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has a heart murmur coming and going, he comes to you as a GP for diagnosis. He has no cardiac symptoms, no SOB. Everything is normal, no family history of heart problem. General health is fine. Tasks: 1. do a cardiovascular examination. ( please do not cover abdominal examination and lower limbs examination.) 2. present what you have found to your examiner. 3. present your diagnosis to your examiner and answer examiner. My approach: do the physical examination following the textbook. It was a medical student with no murmur at all. Questions from examiner: 1. what other physical examination do you want to do? ( I stopped after I auscultated role player.) valsava examination. 2. if a patient has a murmur coming and going, what do you think? – functional murmur? Question 2: A young student presents with dry cough, mostly in the morning or at night, general health ok, non smoker. Tasks: 1. do a respiratory examination, 2. report your finding to your examiner. 3. answer examiner’s question. My approach: Again, follow the textbook’s instruction. It was a medical student with no positive finding. I told the examiner that there was no positive finding. Then she asked me what was the diagnosis- asthma. Immediately she asked me what else I wanted to do. I said spirometry. She handed over a spirometry result: FEV1 decrease, FVC decrease, after bronchodilator, FEV1 increase but lower than normal, FVC increase but lower than normal. I said it was consistent with the diagnosis with asthma. Question 3: (same question from April Melbourne 2006) A young lady driver has a few car accidents because she can not see the car coming from the intersection. Please do a visual examination. Tell your examiner what is your finding.
Make a diagnosis and management plan. Please note that MRI is the gold standard of diagnosis. Question 4: (same question from November, 2005, Melbourne) You are an ED intern, a 45 years old man presented with right upper quadrant abdominal pain for 6 hours, nausea but no vomiting, this is the first attack. On examination: temperature 38.3 C, other vital signs normal. 1. please explain to your patient what is the most likely diagnosis 2. do the essential investigation. 3. management plan Question 5 A young student presents with poor sleeping, examination is coming, he is worried about the exam. Recently, his father passed away unexpectedly due to heart attack. Please take a history, Counsel this patient, Make a management plan My approach: I asked all the questions related to depression anxiety, such as drinking, eating, weight, sex drive, usual interest, the impact of his father’s death on his life. and also the past psychiatric history, drug and alcohol history, medical history, social history including performance at school, family relationship, employment, Explain to him: the reaction of bereavement. Emotional support, Management: sleeping pill, medical certificate, psychologist counselling. Question: how should I use sleeping pill, what is the prevention of heart problem. Question 6: A 2 year old girl presented with headache, fever for 2 days, father is concerned, he brought his daughter to your GP setting, Her father has family history of migraine. Please ask for examination finding from examiner. ( no further history taking) Manage this case. My approach: ask for general appearance. Vital sign, ENT, any rash? Neck stiffness, kernig sign? Other system. – only phalangitis, and bulging ear drum. Sign of dehydration, not drinking well _ from father, but examiner said baby looked well?
My management plan: Explain to father that it may be viral infection however I can not exclude meningitis or other serious infection, so please observe and send to ED if rash, fever increase, drowsy, not drinking well or eating well. Question 7 24 years old lady presents with vaginal bleeding 2 hours after 8 weeks amenorrhoea. General health ok. She is obese. You are a GP. Please take a history Ask for physical examination. ( investigation not available) Discuss with examiner about your management plan. My approach: she is not planning for family, partner is using condom, she is not on pill, bleeding more than usual. LMP 8 weeks ago. Regular period, no pain, no STD history. No family history of bleeding tendency. Not on any regular medication. PAP smear 6 months ago, normal result. No pregnancy history. No abortion history. Now she has no abdominal pain. Only per vaginal bleeding. Has stopped now. Physical examination: haemodynamically stable. No tenderness or mass in pelvic, speculum: os close, no bleeding, no polyps or ulcer. Examiner asked: what is your diagnosis if beta HCG positive? Threaten miscarriage. What other investigation do you want? – U/S What if beta HCG negative? Polycystic ovarian disease. Or other bleeding tendency, or problems in the uterus such as PID…. Question 8 61 years old bricklayer(male) presents with two years history of back pain and thigh pain? (not remember bilateral or which side) Past history: osteoporosis Your task: 1. history taking 2. ask for physical examination finding 3. your provisional diagnosis and management plan my differential diagnosis: 1. sciatica – fracture or disc prolapse – malignancy or osteoporosis 2. osteoarthritis 3. claudication
au/html/ma. no gloves. Discuss results with the patient. back. Stems were also much longer. Photo dorsum of hand. first. Pt loves his job. (Not from AMC book –scaly lesions on whole dorsal surface of hand. . holidays made it better.nationalasthma.18 y. discuss condition with patient. Then I asked examiner the hand examination and shoulder.2. comes to your GP practice TASK. Then I got a clue…… Management x-ray and referral to rheumatologist… I am not sure I am right or not? AMC MELBOURNE 29/04/06 I never realized how difficult it will be to make a recall after the exam. Rash very itchy. Rash has been there for 3 months. Brother has psoriasis (to confuse you). neck. So please be careful when you read these questions and find your own answers!! NEW QUESTIONS 1. at work does everything with hands. has he been to any doctor? He told me that a doctor told him that he had got spondylosis of spine (x-ray) then I knew it might be osteoarthritis. 3 months after he started his work.asp Video is there FEV1. I do not remember all the tasks and some of the examiners questions. FVC interpretation..4._spiro. To answer properly I’d look up for spirometry from http://www. FVC and ratios.take Hx.org.. pain question.. knee etc… The examiner told me : heberdon nodes on hand. (normal values were provided by examiner) Pt asked one question – Do I have asthma? Other candidates had Normal result of spirometry and reassured the pt . TASK Do spirometry. trauma? I asked the history carefully. calculate FEV1. red). Then I asked during the last two years.Pt is a brick layer started new job 6 months ago. hip. He had asthma when he was 11.o patient comes to your GP practice for insurance purposes.
BMI 34.tell Dx. Reassured-.normal. What other tests?. 50 y o patient wants some advice about loosing weight. She will ask you about medications. Accommodation – couldn’t see a thing but said normal Pupils reflexes –examiner said normal. saying I can’t see from LEFT and RIGHT. You’ re GP. My answer: role-player helped me.com. hypothyroidism excluded. Exercise (all the info from Pt’s Edu and http://www. good decision. CVA?she said no). The examiner asked about complications. Examiner expected to hear oral steroids as tx . Examiner asked about surgery – Lap banding of stomach 4. possibly optic chiasm. Look up Talley.-Theory-from the book.o.heartfoundation. Advised re: Diet . Eye movement – Normal Examiner asked Summarise findings – Bitemporal hemianopia.bitemporal hemianopia Fundoscopy-examiner said normal.…. can’t see the signs when driving car signs on the left and right bumping into things and people. TASK – Examine eyes. Cushing. only they can give you high BP. (My answer cellulitis. but in this exam the man is 50 y.offered dietician. Spoke re:cardiovascular risk factors Explained the risk of increased weight –heart. Visual fields. I told the role-player he does not have to change the job.My answer: contact dermatitis. not only topical steroids and gloves as protection. BP. CVA again. What’s the cause – brain tu.I said CT and P. very good and important that you came. TAKS – discuss with patient. safe levels of alcohol Re medications :said don’t know much about. No further Hx My answer –still talked re:Family (anybody with diabetes. Examination from the DVDinvaluable for any examination (only hip& back not there) . 50y o man problems with vision. (looks like old question – Myopia –Mel NOV 2004). which he liked. angina. Examination Snellen chart. DM. full neuro examination and baseline bloods.au) And spoke about osteoporosis if she does not exercise No smoking and. What other investigation would you do. in a sensible way. treat with oral Flucloxacillin after checking BSL and lymph nodes) I’d read at least from Murtagh and Pt’s education re: this topic 3. She was not interested anyway (in contrast to the stem!!!) Loose your weight slowly.
P. I’ll keep an eye. BP. presenting part. My answer: I asked how long in labour – Pt said 3 hrs.5. 3cm dilation. Baby in OTposition. low Fe saturation.call another DR in Hospital for 2nd opinion. baby turning into good position. T. -Asked re:meconium Examiner green . ask examination findings. Discuss condition with pt (same as Syd MARCH 2005 Retest) 6. I asked for iron studiesExaminer gave me a paper --low Fe. high transferrin.suction airways of baby. 41 weeks (can’t remember possibly primi ) in labour. cervix effaced . asses cervix. You’re GP working inObs Ward of countryside hospital – no obstetrician available. baby between OT and OA. low ferritin. OLD QUESTIONS/PAST RECALL PAPERS INCOMPLETE and CONFUSING 6.pt NO ANcare. Station 0. (Similar to Syd SEPT 2005. or Syd MAY 2004 but changed) 5. Talk to pt. are you comfortable – dehydration.Obvious IDA I asked for tissue transglutaminase for celiac – Examiner – normal and nothing else available. . discuss situation wih pt. A lot of Interactions with the examiner at this station which makes it harder. Passed meconium. esp DM ( sweet drink at 28 weeks) – pt all OK Contractions? – examiner said every 3-4 min. you can’t tell thick or thin -I want to re-examine pt. examiner – cervix 10cm now. 50 y o women postmenopausal come to your GP practice for the results.station +1 talk to pt Talking was reassurance. pain.canal for baby open.exclude cord prolapse. TASK. Result of microcytic anemia attached NO further Hx to be taken.countryside. . TASK ask examiner examination findings.Examiner not available.hydration. -Put CTG (examiner said– reactive) and LEAVE IT ON. Check pt GA. moving down. Green stuff passed but does not mean there’s a problem (41 weeks). Similar case in Greer – Problem based Obs&Gyne. Examiner also wanted to hear .Take Hx from patient. -Fetal scalp electrode. augmentation not required.getting stronger Examiner said Manage I said .
The case was really “dealing with difficult Pt/convince her to have the test”. PE from examiner.smoke.unavailable My answer : explained – exclude pregnancy first . 2 months not significant. Yes.You’re intern ED.take further history.Devitt 7. no dry skin/cold intolerance.but hidden points were Pt is 85kg. You’re overweight pregnancy MAY be complicated by high BP and DM.We have to exclude pregnancy now and wait for period to come back. Pt asked.I explained IDA. no test necessary now If you concerned we can stop Pill and wait (use barrier protection) or change Pill to higher estrogen or Triphasic. jittery. Pt asked “Will I get pregnant”. Explained why loosing iron maybe diet. Can you give me Iron? – OK.no gyne procedure. maybe ulcer. may improve your symptoms. wants to be pregnant in 2 yrs) 7. NO Ix result available TASK further Hx.Did you have sex over last 2 months. The woman did not want any tests. If losing iron due to ulcer it’s easily treated. does not . I have to ask you sensitive qq. if sthn else/sthn nasty better to know early. You really need the tests. comes to you as GP. discuss condition with Pt. ( same as Syd AUG 2003) 8. now 85 kg. in taking Hx I repeated what was in stem. discuss condition with pt. no pain. we have to find the cause. women came 3 days ago-previously on Prozac stopped 3 days ago. 8. no acne/funny hair on face/Fhx of PCOS. Go home/ speak to husband/come back with decision in few days. PE – Examiner all Normal Pregnancy test.Can it be sth else??-Not likely we need to find the cause.maybe other cause. Today she’s vomiting. maybe due to diet. IDA from P. dizzy. see if period back and loose weight over next 2 yrs. started on Zoloft. did not loose/put on weight recently. if negative don’t worry.30 yo woman on OCP no period for 2 months. Still confusing this question.maybe sth more serious. TASK. no meds only Pill. See me in 2-3 weeks. but still need to find the cause. HX – on Microgynon 30(forgotten to ask for how long!). . (same as Adel SEPT 2004.continue same Pill (as 2 months no periodno reason to worry). no headache/vision probs/nipple discharge. periods regular before. Other option I’d recommend . Colonoscopy/gastroscopy invasive but done under sedation so you will comfortable.
T-40.baby 10th percentile asymmetric What's your Dx? . no smoking. Funny other candidates got Small for Dates from Ix.CTG (examiner says reactive). Good diet. discuss results with Pt. (same as Mel FEB 2006 !!) 10. Did not take any other meds. Started explaining and bell rang. sweet drink 28 weeks. unwell today. Pt asked I can’t sleep. which artery ?.S/D ratio. OLD QUESTIONS REPEATED 10. to others examiner said. urine dipstick no protein I asked for Ix . no neck stiffness.NO Ix available. today drowsy.what will you write in chart? Iv line. brisk reflexes Urine no ketones.explain condition to father. ask PE and Ix. PE – P-normal. ANCare normal –USS 18 weeks. You’re GP. This question still confusing. so I'll explain very briefly. petechial rash. no iv drugs. I explained all due to SE of antidepressant. manage the case. Boy had sore throat last 2 days. there’s sthn we call serotonin synd. TASK . 2 y o boy brought by father to your GP practice 50km from Hospital.which parameters you're looking at ?) tone. (Similar to Syd May 2004) 9. Ix not available. My answer: it's urgent. In Hx no headache. very dangerous if not treated. dehydrated. BP no postural drop. blurred vision. So my Dx is SE of antidepressant. Doppler (examiner-what you're looking at? .same bug as the one . baby kicking less (I forgot to ask how many kicks/day now!!!) PE – P. Blood poisoning. not dehydrated.BP normal Heart sound 140/min. now 4 weeks later she’s 30 weeks. Nsaline.Pt unwell on Prozac before given Zoloft. but usually when 2 antidepr. tummy pain. mixed from different groups.(examiner. no hx of infection. BP low.IUGR Talk to Pt. P-high. Figures may have been different but still decreased growth around 28/34 weeks TASK-take further Hx. Metoclopramide. Your patient was 29cm at 30 weeks.examiner says. I answered I’ll ask senior (did not know if I could give Valium) 9.umbilical) BPP . these 2 are SSRI’s . IUGR from Greer. Photo from AMC book. Examiner. breathing etc USS . CVS< RESP>ABDO NAD.
TASK take further Hx. development OK. you child has 2 hernias-weakening of muscles in tummy. she props baby up after feeding . OK. Pt asked any SE of anesthetics. Put on weight since was born. shared food with child over last 10 days. Pt asked Am I doing sth wrong?Continue breastfeeding as breast milk better for baby and not the cause of .go to ED ASAP.lump in groin. Lumps come and go. you can go with the child in ambulance. says baby vomiting everything after feeding. very important. only a bit on the clothes. Very good you came. Did not feel any lump. can be dangerous if bowel gets stuck outside. I am calling surgeon now. You' re wife pregnant? Pt -No. give benzylpenicillin 600mg iv. Vomit only milk – no blood or green stuff. PE. Still send you for USS to exclude pyloric stenosis if result OK baby has reflux. TASK explain diagnosis and manage the case (same as Mel NOV 2005) 11. Can last up to 9 months. explained about testis traveling from tummy to scrotum. Hx -Baby vomiting not on further questioning not so much. I also need to notify DHS. Guidelines RCH 11. take blood for culture. but benefit outweighs risk. 12. Pt asked. very common. no lump in tummy. daily for 2 days. check tummy if lump-hard . She wants to change to bottle feeding. Think if anyone kissed.about lump around belly button surgeon will decide if he will repairs both together. I explained gastro-esoph. discuss mx with mother (same as Adel OCT 2005) 12. Operation possibly within 2 weeks re. My answer: good you came. Baby hungry 1 hr after feeding (other candidates got 2-3 hrs) then settles. Any allergies to penicillin? Pt . Mother 4 weeks baby comes to your GP practice. PE – normal. gets better with time. Child happy.NO I do iv line. Normally the one around belly-button can wait until 2/4 years If baby crying upset. put on weight.can it be sth else? Not likely as child really sick needs to go to ED now.causing meningitis.channel did not close.? Every medication has SE. hope the child will be fine. Father of 5 months old boy comes to your GP practice re: lumps in Rt groin and another one around belly button. so you'll both need meds for prevention 2 tabs. for appointment as early as possible. reflux/draw a picture/. call Ambos. call Registrar in Hospital.
Dr Gya showed CT with stone. usually multiple factors. You can thicken feeds with Carobel/Gaviscon. Pt asked . Renal colic from P. TASK. discuss Dx with pt (same Syd MARCH 2006!!) 14. Young man comes to ED 2nd episode of severe pain in the back. I’ll take blood tests and ask consultant. ask Ix. red wine etc. Different causes. went away now. what you’ve got is migraine. so write a diary. Stone is 5mm.what’s mx.. Dr Gya. Senanyake. stone builds up around pain.40 yo woman (2 episodes of headaches with nausea. more frequent feeds. pt moving around to make it better No change in urine color.Shoulder examination GP setting. answer questions. Management – Aspirin(asked if no pain I tummy)/ Metoclopramide if not better Ergotamine (asked her no probs with heart or BP) Prophylaxis not required as yet.complications of Reflux? – Bell rang GORD – from Pt’s Education 13. keep baby prone 3060min. Answered borderline. pain radiating to groin. photophobia. very severe. Basketball player had anterior dislocation 6 months ago. comes to our GP practice for advice. Pain occurred suddenly.this problem. Pt was teacher a lot of stress in life.as you have no cancer.examine shoulder give running commentary. the stress may be gone. Can he go home? Consultant will decide. comes for check up. TASK take further hx. Chinese food. KUB and helical CT. (same Syd MARCH 2004) .sediment in urine.explain migraine. discuss further mx (same as Syd AUG 2004) 13.Common Cases. (better answer was “not sure as he has not passed the stone last 2 months”) Where do you refer? To surgeon. Explain the pt . Migraine from Murtagh 14. My answer: Good news.pain happens when stone moving. maybe pt goes home and wees thru mesh. had CT scan done excluded brain tu). elevate the bed 20degrees. Explained re:vessels closing and opening. Devitt. Pt’s Education 15. or lithotripsy. Ix asked for dipstick. and give smaller. 1st episode 2 months ago. TASK.
relaxation. She complains doesn’t have enough energy and can’t organize herself. husband supportive. She just gave birth to baby 6 weeks ago has another 10 years old child at home. Come back in few days if not better maybe start antidepressant RECALL 29th APRIL 2006 MELBOURNE 1. mood low.Which nerve? Axillary Which muscle for abduction? Deltoid Pt asked can I play? Yes but no dunking Examiner asked where you refer? Sport medicine Clinic What do you do for recurrent ? Bell rang.breast milk good for baby. Post Natal Depression The 28 years old woman came to your GP practice after delay 4 days from appointment.15./maybe hormone changes. discuss condition(same as Syd JULY 2004) Pt tired no time for herself. everything normal. try to find time for yourself. psychiatrist. (some candidates got 10kg weight loss). (I forgot risk assessment!) Dx explained Postnatal depression/we don’t know why it happens. suggested iron deficiency anemia).happens to 1/7 women after birth Come back with husband. No hallucinations. has another baby 30months. appetite. energy down. Apprehension test. see old friends. Iron Deficiency Anemia Woman 48 years old menopause came to your clinic to get result from her blood test (attached. Ask relevant history Explain the condition to the patient . Still referred her to PANDA Pt asked – should I breasfeed? Up to you . interest gone. Take relevant history Explain the condition to the patient Management 2. Young women gave birth to child 4 weeks ago. Recently unwell. but takes a lot of your energy so you’ll have to think and decide. 16. Pt does not want to see counselor. tired (can’t remember what else) You’re GP TASK talk to mother. dos not think baby has special power. Common . Examined the shoulder as from DVD . impingement test negative Asked for pin to check patch on the deltoid (examiner says normal) Questions from examiner. no hx of depression in past. sleep.
notify health department.Management 3. explaining condition to the patient. The CT brain result doesn’t suggest any tumor. 6. Take relevant history Management 4. MSU culture and microscopy. • What from the blood you want to look? (Examiner pointed the stones so I understand what he wants) Serum Calcium and Phosphate.O/E GA: looks ill. She had a history of migraine 2 months ago.Order the necessary investigation. Role player asked : • Why do you think I’ve got this condition? Because there’s possibility that you didn’t drink enough water. jittery and unwell. I explained to the patient about stone in his urine passage. abdominal X-ray. vomiting. Management Examiner in this station was very nice. Phosphate and Uric acid. Septicemia Father of 4 years old child came to your surgery because his child looks very ill. • What else? (Examiner stopped him and said okay you finished earlier you can wait outside. The doctor gave her Sertraline. prophylaxis for household contact. Examiner asked: • What else the investigation you need to order? CT KUB • What stones do you think it is? Calcium. I said to examiner I want to order for FBE. Explain the condition to the patient . The pain radiates to his right groin and testicle. U&E. She’s been on fluovoxetine for 3 years and then she came to ED. VS: BP 100/60 Temp : 40 degree RR: 98 Explain the condition to the patient Management You know the song guys. Management of migraine The woman 38 years old came to your surgery with severe headache and vomiting. fever and developed rash (as picture in AMCQ book page 118). Renal stone 28 years old came to your surgery after having severe abdominal pain 2 hours ago. Side effect of antidepressant Woman came to ED feels nausea. He had similar pain 2 months back. 5. Take relevant history (no more than 2 minutes) Explain the condition to the patient Management .
24 hour serum cortisol level. TFT. I gave him prednisolone and antibiotic. Two days ago he had accident because he didn’t see a truck coming from the side of the road.That real patient had visual lost on the lateral side. I said to the examiner that he has bitemporal hemianopsia probably due to compression of optic chiasm. Presented with hand (the picture attached: swelling with sign of dermatitis and infection between the fingers) Take relevant history Explain the condition to the patient Management From history the patient said it came suddenly. blood sugar. hay fever or asthma. • What else? I wasn’t sure about this station because examiner kept asking what else? Then the bell rang. visual field and funduscopy. Then report to your employer regarding his condition. He is a builder and recently he worked with cement. You as a GP can give her she said.I congratulated the patient and explained to the patient about enlargement of blood vessel on the scalp and tried drawing the picture as well. Bitemporal hemianopsia The man 48 years old came to your surgery. He complained of having visual disturbances. Contact dermatitis The 32 years old man came to tour surgery. he doesn’t have any allergy. cheese. Examine the patient eyes Order necessary investigation I checked for the visual acuity. I explained to him that he had an allergy probably due to cement complicated by bacteria. smoking. 7. Then I gave her an advice about lifestyle modification reduce wine. caffeine. lipid profile. 8. etc and paracetamol and antiemetic tablet. There’s possibility that they’ll move you to another department Role player asked: . as well as family history of those conditions. I talked about referring him to allergic clinic to have a test done and avoidance to the materials that you allergic to. Examiner asked: • What if she doesn’t get better? I’ll refer to neurologist and they might give her sumatriptan or ergotamine.…. CT brain. (Pituitary adenoma) Examiner asked: • What are the sign you looked on the patient? • What investigation you want to order? FBE. prolactin level.
No past history of STD. I reassured mother that’s nothing wrong with the baby and the breast milk. I said sorry to examiner then asked GA. The 18 years old student playing in basketball competition. Examiner asked: • What nerve could be injured? Axillary nerve. Go on examine the patient. If the condition doesn’t get better you can add corn flour to your milk or gaviscon. And role player asked are you sure that’s my baby’s okay? Bang! I realized I forgot to do PE. 9. Mother thinks there’s something wrong with her milk. but not sure.• How long you going to put me on antibiotic? I haven’t answered and bell rang…. The mother of 1 month old baby came to your surgery because the baby always vomits after feeding. He had shoulder dislocation on the right and nerve injury. I started examine the shoulder. the baby’s well so far. Then I said to the patient your baby’s normal. ENT. usually this condition will clear up by itself when solid is introduced abut 6 months old. 11.VS. He came to your surgery asking you when he can go back playing basketball again. He already had an operation fixing it up 6 months ago. The woman 26 years old came to your surgery complained of stopping her period after two courses of oral contraceptive pill. . 10. abdominal examination. So please check the books. heart and lung. Ask relevant history Ask examiner examination finding and order necessary investigation Explain to the patient From further history the woman stopped her period suddenly. Then explaining about GE reflux and drawing a picture. Take relevant history Ask examiner examination finding Management I took further history. The baby grows and develops well. doesn’t have tummy pain and vaginal discharge.. I’ll follow her up in 1 week. Gastrooesophageal reflux. All normal. Examine the patient Advise the patient about returning to the competition The examiner was really old and very nice. but if you have any concern come back to see me. Examine the shoulder and nerve injury. I examined for sensation on deltoid muscle and power (abduction) • What else? The bell rang… I was thinking about radial nerve as well.
The umbilical hernia. 41 weeks primigaravida came to ED. 15. You are HMO in Obstetric and Gynecology department. I said to the patient I’m waiting the result of the test I ran. If there’s abnormality I’ll refer you to specialist straight away. prolactin level.Hypertension. Check it again in the book. O/E cervix dilated 3 cm LOP (in the morning LOT. Then referring the patient to a surgeon and saying possibility of twisting if it’s not corrected and should be in two weeks time. means tranverse) and meconium stained. otherwise the baby is fine. She is in labour. If they come back normal we’ll wait for another 3 months if your period doesn’t come I’ll refer you to sp. LH. It could be due to stress or side effect of OCP. Now she came to you and her fundal height 30 cm Take history Ask examiner examination finding and order the necessary investigation (Examiner only will give you what you ask) Manage the patient 14. both testis are in the scrotum Ask few clarifying questions Manage the condition I explained and drew a picture as usual. Ask relevant history Ask examiner about examination finding Manage the patiet 13. Weight reduction Woman 43 years old BMI 33. it’ll reduce by itself when the child gets older but if it doesn’t when the child 5 years old. DM. swab. 12. . TFT. FBE. Huh? Okay. I asked examiner for Pregnancy test urine and blood.O/E : There’s umbilical hernia 1cm. need to have operation done and don’t put anything on it. She came to you for advice on weight reduction Advice the patient Answer patient questions regarding medication to lose her weight. FSH. You have to manage her by yourself. I wasn’t sure about this case. Primigaravida woman 28 years old came in for routine check up. ObsGyne registrar and consultatnt are not there. Examiner said good but they are not available. Umbilical And Groin Hernia A father of 4 months old baby came to you complaining of a lump in his right side of the abdomen as noticed by the father in the bath comes and go. Family history (-). Four weeks before you checked fundal height 26 cm.
Any side effects associated with OCP? 3. Read it in the Talley o’Connor. I had no idea at all.Young university female student wants to start taking OCP. Task: Pre pregnancy counselling Pt asked: .Should I keep taking Insulin? .Young mother comes to see you. Felt really bad.Any harmful effects on my daughter or her baby? Paediatrics: 4.16.A primi 38 wks had a convulsion while sitting in the waiting room with her mum to see you. He hasn’t been using ventolin in the past 2 years.How would DM affect my pregnancy? . 2006 O&G 1. Clinical Exam Melbourne Feb 11. Task: Manage this pt and answer the questions raised by her mum Her mum asked: . Spirometry 28 years old man with a history of asthma came to you. enquiring about circumcision. He has symptom free for 2 years.What type of OCP is suitable for me? . Task: Counselling Pt asked: . Do spirometry Explain to the patient the result compare to the expected value I gave up in the middle of this station so definitely I failed this station .How are you going to deal with my daughter? .Would I need a CS? Examiner asked: . a remote GP.25 yo female patient with more than ten years’ history of DM type 1. a GP.What are the effects on my baby? .What kinds of blood test are you going to order? 2. Task: OCP Counseling Pt asked: .What’s wrong with my daughter? .
and Mx Examiner asked: . Task: Management and counselling his father Examiner asked: .If allergic to penicillin which AB would you give? . She denies any abnormality. Patient asked: .No suicidal ideations .No insight Task: Focused hx and mx.Can my son go to camp with school? .What are the complications? 5.Very agitated and swears all the time .? (Septicaemic Meningitis) .1st episode acute Psychosis: nurse noticed wrist injury.Does my son need insulin for the rest of his life? . Father asked: .What’s your dx? Why? (Anorexia Nervosa) .What are the benefits of circumcision? .What do you think he has? . Task: Counseling.What is your provisional diagnosis.If it’s hard to establish iv access. lives with 3 friends Note: no more hx required .. His father wants to know more about it. a GP working at remote area.Patient wanted to go home to sleep .How about him overstaying with his mates on weekends? 6. what are you going to do? Psychiatry: 7. Task: Hx.What are the contra-indications? . Dx.What’s your management? .What’s the management to my son? .Patient has auditory hallucination .Can you give me something to get some sleep? Examiner asked: . are seeing a young boy who presented with fever and rash (Picture is presented).Young female comes to see you just because her parents asked her to do so.A 9 yo child is just diagnosed Diabetic type 1.You.Would you admit this patient? Why? 8.
A 67 yo lady wakes up in the morning with weak Rt arm and slurred speech that lasted for one hour (TIA case) Task: Examine the relevant system/s 11. Task: Counseling Patient asked: . no hx of dark urine. non alcoholic. abnormal of live function test. cardiac problems. feels tired. Task: Examine her CVS and report to the examiner your findings. she wants to travel oversees. Dx: Haemochromatosis Surgery 13.. nausea.Is there a way to cure or prevent these reactions? . Dx. Mx. and then gets better after taking Ventolin.What if he refuses to be admitted? . Task Ix.A 60 yo lady has been told by a previous GP that she had a murmur.An asthmatic patient was at a party last night and tried walnut butter for the first time. bradycardia.What will you give him? . referred by his GP to see you.Can I go camping? 12.What are the side effects of Haloperidol? Medicine 9. Dx: Aortic Stenosis 10.65 lady had pain for 3 hrs in the morning and bloody diarrhoea.50 yo male patient with a swelling in his scalp Task: examine.Would you admit him? .45 yo male patient. Hx of AF and appendicectomy . He gets swollen lips and difficulty breathing.What else should I not try? . Dx & advice on management.Am I going to get these reactions every time I have walnut butter? . Dx: Lipoma 14.
2/ A woman came to you because she had slurred speed and upper limb weakness 2 hours ago. e. DD Pneumothorax / pleurisy / PE / Pneumonia / MI 16.For how long should the patient use the sling? Melbourne 11/02/2006 Medicine 1.How can I have a shower? Examiner Asked: .What are you going to do for him? . DDx are a) Angina or MI → ECG. Task: Hx. she is normal. Now. Task: Management. heart block.How to do the sling? ./ Heart examination. The diagnosis is TIA and to differentiate with other causes. Patient asked: .A middle aged patient fell of his motor bike and fractured his clavicle. Your tasks are: • To do physical examination? • To discuss the DDx and tests that should be done to confirm the diagnosis with the examiner? You do the upper limb examination and talk to the patient for 1 second to prove she does not have any speaking problem.Can I ride my motor bike? . • To take the history? • To take the physical examination and order the tests to have DDx? The symptom is only the pain radiating to the left arm.Task Hx. The painful area is in the border between the left chest and abdomen. troponin enzyme. hypoglycaemia.g.An obese male presents to you with pain in the left lower chest. DD Mesenteric artery occlusion / ischaemic colitis 15. So.Can I drive my car then? . . The rest is normal. Your tasks are. 3/ A 35 yo man came to you because he has developed the chest pain that only radiated to his left arm and his neck. The physical sign has not been detected any abnormal sign.
Blood tests and others for preparing surgery.irregular →gut necrosis. 2. He does not drink. the information of nut allergy in the wallet or bracelet to let the ambulance officer knows his nut problem. Surgery 1/A woman comes to the hospital because of a serious abdominal pain. Mx: 1. Your tasks are: • To discuss with him about his problem. It will be confirmed by CTscan and barium enema without preparation. Your task are • To take the history? • To ask the physical examination and test results from the examiner? • DDx? This case is haemachromatosis→ because he also has a heart problem and serum iron increased?????. he developed throat irritation that was subsided after inhaling antihistamine (I cannot remember the name of medication). 5/ A man has migrated to a new area. and smoking.b) PE or pneumothorax→ chest X-ray and CT scan. 3. Your tasks are: • To take the history? • To ask the physical examination. the test results from the examiner? • Mx? The woman has 9/10 abdominal pain. Morphine. You also warn him about anaphylactic shock with serious symptoms and signs. The US show fatty liver. . Call surgeon to admit to theatre (critical error if you do not know). Her abdomen is totally distended and rigid. Q: Will I allergy with other food? A: It’s very good question but the specialist will discuss with you when you meet him. c) Herpes zoster 4/ A man comes to you since right after eating the nut. talk to him about epi-pen. fluid and other resuscitation. She only has taken the medication for her heart. CTscan is the best since it can prove PE or pneumothorax quickly and accurately. You must refer him to the immunologist. Her pulse is irregular. He comes to you with liver enlargement. Her faeces is brown colour. She did not take aspirin or NSAIDs or other medication that can cause gastric bleeding.I was not very good for this case. as well as another serious problem? • MX? This is a case of nut allergy.
Q: What else will you do? A: I will inform to the authorities and prescribe rifampicin to his relative. Your tasks to discuss with his father are: • What is the kind of DM in his son? • Mx • Complications? How to avoid? . you draw out his blood into the tube. 3/ Clavicular broken bone with X-ray film that is very clear cut. He has no neck stiffness. Removing it and studying under microscope will give an accurate answer. and IM antibiotic are the basic procedures in the country-side clinic. Q: What is the S/E of rifampicin? 2/ A new case with 2 examiners. you will call ambulance immediately. You must explain to the patient that the lump is not likely to be a cancer lesion because he has had for 2 years and you cannot find out any lymph nodes in his neck and head. Then.) Q: During waiting the ambulance. and rash that is illustrated in the picture.2/ A man has had a lump in his head for 2 years. During waiting for the ambulance. Your tasks are: • To explain to his father what has happened to him? • Mx? This is a case of septicaemia. cold temperature. Explain to his parent about the disease. if the boy’s vein collapses. what will you do? A: Fluid transfusion into the tibia. Refer to specialist. A boy who develops DM has been discharged. Your tasks are: • To do physical examination? • To give DDx? It is a case of lipoma. and then inject ceftriaxone 50mg/ kg (explain why you do not use penicillin because of the anaphylaxis in some people. Your tasks are: • To explain the problem? • To discuss the complication and Management? • To perform the sling? Paediatrics 1/ A 2 yo boy comes to you because of hypotension.
no problem occurs. Q: Can you choose the pills that are suitable for me? A: I cannot. Talk briefly about the complication. Candidate must say circumcision is not common procedure in Australia any more. hyper/hypoglycaemia. Your tasks are: • To take history? • Counselling? • To discuss what she wants to know? During the conversation. Do not scare when you see 2 examiners. she asks Q: Can I conceive? Yes Q: What should I do? A:I will refer you to DM clinic since you need a DM specialist. She has used insulin for a long time and her DM has been controlled very well.g. He can go out to camp.Patient education is a good source. she is normal. e. She has just married. a dietician as well as a physiotherapist to prepare you for your pregnancy? Q: What will happen to me during the pregnancy if DM is not controlled well? Q: What will happen to my baby if DM is not controlled well? 2/ A young woman comes to you because of contraceptive pill. Then. Do not forget to make sure she is not pregnant. Then you select the pill that is the most suitable for you. Your tasks are: • To discuss what she wants to know? • If she wants. . Discuss short and long acting insulin briefly and leave the answer for DM specialist since he will prescribe short or long acting insulin. 3/ A mother comes to you because she want her male baby will have circumcision? Candidate should ask what she knows about the circumcision? The mother will say she has heard from her friend. Obstetrics & Gynaecology 1/ The DM young woman comes to you because she wants to conceive. You must say his son’s life will be normal if the son follows the advice from the specialist. I will introduce the advantages and disadvantages of every kind of contraception pills. to play sport with his teachers’ notice. the dietician and physiotherapist (very important to keep BMI in the normal range). complication of the pill. it was easy to talk. you can outline other contraceptive methods? You must discuss about the S/E. Like this case.
delusion and illusion. Otherwise is normal. Physical examination is normal. not eye contact. Now she is conscious. So. She thinks her thighs are quite big. Your tasks are: • To take the history and to explain what happened to her mother? • To take some signs and symptoms from the examiner? • To manage the situation? The mother said her daughter had had antenatal care very carefully without any abnormality. epilepsy or hypoglycaemia (see that rule in the eclampsia topic from the royal women hospital website). Now. she tried to cover her body. he wants to go home and sleeps with sleeping medication. 3/ A 35th week pregnant woman got the convulsion in the outpatient clinic. Dx is anorexia nervosa and you must admit her immediately to hospital because of dehydration. She did not contract with epilepsy or hypoglycaemia. . 2/ A man who develops psychotic problems with hallucination. Psychiatry 1/ A teenager girl comes to you because of tiredness. He was admitted to hospital because of the laceration in his left wrist. esp. such as microgynon 20. Report to examiner about her behaviour during the conversation. Your tasks are • To take the history? • To report the psychiatric problems to the examiner? • To diagnose and manage the case? This is a case of anorexia nervosa in the young girl who eats 3 meals/day with only vegetable. Your tasks are • To Talk to the patient to find out the problems? • Mx and to discuss with the examiner about his condition? Introduction. e. • You persuade him hardly to stay in the hospital. then you should talk to the patient to satisfy 3 things: • You are here to help him.Q: Which kind of pills you will prescribe for me? A: I will prescribe the lowest dose of pill for you.g. You must know the rule in this case that is the pregnant woman must be treated as a case of eclampsia until you can prove other causes. Her BMI is 15 and the signs of dehydration. The examiner says every thing was not available yet. esp. • You do everything to calm him down. The important sign from the examiner is dehydration. blood pressure or proteinuria. She has had amenorrhoea.
The performer disagrees and always wants to go home with sleeping pills. A 9 yrs old boy is just diagnosed of type I DM. if the patient becomes violent. 1st pregnancy. 11-Feb 2006 Clinical Examination Melbourne Paediatrics 1. then you call CAT team to admit him involuntary to the hospital. You are a HMO in the hospital. what will you do? A: I will stay with him during waiting CAT team. If he becomes violent. I will run away because I must be safe first. Circumcision 2. Task: talk to the father and answer his concerns. 6 people (in Murtag)). Just husband had it done when he was a child. I will come back to inject haloperidol to him. no religious reason. He is still in the hospital. 38/40 pregnant woman comes to see you as a GP and asks about neonatal circumcision. So. what are you going to do? Answer: it is patient’s choice. When I have more people (Ideally. Q: During waiting for CAT team. talk to the examiner about his risk of suicide (he cut his wrist before he was admitted to the hospital). Q ‘s from the role player: What are the disadvantage and advantage of circumcision? What are the contraindications? When is the best time to have it done? Q’s from the examiner: If the patient insists on having it done for her child. Q: How to limit the S/E of haloperidol? A: I have to use the minimum dose. I’ll refer……. Task: Tell your patient about the medical opinion and answer her questions. .
the child was not interested in eating. Over the lase a few hours. BP 180/110. married. urine dipstick – protein +++. take the focus history and ask examiner the finding. what are you going to give her? Q’s from the mother: Can she have any fit again? Any dangers to the baby? Will she have high blood pressure after delivery? Are you going to the hospital with her? Eclampsia 2. manage the situation. A father brought his 2 yrs old child to see you. GP setting. 50 km away from city. I just want to know how long he needs insulin. lethargy and drowsy. how are you going to give fluid? – putting IV cannula. Task: manage the case. Task: talk to the mother. what will you do? The child is dehydrated. Can my child have normal life? Can he go for camping? How about playing sport in school? Diabetes Type I Juvenile – counselling 3. You were interviewing a mother of 38/40 pregnant lady who just had a fit in the waiting room.Have you heard about DM? – yes. Now she is not fitting. asked for different types of . but a bit drowsy. My uncle is a diabetic. rash (picture from AMC’s MCQ book page 118). GP setting. What else? –intraosseous infusion. No neck stiffness. No history taking and physical examination. Q’s from examiner: If you don’t have Mg SO4. A 24 yrs old lady. GP setting. Q’s from examiner: If the child is allergy to penicillin. History and examination findings: 1st episode of fit. I know what it is. Lethargic febrile 2 yr old O& G 1. Temp 40’c.
are you going to look after me? Q’s from the examiner: When are you going to refer her to endocrinologist. no CI of OCP. GP setting. He had problems with his previous employer. fine hair. Task: give her advice and answer her questions. dehydration. Now you are seeing the girl. a young man had a right wrist injury and lived with other young people. . postural BP drop. denied any suicidal ideation. (long stem). GP setting. In this case. lack of insight. poor sleep. If I become pregnant. You did a limited mental examination as following. Tell her 7 day’s rule. GP setting. Task: history taking.OCP. Anorexia nervosa 2. Q’s from the role player: I want to know how DM affects my pregnant and how pregnant affects my DM. She wanted to get pregnant. A mother of 16 yrs old girl concerned about her daughter’s weight. No Ix result. ask examiner the physical finding and give her advice. not protecting her from STD Contraception request 3. Task: Take a history and ask examiner the finding Tell examiner about your diagnoses and the management. before pregnant or after? What do you need to check before she becomes pregnant? Pre-pregnancy counselling – diabetic Psychiatry 1. She can have combined OCP. A 26 yrs old has 15 yrs history of well controlled IDDM. Task: manage the case. He was having hallucination and paranoid. Last week the weight was 45kg but now is 40 kg. No more history taking and examination. Finding —BMI 14.
what are you going to do? Under which law you can admit the patient? While you are waiting for ambulance. which medication are you going to give? – Haloperidol. What medication to revert it? What are you going to do if the CAT team comes late? Psychotic episode with violence – crisis management Medicine and Surgery 1. if you give haloperidol. Slightly increase in size and asymptomatic. Dysphasia & upper limb weakness 3. Task: take a focus history and do an examination. Which route? -im. which was told by her previous GP. Can it become cancer? What is the complication of the lump? – infection How do you remove it? Subcutaneous lump . A patient has a lump for several years. GP setting. Pansystolic murmur at the mitral valve area. One hour ago a 46 yrs old lady had a difficulty in speaking and weakness in right arm. A middle age lady wants to go for overseas and comes for check up.Q’s from the examiner: What do you think about the diagnosis? Patient refuses to go to hospital. For other symptoms. When she was in the waiting room the symptoms resolved. Task : do the physical examination and tell the examiner about you diagnosis. GP setting. Patient ‘s mother had a stroke. what medication are you going to give? – Diazepam. Task: examine the relevant systems. She was asymptomatic. This is a young man. She has heart murmur for several years. what do you expect? – Extrapyramidal side effect. Q’s from examiner: What else do you need to examine? – lymph nodes. Q’s from examiner: What is the cause of MR? Cardiac murmur 2.
. Your diagnosis was nut allergy. had no history of infectious liver disease. Pleuritic chest pain 7. Last night in the party after eating a walnut he started having wheezing. some bright red blood in the stool) Ask examiner the finding ( irregular pulses. ALT. A 35 yr old man complains of left chest pain. He was not an alcohol drinker. There was tenderness over the right clavicle. A young man had a history of eczema and asthma.4. Task: take a focus history. call an ambulance first or give Epipen first? Nut induced anaphylaxis 6. You did the examination. slight rebound. A letter from his previous GP said that his LFT’s was abnormal. occasional bowel sounds. He had permanent pacemaker insertion a few years ago for the bradycardia. Task: Explain to him about the diagnosis and how to prevent it happening again. A patient comes from other city. SOB and urticaria. Task: history taking and give your DDx. A 25 yr old man fell on outstretched hand. 9 and 17 years old. Task: ask the examiner about the Ix result and talk to the patient. HMO in ED.) Tell what you are going to do Acute abdomen 8. Q’s from the examiner: How often is the venesection done? What diet? How about the siblings and children of the patient? Abnormal liver function tests 5. what he can do next time. GP setting. Acute abdomen pain. (pt on Digoxin. What test do you confirm the diagnosis. Q’s from role player: If it happens again. He had peanut allergy at 7. You have ordered some tests.AST all increased. LFT’s was GGT . generalised tenderness of abdomen.
an important player in orchestra. ESR and RF and the results showed that she has early rheumatoid arthritis. All materials included a sling and the ones for figure 8. it varies individually. (Yes. sausage swelling and stiffness in both hands recently and was tested for ANA.( I failed this station. C/O pain. It should be OK. Today she comes to you (a GP) for the result and tell her your Mx. order your Inx and Mx On P/E. ‘Dr. . Patient was shocked and knows that it’s a very severe situation because her mother is 62 y/o and has RA for many years ( I explain ‘ early stage. My mom took it and I know there are a lot of SE. no steroids. but anyway I will refer you to the specialist. A 28 y/o male fell his Left wrist on the floor yesterday and still sore today.) 2. He came to ED and you’re a ED HMO. any other medication can relieve the pain quicker steroids-she’s shocked. modern medications and more therapy will keep the function well.) Give leaflet and suggested the Internet. A 40 years old lady. tenderness in the sniffbox-------I’ll do a X-way Examiner asked what’s your possible Dx? (scaphoid #) Here is the X-way ( it’s a scaphoid #). various ranges.Task: read X ray Tell what you are going to do and manage the condition with the materials provided. I really can’t take any rest. This is a picture from AMC which is too clear to be missed. I will refer you to the rheumatologist’ and totally forgot the magic words: early intervention and multidisciplinary team management. Questions: Can I continue my career (yes) What medications you would give me ( first Brofen and take rest) She said. This case looks easy but I was not sure the details of the Disease.modifying agents. but in short term. Task: focused P/E. Q ‘s from the role player: How long do I have it on? – 3 weeks Do I have a lump over the collar bone? Can I go to work? Fractured clavicle 12/11/2005 Melbourne AMC Clinical exam Recalled by Ling Medicine and Surgery 1.
Go ahead ( I started with− pain sensation check for stocking distribution which disappeared below the mid-tibia.) o ( he’s not happy) Why not? I am her husband. Examiner asked: what do you want to check first (peripheral vascular disease). A 60 y/o male. the blood circulation and then they may check in 2 weeks when the swelling fades away and sometimes the bone may die because of the poor blood circulation. was seen by you 3 days ago. Poorly-controlled DM for several years comes to you for check up. terrible . then vibration loss below knee and also proprioception loss on both big toe joints on a role player. who is your infrequent patient. First they may see you in the next 24 hours to check the plaster. But I can’t. But it must be assessed by the Aged Care Assessment team. a lot of trouble. Go ahead. His wife. (Oh. I think she needs to stay in hostel. The− surgeon will look after you and I think you will be fine. You took Hx and P/E her and found she was normal. But they will assess− you regularly. I can’t do the assessment. I should do something earlier to put her on the waiting list. Do relevant P/E on his lower limbs. I need your referral.) (Then I asked ‘Do you have any other concerns) No. You may be interrupted by the examiner because of time saving. Then examiner remaindered me to wash my hands. 3.Talk to the patient. your frequent patient. What do you find wrong with your wife?) o She ‘s terribly forgetful. (It depends. Doctor.( I understand. (I did inspection and palpation for pulses. That’s why I came to you. I am afraid she may make fire at home when she cooks.)− What’s other change? （peripheral neuropathy）. a 60 y/o lady. Task explore the husband regarding the marital issue Response to the husband’s concern From the beginning.) o I know. She didn’t tell me anything about it’ (I am sorry I can’t tell you any thing about your wife’s condition without her written permission. I hesitated and asked whether I need to do the power and tone. (I explained and refer him to the Orthopaedics surgeon) His Qus: What are they going to do for me? (They will put a plaster for you)− How long do I need to have it ( about 6-8 weeks. Do as you want. (So when I was doing the reflexes the bell rang). 4. It’s patient’s confidentiality. It’s me to look after her all the time? (I can understand. complaining that her husband found her more forgetful than before. he complained his wife and asked ‘what did you find wrong with my wife. came to you (GP) today wanted to enquiry about his wife because he found she is getting more forgetful recently.) You mean my hand will return to normal after 8 weeks.
ups and downs. no chest pain (?). Smoking by 20/day and alcohol by 4-5 glasses of wine since teenage. heart and lungs are all normal. But about this issue should ask your wife to make the decision. but I think every couple are the same. Task: focused Hx P/E from Examiner Mx Qu: What’s the reasons for my headache？（DDx）( Then talk to the . C/O terrible headache since yesterday and getting worse. (? ED or GP setting) Task: focused Hx P/E and Investigation from examiner Read an ECG at 7th minute This is a quite confusing case. I can’t remember the other details. Dr. not related to exertion.) 5. SOB. (I gave up the marital issue. A 51 y/o came to ED with severe right upper abdo pain. (Anyway. She has the right to make her own decision) (This time he didn’t come back straightaway.) o (I know. Palpitations sometime happen at night. (Do you have any children? How do they think about your wife?) o They agree with me. regularly. 7. we’ve been married for 30 years already. A 30 y/o male came to ED. Last time I force her to come. Hx. Can you come to see me next time with your wife together?) o I don’t think she would come. drinking a lot of caffeine. How is the ECG? (ECG was given. a typical acute cholecystitis case. no tinnitus and spinning feeling. P/E: Bp155/96. Examiner asked: What’s the likely cause (Tachycardia) Which one (maybe sinus tachycardia. I can’t give you any information about your wife. A 60 y/o male C/O episodes of palpitation and dizziness recently. like the early time?) o ( Laughing) No. not sure).) Which degree of the block(4 to 1). I think I asked too much Hx. Task: focused Hx . It’s an atrial flutter. p150.case. DDx Answer patient’s Qu Again. And I can ask Qu: How about your relation with your wife?) o Quite good. I have to repeat again and again. (Do you think it is as fresh as before.( bell rang)． 6. We’ve been married for 30 years. She is conscious now. His BP 155/96. No target organ damage symptoms (visual problem. Finally the bell rang. No medications. Sometimes. No Hx of heart attack or stroke or thyroid disease. pain in calf or body weakness).
− Any diseases: DM.examiner) P/E (T: 38. What tests are you going to do with the fluid (pressure. what− else? (lumber puncture). it can be wellcontrolled) Admit to hospital at this moment. How about the periods since then ( as normal as before. Task：talk to patient. which hospital (RWH)， any fever after that(no). the surgeon just said the changes exist in the whole large bow which suggests ulcerative colonitis without giving a report. Any anti-D after the procedure (not sure). But the distribution of the inflammation can tell the difference).5℃. No bleeding.− same partner (yes). skin changes and liver problems. A young male had bloody diarrhea for 6 months and had colonoscopy done today. O+G 9. A 28 years old lady come to you for advice of next pregnancy regarding that se had an abortion 2 years ago. culture and biochemistry). Blood culture)− What else? (CT head). no rashes) What are you going to do for the patient (consult my Reg or senior Dr. about 4 weeks a cycle). smoking. I hadn’t finished the whole Mx ( Notification). The patient brought the picture of his colon change to you (a GP). neck stiffness. Admit the patient. can be caused by infective inflammation. Why? (Rule out bleeding). Qu from role player: How about my diet ( low fibre diet)− Any operation now ( not this moment.)− What investigation( FBE. How is about my two kids (9 and 11 years olds) ( I will give all your− family members rifimpicin for prevention). alcohol drugs− Qu from role player: Will it affect my fertility?− .− Blood group (“O” negative). like germ infection or Crohn’s disease. Blood clotting problems. patient has a Qu. Unfortunately. such as eye problems. mouth ulcer.when get her first period after the procedure( a month)； any check up by any obstetrician (Yes). Other organs can be affected. bacteria staining. Explain ( lifetime situation. 8. HTN. What’s the complications (bleeding. Task: relevant Hx adverse effect to the next pregnancy and evaluation。 I asked and give possible effect on the future pregnancy:− how many weeks of pregnancy（14/52）. The bell rang. perforation and higher risk of− bowel Ca. sometimes may need surgeon)− Can it be other situations according to the picture? (the picture− suggests inflammation. multidisciplinary Mx. give AB. OK.
. P/E: Vital signs are normal. no pregnancy reaction symptoms. P/E and Inx from examiner. no fever. no PHx of PID or STD. At weekend her daughter stays with her exhusband but she refused to go there yesterday. no smoking or alcohol. The child is all normal with P/E and growing well. but you said you will check the book for her. Role player’ Qu: First she asked me to talk through the schedule of vaccines from 6 weeks to pre-school− Is there any reaction after the vaccines ? (Yes. so I fail this station easily and completely. Mx Hx: A dull pain at 5-6/10.They will remove the cyst now? (I don’t think so). All P/E are normal. Immunization advice for a mother with a 6 weeks old child (her first child). A 50 y/o lady C/O hot flush and irregular periods for 11 months. not ruptured. no discharge. Is− there any condition you should not give vaccine (Children with encephalopathy caused by pertusis must not be given any pertusis vaccine) Some parents suggested to use diluted protein (a natural way of− immunization). Then she told me she has no Qu for me. So that’s fine 13. Is it recommended?’ The examiner told me ‘No. Paediatrics 12. US: normal pregnant sac in uterus. No weight loss or discharge. A young mother bought her 4 years old daughter to your suburban clinic. (GP setting) A 25 y/o Ph D student was 8 weeks of pregnancy. Two children (20 and 22 y/o). What is the complication of Pertusis vaccine (encephalopathy). no burning− sensation or frequency passing urine. which is compatible with 8 weeks of gestation. Mx: I will refer you to the obstetrician. not torsion. C/O that her daughter has some rashes in her genital area in the last several weeks and it’s getting worse. Speculum P/E: Os is closed and PV P/E showed tenderness in the right adnex. planned. She complained right lower intermittent abdo pain for a week. A cyst of 5 cm was found in the right ovary. She suspected her daughter was sexually abused by her ex-husband. 11. She has a new boyfriend moved in 5 months ago. －How to prevent it? (Paracetomal). Task: focused Hx. I said that ‘I am not sure− about the diluted vaccine.10. Task: Mx (no further Hx and P/E) I was on the wrong track and gave her OCP.1st pregnancy. some children may− have mild fever or unwell). no diarrhea. Is that the same as the immunization schedule (I haven’t heard this before and not sure its effect but I will check this for you. Only superficial tenderness in the right− lower abdo. Pap smear is normal.− Patient asked:. She devoiced for a while and looking after her daughter.
I kept repeating that they will take Hx. which are normal. Not sure what else they want. do P/E and do Investigations.) 14. He found one lump in his right groin area. She went to see the doctor (P/E was normal) and was investigated. Poor sleep and always wakes up at 3 Am and can’t go back to sleep. A 60 y/o lady with right lower abdo pain for 6 weeks and lost 5 Kg in the last 6 weeks. 2006 4:43 pm Post subject: --------------------gorani Guest . worrying about his 5 months old son. Hx: The RL abdo pain for 18 months and getting worse in the last 6 weeks. (It looks easy. which comes out when he’s crying and goes back when he’s sleeping and another lump in his tummy button Talk to the father about the Mx (totally repeated case) Psychiatry 15. A father came to you. Appetite is Back to top gOOD sAMARITIAN Guest Posted: Thu Sep 28.Task: Give the mother your Mx plan. I need to call Gatehouse now. NO particular event 6 weeks ago. The question here is how to explain this 2-3 sentence in 8 minutes. Today she came for the results. including. blood tests and colonoscopy. ( GP setting) Task: Take HX for the psychiatry cause Give the patient your DDx Explain the nature of her condition and Mx.
2006 12:53 pm Post subject: -------------------------------------------------------------------------------all of the following are the signs of Ischaemia of the lower limb EXCEPT: A . I like it because I was seeking for this from long time. This was such a nice info you have shared with us.Posted: Fri Sep 29. Ulcer above medial malleolus *** e .Rest pain d. MY OPINIONS ARE STILL THE SAME AND EQUALLY VALID." 12-29-2009 12:07 PM jhon01 Banned Posts: 30 Joined: Jul 2010 Post: #2 RE: AMC QUESTION BANK CLINICALS/MCQS AMC part 2 QUESTIONS Hello.Indirect I "IT DOES NOT MATTER IF YOU THINK I’M CLEVER OR OTHERWISE.Hair loss on lower limb 2. Keep sharing………Thanks!! ___________ wholesale cosmetics 11-08-2010 07:30 PM Top of Form Enter Keyw ords Bottom of Form « Next Oldest | Next Newest » . Hope this will benefits all who land up here.Ulcer at Halluces B . Direct Inguinal hernia b . A painful lump in the groin of sudden onset in an otherwise healthy young man is MOST LIKELY to be? a.Intermittent claudication c .
.Med Gadget Blog.773 topics for the exam must read Last Post: jhon01 AMC PART 1 exam important questions 10-27-2010 02:31 PM avatar 1 4.net | Return to Top | Return to Content | Lite (Archive) Mode | RSS Syndication Powered By MyBB. Tema Yapımcısı: MyBB Here's a Live Doctor.044 Last Post: cube12ic (AMC) EXAM AMC step 1 MCQ Important questions 10-25-2010 08:46 PM examination centers in India AMC exam avatar 1 2. Thread: Author Replies: Views: Last Post Amc medical council AMC MCQ 1 exam 04-13-2011 11:16 PM avatar 7 4.564 Last Post: cube12ic 2010 • • • View a Printable Version Send this Thread to a Friend Subscribe to this thread Top of Form Forum Jump: Bottom of Form Contact Us | Medicaltalk.AMC part 2 study methods.738 2010 questions download Last Post: cbar1 experience in preparing for AMC exam 12-18-2010 10:31 PM avatar 2 3. .114 2010 updated Last Post: cube12ic Australia medical Job questions and 10-25-2010 08:47 PM opinions Australian Medical Council avatar 2 2. © 2002-2011 MyBB Group.619 1. tips Last Post: denimass 12-16-2010 05:10 AM AMC annotated MCQs (Book) Graduate 4 559 Last Post: mickelhussy AMC-part 1 there are several important 11-08-2010 06:38 PM avatar 1 2.Ask a Doctor online forum.Possibly Related Threads..
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