melbourne retest exam - september 07

Discussion in 'AMC Clinical Exam' started by dr_t_s, Sep 8, 2007.

  1. dr_t_s

    dr_t_s Guest

    dear colleagues,
    i have been using the recalls from this website for preparation for my exam. it wouldn't have been fair if i hadn't put my own recalls here. i just came out of the exam and recalled the questions, almost all of them were repeated ones.

    Melbourne 8th of September 07 (retest)

    Case 1:
    A young student with bad marks recently, whenever thinks about the word “KING†gets worried and needs to walk around the room three times in order to be able to resume his jobs.
    Childhood/educational /sexual/social/medical history is all given in stem. Nothing significant.
    Task:
    Take further history,
    Give differential diagnosis

    (no suicidal ideation/no hallucinations/no delusions/ mood not depressed/ unwanted obsessions + unwanted compulsion of walking around the room whenever he thinks about the word “KINGâ€)

    Case 2:
    A young male student, seeing you because of insurance purposes, has a history of mild asthma. Well controlled. History and physical examination was done. Nil significant.
    Task :
    Do spirometry
    Calculate figures
    Inform patient about results.

    (results are normal, Pt asks if he has asthma)

    Case 3:
    45 year old female, had cholecystectomy 6 months ago. Now is in your GP practice with jaundice/fever and RUQ pain.
    Task:
    Take further history (no more than 2-3 minutes)
    Ask examiner about Ph/Ex findings
    Inform patient about Dx/DDx and Mx

    (been unwell for 2 weeks/got worse during the past 2-3 days/ fever 39.2 + chills/jaundiced/RUQ pain radiating to tip of right shoulder/ pale stool/dark urine/ no other significant findings in history/ no history of overseas travel
    t=39/vitals stable/chest Nl/ abdomen àRUQ tenderness, palpable tender liver 2-3 cm below costal margin/ no mass/ GA à looks ill)

    Case 4:
    Young lady bringing her child to your GP practice because of trauma to her arm. In examination she also had a bruise on her cheek. Baby was born 28 weeks and her mum works fulltime, her boyfriend looks after the child when mum’s away. You have ordered an X-ray and results show an spiral fracture of humerus. Mum’s back to get the results.
    Task:
    Inform her about the results
    Speak to her about the Mx
    (no more history to be taken)

    (role player insists that injuries are due to her baby’s fall from the changing table the other day/ not happy about informing child protection services/ asking what do you want to do with the broken arm)

    Case 5:
    45 year old female with dysmenorrhoea for 12 months now. Pt has 3 teenage children. Been anaemic recent HB 70. Last week had a diagnostic D&C done; pathology results are back showing no atypical cells. Examination under anaesthesia was normal.
    Task:
    Inform patient about results.
    Take further Hx
    Talk about management


    (bleeding 8 days each period/regular ?/heavy all days/changes 9 pads per day/ +clots/ sexually active/ using condom for contraception/ not symptomatic with the anaemia/ just feels tired /I forgot to ask about chest pain but didn’t have any dizziness - palpitation - … / last pap smear test ws 12 months ago.
    Was not happy about surgical options (hysterectomy)/ keen about HRT/ no history of migraine/ breast cancer/ ovarian cancer/ no family history - again I forgot to ask about DVT)

    Case 6:
    A young male patient with Hx of upper abdominal pain and indigestion . You referred him to gastroenterologist and had an upper endoscopy done yesterday, showing an active ulcer (picture is provided). Specialist was called after the procedure and was not able to explain the results to the patient . He contacted you to see the patient and commence therapy.
    Lots of history was given on the stem; including some important stuff: positive history of smoking, alcohol (2 glasses of wine everyday, taking Naprosyn (I’m not sure if it’s the brand name for naproxen) for back pain, having a stressful job.
    Task:
    Explain results to the Pt
    Tell patient about complications
    Discuss Mx
    Address his concerns

    (pt asks if it’s cancer or not)


    Case 7:
    A 47 year old male, businessman with 6 month history of diarrhoea, in gastroenterology outpatient clinic. You are an intern (or RMO). Has seen you before and was advised to come back if diarrhoea persists.

    Task:
    Take history
    Ask about examination findings from examiner
    Discuss investigations with Pt

    (6 month history of persistent diarrhoea/ no mucus or blood/ vague abdominal pain, relieving with bowel motions/ bloating/ increased wind breaking/ stool is hard to flush/ no melena/ no nausea / no vomiting/ no history of recent overseas travel/ no past medical history/ no meds/ no FHx of bowel cancer/ no smoking/ occasional alcohol/ has lost weight significantly
    Physical examination is normal)


    Case 8:
    You are working in ICU. You have admitted a patient with PE the other day, he’s on oxygen and heparin infusion at the moment. Patient is stable now.
    He had a cholecysyectomy done a week ago and has been in bed ever since.
    His wife wants to see you and get some information.

    Task:
    Explain the condition to patient’s wife
    Answer her questions
    (I forgot to address the confidentiality issue, hope it’s not critical error
    Role player asks if her husband has had a heart attack/ if he’s going to stay in hospital for long/ what are the side effects of his treatment/ why did he develop a PE/ …
    If you specifically ask, he is a business manager and travels a lot by air)
  2. Guest

    Guest Guest

    Thanks dr_t_s, I will do the same after my clinical examination.
    I hope everyone using this website can post their recall qestions here,
    so we will not have any difficulty to pass the clinical examination.
    Good luck for everyone. and study hard!
  3. aaljobair

    aaljobair Guest

    thankx

    Thanx for ur time for writing up all recalls quickly . Hope you should get the target nicely .
    Would you mind , can you put your Dx in a short .


    ALjobair
  4. samora

    samora Guest

    thanks alot

    we all do thank every one who spend any minute to remember these recalls and help other doctors. thank you very much
  5. dr_t_s

    dr_t_s Guest

    i passed teh exam!
  6. samora

    samora Guest

    congratulation

    congratulation and wish you the best of luck in your future steps.
    wish us the same, please!!

Share This Page