 80-year-old male who was recently commenced on apixaban presents to the emergency department with a life-threatening bleed.
Which of the following tests is most helpful in this urgent situation?CorrectIncorrect
Q3. A 68-year-old gentleman has a metallic aortic valve. He is anaemic and you suspect he has intravascular haemolysis. Which of the following tests is most appropriate to confirm your diagnosis?CorrectIncorrect
Q4. Which of the following is most commonly seen in myelofibrosis?CorrectIncorrect
Q5. Which of the following tests is best for monitoring the activity of low molecular weight heparin?CorrectIncorrect
Q6. What is the mechanism of action for tranexamic acid?CorrectIncorrect
Q7. A 42-year-old female presents with a PE following a cholecystectomy. While there is evidence of RV dilatation on echocardiogram, patient is hemodynamically stable. What is the appropriate duration for anticoagulation?CorrectIncorrect
Q8. What finding in CSF is most associated in narcolepsy?CorrectIncorrect
Q9. A 55-year-old male presents with painless weakness with bilateral ptosis and diplopia which has been developing over the past two months. He has had trouble swallowing, slurred and nasal speech. He is reported to become fatigued and weaker with activity, improving with rest. With symptomatic treatment with pyridostigmine and immunosuppression, he makes an improvement in his symptoms. Investigation with a CT chest reveals a thymoma. Which of the following antibodies is often associated with thymoma?CorrectIncorrect
Q10. A 47-year-old woman who was previously well and not on any medications presents with complaints of unsteadiness, syncope, constipation, and urinary retention. Examination reveals bradykinesia, mild resting tremor, extensor plantar reflexes and a postural BP drop of 50 mmHg. Which of the following conditions is the most likely diagnosis?CorrectIncorrect
Q11. A 34-year-old woman presents with choreiform movements and intellectual decline over few years. She says there is a family history of some neurological disease, but she doesn’t know the details. Examination reveals continual choreiform jerks involving hands and feet with normal sensation, power, and reflexes. Her blood tests including liver function tests are normal. What is the most likely diagnosis?CorrectIncorrect
12 A 70-year-old lady presents with exertional dyspnoea. What is the best interpretation of her pulmonary function test (shown below)? (Assume there are no technical limitations to the study)
If image is difficult to view, see attached PDF – Spirometry ResultCorrectIncorrect
Q13. Which of the following is NOT true regarding paraneoplastic disease of the lung?CorrectIncorrect
Q14. Mr Covid works for lonely planet and presents to hospital with bilateral pulmonary infiltrates and peripheral eosinophilia. Blood parasite studies showed no aetiology until nocturnal blood samples were tests and microfilariae was noted. Which of the following is correct?CorrectIncorrect
Q15. Mr Doublevis presents with dyspnoea, cough and chest pain and has had a diagnosis of non-small cell lung cancer. Which of the following regarding NSCLC is NOT true?CorrectIncorrect
Q16. A 75yo gentleman presents to the clinic with worsening cognitive impairment. His past medical history includes hypertension and benign prostatic hypertrophy with an overactive bladder. His bowel and bladder functions are normal. His medications include olmesartan, amlodipine and solifenacin. He is independent with his activities of daily living. His blood pressure today is 120/80mmHg. His cardiovascular and neurological examination was otherwise unremarkable. His Mini-Mental State Examination Score today is 24/30, his last score two years prior was 27/30. Which of the following is the next step in his management?CorrectIncorrect
Q17 A 90-year woman presents to hospital after having another fall at home with no injury on a background of severe dementia. She lives at home alone. Her house is unkept with dead mice found in the living room by the occupational therapist and piles of old newspapers stored in the kitchen. Her physician is asked to review her capacity to decide about her living arrangements. Which of the following is assessed as part of a capacity assessment?CorrectIncorrect
Q18. An 85yo gentleman from home alone with a Lewy body dementia presents to the hospital with chronic visual hallucinations and delusions. The delirium screen is negative. Which of the following medications is used to manage psychotic symptoms in this patient:CorrectIncorrect
Q19. An 85yo obese gentleman presents with a history of a recent myocardial infarction with poorly controlled diabetes with fasting blood glucose levels 12mM. He is on metformin. Which of the following would be most beneficial in the current scenario?CorrectIncorrect
Q20 A patient’s daughter asks about the use of melatonin for her 90yo mother with insomnia. Which of the following is the best answer for the side effects?CorrectIncorrect
Q21 An 80yo gentleman with Alzheimer’s dementia presents with myoclonus and new delirium. He was recently treated with antibiotics (trimethoprim) for a urinary tract infection. His medications include: targin (oxycodone/naloxone), citalopram, memantine and warfarin. He son noticed that at times he forgets to take some of his medications. Which of the following is the most likely explanation?CorrectIncorrect
Q22. Which of the following occurs in the respiratory system with normal aging?CorrectIncorrect
Q23. Which of the following interventions has shown to be effective in treating frailty?CorrectIncorrect
Q24. Which of the following is not a risk factor for falls?CorrectIncorrect
Q25. Which of the following interventions does not reduce the incidence of falls?CorrectIncorrect
Q26. A 72-year-old woman with a background of breast cancer in remission presents feeling unwell. Investigation reveal a creatinine of 146 umol/L (3 months prior had a creatinine of 98umol/L) with normal K and HCO3, Hb of 108 g/L (3 months prior was 136 g/L)) and a platelet count of 35000/microL. Urine analysis revealed trace hematuria and 1+ proteinuria. Further investigations reveal a low haptoglobin and high LDH/reticulocyte count. The haematologist reported fragmented RBCs on peripheral blood film. Both lambda and kappa serum free light chains in serum are five times the upper limit of normal. Which of the following investigations should be done urgently?CorrectIncorrect
Q27. The above patient is found to have an ADAMTS13 activity level of 35%. Further history taking rules out any history of recent diarrhoea. Patient’s AKI continues to worsen despite getting plasmapheresis to cover for TTP while awaiting the lab to report the AAMTS13 level. The platelet counts are stable. The coagulation tests and fibrinogen levels are normal. What is the likely diagnosis for this patient?CorrectIncorrect
Q28. Eculizumab is a monoclonal antibody used for the treatment of complement mediated HUS and paroxysmal nocturnal hemoglobinuria. It acts by binding to:CorrectIncorrect
Q29. The pathogenesis of ADPKD is linked to-CorrectIncorrect
Q30. Antibiotic of choice while pending culture reports in a suspected case of pyelonephritis in patient with ADPKD is-CorrectIncorrect
Q31. Tolvaptan group of drugs are useful in which disease?CorrectIncorrect
Q32 Which of the following is not an option in the management of hepatorenal syndrome (HRS)?CorrectIncorrect
Q33. In a patient requiring urgent dialysis which of the following parameters would favour continuous renal replacement therapy (CRRT) rather than intermittent haemodialysis?CorrectIncorrect
Q34 Which of the following describes the solute movements that occur during haemodialysis?CorrectIncorrect
Q35. Which of the following factors does not contribute to diuretic resistance in patients with nephrotic syndrome?CorrectIncorrect
Q36. Indication for screening for intracranial aneurysm in patients with ADPKD does not include-CorrectIncorrect
Q37. ANCA positivity is not associated with-CorrectIncorrect
Q38. Which of the following is not associated with an increased predisposition to renal calcium oxalate stones?CorrectIncorrect
Q39 Which of the following is not an indication to screen for asymptomatic bacteriuria?CorrectIncorrect
Q40. Which of the following is not a risk factor for developing multi drug resistant (MDR) cystitis?CorrectIncorrect
Q41. You are planning to commence your patient on oral ciprofloxacin for a Pseudomonas aeruginosa UTI. Which of the following is NOT recommended when prescribing these antibiotics?CorrectIncorrect
Q42. A 64 yo male presents to his GP with left lower limb pain. On examination, the left calf is erythematous, oedematous, and warm to touch. His GP commenced him on oral flucloxacillin and advised simple analgesia for the pain. The patient presented 48 hrs later with worsening left lower limb pain despite antibiotics. On examination of his left calf, the swelling and erythema has ascended the leg with tracking lymphangitis towards the groin. On further examination of the patient’s foot, there is a 2cm cut under his heel with sloughy discharge and is tender to touch. The patient now recalls cutting his food on some shells when fishing down the coast last weekend.
What treatment would you recommend at this stage?CorrectIncorrect
Q44. A 29 yo male presents to the sexual health clinic with dysuria and urinary frequency. He also reports a new urethral discharge since he had unprotected sex four days ago. He was treated for Mycoplasma genitalium during his last visit 16 months ago, but otherwise has no background medical history. A first pass urine was collected for Chlamydia trachomatis PCR and Neisseria gonorrhoea PCR and culture. A urethral swab was collected for a gram stain performed on site, which showed leukocytes with intracellular gram-negative diplococci.
What is the most appropriate treatment?CorrectIncorrect
Q45. What is the mechanism of methicillin resistance in Methicillin resistant Staphylococcus aureusCorrectIncorrect
Q46. A 42 yo Sudanese born female presents to her GP with a left neck swelling. It is non tender, non-fluctuant and non-mobile, and has been gradually enlarging for the last 12 months. She reports occasional fevers and night sweats over the same time. She has a background history of type 2 diabetes mellitus, hypercholesterolaemia, hypothyroidism and gout.
A core biopsy shows necrotising granulomatous inflammation and acid-fast bacilli on Ziehl Neelson stain consistent with Mycobacterium tuberculosis lymphadenitis. On further history she denies any cough, haemoptysis, lethargy or weight loss. She migrated to Australia three years ago with her two children. She does recall being admitted to hospital as a teenager for a serious lung infection and was treated for many months with many antibiotics but cannot recall the specifics.
Which of the following is NOT a risk factor for Multi-drug resistant Tuberculosis (MDR-TB)?CorrectIncorrect
Q47. 67 yo female with recently resected breast cancer on adjuvant chemotherapy doxorubicin and cyclophosphamide (AC) presents with left sided facial pain. On examination she has a tender erythematous rash over the left side of her cheek, from her bottom eyelid to the left side of her nose. There are vesicles of different ages consistent with herpes zoster reactivation of the V2 maxillary branch of the trigeminal nerve. There is no involvement of the V1 ophthalmic branch of the trigeminal nerve, and an ophthalmology review reveals no involvement of the eye fortunately.
A vesicle is deroofed and swabbed; a viral swab detects varicella zoster virus PCR and a bacterial swab isolates methicillin susceptible Staphylococcus aureus.
What is the most appropriate initial treatment?CorrectIncorrect
Q48 A 21-year-old female presents to her GP for her routine cervical cancer screen. She received the Gardasil vaccine in high school and her PAP smear two years ago was normal.
Which of the following virus is oncogenic and associated with cervical cancer in women and anorectal cancer in men?CorrectIncorrect
Q49. A 42 yo female is referred to your liver clinic with a history of hepatitis C and mild deranged liver function tests on recent bloods with her general practitioner. She reports that she acquired hepatitis C many years ago when she experimented with intravenous drugs but believes she was treated at a similar clinic with a series of injections. She denies any recent intravenous drug use or high-risk behaviour.
What is the most appropriate next step?CorrectIncorrect
Q50 A 74 yo Vietnamese woman presents with one-week history of fevers, rigors, abdominal pain, nausea, vomiting and watery diarrhoea. On examination she is febrile at 39.4C, tachycardic 112 bpm and her abdomen is tender with a right upper quadrant fullness. A CT abdomen-pelvis shows a large ring enhancing mass in the right lobe of her liver.
White cell count: 14 x 106/L
Eosinophil count: 2.4 x 106/L (0.04-0.4 x 106/L)
Entamoeba histolytica antibodies: Indirect haemagglutination (IHA) titre 256 (IHA titres > 16 suggest current or past exposure to Entamoeba histolytica)
Blood culture x2: negative after 48 hrs
Stool microscopy and culture: no pathogens isolated
OCP: no ova cysts and parasites seen
The patient had a CT guided percutaneous drainage of the liver abscess, with thick brown ‘anchovy paste’ discharge
Fluid culture: moderate leukocytes and no organisms on gram stain, negative culture after 48 hrs
An Entamoeba histolytica polymerase chain reaction (PCR) is added to the fluid and is positive for E. histolytica DNA.
An E. histolytica PCR is also added to the stool sample sent earlier and is also positive for E. histolytica DNA.
What is the most appropriate therapy?CorrectIncorrect
Q51 The main inflammatory cytokine involved as the driver of inflammation in gout is:CorrectIncorrect
Q52. Which of the following antibiotic has the highest risk of bone marrow suppression and methotrexate toxicity with concurrent use?CorrectIncorrect
Q53. A 37yo male with radiographic axial spondylarthritis has not felt any improvement to his nocturnal back pain and morning stiffness despite commencement of infliximab 5 months ago. On your review he complains morning back pain and associated stiffness lasting 45 minutes to an hour, with reduced lumbar flexion. His ESR is 30 and CRP 32. What is your next step in your management?CorrectIncorrect
Q54 A 76yo male has a new onset of shoulder girdle pain, severe headache, jaw claudication, left temporal tenderness and complains of intermittent visual disturbance beginning in last 2 days. His bloods show a CRP 102, and ESR 110, raised white cells and Hb 105. What is your next step in management of the patient? What is your next step?CorrectIncorrect
Q55 An 80 female has fractured her neck of femur post-fall and requires a hemiarthroplasty. You receive a call from the surgical intern about which medications to stop prior to her operation. She has rheumatoid arthritis which she takes hydroxychloroquine 200mg BD, methotrexate 20mg PO once weekly, folate 1mg on other days, leflunomide 10mg once daily, prednisolone 10mg and tofacinib 5mg BD.
Which of these medications would you recommend stopping pre-operatively?CorrectIncorrect
Q56. A 60year old male has had difficult to control rheumatoid arthritis with recurrent flares on methotrexate, hydroxychloroquine and low dose prednisolone. In order to achieve remission baricitinib was commenced.
What is the mechanism of action of Baricitinib?CorrectIncorrect
Q57 Which of the following biologics in the use for psoriatic arthritis was associated with the lowest rates of hospitalized serious infections?CorrectIncorrect
Q58 A 33-year-old man is admitted to hospital with flare of psoriatic arthritis involving his sacral-iliac joint on MRI and recurrent bloody bowel movements up to 8 times a day associated with abdominal pain. Magnetic resonance elastography (MRE) demonstrates terminal ileitis. He had previously trialed, sulfasalazine, adalimumab, and infliximab. Which of the following is the next appropriate treatment for this patient?CorrectIncorrect
Q59. Which of the following gene mutations have been associated with polyarteritis nodosa-like disease with stroke-like syndromes?CorrectIncorrect
Q60. Which of the following is not considered a poor prognostic factor in reactive arthritis?CorrectIncorrect
Q61. Thiazides are often implicated in pathogenesis of gout and hyperuricemia. Which of the following transporters is affected by thiazide on the basolateral membrane of the nephron?CorrectIncorrect
Q62 Which of the following conditions are not associated with calcium pyrophosphate deposition disease?CorrectIncorrect
Q63. An aged care resident with advanced dementia and multiple co-morbidities is in the deteriorating palliative phase. Appropriately the care focus shifts to comfort measures. In the event of further deterioration, the following statements supports avoidance of re-hospitalization except?CorrectIncorrect
Q64 Phenobarbitone is often used as per guidelines for palliative sedation. In relation to palliative sedative therapy, which of the following is not true?CorrectIncorrect
Q65. Palliative radiotherapy is often considered and utilised to improve symptom control and quality of life for patients living with a life limiting illness. Which of the following malignancy related symptoms or complications is palliative radiotherapy least effective for?CorrectIncorrect
Q66. In the management of cancer related pain, what is the underlying principle of determining the safety profile in selecting an opioid for patients with chronic kidney disease (eGFR<30) and end stage renal disease?CorrectIncorrect
Q67. An opioid naive 68-year-old man with prostate cancer presents with new onset moderate pain in his lower back. There is a neuropathic component radiating down his right leg. Imaging is consistent with new erosive bony metastasis and right para-vertebral soft tissue mass at L4. Which of the following would not be a reasonable option for cancer pain management in this clinical scenario?CorrectIncorrect
Q68. Hydromorphone is approximately how much more potent than morphine?CorrectIncorrect
Q69 A 48-year-old man with head and neck squamous cell carcinoma (SCC) was admitted to hospital for flare up of pain and mucositis after recently completing radiotherapy, as part of definitive treatment. During the admission, pain was managed with subcutaneous morphine 20mg delivered via a syringe driver over a 24-hour period. He is now stable and able to swallow satisfactorily. In anticipation of discharge from hospital, which of the following would be the best option for route of delivery and dosing of the selected opioid?CorrectIncorrect
Q70. A 60-year-old lady with metastatic urothelial transitional cell cancer (TCC) presents with worsening lower back pain. Imaging has ruled out spinal cord compression but is consistent with widespread spinal metastasis. She completed palliative radiotherapy to the lumbar spine 2 weeks ago. Optimization of non-opioid analgesia and commencement of a morphine syringe driver, with rapid dose escalation over 48 hours does not result in satisfactory symptom control. You are asked to review her. Your assessment is consistent with poor pain control combined with signs of opioid toxicity, indicating opioid induced hyperalgesia. What would your next reasonable course of action be?CorrectIncorrect
Q71. In cancer induced bone pain, which intervention listed below is beneficial and best supported in terms of number needed to treat (NNT)?CorrectIncorrect
Q72. A 44-year-old man with metastatic colorectal cancer has rapidly enlarging liver metastatic lesions on imaging done to investigate jaundice and deranged liver function tests. There is evidence of new metastatic lumbar bony disease on the said imaging. This is now symptomatic. Which of the following would not be a suitable option as a sustained release opioid option for cancer pain management in this man?CorrectIncorrect
Q73 . A 64-year-old woman presents is referred to the emergency department with a rapid heart rate by her local medical officer. She has a history of hypertension and newly diagnosed type II diabetes mellitus. Her current medications include Olmesartan 40mg daily and Metformin 500mg daily. Blood tests reveal a normal thyroid function test, normal electrolytes, serum creatinine of 90umol/L and a calculated creatinine clearance of 59ml/min. 12-lead electrocardiogram reveals atrial fibrillation with a ventricular rate of 110bpm. She tells you she has undergone a recent cardiac ultrasound with her cardiologist which has revealed no abnormalities. With regards to stroke prevention, which of the following is most appropriate?CorrectIncorrect
Q74 . A 50-year-old lady is referred for assessment and management of hypertension. She has a history of poorly controlled type II diabetes mellitus complicated by renal impairment with microalbuminuria, hypertension and previous transient ischaemic attack. She has been commenced on Sevikar HCT (Olmesartan 40mg / Amlodipine 10mg / Hydrochlorothiazide 25mg) daily by her local medical officer, but outpatient ambulatory blood pressure monitoring has revealed consistent blood pressure readings up to 170/110mmHg despite adherence to her medication regime. Outpatient assessment of secondary causes of hypertension have not revealed any significant pathology. On your review, she is clinically euvolaemic with an unremarkable cardiorespiratory examination. Blood pressure readings on your review remain elevated at 170/100mmHg without postural drop. Pathology tests reveal a serum creatinine of 100 umol/L with an eGFR of 55 ml/min/1.73m2 and electrolyte values within the normal range.
With regards to her hypertension management, what would be your next step?CorrectIncorrect
Q75. Dobutamine is a commonly utilised inotropic agent in the management of cardiogenic shock. With regards to its effect on receptor binding, which of the following is most accurate?CorrectIncorrect
Q76. A 40-year-old man with an established diagnosis of schizoaffective disorder has been stable in mental state for many years. He has recently become non-compliant with his medication. Previously patient was stable on a combination of Risperidone 10mg and Lithium 1200 mg. Family report that recently there were some signs of relapse of patient becoming suspicious and irritable. He was brought to the emergency department with history of being mute and staring at the ceiling. On examination patient is mute, has waxy flexibility, posturing, and extremely resistive to movement.
What is the most likely treatment of choice in this patient.CorrectIncorrect
Q77. A 30-year-old man is admitted with a diagnosis of schizophrenia. He has been commenced on Risperidone and the dose has been increased to 10 mg since admission. He currently reports that he feels restless in this leg. He finds it difficult to keep still and has a constant urge to move his legs and is pacing up and down in the ward. What is the best treatment of choice?CorrectIncorrect
Q78. A 20-year-old woman has a diagnosis of the schizophrenia. She currently on 10 mg of Risperidone. She complains of discharge of milk from both breasts, and amenorrhoea. Pregnancy test is negative. Her previous menstrual cycles were normal.
Which of the following test are more appropriate to do?CorrectIncorrect
Q79. A 35-year-old man is currently admitted with a history of schizophrenia. He has been commenced on Risperidone 6 mg. About 7 days later he presents with a history of fever, rigidity, confusion, fluctuating blood pressure and pulse rate.
Which is the most likely diagnosis:CorrectIncorrect
Q80. Which one of the following is a known major side effect of hydroxychloroquine?CorrectIncorrect
Q81. A 23-year-old male presents with 5-day history of ascending purpura on lower limbs associated with arthralgia in small joints and abdominal discomfort. This was preceded an episode of respiratory tract infections one week prior to presentation. There were no other focal symptoms or signs on history or examination and the patient is not on any medications. A vasculitic screen including ANA, ANCA, dsDNA, complements, cryoglobulins, hepatitis B and C serologies were all negative. Urinalysis revealed microscopic haematuria and proteinuria, but serum creatinine was normal.
What is the most likely finding on biopsy of his lower limb purpura?CorrectIncorrect
Q82. Which of the following pharmacokinetic parameters is most important in regard to dose adjustment of medications in people with renal failure?CorrectIncorrect
Q83. Probenecid is a medication used in the treatment of gout. It may also be useful in increasing the serum concentration of beta-lactam antibiotics allowing for less frequent dosing in an ambulatory setting. The mechanism by which probenecid achieves this is best explained by which of the following?CorrectIncorrect
Q84. Steven Rajagopalan is a 76-year-old male is admitted to hospital with septic shock. He is being treated with multiple antibiotics including intravenous gentamicin. What effect will septic shock have on the volume of distribution (Vd) for gentamicin?CorrectIncorrect
Q85 A 41-year-old woman is hospitalized for the management of alcoholic hepatitis. She consumes 1 L of vodka every 2 to 3 days and was drinking up to the time of admission. On presentation, she is jaundiced and has muscle wasting and ascites. Her calculated MELD score is 32. A diagnostic paracentesis is performed and there is no evidence of spontaneous bacterial peritonitis. Her treatment includes prednisone for alcoholic hepatitis, an alcohol withdrawal scale, and dietitian input in regard to feeding. On the third day of her admission, she becomes progressively confused and subsequently passes a large melena stool. She is transferred to the ICU, where she is intubated. IV octreotide therapy is initiated. Emergency gastroscopy shows large varices with stigmata of recent bleeding. In addition to band ligation of the varices, which of the following should you recommend?CorrectIncorrect
Q86 A 65-year-old woman with an unremarkable medical history complains of vague, infrequent right upper quadrant discomfort. Transabdominal ultrasonography shows a 19-mm, fixed, hyperechoic lesion protruding into the lumen of the gallbladder without an acoustic shadow. Which of the following should you recommend at this time?CorrectIncorrect
Q87. A 60-year-old female presents to the gastroenterology clinic for further evaluation of abnormal liver function tests. She reports pruritus that has been worsening over the last few months and is noted to have an elevated alkaline phosphatase. Her AMA is positive and liver biopsy is consistent with PBC with stage 2 fibrosis. She is started on treatment with Ursodeoxycholic acid at a dose of 15mg/kg and three months later has improvement in her alkaline phosphatase. At 6-month outpatient follow-up, her labs show bilirubin 12 umol/L, alkaline phosphatase 220 IU/L, AST 36 IU/L, ALT 35 IU/L, albumin 38 g/L, INR 1.0, and a platelet count of 110,000. There is no history of ascites, overt GI bleeding or hepatic encephalopathy.
What should be the next step in investigation?CorrectIncorrect
Q88. A 56-year-old female with a 10-year history of Crohn’s disease attended the gastroenterology clinic with symptoms of back pain and bilateral hip pain. An x-ray showed evidence of sacroiliitis. Her Crohn’s disease has been in remission for the last few years on Azathioprine. Her colonoscopy six months ago had demonstrated endoscopic and histological remission.
Which of the following statements is most accurate with regards to the extra intestinal manifestations (EIMs) in Crohn’s disease?CorrectIncorrect
Q89 A 61-year-old woman a history of excessive alcohol consumption was admitted with acute abdominal pain. She appears unwell, is tachycardic with a heart rate of 115 beats/min and is borderline hypotensive with a BP of 95/60 mmHg. Her lipase level is 2250 U/L (normal range 60–180 U/L), and she is diagnosed with acute severe pancreatitis. Her Apache II score is 9.
Which of the following would be the most appropriate for nutritional support?CorrectIncorrect
Q90 . A 38-year-old female with constipation for the last 8 months was treated with Movicol and sodium docusate at maximum doses with no improvement in her symptoms.
Which is the most appropriate next drug to try?CorrectIncorrect
Q91 A 60-year-old female has 2 episodes of bright hematemesis associated with hypotension and pre-syncopal symptoms over the last week. She drinks 2-3 standard drinks daily and uses ibuprofen daily for her chronic back pain. She has undergone two gastroscopy procedures with normal results; both are done about 4-5 hours after each episode. What is the most likely diagnosis?CorrectIncorrect
Q92 Mr Eatmeet is a 45-year-old man who presents with shortness of breath and haemoptysis and headaches over the course of 4 weeks. He has a history of rheumatoid arthritis and has used etanercept in the past. However, his RA is now well controlled and has not required any recent immunologic therapy. Examination shows axillary lymphadenopathy. A CT chest showed bilateral cavitating lung lesions and a giemsa stain was positive. On further history it was revealed he had a hobby of bushwalking and has consumed raw meats in the past. What is the most likely diagnosis?CorrectIncorrect
Q93. Mr SPN presents with an incidental finding of a solid pulmonary nodule of 7mm in size and has been referred to your practice. You are trying to triage how best to follow him up:CorrectIncorrect
Q94. Mr JJ is a 35year old CF patient who has severe bronchiectasis and has a FEV1 of>30% and has had 5 exacerbations in the last year requiring hospitalisation. He now asks you regarding his chances for transplantation. Which of the following is true in the case of Mr JJ and CF?CorrectIncorrect
Q95. A 60-year-old patient who’s had severe dyspnoea and dry cough for two months is reviewed in clinic. She’s had previous asbestos exposure and changes in the right upper lobe, right middle lobe and right lower lobe. She has had had 1 month of doxycycline and Augmentin with no response. She is originally from Chile and settled in Australia 20 years ago and has not travelled back since. She has squawks on auscultation over the right upper lung zone.
Which of the following is false?CorrectIncorrect
Q96 Which of the following is false regarding the further evaluation of a patient diagnosed to have hyperthyroidism?CorrectIncorrect
Q97. A 24-year-old lady with a background of Addison’s disease presents with cough and fever. She is normally on hydrocortisone 10mg mane and 5 mg nocte and fludrocortisone 100 mcg daily. Her temperature is 37.9 C, blood pressure is 128/72 mmHg, oxygen saturation is 97% on room air and heart rate is 102 bpm. Chest x-ray is normal, and her throat appears congested. She is admitted for intravenous antibiotic therapy for upper respiratory tract infection with the plan for possible discharge after 48 hours on oral antibiotics. What should be done about her usual medications?CorrectIncorrect
Q98 A 26-year-old female with type 1 diabetes is admitted for elective cholecystectomy the following day at 1100. She is normally on insulin glargine 30 units nocte and insulin aspart 8-12units pre-meals. Her last measured HbA1c was 7.2%. In 2000 her blood sugar was 7.8 mmol/L. What is the best way to manage her diabetes perioperatively?CorrectIncorrect
Q99 Which of the following triggers ovulation?CorrectIncorrect
Q100. A 17-year-old male is found to have persistent hypertension. He has a strong family history of early onset hypertension and blood tests reveal a hypokalemic metabolic alkalosis. Further investigations reveal both plasma aldosterone levels and plasma renin activity are severely low. What is the likely diagnosis?CorrectIncorrect