PAST AMC CLINICAL QUESTIONS

Discussion in 'AMC Clinical Exam' started by Guest, Nov 27, 2005.

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    THERE MIGHT BE SOME TYPING ERRORS SO BEAR WITH THE TYPIST (GOOD SAMARITAN FROM MELBOURNE )

    (Perth Oct 2005)...
    1) 60 y/o man comes to you with severe chest discomfort, take history..and present to examiner..tell examiner what investigations...u would do...Examiner then gave me a ECG to read..the patient also said that he was recently injected with some steroids for joint pain..i.e pain could be ulcer related..as a differential ( i think...there was ST elevation in leads I II and AVF ...he wanted to know what type of infarct..i wasnt sure..inferior infarct)


    2) Mother comes to you to see about her 5 yr old son who is fine but with blood test showing glucose at 21 and some ketones in urine...discuss short term management(need to be admitted to hospital ..) and long term management ( explain about diabetes and care needed with it..) with mother..

    3) 50 y/o man comes to you complaining of on going hoarseness for the last 3 weeks..take appropriate history and discuss investigation and management with examiner

    4)a man comes to you (emergency department doctor) saying that his wife who recently gave birth has started to act strange..accuses baby of being evil (child of satan)..wants your help..

    5) a married woman mid 20's comes to you (GP) with 8 weeks of amenorrhoea and suddden onset of period..take history and discuss with patient..(allowed to ask examiner for investigations) diagnosis andmanagement

    6) 60 yr old woman comes to you (GP) with feeling unwell, dull pain in left lumbar region...take history and ask examiner for findings..discuss management and diagnosis with examiner

    7) a father comes to see you (GP) about his child (i think 5 yr old child) who has a known murmur and is well, was advised by previous GP that the murmur is benign and to have annual check up...the father is to take the son to the dentist next week.(murmur is 4/6, parasternal heave,)..child is well with no complaints. Discuss diagnosis and management with patient.

    8) a man in his 20's comes to see you (GP) about a tense scrotal swelling in his left testis. it is transilluminable and you cant feel the testis separately.Discuss investigations and diagnosis and management

    9)a lady comes to see you (GP) mid 20's, she suffers from epilepsy and is on phenytoin..has been seizure free for the last 2 years .She is keen to get pregnant and would like to discuss this with you.you need to give her pre-pregnancy counselling

    10) a university student comes to see you(GP) ..finding it difficult to concentrate on studying always checking her work..and submitting papers late...Please take history and discuss differential diagnosis and manageemnt with examiner

    11) A man comes to you (GP) with a flu like illness and a rash on his chest..he also has palpable lymphadenopathy and hepato-splenomegaly..take history and disccuss potential diagnosis and management of this patient(going in i thought this might be epstein barr, the catch here is that this man is gay, and that this could potentially be HIV)

    12) a woman comes to you (GP) with a complaint that her baby keeps banging her head in the cot when she sleeps at night.ask examiner for investigations (all normal)...
    (this one was tricky..i had no idea why this was happening from the history , her partner left her and she has no financial support..so i thought a cry for help.. maybe...once i finished exam and checked up there is a thing called benign rolandic epilepsy that happens only when babies sleep..so i feel i failed this station)

    13) a woman comes to yo(GP) u after you referred her to gynaecologist for menorrhagia (hysteroscopy, pap smear..normal)..now suffering from menorrhagia again ,Hb 70 ..discuss management with patient

    14) a man comes to you (GP) with lower left quadrant pain..feeling unwell please perform abdominal examination...and discuss management with examiner
    (so ur standard abdominal examination...hands,face,abdomen..the actor was tensing up his abdomen ..so when i started his deep palpation i couldnt get him to relax i stopped and told examiner this man has a rigid abdomen i explained what i would do in terms of completing my examination but there was no point as u cant palpate anything with a rigid abdomen...and he needs hospital admission with surgical evaluation..disccussed this with the examiner)

    15) a woman postmenopausal comes to you (GP) after having lumbar xrays( vertebrae fracture) and dexa scan showing -3.0..i.e osteoporosis..take appropriate history and discuss diagnosis / differential and management with patient

    16) a woman comes to you with a complaint of nervousness ..take history and ask examiner for examination and explain to patient diagnosis and management.

    1) myocardial infarct
    2) diabetes
    3) lung cancer..hoarseness of throat the cancer has invaded recurrent laryngeal nerve..poor prognosis
    4) peuperal psychosis
    5) spontaneous abortion
    6) UTI/pyelonephritits/cholecystitis
    7) this murmur..could be VSD..realy not sure recomended peadiatrician to see since patient recently moved here (for specialist assesment..made a mention about prophylaxis for endocarditis)
    8) orchitis ? cancer...
    9)Would need to stop phenytoin / change but advised discussing with neurologist and getting his opinion ..and all the other prepreganancy stuff..immunisations/alcohol/smoking /etc
    10) OCD
    11)HIV
    12) ? rolandic epilepsy / social worker needed
    13)OCP pill for temporary management , will probably need transfusion since she was symptomatic, refer back to gynae
    14)acute abdomen..diverticulitis.IV antibiotics vs Surgery
    15)HRT,calcium,vit d..suppose potential differential would be mets to bone / multiple myeloma but she had no hx of cancer
    16) hyperthyroidism..goitre



    Clinical exam April 04 Perth

    1 a mother comes to you regarding her 8 yr son’s deteriorating school
    performance of last 6 month; take the history and dd, diagnosis, child hood depression, phobia

    2 21 year uni student deteriorating performance at class the to delayed
    submission of assignment for last 3 month OCD

    3 48 year old man old CIA/FBI following him co dizziness after taking
    riseperidon 2 days ago, take focused history, management, side effects, anti depressant

    4 48 year old female BMI 27, smoker, came for endoscope report, shows reflux oesohpagitis, examine, management

    5 55 female had difficulty swallowing was treated with omeprazole, felt
    better with it, now it does not help; now difficulty with solid, swallowing
    last week, take the history, investigation, management, ca esophagus

    6 45 male his brother had bypass surgery came, for check up, assess the risk factor BMI 28, smoker, office job and council the patient, man died of heart attack at 55 years

    7. 65 of female post op day 5 L THR c/o chest pain SOB on heparin 500 u bd, post op task, take the history, dd, investigation,

    8 28 year female with a history of 3 year, amenorrhea, patient asked will I be pregnant, take the history, ask examiner test result, management agree


    9 37 female primigravida 8/52 amenorrhea 2 wks history of vomiting take the history investigation, management, count the patient don’t forget about Downs syndrome

    10 26 female 10 days post parturition of 2nd normal delivery time and with sudden onset of vaginal bleeding 1 day history. Take history, management, patient wanted to know do I need blood transfusion

    11 40 year female, found a murmur 2 yrs ago during a routine check up,
    patient asymptomatic, since she was diagnose with murmur, comes to you, examine the CVS and tell the findings, give running commentary- MR

    12 23 yr female with history of dry cough not relieved, take the history,
    examine, giving running commentary, examiner asked what investigation, you will do and the management

    13 42 year female with history of leg pain when she walks 100 meter relieved by rest, examine the leg, give running commentary, examiner asked what test you will do

    14 19 female, single mum with her 6 month old baby, has fever, vomiting,
    irritability baby was seen by colleague 2 hrs ago found swelling R humerus, and bruise on cheek requested x-ray, showed spiral fracture R humerus, mother came to you to know about x-ray, task explain x-ray finding, management

    15 mum came to you with her 18 year old girl who has T 38, urine shows
    numerous leucocytes, child is otherwise ok, take history management mum wanted to know whether I am going to give antibiotics


    1 primary postpartum hemorrhage
    2 pre pregnancy advice for a lady who had DVT and PE postpartum 2 yrs ago
    3 missed abortion diagnosis management ant treatment
    4 croup diagnosis management
    5 functional constipation in a 6 year old boy diagnosis and management and
    history
    6 behavioral disorder ADHD
    7 mumps orchitis diagnosis management
    8 Bells palsy management
    9 hepatitis c management
    10 herpes zoster diagnosis and management
    11 dizziness in schizophrenic on risperidone management
    12 PVD examination and diagnosis
    13 loss of voice in a 17 year old history
    14 acute abdomen exam and diagnosis
    15 distal humerus fracture in a 11 year old diagnosis management
    16 Tiredness and weight loss in a 60 year old

    Clinical exam in Sydney stage 2 may 2002

    1 F /30s acute appendicitis diagnosed by an intern occupation lawyer very
    busy management: d/d what if dx is incorrect, types of appendicitis,
    possible findings of chest x-ray in appendicitis.

    2 M/50s post op anuria possible causes, p/examination, review U/S, fluid
    chart, then management, write down your prescription

    3 F/20s mother died of heart attack since then she has developed chest pain
    palpitation circumoral tingling sense, spasms of hands, clinical management,
    hypocalcaemia clinical management.

    4. M/20s injury to left knee relevant history p/ exam, then I was asked what
    structures are damaged.

    5 F/20s family history of breast ca the patent has cyclical mastalgia,
    reassure, primrose oil, management, included interpretation of u/s FNA as
    well as explanation to patient, is this condition related to Br ca (danazol
    bromocriptin tomoxifen, t4, FNAB c5 ca c4 suspicion/ probable ca c3
    suspicion/ probably benign c2 benign c1 inadequate sample

    6 F/20s regarding alcohol drinking e peer performance in the work place,
    history, management, short term and long term problems, safe level of
    alcohol drinking for women

    7 M/50s black colored patient with a long history of alcohol drinking p/
    exam this is a real patient, elicit & demonstrate relevant physical finding
    alcoholic cirrhosis on eye exam nystagmus on lateral gaze was revealed

    8 M/20s with occipital injury do cranial nerve test

    9 M/30s with pain on the soles of both feet
    History, pt management, x-ray, plantar fascitis

    10 M/20s DVT developed following a long hauled flight, explanation,
    management, risk factors, prevention, treatment, then write down your
    investigations prescription on day 1 in hospital heparin 15000 unit /12 hrs
    via pump compression, uss

    11 M/20s presents with pain around the wrist management, history and
    pat/examination revealed that the patient has De Quervain tenosynovitis
    physical signs the tendon involved



    12 M/40s with IDDM narrowly escaped a car crash this morning he as and
    insulin injection this morning as usual without taking meals because of
    running out of time management

    -------------------------------------------------------------------------------------
    AMC clinical Melbourne may 2005

    1 History of 3 year old boy of viral infection 2 weeks ago blood result
    pancytopaenea.Management, talk to father

    2 Henoch scholien purpura, 5 year old boy, photo shown, urine protein ++,
    rbc++,
    Management.

    3 SIDS, baby 3 month old died, history of viral upper respiratory infection
    2 days ago, talk to the sister of baby’s father.

    4 24 weeks ADG, 20 years old, lives 80 kms from the city very much worried because her first pregnancy was OP position with prolonged labor, delivered by forceps, now she is very worried, history and management

    5 20 year old lady, 20 weeks pregnancy, had previous history of herpes
    simplex, now she has developed ulcer on labia, not much painful, history
    management of recurrent herpes simplex

    6 a lady delivered a baby 4 days ago, now developed fever, mastitis, history management investigations.

    7 20 year old man, wanted to lift a very heavy object, to sever pain in his
    shoulder task examine R shoulder, history for diagnosis of rotator cuff tear or shoulder dislocation

    8 40 year old male going to overseas, gp found a heart murmur, examine the CVS of patient and comment to examiner

    9 a lady 60 year old, had bowel operation 6 weeks ago, now suddenly she has developed R sided pluritic chest pain, tasks describe cxr and management pleural effusion

    10 40 year old has action tremors for last 20 years, father had Parkinson
    disease, task history, management, investigation, diagnosis, benign
    essential tremor

    11 25 year old had mump 2 weeks ago, now he develop orchitis, his sons also had mumps, he is very worried about orchitis, future fertility, sexual life,task, management worried about 3 years old son because he might get mumps

    12 a unistudent checking his study all the time, cannot study, failed in the
    examination d/d OCD, delusional disorder history d/d talk to examiner

    13 a 20 year old lady came back from overseas long hall flight develops pain in R leg, uss, DVT task, history, management

    14 49 year old male complains of pain in R upper abdomen with rigors and fever, and mild jaundice, tasks, history, management, investigations,
    diagnosis, ascending cholangits

    15 a 50 year old lady had colonoscopy, showed colonic polyps, with mid
    dysplasia, which were removed, task follow up, talk to patient

    16 daughter of a 65 year old mane with Alzheimer’s disease comes to see you, she is very much concerned about his father, he lives alone, impairment of cognition, is wandering around houses, council daughter about the management of her father

    -----------------------------------------------------------------------------------------------------


    Sydney may 2003

    Station 1 h/o DVT management write prescription down
    Station 2 low back pain examine lower back
    Station 3 young female on ocp, bp, 160 /105 management
    Station 4 fibula fracture management
    Station 5 rest
    Station 6 renal colic management
    Station 7 Woman young excessive alcohol for last 6 month dd post traumatic stress disorder, depression, alcoholism
    Station 8 examination hand H/o arthritis
    Station 10 young female patient comes to you in tell her about the report
    FNAC shows papillary carcinoma of thyroid
    Station 11 young male patient with history of asthma comes to you because he bad allergic reaction atopic dermatitis management
    Station 12 55 yr old male patient comes with long standing COPD council him about management, also instruct how to use of bronchodilator inhaler



    OSCE’s

    1.8 yrs old john come to see you and his mother for last few days is
    complaining of bad pain all exam
    Urine NAD
    Task relevant history
    Discuss with mother about diagnosis and management

    2.65 female come to your practice for her x-ray report. x-ray shows
    compressed fracture T11 no neurological deficit x-ray provide
    Task: take relevant history
    Discuss with patient about x-ray finding
    Discuss the management with the patient

    3.You are working in emergency department in a tertiary hospital a 32 week primi-gravida presents to you after a MUA no injury found
    Task: take relevant history
    Ask examiner about exam investigation he will only tell you if you ask.
    Discuss your management with the patient

    4. You are about to see a patient in ED brought by friend from hostel who
    has found him unconscious. He has just come to the hostel. The person who brought him does not know him at all
    Examination time 4 min rest 4 min for d/d and inv
    Do appropriate e exam narrate it to examiner or tell him at the end of exam
    Tell the examiner d/d
    Tell the examiner appropriate investigation and why you’re doing it.

    5. GP 23 year old accountant comes to you has found elixir of life wanting
    to tell it everybody cam to you so that you can help him to distribute his
    elixir of life
    Task: take relevant psych history
    Tell 4 dd’s to examiner
    Management to plan

    6.4 yr old boy brought in by anxious father the boy the father both had
    lower resp tract infection 10 days ago now father is ok but the boy is
    coughing for last 10 days. He has a 2 yr old son also. x-ray, spirometery
    and chest x-ray and sputum Normal
    Tasks take relevant history
    Discuss management with father.

    7. 32 years old women comes to you of SOB and palpitations for last few
    weeks she has been involved in MVA few months ago General examination
    Take relevant history as k the examiner examination finding discuss the
    diagnosis and management with patient
    8. 28 year old primi-gravida 12 weeks pregnant work as prostitute came to visit you seen by your colleagues 1 week back and done some inv she wants to know the result
    Take relevant history ask the examiner about exam he will only answer if
    asked. Discuss management with patient.

    9. ED 20 year old man come to see you with rash snap shot supplied he was seen by a gp 1/52 back of sore throat
    Take relevant history 4 min
    Ask examiner about inv and exam he will only answer if you ask
    Discuss your management with patient

    10. 36 years old lady long standing mild hypertension and type 2 DM comes to you for visual loss temporary on rte y. she is on perindopril 2 mg glicalzide
    Task: take relevant history 23 min as the examiner about the examination finding 2 mins
    Ask the examiner about examination if discuss tithe patient about what
    investigation you are going to do and management plan

    11 4 years old lady come to you found to have fist blood sugar 15 bp 150/96 mild obese
    Take relevant history 4 months
    Ask the examiner about exam finding
    Discuss with patient inv and management

    12 40 year old man comes to you with cp which wakes him up at 2 am
    Relevant history ask the examiner about examination
    Discuss with patient about inv

    13 40 year old lady comes to you with PR bleeding exam 2 hemorrhoids
    Relevant history
    Discuss with patient about her further management

    14 anxious mother came to you because her 4 years old son in bed wetting
    general exam
    Urine nad
    Relevant history
    Discuss management plan with mother

    15. a young lady come to see you she is going to Europe for a month long holiday on her way she will stop over in Thailand for 2 /5 days
    Task discuss immunization answer her questions

    16. Anxious mother came to you with her 12 years old daughter she has
    started her periods which is to going to last 10 days
    Tasks relevant history
    Ask examiner about exam and invest finding
    Discuss with mother about management


    Adelaide 2001

    Management DVT and anti coagulants knee examination of a rugby player
    injured
    Management of urinary tract infection and write a prescription
    Appendicitis operation advice
    Carpal tunnel patient examination and causes of thenar muscle atrophy
    Examine abdomen liver cirrhosis
    Pain right upper quadrant Examine abdomen us supplied diagnosis gall bladder
    stone cholelcytitis
    CVS examination and pansystolic mummer
    Or tem r
    Advice HRT effect on br cancer
    Int claudication examiner and manage


    Sydney 2001

    1.Examine CVS VSD v wave r and PS heave pansystolic murmur tapping apex ,diagnosis mitral regurge dd MR

    2.Examine GIT nad history varices hepatospleenomegaly had chr Liver disease

    3.Young girl high blood pressure history investigation and management OC pill and smoking most for cv risk, stop ocp advice stop smoking

    4.Renal colic diagnosis explain investigation management ivp given and stag horn stone

    5.video tape 3 min watch patient and mental exam
    dd anorexia bulimia nervosa

    6.Examine comatosed patient

    7.History and management rectal bleeding patient 23 history father died of bowel cancer 57

    8.Picture of left supra clavicular node exam and investigate report given FNAB squamous cell ca dd skin GIT malignancy lung ca

    9.Wrist injury with tile cutter examine hand diagnosis ulnar nerve injury ,
    tendon - branch flexor carpi ulnaris injury

    11.Examine breast lump formal breast examination in a normal acting patient dd fibroeadenma now cyst cancer history breast cancer family ovarian cancer

    12.Examine diabetic patient for review 6 months and mention any bruit neck chest heart kidney abdomen of AAA then I did p vascular examination Left limb then I did neurological examination on Left limb

    13.Exam abdomen and history for right hypochondrial pain acute cholecytitis


    Melb 2002

    1 55 65 year old male drinking alcohol in past examine him examination
    revealed a large distended abdomen bulging in the R side with old scar. What is the diagnosis?

    2 32 year female picked or pulled up heavy things1/52 ago now she has got shoulder pain examine and diagnose

    3 32 y female past history of knee trauma medial side with tenderness
    examine diagnosis and management

    4 33 year old female police officer refer to you for diagnosis what is wrong with her She is not good in her job always drinking drowsy not doing her job well drinking 8-9 glass wine every day management otherwise losing her job do u get withdrawal if u don’t drink

    5 45 y old IDDM 3d episode of hemiplegia and slurred speech
    history, management TIA

    6 32 year old female has checked BP 150/110 she is on the pills management (pill e BP)

    7 lump in the back of her hand diagnosis and management gangelion breast

    8 45 y of female had leukemia 1 year ago had chemotherapy now `10% wbc.She is crying refusing chemotherapy management

    9 cxr diagnosis pneumothorax history 3 yrs ago which had was running p/w SOB

    10 28 year old male after death of father not sleeping diagnosis


    Management

    1. 65 years old male with back pain x-ray shows t12 density decreased BPH 32 year ago operated smoking

    2. 35 year old male testicular swelling 2 weeks ago

    3. Young man severe asthma attack

    4. Migraine

    5. Difficulty of urination

    6. 50yral old male good health father died of heard attack worried take
    sleeping pills before to see you BP 150/89


    7 60 year old male with heart failure and AF on warfarin for 3 months has
    had cholesterol 6.5 and on lipid lowering tablets he was also on digoxin
    tablet INR 25. Today planning to have a long flight travel worried to have
    DVT candidates have been asked lots of question regarding anticoagulation therapy complication contraindication interaction with other drugs etc you are not allowed to ask more questions

    8 20 -25 year old female notices an upper outer quarter breast lump the lump was 2 cm by 2 cm non tender lobullated firm she felt it about 2 months ago no significant change in the last 2 month a few small ancillary lymph nodes palpable last period 3 weeks ago no family history of breast cancer on OCP discuss your management plan of the patient

    9 65 year old male ultrasound found 6 cm 2 week ago and 7 cm today of his abdominal aorta please discuss his management plan

    10 4.45 year old male complains of chronic abdominal pain, endoscopy found duodenal ulcer H pylori and discuss your management plan

    11 50-60 year old female who underwent laparoscopic cholecystectomy a week ago developed sudden onset to breathlessness 2 hours ago in ICU now suspected as having PE x-ray, ecg and lung scan shows V/Q mismatch she is on O2, IVF, heparin informed the surgeon who is on his was asap non smoker no previous medical problem once drinker married with 2 children lives close to husband the husband very distressed wants to know how is his wife is it serious condition upset that the surgeon did inform that it couldn’t be a complication of surgery wants to sue the surgeon. Also discuss how could it be prevented in the future
    Acknowledge his distress risk factor prognosis anticoagulation warfarin INR precautions monitoring prevention

    12 42 year old man married with 2 daughters school teacher occasionally
    takes alcohol no smoker found to have BP 160/95 mm with he win tot donateblood at red cross camp to see you a gp clinic with BP lying 165/90 and standing 150/85 fundi exam normal CVS exam normal urinalysis normal no secondary cause of hypertension ,glucose 6.8 (not fasting) cholesterol 5.5 (not fasting) ecg norm BMI 31 24 hour monitoring 160-185/90-105 family history father had coronary angioplasty mother type 2 diabetes and angina you see him for review discuss management

    12 50 year old male had colon cancer diagnose with colonoscopy biopsy
    results adenocarcinoma. he was on waiting list for operation the specialist
    will remove cancer within is locate in 17 cm above anum and temporary stoma
    P/H healthy F/H father had bowel cancer mother had heart problem smoker and social alcohol the examiner kept asking he is on waiting list how to quit smoking? what would happen before operation? (DVT, bowel problems, medications).

    13 35 year old male known to your surgery whose father died 3 days ago of a massive myocardial infarction. He is worried about the possibility of the same happening to him. Also concerned about his mother who does not seem to coping very wellnote I explained to him what myocardial infarction is and I went through the cardiovascular risk factor and advised him regarding them I offered a consultation with his mother but she was not keen to come to the surgery so I suggested a home visit at the end of the case the observer examiner asked me about the causes of sudden death

    14.A 26 year old women presenting to you after her father sudden death 1 month ago at the age of 57 years which was completely unexpected because he neither complained nor visited a doctor in the last 20 years he was not smoker did not drink alcohol did not have any know risk factor for cardiovascular disease postmortem examination proved massive myocardial infarction her mother is patent of yours for 20 year visited you just before the death of her husband and her medical check up was normal the woman presenting to you today wants to wants to enquire about the reason of her father death and also she is concerned about her mother who is still in shock she thinks that her mothers grief may has exceeded limits because she claims seeing and having her husband feeling of blame

    15.45 year old man bleeding after opening his bowel

    16.40 year old man has observe bright red blood on his feces he had a back injury some years ago and is taking pain tablets which he buys over the counter

    Second stage

    1 . 24 years old female present d to your surgery after an eversion injury
    to left ankle today she has limited rage of an active and passive movement
    especially lateral flexion. There is swelling & tenderness crepitus on
    lateral malleolus, other examination are limited because of pain. You have
    an urgent x-ray of left ankle AP and lateral
    Your task View the x-ray that you have ordered
    Explain for the examiner about finding and management plan
    Advise the patient (a comminuted fracture of distal fibula. how long it take
    to heal how long it takes to move? does she need physiotherapy what is you first management now)

    2 a video showing 42 year old lady being interviewed, the lady was saying
    that she has erratic eating and binge eating since aged 15 year your task to tell the examiner about her mental status. Answer the examiner and give your provisional & differential diagnosis. The examiner asked me what are the other things you want to know and not present in this video. (Patient rapport?? examiner every thing is guarded I would like to ask about suicidal attempt, hallucination) provisional diagnosis is bulimia nervosa next question what other physical problem you have to exclude

    3 A Victorian police officer 31 is your patient for a long time, presented
    by her senior officer because of changing behavior, less performance at work having sick leave in beginning of each roaster she also starts drinking alcohol in the last few months. Your task is take further relevant history and give 3 differential diagnosis
    answer the examiner question from the history she had two accident one of her colleague died in front of her and another of fire shooting accident.
    She didn’t have counseling after that she complains of insomnia, poor
    concentration, loss of appetite, drinks 6-8 glasses of wine/ day feels
    depressed and lives alone she has history of depression and feels life is
    not worthy of living provisional diagnosis PTSD leading to depression and
    alcohol abuse examiner asks about short term effects of alcohol and normal limit of alcohol drinking per day and week

    4 a young patient presents to you with injury to rt writ your task take
    further relevant history, examine the patient, explain diagnosis, exact
    injury

    5 a 35 year old female presented to you with dysuria, frequency and burning sensation you have ordered dipstick of urine for her, which shows protein urea and nitrate. Your task is explain the diagnosis what is your advice for the patient about management write a prescription

    6 35 years old female in general medical ward she has long history of
    controlled NIDDM your task is examine the patient tell the examiner about
    your findings a sgyo go she has peripheral neuropathy with two rounded red smooth and non ulcerating skin patches you are not allowed to take further history

    7 24 years old presented to you with repeated increase in bp it was checked two times in the last few weeks and you check it today is still the same reading which was 150/105 she does not have any complaints, on physical examination she was normal her bp was checked once years ago it was 130/80 when her previous gp commenced her on ocp your task is take further relevant history explain your management plan to the patient

    8 a 60 year old female patient complaining of backache. her x-ray showed osteoporosis which was confirmed by low bone densitometery scan take further relevant history examine patient the diagnosis, advise her patient about you management plan, the patient asked about HRT, what are the contraindication, if she should not take the HRT what other tablets she should take

    9 a 35 yr old male presented to you with backache after lifting heavy weight at work your task is to examine the patient give your diagnosis the patient has L5 nerve root compression

    10 a 45 year old male alcoholic presented to with you, real patent, your
    task is to examine the abdomen of this patient, tell the examiner about your finding as you go, patient has hepatomegaly with ascites

    11 a 25 year old male a basket ball player presented with anterior shoulder dislocation while he was playing basket ball, the dislocated shoulder was reduce by another gp the patient has history of previous anterior shoulder dislocation before two months, he has history of loss of sensation in other part of the arm your tasks is to perform relevant physical examination, tell the patient about your management and answer the examiner questions, which nerve is affected by anterior dislocation, can be always posterior dislocation do you need any further investigation
    What will be the further management for this player?

    12 a 18 year old female present to you by her brother, she had RTI 3 days ago, temp 40 she is drowsy and lethargic your are unable to communicate to her o/e no neck stiffness has had a rash (the picture will be shown to you in examination room) your task is give the brother your diagnosis what are your advice regarding further management the examiner asked what would you do to this patient before sending her to hospital antibiotics what type what is the dose.

    Brisbanse 29th October

    1) My first case was a snake bite . How do you manage it? in the ankle,
    pateint stable, young, bitten 30 minutes back

    2) A 3 yr kid with previous dx of asthma, hospitalized for a week , he is
    going to get discharged, Talk to the father (counselling) Spacer counselling

    3) Liver metastaisis, counsel, and tell about the diagnosis and
    investigations (repeat from adelaide)

    4) A patient with known hemaoohoids 65 yrs, comes with left illaic fossa
    pain pain and discomfort, in further talking we realise that his father has
    colon cancer, talk to him about his investigation. He was tired, no waight
    loss, no colonscopy done before. Might be cancer so rule that out

    5) Patient with known 1.5 cm breast mass, FNAC diagnosis cancer, patient
    asked what the specialist will do? Cure rate No lymph node clinically
    palpable. Discuss about tt

    6) young girl with severe headache from yesterday morning, furter
    photophobia, neck stiffness, ask for CT scan and admit to hospital with dx
    of subacranoid hemorrhage. Slight fever so rule out meningitis also.

    7) 30 hour newbornwith jaundice but parents have noticed jaundice before 24 hours as well : ABO incompatiblity, pt is well but yellow manage and counsel father. Mother 0 + and baby A+

    8).Girl caring for a end stage cancer mother, all of sudden she lost her voice. Funny station. Ask about HEADSSS, she could only nod yes or no. Asked about
    suicide, and finally I get her to answer me by writting, but the time run
    out when I had asked just two questions to be written including her name.

    9) Examination of diabetic foot. No finding except glove and stocking
    sensory neuropathy. No motor, no pulse. basically normal person acting as a diabetic.Vibration was ok.

    10) young 40 yr od man , first time UTI manage it, Since it is first in male
    below 60 he sould be investigated. He was asking why should I get
    investigations. What antibiotics > trimethoprim.

    11) Patient has huge pneumothorax, without symptoms, first episode. Young male. Hat to do, when someone else asked about aspiration he was asking are you sure. I just managed conservatively.

    12) Recurrent abortion at 8 weeks and 10 weeks andeveryting else including all imaginable investigations were normal. Including blood : anti
    phospholipids, USG, chromosomal, hisograms. pt asked about cerclage, but I refused as it is not 2nd trimester abortion. Referred to get rid of the case

    13) 5 yr old boy, with fever and leg pain, slightly under the knee. without
    any other problem, Possible osteomyleitis, Xray and DD

    14) gestational hypertension : 34 weeks now. 150 / 100. Rcollege of obst
    says that follow with freq checkings, no drugs , I did that. no proteinuria,
    no odema.

    15) 55 yr old female with incontinence what to do. Investigations ordered
    and asked to do pelvic excercise.

    16) Schizophrenic with olanzapine complaining of weight gain, talk ask and investigate., also ask about diabetis.

    Queries welcome, will post more details if anyone wants to ask specific
    question you are welcome, But remember if you get help from here try to help people later after your exam.....

    AMC PART –II CLINICAL EXAMINATION

    MELBOURNE 26TH FEB 2005

    OSCE



    1) You are GP in town, and 38-year-old female presents to your practice c/o
    “heart turns”. She has heard that you are very good and wants to talk to
    you. She is worried about her heart and describes these as runs of fast
    heartbeats, which is pounding and loud enough to be heard. This has been
    happening for 6 months every now and then. Your fellow colleague had seen her 2 weeks ago when he did basic blood tests including sugar, Hb,
    Electrolytes, Renal and Thyroid Function tests and ECG. All have come
    normal. Task: Please take relevant history and tell the diagnosis to the
    patient. Answer her questions.

    2) You are medical officer in an Emergency Department and a young
    19-year-old boy is brought in by the ambulance who was found unconscious in his flat. His flat mate has only recently moved in to his flat and hence has no idea about his past life. In ED, the Airway, Breathing and Circulation has been assessed and secured. Task: Please assess his level of Consciousness (GCS) and other relevant areas to suspect the cause. At the end the examiner would ask you four causes of coma probable in his case.

    3) A 24-week pregnant lady comes to your practice who is curious about
    circumcision. She wants her son to be circumscribed but has heard both, good and bad about it. Task: Please answer her queries.

    4)Your next patient is a 32-year-old lady having 3 kids and wants
    sterilization operation on her. She already has discussed this with her
    husband and they have agreed to it. Task: Please take relevant history and counsel her regarding sterilization.

    5) A 42-year-old patient has come to see you. He is your old patient, had a Bowel Carcinoma 2 years back was operated for the same and was doing well until 3 weeks ago when he developed Ac Intestinal Obstruction and was taken to ED. Laprotomy was performed to see that the cancer has spread beyond pelvis, into the mesentry, liver, para-aortic LNs, peritoneum. Grossly adhered loops and obstructive growth recurrence was cleared with great difficulty, and an end-to-end enterostomy was performed. Now his bowel function is normal. On discharge he was given Panadol 1G q4h for pain, which is not doing enough. He has come for pain in pelvis. Also he is worried and wants to know about his disease and condition. Task: Please tell the patient his condition, and develop a plan for him. Answer any questions he has to
    ask.

    6)A man comes to you c/o tired ness, week ness and problem with his water works. Task: Please take history from the patient, give your differential diagnosis to the examiner and answer any question he has to ask.

    7) Photograph of Alopecia Areata. This gentle man comes to your practice
    with c/o hair loss over a period of 4 weeks. Now he is worried about his
    condition. Task: Please tell the patient the diagnosis and answer any
    question he has to ask.

    You are in ED as medical officer, and a father bring his 2-year-old son who was unwell for last 2 days with ear infection, and had a fit today morning at home which lasted for 5 min. When you examine him, he is playing and looks alert and cheerful. The father is worried about his son. Task: Please explain to him what is going on, and answer his questions.
    You are night intern and are call by the surgical ward nurse to see a
    patient who had undergone a laparotomy 6 hours ago for a perforated peptic ulcer. She is worried that he hasn’t passed any urine since the surgery. He has a temp of 37.8, Pulse of 110, and a BP of 124/82. He has a NGT in place, which has drained 350 mls of bilious fluid from his stomach. He has been receiving Dextrose 5% 1L over 6 HRS, which is about to finish now. Task:
    Please examine the patient, find out the cause of anuria, and write down a
    management plan including fluid order for this patient. The examiner will
    then ask you some questions

    9) A 35-year-old lady comes to your surgery and wants to see you to get a letter to the Ministry of Housing to enable her to change her location. Her worry is that her neighbours are playing games with her. Task: Please take proper history and give the differential diagnosis to the examiner.

    10) You are medical officer in Obs and Gynae ward and are stitching an
    episiotomy of a young woman who has just delivered a healthy 3.5 KG boy by forceps. This was her first pregnancy. Suddenly she has generalized convulsions and becomes unconscious. Task: Please ask for examination finding from the examiner (No history please), and tell the lady’s husband who is sitting outside the labour room, as to what has happened. Answer any questions he has to ask. The examiner will then ask you to manage this patient.

    11) A 55-year-old taxi driver comes to your practice c/o very severe pain in his right great toe for last 2 days. He denies and injury. He takes
    indepamide for BP, smokes 20 cig / day and drinks about 3-4 beers / day. You find that his great toe is swollen, red and tender. Task: Please tell the
    patient the diagnosis and what investigations you would do. Also plan a
    management for him.

    12) A 36 week pregnant lady comes to your surgery because she is puzzled, if
    breast-feeding is better or not than formula feeding. Her friends have told
    her that breast-feeding causes anemia in child and also that it causes
    breasts to hang down, obesity and weakness. She is very health conscious and educated lady. Task: Please tell her which is the best option and why, and also answer her questions. Also explain to her the steps of safe formula feeding.

    13) A young female of 25 years comes to the ED, where you are MO, with
    severe pain on the right side of her abdomen. Task: Please take relevant
    history ask the examiner for physical finding and to provide differential
    diagnosis. You will be asked about management.

    14) A 27 years old 30-week pregnant female comes to you with h/o sudden pain
    abdomen with some bleeding P/V 2 hrs ago. Now she is settled. Task: Please take relevant history, ask for physical findings, do proper investigations and reach a diagnosis. Examiner will then ask you further questions regarding management.

    15) A 65 years man comes to your surgery with c/o gradual onset of pain in shoulders and pelvis over last 6 months. Task: Please take relevant h/o, ask for physical findings, and investigations, and give differentials. You may
    be asked about management.

    Answers:

    1. Anxiety

    2. REST

    3. Coma (GCS) assessment

    4. Circumcision in New born

    5. Sterilization in 32YO F

    6. Advance Bowel Carcinoma

    7. REST

    8. BPH

    9. Alopecia Areata

    10. Febrile convulsion

    11. Post op Fluid balance

    12. REST

    13. Paranoid Schizophrenia

    14. Post Partum Eclampsia

    15. Gout

    16. Breast Feeding Vs Formula Feeding

    17. REST

    Brisbane
    1. pyloric stenosis
    2. 40 weeks fetal death in utero
    3. 28 weeks pregnant with ovarian cyst
    4. 4. hyperprolactinemia noral FSH LH 28 years
    5. OM serious
    6. Tx of RA
    7. sexual abuse
    8. abdominal plain with jaundice increase ALT UTI in 6 month dd and tx


    Adelaide
    Carpal tunnel examine the hand
    Counsel for appendectomy
    GIT exam of chronic liver disease
    25 year girl with recurrent UTI
    Rugby player with knee injury complaining of knee pain
    CNS exam
    Woman on the HRT counseling
    Male intermittent claudication
    Acute cholecytectomy surgical counseling
    Male gp cvs murmurs systolic as
    Female with DVT management
    Hand exam osteoarthritis

    pediatric

    5 y/o wheezing
    Eczema on hand
    Soiling
    16 year with DM sugar 5 taking thiazide


    Sydney stage 2

    80 year male going overseas gp found murmur systolic know causes usually as

    70 yrMale admitted previously with 2 episodes of hematemisis

    Examine GIT liver spleen know borders and technique
    peptic ulcer
    portal hypertension
    White nail
    Duputyrens(negative)
    Hepatomegaly (positive)
    tremor (negative)
    jaundice (negative)
    What invention FBC LFTS clotting studies
    Chronic liver diseases can’t be ruled out might have ruptured esophageal
    varices

    Female on pill of 3 years diastolic BP 105 mmHg
    Kidney problem
    polyurea
    Known causes of high BP discuss factors long term management stop ocp and
    other forms of contraception diagnosis fibromuscular dysplasia because she
    still young

    Video about a woman talking and about eating problem what is your dd
    anorexia & bulimia

    Renal colic explain to patient the condition long term management pain
    relief very important
    Investigations IVU

    Patient with RUQ pain his five jaundice (negative) exam in abdomen acute
    cholecystitis and then explain why

    60 year old woman diabetic for 5 years in hypoglycemia
    Discuss risk factor of diabetes
    What are the hypoglycemic drugs suited for him advice

    Girl in coma brought in ED by flat mate who did not know anything what to do
    abc Glasgow coma scale
    pupils
    FBC
    blood culture
    bsl
    ct scan
    parent look stable in observation room what you ddx
    drugs dose epilepsy diabetes

    Boy at work cut right wrists palmer examine ulnar nerve damage flexor
    digitorum profundus superficailis

    Breast exam technique
    dummy breast on table but still treat it as a person introduce yourself and
    explain what you are about to do
    FNA lump on neck Bx result SCC where do think the primary lesion anything
    around month neck chest
    Investigation CT scan MRI Lymphoma Virchows node lf supraclaivular fro GIT
    metastasis

    PR bleeding for 3 week s 28 yrs father with colon ca d I am considering
    colonic a I would like to request t for FBC colonoscopy if old do
    sigmoidoscopy then proctoscopy

    ---------------------------------------------------------------------------------




    Stage 2 Melbourne 2002 April

    1 36 year old female pre examination PR bleeding please take the history and outline the management positive family history of bowel cancer mother died of it at the age of 46

    2 25 year old non smokers complaining of sudden onset of exertional dyspenia please take the relevant history outline the management and prevention (look in CVS and RS examination x-ray explain)

    3. Young girl present to ED complaining of RIF pain of 1 day duration
    surgical registrar made the diagnosis is acute appendicitis you are the
    intern please take the history relevant examine and do necessary
    investigation. counsel the patient regarding the surgical complications

    4 27 year old female in OCP of HBP find BP 135 /104(or 150/100) mm hg
    checked you on 3 different occasions you did urine ecg and chest x-ray all
    normal please manage the patient

    5 18 yr old boys mother died of 2 months ago with cardiac rest now he can’t sleep lack of concentration during daytime he is law student please take brief history and counsel patient

    6 60 year old lady 2 year ago had leukemia and treated of the last 20 month her blood count checked is normal her last blood count however showed increase she has another relapse your task is to tell the patient about the relapse of symptoms patient was crying the whole time refusing the chemotherapy management

    7 4 year old police women was sent by her supervisor to you regarding her recent poor performance eat work he also noticed about her recent alcohol intake please take the history and out line the management

    8 20 year old boy had sustained shoulder joint injury 2-3 week ago now he complains of pain please examine the patient give your diagnosis rotator cuff lesion painful abduction 60-120

    9 20 year old boy sudden knee join injury 2-3 weeks ago now present of pain of left internal knee joint please examine the patient diagnosis and
    management medial collateral and meniscus tear

    10 55 year old male presents of lump on the back of the neck lipoma please examine outline the management now to do fine needle aspiration and cytology excision biopsy

    11 45 year old male heavy alcoholic present to ED complain of hematemesis please do relevant examination and out line the management



    12 50 year old male now present to left leg weakness NIDDM I week ago he had similar episode associate expressive dysphsia please examine the leg (neurology 0 where else would you like to examine the patient what are the investigation give 2-3 main advise to the patient

    mcat sept 2001

    1. History give pain tingling R hand especially at right for 3/52 exam and
    counsel patient carpal tunnel syndrome (thickening of flexor retinculam
    trapped median nerve in the carpal tunnel)

    2. Exam this patients hand give a differential diagnosis how to investigate
    and manage osteoarthritis

    3. Pt presents to ED after vomiting 500 ml of fresh blood had previous
    history of hematemeis and found to have esophageal varices on endoscope he has history of alcohol abuse exam the appropriately

    4. Pt presented to ED after a fall on occipital region had short duration of
    LOC how You have examined her and found marked tenderness at R
    hypochondrium. temp 38 pulse 100/min BP 140/90 you have ordered an us exam please look at the us counsel pt appropriately acute hepatitis


    Management cases

    24 year old man single urethra discharge culture G diplococcus discuss drug course route screen other STD prevention prognosis fowl up
    Bowel ca resect rectum now recurrent

    25 y/o wants vasectomy

    Respiratory COAD, asthma show to resolve pneumonia coin lesion on x-ray
    Cardiology palpitation atrial fibrillation angina myocardial infarct his
    blood pressure
    Neurology TIA completed stoke migraine carpal tunnel SAH
    Endocrine diabetic new diagnosis IDDM migraine diabetes random elevated
    sugar hyperthyroid
    Rheumatology got osteoarthritis rheumatoid arthritis
    Gastroentology Diarrhea irritable bowel constipation hepatitis duodenal or
    gastric ulcer
    Psychiatry depression anxiety bereavement
    Renal hematuria
    Renal colic
    Vascular surgery claudication TIA abdominal aneurysm
    GI surgery gall stone colonic ca
    Genetics x linked autosomal dominant and recessive



    -----------------------------------------------------------------------------------------



    the mcats part of the clinical examination

    1.the task is to comment on the mental state and the differential diagnosis
    of as woman after watching a recorded videotape of and interview by her
    psychiatrist. The sound quality was really bad but the woman looked a bit
    disorganized in appearance with slight hysterical feature and the subject of the interview was about bulimia nervosa

    2.a woman with diabetes mellitus has come to you for medical cure up
    systemic exam is normal complete the check up and your advise to the patient

    3.a 23 year old female was found unconscious examine her and asses the
    degree of coma Then give the differential diagnosis this was solely a role
    play station

    4.a 26 year of man has come to you complains of renal colic and the
    examiner hand and an IVU showing a filling defect in renal pelvis explain to the patient to you management

    5.a 24 year old female present to you because of her blood pressure with
    was 140 /104 on 2 occasions measure by a nurse and today is 140/100. Explain your management to the patient.

    6.a 54 year old male presenting with acute severe epigastric pain that
    faded over the last couple of hours. he had fever 38 and tenderness on the upper abdomen examine the abdomen and give your diagnosis

    7.a 46 year old man consulting you before his overseas travel and you
    discovered a murmur on his chest he had normal water hammer pulsation and visible neck pulsations and faint diastolic murmur best heard on the aortic area and on leaning downward during expiration examine the CVS

    8.examine the GIT system of this man who is 58 years old alcoholic

    9.examine this man who sustained and injury to his wrist during his work
    with a sharp instrument a role player with band on his wrist than I was
    asked not to remove examination revealed a median nerve injury and injury to ulna half of flexor digitorum profundus then I was asked about how to mange such a case

    10.a 25 year old male complain of passing blood after passing stool my task was to take a history and to mange the case.

    11.10 month old baby girl with recurrent URTI in between episode she has a moist young developed a dry cough that age of 5 months now there is a
    medical problem no failure to thrive and passing one broken stool a day the with history of mild asthma she is in day care 3 days a week immunization up to date


    step 2 mcats

    1. 75 year old male with murmur examine his cardiovascular system

    2. 55 year old male with 2 episode of hametemesis advised to stop drinking
    examine his GIT

    3 42 year old male with renal colic explanation and long term management

    4 3 minute duration video of male talking about eating patterns then asked
    of and mental state to the patient

    5 27 year old male with history of per rectal bleeding

    6 breast examination in a model and in a patient

    7 male with lump in base of neck who had fine needle aspiration with c
    return squamous cell ca examine him and give differential diagnosis

    8 27 year old female on the pill for 3 years. in a routine check up she has
    been found to have diastolic of 105 mmHg management

    9 male with injury to his left wrist deep laceration examine his and tell
    what has been damaged it was ulnar nerve flexor tendons

    10 55 year old female non insulin dependant for 5 years controlled by diet
    and oral hypoglycemics follow up examination of relevant systems

    11 male in his 50s with pain in the upper quadrant for 3 days also pyrexia
    and vomited once take a brief history at the same time you examine him
    explain your differential diagnosis and management

    12 21 year old female brought to emergency department by her flat mate found
    to be unconscious there is no history no personal details what are you going
    to do in the emergency department asked about causes of coma relevant
    investigation and also coma scale she had a GCS of 12 over 15 then.



    Stage 2

    Station 1 70 year old lady with SOB examine her cardiovascular system
    comment on your findings as you got through pacemaker present mitral
    regurgitation aortic stenosis mild JVP elevated

    Station 2 read and proceed
    Laminate a4 paper
    This 40 year old man attending the ED with vomiting of small amount of fresh blood he had similar episode in the past but treated conservatively now she is hemodynamically stable he also says that he is unable to give up drinking in spite of repeated advice examine this patient
    relatively obvious case of chronic liver disease with evidence of portal
    hypertension spider neavi gynecomastia distended abdomen with loss of male distribution of hair with abodmen and axilla testicular atrophy left side testes is very small soft and atrophic just like birdseed liver 4 cm below costal margin spleen just palpable ascites pr not allowed no ankle edema no fetor hepaticus no flapping tremor

    Station 3 resting station

    Station 4 Read and proceed this 26 year old girl thought to have high blood pressure of 150/105 on a routine examination the pressure was checked on repeated occasions and still found to be high she is on pill combined for the last 3 years but BP was normal 3 years ago before her first prescription. The previous doctor could not find any abnormality on physical examination your task is to take a relevant history examine
    discuss how are you going to proceed further history did not give any clue
    of a secondary cause physical examination and office test did not show organ damage

    Hence mentioned about the investigations

    FBC
    ecg
    LFTs
    TFT
    24 her urine for vma
    cxr
    us scan
    kub
    bsi

    Station 5

    introduction by the psychiatrist

    in this station a 3 minute interviews will be played in the video your task
    is to do a mental state examination of the patient and come to a reasonable diagnosis with other differentials you will give 2 minute to prepare your self and use this pen and pad of any notes with you ready this video will be displayed
    Interview
    Female patient but her statements were not very clear but few clues were
    thereStill at night time I tend to eat more but I try to bring it out doctor
    Sometime I us purgativesI lost 5 kg but not very happy still

    For mental state examination follow the below mention rule

    Appearance (clothing, hygiene, makeup)
    Behavior (posture eyes contact etc)
    Conversation (rate tone content flow of ideas)
    Affect mood suicidal thoughts
    Perception
    Cognition
    M memory shot and long term memory
    O Orientation
    A Attention
    T Thought process

    Judgment how well responding to demands in society the is patient a thereat
    to self or to others
    Insight about his illness
    Rapport

    Dd
    Bulimia nervosa
    Depression
    Anorexia
    Endocrine thyroid

    Station 6
    This 25 year old male patient suffered an episode of abdominal pain which
    radiated from right loin to groin and was shooting down his scrotum now he is pain free.Task come to a reasonable diagnosis explain and discuss about your management
    Discuss Ureteric colic is the most likely diagnosis
    Principles of management
    Investigation to find out the cause FBC EVC blood calcium phosphate uric
    acid us can IVU x-ray KUB.
    If it is at one establish the size already existing damage wheter
    intervention necessary at this stage
    How to tackle the pain if it recurs
    Pain relief indocid suppositories other analgesics to take home if
    If intervention necessary they meant the methods available briefly IVU
    showed dilated calyces of rt kidney.

    Station 7
    This 40 year old man came with right hypochondrial pain and fever with chill and rigors
    Examine the abdominal system discus your management
    On examination icteric febrile 38
    RBC positive Murphy’s sign
    Pr not allowed
    Patient also had obvious clubbing
    Discussion could it be ascending cholangitis hence nil orally IV cannula
    catheter monitor vitals
    Pain relief operates
    Antibiotics ampicillin gentamicin metoronidazole
    Hydration
    Blood FBC EVC LFTs culture
    Group and save
    Obtain consent in case of cholecystectomy

    Station 8 resting station

    Station 9 read and proceed this 45 year old lady with diabetes of 65 years
    comes to your clinic for a routine check up she is on oral hypoglycemia only take relevant history examine appropriately discuss about your plan
    History find out any organ damage eye heart kidney nerves
    Go through blood sugar diary BSL was between 4.5 and 6.5 on two occasions it was more than 9.4 and other two occasions she had migraine for the whole day went out for lunch and difficulties or doubt about glucose monitoring.Examination of fundi
    BP
    Lower limbs neuropathy ulcers callous cones
    Urine Albumin
    Blood BSL
    HbA1C
    Lipid Profile
    EVC

    Station 10

    This 60 year old man had a lump as showing the picture (picture showed
    enlarged supraclavicular lymph node) the FNAC showed moderately
    differentiated squamous cell carcinoma.
    Task talk to the patent to clarify and possible caused and perform a
    relevant examination explain him about your plan
    Most likely cause is brochogenic carcinoma or skin cancer ca esophagus very rarely, asked about
    hemoptysis cough
    Smoking etc examination
    Hands
    Clubbing
    Nicotine stain
    T1 lesion
    Wrist tenderness pulmonary osteoarthropathy
    Face Horner’s syndrome
    Lungs pleural effusion etc
    Tests cxr bronchoscopy etc

    Station 11

    Read proceed
    This is a 26 year old female lives in a flat but the flat mate does not know
    about their occupant as she moved in last week only. This morning she was found on the floor unconscious flat mate called the ambulance and sent to the hospital airway and circulation are stable

    Now consider you are the doctor on duty and show the examiner what you would do
    Call for help: blue code
    Immediate assessment cannula bloods cardiac monitor pulse oximeter finger prick BSL catheter PRN
    Shake the patient gently because she is a role player
    Say open your eyes for do know where your are
    Pinch gently she opened her eyes and closed it again put you legs/ hands up Pupils reactive
    GCS was 7-8
    Look of indication marks drug addicts
    Search of head injury
    Neck stiffness Kernig’s signs
    then proceed to do CUS RS and CNS
    Examiner asked what should be the cause of this state
    Toxin poisonous opiates/drugs organophosphorus
    Infection septicemia meningitis esp. meningococcal examine specifically
    asked
    The patient mimicked of having neck stiffness
    The antibiotics would be ceftrixone benzyl penicillin
    Then depending on the two reports choose one of the two
    Blood urine CSF for polymerase chain reaction PCR
    Head injury CT
    Hypoglycemia

    Station 12 read and proceed
    This 25 year old man complain of bleeding pr on and off for there weeks
    Task take a relevant history
    Counsel the patient regarding further examination
    History fresh blood after defecation
    Bright red in color other features to suggest any management of infective
    process. Further analysis father had ca colon at the age of 52 and had some surgery but lived up to the age of 80 years
    Two brother healthy
    Examination of patent not allowed
    This patient needs referral to a gasteroentologist
    Colonoscopy flexible sigmoidoscopy
    Follow up and screening to be began before the age of 46 year
    Include his brother as well of screening program
    Screening includes fecal occult blood testing and colonoscopy or Ba enema
    Trace his fathers pathology report if possible
    Diet advice
    Presently the problem may well be due to hemorrhoids which needs appropriate treatment but because of the family history of ca colon he needs a through
    investigation.

    Station 13 resting station

    Station 14 role playing patient with crepe bandage around the right wrist
    This is 18 year old boy sustained a cut injury on the ventral aspect of
    right wrist. Examine his hand
    Look of damage to blood vessels
    Radial and ulnar arterial pulses
    Capillary refilling time
    Damage to nerves motor and sensory function ulnar medial cranial nerves
    Skin sensation of pin prick
    Patient demonstrates ulna nerve damage ulnar claw impaired pin prick over
    little and ring fingers
    Examiner observes how to check for never functions and asked about ulnar
    paradox
    Tendon damage
    Other questions asked the small muscle supplied by the median nerve action
    of lumbrical muscle

    Station 15 a breast prosthesis was kept on the table examiner asked to
    examine this breast prosthesis and find out the lump well defined 0.5 cm
    lumpFirm in consistency now examine this male patent but consider him as a female the a real of the lump is marked on his right chest show us how you will examine this patient routine breast examination.





    2001 oct stage 2 mcats

    1 a 75 year old male with murmur or a 46 year old man consulting you before his overseas travel and you discovered a murmur on his chest he had normal water hammer pulsation and visible neck pulsations and a faint diastolic murmur best heard on the aortic area and on leaning forwards during expiration examine his cardiovascular system

    2 55 year old male with 2 episode of hematemis advised to stop drinking
    examine his gastro intestinal system.

    3. A 42 year old male with renal colic explanation and long term management the examiner handed me on IVU showing a filling defects in renal pelvis

    4 3 minute duration video of a female about eating patterns then asked of
    did and mental state of the patent. The sound quality was really bad but the woman looked a bit disorganized in appearance with slight hysterical feature and the subject to the interview was about eating patterns. Then asked of
    differential diagnosis and mental state of the patient. The sound quality
    was really bad but the women looked a bit disorganized in appearance with slight hysterical features and the subject of the interview was about
    bulimia nervosa

    5 27 year old male with history of per rectal bleeding this is to take a
    history and to mange the case.

    6 Breast examination in a model in patient that was a funny case I was asked to examine a lump in the breast model and in a patient that wand describe its characters which was supported by joined in 26 year blood female and then I was asked to give the differential diagnosis of the lump next I was asked to examine the patient on a male who was male role play a female

    7 A 53 year old male smoker with lump in the neck role play who had fine
    needle operation which turned as squamous cell carcinoma examine and give differential diagnosis to identify the primary

    8 27 year old female on the pill for 3 years in a routine check up she has
    being found to have a diastolic of 105 mmHg 140/ 104 on 2 occasion measured by the nurse and today it is 140/100 management

    9. Male with injury to his left wrist deep laceration examine him and tell
    what has been damaged ulnar and flexor tendons on examination this man who sustained an injury to his wrist during his work with a ship instrument a role player with a band on his writ that I was asked not to removeExamination revealed a median nerve injury and an injury to ulnar half of flexor digitorum profundus and then I was asked about how to manage such a case.

    10 55 year old female non insulin dependant of 5 years she is controlled any diet and oral hypoglycemia has come to you for medical check up systematic review is normal complete the checkup and you advice to the patient or your follow up and examination of the relevant systems

    11 Male in his 50s which pain in right upper quadrant for 3 days. Also
    pyrexia and vomited once. Take a brief history at the same time you examine him. Explain your diagnosis differential and management

    12 21 year old female brought to ED by her flat mate found unconscious there is no history no personal details what are you going to do in the emergency department asked about the causes of coma. Relevant investigations and Glasgow coma scale (she had GSC of 12/15 then the examiner asked me whether intubations is appropriate (abcd and neurological) this is a role play station


    AMC mcat sept 2001

    1 history given pain
  2. Oo

    Oo Guest

    Hello,Niruben

    Thank you very much for the questions.

    All the best,

    Oo
  3. Guest

    Guest Guest

    Thanks niruben! :D
  4. Guest

    Guest Guest

    Thanx sooooo much Niruben!! You are a life saver!! :D
  5. vmshashii

    vmshashii Guest

    AMC student resource CD

    Thank you for the resource, appreciate your hardwork in typing.
    I have collected (downloaded, barrowed etc.. etc.. ) resource materials of related to AMC exams prep. It has also last 5 year collection of RACGP Check series CD's, complete MERCK manual, Common Sense Pathology etc.. past MCQ papers, etc.. If any one is interested, I will be happy to send a copy. (please bear the postage cost).

    Best wishes,
  6. Guest

    Guest Guest

    thanks for the questions :D
  7. hyd_suresh

    hyd_suresh Guest

    Common cardiovascular OSCEs


    Guys, these are some recalled cases from different OSCEs. Would be of great help to familiarise yourself on these topics...



    William Hartman is a 46 year old man who comes to your office with chest pain. In the next ten minutes take focused history and address his concerns. (Chest pain).

    Michael McCarthy is 52 year old man, who is a known case of hypertension. He came to your office for his annual check up. In the next ten minutes perform a complete physical examination. On the eighth minute the examiner will stop you and ask you questions. (Hypertension).

    Melissa Pilgrim is a 27 year old woman who has come to your office because oh heart racing. In the next ten minutes take focused history and talk to her about a possible management plan. (Palpitation).

    Dan Greenspan is a 68 year old man who had brought to the emergency because he passed out earlier today at home. In the next ten minutes perform a complete physical examination. On the eighth minute the examiner will stop you and ask you questions. (Syncope).

    Jenny Davidson is a 23 year old girl who suddenly lost her consciousness today and fainted. In the next ten minutes take focused history and address her concerns. (Syncope).

    Lenny Sullivan is a 56 year old man who got a sudden bad chest pain when he was having lunch with his family. He was brought to emergency few minutes ago. In the next ten minutes manage him. (MI).

    Alfred Sabitto is a 53 year old man who comes to your office because ho got swelling of his legs. In the next ten minutes take focused history and address his concerns. (heart failure).

    David Perry is a 54 year old diabetic man who came to your office because of leg pain after walking. In the next ten minutes take focused history and perform a focused physical examination. (Claudication).

    Eric O'Malley is a 51 year old man who came to emergency because of chest pain and palpitation. In the next ten minutes take focused history and address his concerns. (Chest pain/ Atrial Fibrillation).

    Sandra Anderson is 81 year old woman who was brought to emergency by ambulance semiconscious, hypotensive and bradycardia. In the next ten minutes manage him. (Digoxin intoxication).

    Andrew McDonald is 60 year old man who has a cardiac arrest while the ambulance is rolling into the emergency. He is quickly brought into the resuscitation room. In the next ten minutes run code blue and manage him. (Cardiac arrest).

    Tina White is a 22 year old woman who was referred to you by a community nurse because of high blood pressure. In the next ten minutes take focused history and talk to her about a possible management plan. (Hypertension/ Pheochromocytoma).

    Tim Brown is a 39 year old male who came to emergency because of sharp chest pain. He feels unwell and trouble breathing. In the next ten minutes take focused history and perform a focused physical examination. (Pericarditis).
  8. hyd_suresh

    hyd_suresh Guest

    Here's more....


    A must know cardio cases for OSCE 's:


    Chest pain.

    Myocardial ischemia/infarction: ER management.

    Cardiac arrest.

    Palpitation.

    Atrial fibrillation.

    Syncope.

    Hypertension.

    Hypotensive shock: ER management.

    Digoxin toxicity.

    Pericarditis.

    Infective endocarditis.

    heart failure/ generalized edema/ ankle swelling.

    Intermittent claudication.

    Acute/ chronic leg pain.

    Deep venous thrombosis.

    Complete cardiovascular examination.

    ECG interpretation.

    Drug counselling for post MI prior to hosp discharge, etc



    Hope this helps...
  9. hyd_suresh

    hyd_suresh Guest

    common respiratory osces

    common respiratory osces

    Asthma: in all scenarios: Acute ER setting management, Worsening follow up, After attack follow up, Consult.
    Wheezes.
    Pneumonia, typical and atypical.
    Chest pain.
    Cough.
    Coughing up blood (Haemoptysis).
    COPD: in all scenarios: Acute ER setting management, Worsening follow up, After attack follow up, Consult.
    Shortness of breath.
    Chronic shortness of breath.
    Pulmonary embolism in ER setting.
    Bronchiectasis.
    Pleural effusion.
    Interstitial lung disease, occupational cough/SOB.
    Solitary pulmonary nodule on X-ray.
    Pneumothorax in ER setting.
    Rhinorrhea / Sore throat.
    Sinusitis.
    Chest X-ray interpretation.
    Pulmonary Function Tests interpretation.
    Arterial blood gases interpretation.
    Smoking consult.
    Respiratory system examination.
  10. acon66

    acon66 Guest

    Brisbane clinical exam 2006

    1. PPH management over phone
    2. Examine hands
    3. History - haemochromatosis
    4. Management - x-ray #ankle with shift
    5.
  11. acon66

    acon66 Guest

    Brisbane cond

    5. counselling daughter of patient with early dementia
    6. Parent of child with asthma
    7. History pleural effusion
    8. l5 disc prolapse
    9. History - inflammatory bowel disease
    10. Request for morning after pill
    11. prepregnancy councelling - post partum DVT and PE
    12. Child with new onset faecal soiling
    13. Perferated viscous

    Sorry, cannot remember any more!
  12. acon66

    acon66 Guest

    Brisbane cond

    5. counselling daughter of patient with early dementia
    6. Parent of child with asthma
    7. History pleural effusion
    8. l5 disc prolapse
    9. History - inflammatory bowel disease
    10. Request for morning after pill
    11. prepregnancy councelling - post partum DVT and PE
    12. Child with new onset faecal soiling
    13. Perferated viscous

    Sorry, cannot remember any more!
  13. Guest

    Guest Guest

    Hello again guys,

    I got feedbeck from AMC

    Stations which I passed:

    1. Abnormal liverfunction tests
    2. Acute abdomen
    3. Anorexia nervosa
    4. Cardiac murmur
    5. Circucision (Paed)
    6. Contraception request (O&G)
    7. Eclampsia (O&G)
    8. DM type I juvenile - counselling ( Paed)
    9. Dysphasia & UL weakness
    10. Lethargic febrile 2 yr olad (Paed)
    11. Nut induced anaphylaxis
    12. Pre-pregnancy counselling - diabetic (O&G)
    13. Psychotic episode with violence - crisis management
    14. Fracture clavicle

    Stations failed

    1. Pleuritic CP
    2. Subcutaneous lump

    Good luck to you all , guys. All the best.
  14. Guest

    Guest Guest

    Hi ! special thanks to Niruben and the "typist".

    disc prolapse
    dvt and embolism and pregnancy
    perforated abdomen
    breast milk jaundice
    functional constipation
    pph
    anxiety neurosis
    plueral effusion
    chronic diarrhea
    acute asthma
    fibular syndrome
    hiv gonorrhea and clamydia
    bronze diabetes
    psoriatic arthropathy
    alzhiemers
    bells palsy
  15. Guest

    Guest Guest

    a few stations in one of the clinical exam held this month



    1 a pt of incontinence
    2 a pt. of H.I.V.
    3 a pt of anaemia
    4 a pt of diarrhoea
    5 a pt of neonatal jaundice
    6 a pt of hand injury
    7 a pt of cervical spondylosis
    8 a 16 yr girl who ingested her mother's vallium counselling regarding mother to be informed or not.
  16. shanks

    shanks Guest

    :shock: :lol: :lol: thanks a lot for all de trouble taken..........

    you r an angel
  17. Retest

    Retest Guest

    AMC re-test Stdney march

    Could someone who has taken Re-Test at Sydney on March 17th, please mail me to this ID: drbrinkart at rediffmail dot com
  18. Guest

    Guest Guest

    Thanks mate,God bless u.U r wonderful person.
  19. Nez

    Nez Guest

    AMC

    Good Idea. Thanks for collections.Pl continue to do so.
  20. Guest

    Guest Guest

    hi vmshashii,
    i hope im not too late.i would be interested in those papers. pls send me a pm,

    regards,
    D
  21. 123456

    123456 Guest

    i too need amc question

    Even i m desperately in search for amc question. So plz email them to me. My email id is syed_farhan_2k@yahoo.com
  22. OY

    OY Guest

    Can somebody post AMC of 2006 in Adlaid? Many thanks.

    Can somebody post AMC of 2006 in Adlaid? Many thanks.

    Recalls of AMC on 25th Feb, 2006, Brisbane.

    I started from station 20.

    1. You are working in a district hospital as an RMO. You live about 10’ drive away from the hospital. At night you are called by the midwife saying a patient had about 1250ml bleeding PV. The patient delivered a baby today which lasted about 10 hours. Initially, she bled about 250ml.

    Tasks: talk to the midwife over the phone and ask about patient’s situation and tell the Mx.

    2. A 52 year old retired pharmacist came to see you with tiredness for about 1 moths.

    Tasks: take history, physical examination, investigations, and Mx. (haemochromotosis).
    Skin pigmentation, I forgot to ask about Iron study.

    3. Brest milk jaundice. Hx, PE, Ix, Mx. Know the significance of conjugated and nonconjugated bilirubin.
    4. fracture of left distal fibula and dislocation of the talus. Read xray, and Mx.
    5. A woman with chronic diarrhea with blood and mucus for years. Brother has similar problem.
    6. An old man’s daughter came to see you about her father’s dementia. CT generalized atrophy. I failed this one. Why?
    7. Postnatal DVT. To have another baby. Counseling.
    8. Hand examination: O/A. Heberden;s nodes in both hands. Otherwise ok. Associated with SLE. Dermatosclerosis?
    9. a lady took Diclofenac for back injury and has sudden onset of epigatric pain in ED. Examine the abd and tell the Dx and Mx.
    10. a fit young man with pain in the left buttock and left leg after lifting a heavy object. Take hx, Mx. Ix.
    11. a child with wheezes, had a previous episode before. Had mild eczema. Family history positive. T 37.5. Hx, Mx. The diagnosis is asthma not viral bronchiolitis.
    12. postnatal panic attacks. No depression, no suicidal ideation, had agrophobia. Hx, Dx and Mx,
    13. a girl had sex with a boy whom she encountered last night. The condom was broken without knowing until 30 minutes later. She is concerned about pregnancy. Take history and Mx.
    14. Bell’s Palsy. A middle age women with left face paralysis. Before that she had some pain behind the left ear. Ear chech up normal. Dx is Bell’s palsy. Talk to the patient about Dx and Mx. Reassure and no need for CT and referral. Make sure you check the eye. If it can shut or dry. May need patch or artificial tear to protect the eye; facial massage. Take steroid for about 10 days.
    15. boy of 6 years of age, with soiling at daytime. Eats less vegetable. Drinks enough fluid and exercise. Anal fissure?

    16. a middle aged man with SOB. Questions about SOB: onset, side, chest pain, cough, fever. Asked questions about anemia, depression, hypothyroidism. SH: heavy smoker. PE: dullness in right side. Dx; lung cancer.

    Tasks: hx, mx.
    1.
  23. Guest

    Guest Guest

    Thanks for questions, Im preparing for AMC MCQ examination in Melbourne, if anyone from Australia please reply. Also if anyone got study materials for AMC please let me know ,
    Thanks
    Mini
    minithomas5@hotmail.com
  24. Guest

    Guest Guest

    It's a great help for me.

    Any body knows 11th November 2006 Melbourne clinical questions? It’s a great help for me.
  25. helpplease

    helpplease Guest

    Help

    Hi there
    I just passed MCQ, where i can join for CLinic, anyone have any idea, where is the best place with less fees to join ?
    please advise

    minithomas5athotmailcom
  26. sylvia.

    sylvia. Guest

    man presented with pain in the chest, sweating, and shock

    man presented with pain in the chest, sweating, and shock. He was treated with cardio version with DC shock 100 Joules, 200 Joules & 360 Joules. Pt. Still on fibrillation. What you will you do next?
    a) Repeat 360 Joules DC shock
    b) I/V Lignocaine
    c) I/V Adrenaline
    d) I/V atropine
    e) Mouth to mouth resuscitation


    b) I/V lignocaine

    If patient is haemodianamiccaly stable (which is true in this case) we go for second option after D/C cardioversion ie I/v lignocaine
  27. pooellashi

    pooellashi Guest

    Can somebody post AMC of 2006 in Adlaid? Many thanks.

    Recalls of AMC on 25th Feb, 2006, Brisbane.

    I started from station 20.

    1. You are working in a district hospital as an RMO. You live about 10’ drive away from the hospital. At night you are called by the midwife saying a patient had about 1250ml bleeding PV. The patient delivered a baby today which lasted about 10 hours. Initially, she bled about 250ml.

    Tasks: talk to the midwife over the phone and ask about patient’s situation and tell the Mx.

    2. A 52 year old retired pharmacist came to see you with tiredness for about 1 moths.
  28. Guest

    Guest Guest

    That's huge. thanks for all of you
  29. September 22nd--2007 Adelaide Exam.

    September 22nd--2007 Adelaide Exam.


    AMC Clinical Held at Adelaide.
    1) Snake Bite. (emergency management) Please read the australian way. Dont say yo are goint to clean the wound. Australian snake bites aren't cland are washed. Read the ELS manual. Splint and compression bandage is essential.Antivenom ,follow up, notin for signs of posisoning.
    2)A 3 years old child had viral ever . To week later developed bruise all over with purpuric rash. Examine wanted what investigations you woul do . Addres the concern 0of the father, & Management . It is ?? ITP /Henochschonlein purpura. When FBE was requested the examiner handes out to youa result which shows extremely low platelet. Yo must clearly spell out that you are very concerne for the child and would advise admission under paed spl for Platelet transfusion an further mgt.

    3)A 55 yrs old lady come with H/o Bleeding P.V. ( postmenopausal bleed).Take a hist, ask for examination & investigation finding from the examiner & discuss the managemnt.
    4)A young lady admited with pain abdomen seen in the A&E by the Dr. and admitted . Al inv done by him showed NAD. You are the on call Dr for the night and the girl/lady c/o pain abdomen and wants Pethidine. You learn that her GP used to give her pethidine whenever she had pain and wants the same. This a drug dependance case. Please deal it tactfully. You should address the pain at the same time convey to he examiner that you are concerned about addiction. Rad up how to manage drug addiction and ways to manage.

    5) A 35 years old lady regnant & in her 36 wks is teted + ve for GBS ( Group B streptococcus). Patient will ask what oes that meas. What you would do. Read up the Australia and Newzealand college of Obst & gynae regarding this topic. You need to antibiotics ( inj Penicillin). There are protocols for it and varies from hosp to hosp. say you would talk to the spl and take his adv ( be a safe Dr if you don't know anything). premature ruptue of Memb / prev GBS etc warrants antis. Please read the article.

    6)A mum come to you concerened with her 3 yrs old child with fits 3 times in the last 18 months and always with fever.. (typical febrile fits.) address mum's concern and discuss what mgt you would want her to do. Discuss about epilepy and the % . If you have time adess mum's questions.

    7)12 mth baby brought in by mum with H/o diarrhoea . Discuss the management with mum/examiner.
    Please know the % dehdratio calculation and when you are going to institute IV fluid therapy & hospital admission.

    8)A 28 yrs old lady come with DVT.Take a history and discuss the management.
    9) A lady with Heaptiis C. Adress all her issues. Take a short history about her risky behaviour. She come out with having IV drug abuse. From there you kneed to know everything about Hep C. Talk about managemnt , prevention, wht precaution she shouild take now etc. Please read it up in AFP ( given beautifully). The examiner will take you up to CA liver. ( so hurry up in your consult yet in a relaed manner)

    10)A post operative patien for abdominal aneuysm.. Husband come to you very concerned wanting to have information and panicked about tubes runing every where & the patient is in ICU. He would ask you is my wife going to die ? Is that the reason she is there. Address all his concerns. Don't panick. You may not anything about aneurysmal operation . Deal it as if an acute operation.Tell him clearly that you don't ave much idea about it as yopu have recently joined the unit an would gather al the information rom the specialt/ anesthetist / etc and et back to him . There would be many questions he would ask you whic I am sure you would be able to answer if you have done surgery housemanship.

    11)A lady has been taking some anti psychotic medication and since the last ew months she has been caned on ?? Olanzapine. Se has become obese and feel tired. adress all her concerns. THIS IS A TYPICAL CASE OF ADVERS EFFECTS OF THE DRUG. Remember i there is drug involved scenario, 99% of the time it is to with Side efects o the drug. his lady to on histor aking was sugested she could be having DM / Hypercholesterolemis , Wt gain etc. ( the examiner beams a smile). Now he would ask you what Inv you would . Simply tell him the appropriate test for DM? Dyslipidemia ,LFT etc Please ell that you would address these issues, suggest referal to Dieician, Sugset exercis -programme for obesity, Lastly tell that you would consult the Psych spl. She would want you to change the medication. Tell her that anti psychotic medications aren;t changed at the drop of the hat. You would talk to the spl and get back to her.
    12)A 48 yrs man come with Diarrhoe, bloating of the abdomen, etc since last ew months. Take a history. This man will come with everything normal. hen you ask about the Wt he woul say he has been loosin Wt, All investigation -Stol tet, colonoscopy, Blod test etc is normal. Very Confusing indeed. DEFINITELY SCREEN HIM FOR COELIAC DS.
    Carry on from there.)

    13) A man with a Headache noted suddenly in morning when he wake up. He had sex and the he headache pecipiate. Take a history. This man woul tell you that he has Migraine . Screen and ask question for the potential serious condition for headache. Post sex headache could be subarachnoid Hge. Examiner would ask you what inv you would do tell him evrything you would like to including CT. Tell him if In CT no etures of raised Intracranial Pressure is seen you may Do LP. Then he would throw at you ---What would you se. Tell him--Xanthochromia. Forgot to make a mention---screen him for infection ( meningitis etc).

    14)A ?? %) + lady was sitting on a couch with a bandage over the Lt supraclavicular Lymph Node.Biopsy result shows squamous cell metastasis. Do a focused clinical examination , Diagnosis. This one really tests you time management skill. quickly get on to inspect the Cv. L.N. This ladyhad to be examined for L.N , & neurological examination of the Upper limb and face. The finding in this lady was that of Lt.Upper lobe Squamous cell CA. Sh had the typical Horner's syndrome. alk it loud to the xaminer. Neurological examination of the upper limb showed drasticall decr sensation over T1 distribution--Lt arm. Typicall of the upper lobe involvement. Once you reach this point xaminer beams a smile and throws 1 q to you. what is the prognosis. Say it's poor but palliative care and shared care with oncologist is the answer to it. Australia has got wonderful support sysytem . make a mention o it if you have time.

    15)A man come to A&E with Palpitation and dizziness. Take a history and Inv. when you say ECG the examiner would flashan ECG to you. Plaes take it from there. This is a simple station. KNOW FEW ECGS :SVT WPW synd ,AF with Increased Ventricular rate, VT, MI, etc.
    16)This is a lady who had a vaginal delivery before and has come to you asking i she could have vaginal delivery. Adres her concerns. Please find out before saying that trial vaginal as to why she had her prev CS. Take it from ther. Simple station. Tests Basic Obst Knowledge.

    BEST of LUCK Folks.
    Ding Dong
  30. Guest

    Guest Guest

    Hi all.
    There is an error on the date.
    Please read 207 as September 22nd--2007 Adelaide Exam.
    Bye.
    Ding Dong
  31. AMC Clinicals December 2007

    Hello, this site helped me so i feel compeled to make a contribution also. (now guys and girls, these recalls may not contain all the fine details of the stations proper but the scenarios are correct as much as i can remember).

    1. woman with bilateral hearing impairment post partum, started during pregnancy and got worse after delivery. positve family history in mother. do rinnes' and weber test and explain to px management. a case of otosclerosis.

    2. 3 year old child with night cough and wheeze on a background of low grade fever, runny nose and cough. GP setting. other aspects of history normal. manage. case of mild asthma. know asthma management plan.

    3. hiatus hernia/GORD and gastric ulcer in an alcoholic and obese man.

    4. hyperemesis gravidarum in 8 GA, first pregnancy. urine - ketones++++

    5. iron deficiency anaemia, results of iron studies explain to patient the results and next line of action.

    6. alcoholic liver disease, results of LFT for intepretation. educate px on alcohol management.

    7. woman with pancreatic cancer, terminal. she is tired of living and wants your help to end her life. family very supportive. on 5omg of morphine BD only but pain is unbearable. i am not sure if it was a case of depression/suicidality or a case`of palliative care but i addressed both aspects.

    8. 75 yo woman with CVA, explain to husband about management and prognosis.

    9. sudden onset of shortness of breath in a 26 year old man. no significant past medical history. case of spontaneous pneumothorax.

    10. 26 year old woman with 18 month history of infertility. only has coitus twice a week.

    11. 6 year old boy with 6 months history of not doing well at school. has a new teacher and family going through some problems.

    12. painless terminal haematuria in a man with a positive family history of prostatic cancer. has obstructive symptoms of prostatism as well. dettailed history, examination and line of management.

    13. USS report showing DVT in popliteal veins in a 42 year old woman on OCP. explain the results to the patient and manage.

    14.


    15. 18 yr old boy has psychosis, after failing his exams. history of illicit drug use. patient has authorised you to explain to mother patient's condition and treatment only. mother would ask you if her son has used drugs. (he's 18 years old).

    16. 27 year old obese woman with irregular periods coming with 6 week amenorrhoea. she would tell you that her periods can come any where from 4 to 6 weekly. i thought management should exclude pregnancy, ectopic, endocrine issues, PCOS etc. also asked about desire to get pregnant.

    the trick to passing is to revise past questions as a guide and practice the scenarios with others. practice! practice!! practice!!!

  32. Guest

    Guest Guest

    i saw a remote control pacer at wall mart they had some die cast pacers too the companys name was motor max there is a web site called hobby talk that has more info ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

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