MCQ 62

Haematochromatosis is

1. Autosomal dominant
2. Autosomal recessive
3. X - linked condition
4. It has not genetic cause
5. It is a type of iron deficiency anaemia

MCQ 61

You arranged FNAC for patient in question 58. Showed degenerative colloid nodule with carcinomatous changes. You refer patient to Endocrine surgeon for review and further management. What is not true about Thyroid surgery from following?

1. If there are pressure symptoms due to multinodulat goitre with a dominant nodule, total thyroidectomy is recommended choice
2. In a patient with a thyroid nodule and Graves' disease, anaesthesia and surgery must be deferred until TSH has normalized
3. If there is a definite diagnose of malignancy, hemithyroidectomy is appropriate
4. The major risks of total thyroidecomy are hoarseness of the voice and permanent hypothyroidecomy
5. Surgery should be done if there is clinical suspicion about malignancy or concern about growth of nodule even if investigations are unremarkable. 

MCQ 60

Patient in question 58 came to see you again for blood result and US. TFT was unremarkable. US showed 4 cm nodule in thyroid in right side. Unable to comment whether it is malignant or not, but suggest it showed some cystic and solid area. What will be the next step?

1. US guided FNAC
2. CT scan
3. MRI
4. Nuclear medicine scan
5. Do nothing and review in 6 months time. 

MCQ 59

Patient in Question 58, you are suspicious about thyroid gland nodule. What will be the next step for investigation?

1. TFT and US of thyroid gland
2. TFT and XR of neck
3. TFT and CT scan of neck
4. TFT only
5. TFT and MRI of thyroid gland 

MCQ 58

60 y.o male presented with lump on right side of his neck, which he noted about 2 months ago and has increased in size. He is otherwise asymptomatic. His lump is about 4 cm in size and move with tongue. What is likely diagnose?

1. Lymphadenopathy
2. Thyroid nodule
3. SCM muscle haematoma
4. Skin cancer
5. Subcutaneous Lipoma

MCQ 57

Which of following shows best outcome on superficial burn patient?

1. Application of ice
2. Urgent medical intervention
3. Application of cold water for 20 minutes
4. Application of burnaid 
5. Surgical intervention like skin graft 

MCQ 56

If you are being ask to request only one blood test for anaphylaxis, what of following will you order?

1. FBC
2. Tryptase
3. IgE
4. CK
5. Electrolytes

MCQ 55

Which of following is not common sign of anaphylaxis reaction?

1. Hypotension
2. Abdominal pain
3. Wheeze in chest
4. Cold and clammy skin
5. Tachycardia

MCQ 54

30 year old male presented with thickening of skin on extensor surface of both elbow. O/E the thickening showed erythmatous patch with silvery scaly appearance. He also mentioned that his father also had similar rash. What would be the likely cause of his rash?

1. Eczema
2. Psoriasis
3. Tinea Versicolour
4. Squamous Cell Carcinoma
5. Contact dermatitis

MCQ 53

In MCQ 52, you diagnosed that this person is having anaphyxis. What is your next step?

1. Give 0.5 mg of 1:1000 adrenalin IV
2. Give 0.5 mg of  1:10000 adrenalin IV
3. Give 0.5 mg of 1:1000 adrenalin IM in thigh
4. Give 0.5 mg of 1:10000 adrenalin IM
5. Give 0.5 mg of 1:1000 adrenalin IM in deltoid

(Note - If you don't the answer of above question, I would recommend that you visit ASCIA website and consider doing free e-training. Follow the link ASCIA website )

The CEPD at Monash University will be running a 3 day intensive weekend AMC Clinical Bridging Course for IMG / OTD.
Date 27-29 July 2012
Cost $1500
Contact - Ms Caroline Menara  Ph - 03 9902 4498   Email - caroline.menara@monash.edu.au

MCQ 52

25 year old male presented with difficulty in breathing. He mentioned that he is allergic to peanuts and he probably had peanuts with his lunch. On examination, he was flushed with tachycardia and widespread wheeze on lung auscultation. What would be the correct diagnosed?

1. Allergic reaction to peanut
2. Anaphylaxis to peanut
3. Asthma exacerabation
4. Septic shock
5. Cannot tell, he will need further investigation including blood and CXR prior to making diagnose. 

MCQ 51

What is Bowen's disease?

1. SCC
2. BCC
3. Melanoma
4. Squamous Cell Carcinoma in situ
5. None of above

MCQ 50

How does Melanoma of skin spread?

1. Direct spread
2. Lymphatic system
3. Blood stream
4. All of above
5. Neither of above

MCQ 49

How does SCC of skin spread?

1. Direct spread
2. Lymphatic system
3. Blood stream
4. All of above
5. Neither of above

MCQ 48

How does BCC of skin spread?

1. Direct spread
2. Lymphatic system
3. Blood stream
4. All of above
5. Neither of above

MCQ 47

What is the first line abx for tonsillitis in children in Australia (according to evidence based medicine - answer in Therapeutic Guideline)?

1. Amoxicillin
2. Phenoxymethyl penicillin
3. Cephelexin
4. Azithromycin
5. Doxycycline

MCQ 46

45 year old teacher presented with right sided hand pain which is worse at night time and gets better when she wakes up and walk around. What will be the likely cause of her pain?

1. Malignancy
2. Osteoarthritis
3. Carpal Tunnel Syndrome
4. Raynaud's phenomenon
5. Rhematoid arthritis 

MCQ 45

What is the most common cause of moderate to severe exudative pleural effusion in Australia?

1. Tuberculosis
2. Bronchial Carcinoma
3. Metastatic Carcinoma to lung
4. Pneumonia
5. Cardiac failure

Hepatitis - Free resource

If you are working in Western Australia (WA) or planning to work in WA, you will find this resource invaluable. Even if you are not planning to work in WA and planning to come to Australia as health practitioner I would recommend that you go through this resource which provide free online education for Hepatitis B and C. Edith Cowan University has provided this invaluable resource for free which is useful for GP, medical students and health workers. You will need to register once to access, but registration is free (you just need a valid email address).

http://hepatitis.ecu.edu.au/

MCQ 44

Which of following is not notifiable disease in Australia?

1. Tuberculosis
2. Measles
3. Malaria
4. Gonorrhoea
5. Norovirus gastroenteritis

MCQ 43

50 y.o male who migrated to Australia from central Africa 10 years ago presented with 2 weeks history of cough and lethargy. FBC, CRP and EUC - unremarkable. CXR showed circular mass in right apex. What will be your next step for investigation?

1. Commence on AKT (antituberculosis treatment)
2. Arrange sputum AFB staining and if negative reassure patient
3. Arrange culture for tuberculosis and await result before embarking on treatment
4. It is likely that it is old tuberculosis and don't need to do anything
5. Treat him as community acquired pneumonia