Melbourne 11th August 2007 AMC Clinical.

Discussion in 'AMC Clinical Exam' started by 123doc, Aug 15, 2007.

  1. 123doc

    123doc Guest

    1. a young girl with a couple of day s hx of pain in her back.
    take hx, examin, your diff diagnosis and what test to do.

    she has been having chills and fevers, feeling hot and cold. no abdo pain. no dysuria. points to her R flank(over R kidney) where the pain is localise. periods regular. Urin(from examiner):+nitrate.
    case of pyelonephritis.

    2.middle age salesman comes to you for result of his EST. recently admitted and investigated for cp. all ECG's, bloods, coronary enzymes and BP were normal. EST was poditive (test stopped due to ?cp or abnormal readings; can't remember).
    Bloods given (all normal except cholesterol 6mmol).

    tell and discuss the result of the test, answer his questions.

    pt asks if it's dangerous, if should stop his job or decrease his physical activity.

    3.GP setting. 60 year old woman comes to you with increasing L arm swelling. picture at the door.
    she has hx of breast cancer (T1N1M0), had mastectomy with axillary clearance 4 years ago, the XRT afterwards. tumour oestrogen positive. she was on tamoxifen for 4 years.

    talk, explain cause, management.

    pt anxious, asks if it's dangerous.
    case of lymphoedema.

    4. GP setting. 25 year old man with few weeks hx of hair loss. picture from anthalogy book at the door.

    talk, explain, further investigations, answer pt questions.

    pt asks about the cause, if his hair will grow back.
    case of Alopecia areata.

    5. middle age woman with few months hx of non healing R leg ulcer. Picture at the door.
    she is type2 DM on treatment.

    take hx, examination findings from examiner, explain.No treatment is required.

    pt tells that she broke her leg few years ago and it was complicated with DVT.
    case of venous insufficiency.

    6. GP setting. middle age man saw a TV program about harms of alcohol. comes to you for check up.

    take history, examination findings, order tests and further managment.

    pt tells he does not have any alcohol free nights.
    case of alcohol dependency.

    7. GP setting. 65 year old man sent to GP by wife due to his recent change of behaviour. PMHx is HTN, on treatment. few car accidents recently, fine from police, easily distracted, not looking properly after grandchildren.
    MMSE: 25/30.

    take hx, order another test for assessment of his cognition, further management.

    he has no past psychiatry illness. not depressive. not suicidal/homicidal. no hallucinations. beleives wife exaggurated the need of this visit.

    8. GP setting. 50 year old man with recurrent episode of L leg weakness and fall. no LOC. hx of DM, on hypoglycaemic.

    take hx, examinations findings from examiner, your diagnosis and orfer further tests/investigations.
    case of multiple TIAs.

    9.GP setting. middle age woman with recent episodes of abdominal bloating and discomfort. hx of cholexystectomy. Brought CT scan.

    take hx, interpret CT scan, tell pt and your next management.
    case of pseudocyst.

    10. GP setting. father brought 6 months old son with 12 hours diarrhea.

    take hx, examin, investigations and advice.

    child feverish TP 38.2. no vomiting. not dehydrated but a bit tired. immunisations up to date. no abdo apin. no blood in stools. ENT: nad. not sure about wet nappies ( wife changed them).
    case of viral gastroenteritis.

    11. GP setting. mother brought 3 year old daughter for results of investigations. hx of dysuria.

    take hx, tell mother about the diagnosis and your management.
    case of vulvovagilanlis.

    12. GP setting. 26 year old woman came for result of her pap smear. result: grade1 cell dyspalsia due to HPV.

    tell diagnosis, further management and answer pt's question.

    her previous pap smears normal. on ocp. new partner last 6 months. didn't use condom previously. asks if she can be pregnant, if it will affect the baby, if she should use condom.

    13. rural GP setting. 25 year old G2P1 now 24/40 moved from big city to your country town. wants to know when she should go back for her labour.

    take hx, advice pt.

    no past medical hx, no complications during last pregnancy or labour.

    14. GP setting. young girl with 12 months hx of amenorrhea.

    take hx, examin, further tests and your diagnosis.

    period irregular the year before. pap smear normal.
    case of prolactinaemia.

    15.GP setting. father came for result of blood results of 18 months old son. blood result ( iron defficience anaemia).

    take hx, examin, explain to father and advice.

    child drinks only cow milk since weaned from breast milk 8 moths ago, not keen of solids.
    case of cow milk iron def. anaemia.

    16. GP setting. young girl came for result of blood tests. hb:108, Hb electrophoresis A2 4.3%. iron studies normal.
    she is from Greek origin. is going to marry next 3 months. partner from Greek origin as well.

    tell pt about the diagnosis and advice, answer questions.
    case of Thalassemia minor. (recall Melbourne November 2006).


    Good luck
  2. Guest

    Guest Guest

    [9.GP setting. middle age woman with recent episodes of abdominal bloating and discomfort. hx of cholexystectomy. Brought CT scan.
    take hx, interpret CT scan, tell pt and your next management.
    case of pseudocyst. ]

    First, thank you 123doc for your help.

    Second, could you please give brief description about the CT you saw, its location, size, shape, consistency, etc?

    Thanks again
  3. gest1234

    gest1234 Guest

    CT abdo

    dear i was struggeling interpreting the CT scan. it was massive, around the level of lever but in R hand side, not solid, not blood looking(was dark), supressed the milt and pancrease. I said pseudocyst & it was obviously right.
  4. Guest

    Guest Guest

  5. Guest

    Guest Guest

    The patient must have a history of pancreatitis.
    My questions are:
    when did she have cholecystectomy?
    Whether she drinks a lot of alcohol, which is another important factor for pancreatitis.
    The task is clear (as in the recall): take a history and interpret the CT.
    If the history shows that she had cholecystectomy long time ago, 10 yrs for example, and she had on and off epigastric pain in the past few months, then the chance of chronic (alcoholic) pancreatitis is highly likely, So the management is stop drinking alcohol.

    Just my thought for discussion
  6. Guest

    Guest Guest

    I am in a great need for a help

    qualified in Austria and want to migrate to Australia to live and practise medicine. I have tried to get some information in the embassy of Australia in Vienna without any benefit and also tried to know how the necessary steps are in the internet but there are a lot of sites and information that made me confused.
    please can anybody, who has been qualified in his homecountry and could succeed to get a visa to Australia, tell me in concise what I have to do.
    like for examble concerning the IELTS test , do I have to pass the test in ther british council in Vienna before applying for a visa or can I make it in Australia.

    Do I have to attain registration in the AMC before applying for a visa.
    thank you in advance.
  7. Guest

    Guest Guest

    and surgical referral for drainage to stamach or duodenum by open surgery or endoscopic methods 8) :lol: :roll:
  8. omerfadl

    omerfadl Guest

    hi everyone

    If any one in Brisbane interested or already engaged in agroup (clinical),please e-mail me on: omerfadle@yahoo.co.uk

    thanks,

    Omar
    Brisbane
  9. cookie

    cookie Guest

    place in melbourne

    Hi everybody!

    I'm due to sit for a Melbourne retest this sept 8. AmC hasn't told us where it'll be. Does anyone know where the test center is? I'll be flying from sydney and I'm tryingto work out where to stay.

    Thanks!!
  10. Guest

    Guest Guest

    you can ring them(AMC-office) and collect your exam. centre.
  11. samora4

    samora4 Guest

    thank you

    thank you very much

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