Anda di halaman 1dari 13

TRAVEL:

1. A 50 year old man is planning a travel to India for 3 weeks. He has taken
HAV/HBV and ADT vaccines. He comes to you for travel advice. He is also on
some anti-hypertensives. What advice will you give him?

2. 38 yrs male returning from Thailand with fever and malaise (chlamydia STi)
PAEDIATRICS:
Respiratory:

3. a 4 yo female present with harsh cough using accessory muscle ,mod


cyanosed.dd? immediate inv? your immediate mx?

4. 4yrs old child with SOB and Cyanosis , manage, DDX


5. Child with respiratory distress and harsh cough ( Dx: severe croup)
6. mother brings 2yrs old child ,another gp diagnosed bronchiolitis.Mother
insisting you for antibiotics.Child goes to child care
7. 6 yrs old Anna with mother complaining of swollen lips and shortness of
breath after eating peanut butter. nebulisation 5 ml of 1 in k
a. IM adult 0.5-1 ml of 1 in k
b. ml/kg of 1 in 10k
c. 5mg salbutamol nebulisation every 15 min
d. promethazine 10 mg iv in severe reaction
e. glucagon 1 mg iv
f. discharge the patient on diphenhydramine or promethazine
+
prednisolone
g. Hydroortisone iv 500 mg
8. 13 yrs child come with grandma with SOB and wheezing.H/O having vanilla
icecream half an hour before.Known allergy to nut.how you will manage the
case?

9. 7 years old boy with sever asthma

( MOA of steriod in sever asthma, finding of severe n critically severe asthma)


8.a 4 yo fe,ale present with harsh cough using accessory muscle ,mod
cyanosed.dd? immediate inv? your immediate mx?
9.A 3 yr old girl Riya is brought to you by her mother Belinda with breathing
difficulty at night. You have made a diagnosis of croup. Your task is to discuss
the diagnosis with the mother. Then discuss the treatment options with her.
Clarify her queries and misconcepts regarding immunization
10. 18 month old with fever for 3 days + cough, poor feeding, from NL delivery,
updated Immunisation, NL development, what more you ask about history?
DDx? Mx
Hx: no stridor, no recurrent infection
Examinaton: miserable & flushed, Fontanell not buldged
No Wheeze & Stridor
Crepitation right lower lobe, air entry,
Most likely Dx: Pneumonia

Mx?

CNS:

11. A child of 10 who is a known epileptic has been convulsing for 15 minutes.
The patient is still convulsing, he is clearly cyanosed.Immediate
management? Investigations required in the next week? MAIDS
FEVER AND RASH:
12. 18mnth old child fever for 3 days not coming down with paracetamol parents
worried. On examn child has mild dehydration. How u will approach the case.

13. 4 yrs old boy with fever and rash


14. An 8-year-old girl presented with fever, numerous bruises over the entire

body, and pain in both legs. Physical examination reveals pallor and
ecchymoses and petechiae on the face, trunk and extremities. Findings on
complete blood count includes a hemoglobin of 6.3 g/dl, white cell count of
2800/mm3 and platelet count of 29,000/mm3. What would be the MOST
appropriate diagnostic test and how do you proceed from here?
15. A 6-year-old girl presented with low grade fever and arthralgia for 5 days.
She had difficulty in swallowing associated with fever 3 weeks prior to
presentation. Physical examination revealed a heart rate of 150/min and
pansystolic murmur at the apex. There was no gallop and liver was 1 cm
below costal margin. The MOST likely diagnosis is and ur management
16. 4 yrs old boy with rash following sore throat
KNEE PAIN:
17. 7yrs old boy with hip pain (perthhes disease, position of limb)
18. 7yrs old boy with knee pain
19. A 6 year old boy with knee pain, history, examination , dd, management
EARACHE:
20. 7 year old boy with pus ear with mother- culture, interpreter, abo health
worker, h/o urti, culture, pseudomonas ciplox ear drops but no oral, ent
referral, surgery, hygiene-ear dry, dont visit local doctor, closing the gap,
siblings, growth chart, audiometry before and after surgery
21. 18. 6yrs aboriginal boy with bug in ear
22. 19. Aboriginal grandmother with 7 yrs old boy with learning difficulties and
impaired hearing

MISCELLANEOUS:

23. 8 yrs old girl with secondary enuresis


24. 7 yrs old boy with bilat ankle swelling
25. 7 yrs old aboriginal boy with grandmother complaining poor school
performance

26. Aboriginal lady coming with kids all are scratching

CHILD ABUSE:

27. 3 yrs old Child with fracture humerus

You are the solo GP in a small town ,recently came there have noticed that all
well except the Smith family where the father drinks too much. You have
sutured her mothers lacerations several times in the local hospital. This time
she comes with her 6 yr old daughter who looksor her age and the mum says
that she always c/o abd pain & bloating. Shes dressed in crumpled stale
summer suit, she scratches down her legs(groin area) So what are the issues
u would consider in this scenario?(I said child abuse.) What u look for in the
examination? ? Apart from child abuse simple things you look at in her in
examination ?
o She was in 60th centile when she was born bur now her Ht and Wt has
come down to 5th centile while her head circumference to 20 th centile,
how to proceed? Any simple ex in relation to her itchiness . (look for
worms inf) She has whip worms around her anus what u do?
o How to find out any peadiatric problems in her (as she is below the
centiles) apart from doing growth hormone levels? What Ixs?

28. 6month old comes to your practice with father, had been immunized
yesterday has been irritable since morning and fell down one hour before
reaching practice. : case of Child abuse

29. 9 w old baby cannot move left leg with a fall history. Come with mum. ? Child
abuse suspected.

30. Child 6 months old with fall and inguinal hernia


DOMESTIC VIOLENCE AND SEXUAL ABUSE:

31. 15 yrs old girl coming with boyfriend and having lower abd pain (sexual
abuse by family member)
32. 30 weeks preg lady with lower abdominal pain (abruption placenta) dt
assault.
33. 17F recurrent abdominal pain came from South Africa 2 months before. She
has bf. But father doesnt want her to meet bf.
d/d- dysmennorhea, pid, uti, mittleshmerz, ectopic, sexual abuse. Pap smear
from 18 years, gardasil

privacy, confidentiality, 5ps, amenorrhea of 8 weeks, examine abdomen


pelvic examin speculu m inv- fbe, esr, urine routine, culture, upt at 8 weeks?
Swabs for pidserial beta hcg, refer to specialist
how to disclose? Afraid of father.family meeting
father kill her-authorities for safety
ADOLESCENCE PROBLEMS:

34. Young woman on COC presenting for contraceptive advice following broken
condom during sex last night. She also has forgotten to take the pill last
week.
35. 15 yrs with Alcohol and ectasy.....
36. 15 boy consumed ecstasy and alcohol having delusion of samao monster
chasing him- calm down, look into eyes of patient, ur safety, others and his
safety, pulse 160 rr- 28. Limbs are cold and clammy, bp-100/80, temp 35
degrees, iv-20ml/kg, warming, whom to call cat, parents-take history from
them, immunization status, doctor on fone talk to him-, after 2 weeks ask
history esp psychosocial
37. 16 year girl comes to your General Practice with history of missed period for
2 months. Her parents are well known to you. She is in relationship with his
boy friend of 17 years. Discuss your approach to the patient.
38. 14 Yr old with Acne(latest)
39. 18 years old boy found masterbating in his balcony in public his neighbours
brought him to ur surgery in a disoriented state how will u manage
WOMEN HEALTH:
ANTENATAL:
40. a 23y/o aboriginal woman 33week pregnant with abdominal pain and bad
smelling down there
41. 19 years old lady with came to your clinic with history of 34 weeks
pregnancy, abdominal pain with slight P/V bleeding. How to manage this
case?
42. a 10 week pregnant female , comes with bleeding , has 3 children, had one
abortion before
43. 18 yrs old girl with LIF pain (Ectopic )
44. 28 weeks lady with headache and vomiting
45. 25 yrs old, 6 wk pregnant women with excessive vomiting( H.Gravidarum)
(LATEST)
Others:
46. 27 yr guy and 24 yrs lady (sub fertile couple) councel them
47. 48 yrs old lady having menopause who had her pap smear 4 yrs ago
48. 36yrs old lady,BMI 32 come for COC, pap smear done 4 years before(regular
pt of your collegue).what you will do

49. 42 yrs old lady collapsed in waiting area OF YOUR practice read
unconscious patient

50. 40 yr old Philipine lady recently married a retired 67 yr old Aus farmer.She
comes to you to discuss whether to have a baby, and she had never had a
child before. What issue u would discuss in ur GP clinic? Any advices to her
husband or any Ixs? What other tests for her to undergo before pregnancy?
Any other advices to her apart from stopping alcoho, smoking , healthy diet
and exercise?
51. 47 yr old lady with missed period for a few months, lives with husband, has
3 children with NL Delivery.
( Pap smear updated, NL physical examination), what more you ask about
history? DDx? Mx, What antenatal tests?
I said I will check pregnancy in office by Urine They said it is positive
52. 25 year old female with flu-like symptoms. GB syndrome
53. 47yr old with Secondary amenorrhea
54. a 18 year girl ,delayed puberty.all causes and investigation
55. Breast lump in a 38yr old female- how u will approach the case.
56. 32 yrs old lady complaing abnormal pap smear report not given to her for 1
year
57. 48yo woman with night sweats and hot flushes, ddx and management : premenopausal
58. 70 year old woman with painless lump in her left groin and she has nausea
and bloated in her tummy and she had lab showed LDH and ALT increase and
CA 125 324

59. young women with acute lif pain. ? Ddx n mx .


60. a lady came with vaginal discharge and itch,they askked me for the
management,first
history
taking
,examination,dd,
I
said
vaginosis,candidiasis,trichomoniasis,alergic reaction to chemicals,and also
said it is always wise to think about cervical Ca as it may cause sometimes
vaginal discharge ,they aked me for the management I said wiff test koh and
microscopy alythough I do not know they have the fascilty there I will ask the
supervisor,and the asked in case of candidiasis what you expect for the
discharge i answered white itchy thick discharge,and the treatment,azoles
,for 7days ways of application,partner.
MENS HEALTH:
61. 67 yrs old diagnosed case of prostate cancer came to u for mercy killing and
his family is living abroad.
62. 65 yrs old male with prostate cancer complaining of tiredness and low mood
63. .an old man living alone,with end stage ca ,palliative care askink for
mediication to kill himself
64. 62 y old man w hx of dribbling
65. You new to the practice and the rotary club invites you to give a small
lecture about men's health .do you accept the invitation and wgat will you

ask the organisation if you accept the invitation .what topics will be included
in your talk? http://curriculum.racgp.org.au/statements/mens-health/
MEDICINE:

66. A 57 year old man comes to you saying he feels increasingly breathless on
walking, says he cannot even walk 25 steps. He was recently diagnosed to
have COPD. He says he is unable to work efficiently and he feels sad and
depressed about it. He comes to you for advice. How will you manage him?
67. A man of 40 presents with shortness of breath at 4 AM. He is cyanosed,
using accessory muscles of respiration, is reluctant to lie down. Differential
diagnosis? Examination and expected findings? Immediate investigations?
Your management in the first hour.? BLOCC CRAINN
68. just the last one wa staright forward : tiredness in 60 years old man.renal
carcinaoma

69. 65M sob, fursemide 40 mg intermittently, diclofenac for osteoarthritis,

d/d-heart failure
drug reaction b/ fursemide n diclofenac
ecg, echo done, best drug-ace inhibitors, hypo kalemia, stop furse n
start pot sparing diuretic or give pot supplements??
Smoking alcholo
Osteoarthritis is active glucosamine, swimming not affecting joints,

70. A 65 year old obese man comes to you saying he is not feeling good since
few months. He feels lethargic and depressed, says his wife sleeps in another
room. How will you manage him? This was a role play. Probably Obstructive
sleep apnoea
71. a 46 y/o man with a history of 6 month fatigue
72. 54 yrs old butcher moved from england to aus 20 yrs back comes with
tiredness for 3 weeks-VSD CHIME
73. 60 yrs man with tiredness (depression screening questionaires) SADEST,
SADPERSON, K10
74. 64 yrs old man with polyuria and tiredness, inv show bl sugar 11.5, LFT
deranged, problem with vision and ECG with conduction defects. (Haemchro)
75. 68 yrs old lady came with history of fainting attack. How to manage?
76. 46 yrs old obese male with palpitations & shortness of breath. They showed
me EKG which was Atrial Fibrillation.
77. 80 yrs old lady with chest pain radiating to back, chr alcoholic(ac Panc)
78. 80yr old Irish woman lived in Zimbabwe for many years, complaining of
chest pain, drinks a bottle of wine daily and smokes 30 cigarettes a day. DD
and manage
In the third case, I gave a DD of Aortic dissection, ACS (including MI),
Pancreatitis, Musculoskeletal pains. In my management, I also did an ecg and

the gave me an ecg of Inferior MI, and asked my next line of action(alcoholic,
pancreatitis)
79. . In the first case, when I reviewed the patient and did an ecg, they gave me
an ecg of Afib, and asked me my next line of action
80. A 56 yr old man comes to you. He is sweating and pale. He developed chest
pain while playing Golf. What would be your approach to this patient ?
Physical findings revealed on request were BP 146/86, Pulse 76/mt, BMI 32.
An ECG was provided on request.
81. Woman with Shortness of Breath on GTN, CCB and Statin., give DDX,
Management of this pt
82. a man with chest pain ,had surgery in some weeks before,they asked me for
the management,I told them first to stabilise the patient DRSABCD they told
they asked me about the airway management they meant O2,how to
administer o2 and how much ,what other management.callin 000 ,taking a
history,adminestering
pain
killler,I
said
morphine,the
dosage
of
morphine,they gave me an ECG for PE.
83. 62 year old lady with chest pain.it was pneumothorax
Not tension pneumothorax.
84. .A middle aged man having shortness of breath with history of smoking
85. 64 yrs old man with unilateral headache(temporal arteritis)
86. An adult man come with severe headache,different dx & Mx .(cluster
headache)
87. 64 yrs old lady with peticheal haemorrhage on legs and haemangioma on
tongue( not a usual case was asked only once)
88. Aboriginal with diabetes and deranged lfts
89. Aboriginal lady with NIDDM and hy taking medicine mostly and having body
pain on and off , day and night, has 5 kids(non compliance with financial
probs, chronic disease management plan, can be using statin :s/e bodyache)
90. Lady with anemia.taking asprin for joint pain.
GERIATRICS:
91. elderly with confusion
92. 74 yrs old lady with recurrent falls
93. 80 yrs old lady with polypharmacy
94. 74 yr old man comes to your clinic requesting a repeat prescription for
drugs. He hands over to you a bag containing a lot of medicines. The
medicines were Metformine, Verapamil, Atenolol, Furosemide, combination of
Hydrochloro thiazide and amiloride, Digoxine, Aspirine, and Prohlorperazine.
How would you respond to his request?
95. 76 yr old man, problem with memory loss recently. Living alone, with a long
list of medications:
Amiloride, Amlodipine, Digoxin, Furosemide, Warfarin, Panadole/ codein,
Tramadol, Prednisolone, Omeperazole Medical Hx:Atrial Flutter, Atrial
Fibrilation, Vertebra Fx, Coronary Artery Disease, Reflux & ...
Do you think there should be medication interaction problem?
Can you tell us about the medications, which group they are in?
It is a case of Poly pharmacy.

About some drugs that I did not have any idea about I said I will check with
MIMS for drug information and interactions to omit unnecessary medications
and I will check with my supervisor as well.
Then They asked me if your supervisor is busy with other pt what do you do?
Then told me now your supervisor comes and says these are too much
medications so let pharmacist deal with it. Then what you do?

SURGERY AND ORTHO:


96. 28 yrs old man with history of pain in his wrist
97. 55 yrold farmer working in yard plucking oranges comes to your rural
practice with shoulder injury and some test results. He complains of shoulder
joint pain of R side elicited when he tried to pluck oranges. You have seen
him previously and requested xray and USS of right shoulder.
Xray of R shoulder enlocated,has early signs of osteoarthritis including
loss of joint space. No erosive changes.AC joint is normal
USS evidence of partial thickness tear of supraspinatus muscle with
thickening& swelling of long biceps tendon and sub acromian bursitis.
How to explain the test results to the patient? What is the Mx? Any
advices regarding the prognosis of his condition? Will he be able to earn a
living?
98. 18 years old boy with injury to lower leg. There is weakness n numbness in 2
toes. My Ddx- fibular # with common peroneal nerve injury or compartment
$)
99. pt fell on outstretched hand 5 days ago : Scaphoid fracture, examination,
invxn, management including cast
100. Backache with pagets disease(latest)
101. x ray of FB,interpret and say what can you see position
102. Pt 54 yrs old with upper abd pain ....discussed every thing and then gave
me picture of peri umbilical stain( Cullen Sign) ...explain and what this
indicate
103. a 56 y/o who came to your surgery with BP- 75/ 60 mmHg, PR- 120,with
chief complains of epigastric pain and hematemesis...what are your diff.
diagnoses, what are ur managements, how muc Iv will u give, who will u call
first..
104. 64 yrs man with snake bite on foot
105. A man of 65 is bought to the casualty department with a history that he
had been walking in a paddock when he felt a minor scratch on his left calf.
Several minutes later he believed that he saw a snake in the paddock and
shortly afterwards began to feel nauseous and fatigued. Examination shows
two pinpoint puncture wounds on the lower left calf.
Q1. Differential diagnosis?
Q3. Immediate investigations?
Q2. Examination recommended?

Q4. Your management of snake bite?

PSYCHIATRY AND COUNSELLING:


106. 45 yrs old lady with SOB and palpitations (anxiety)( screening tools for
anxiety)
107. Sudanese family migrated to aus with PTSD, her daughter was far qway
from them..they wanted certificate not to attand to english course
108. 65 years old lady presented to your office thae=t recently moved to
nursery house. She has been living alone for 6 years since her husband died.
In the last 6 months she has become increasingly disabled because of
suffering of congestive heart failure and osteoarthritis. She was moved to the
nursing home 3 months back. 4 weeks ago she started to have, weight loss of
around 3.6Kg, has not eaten, lost of interests of all social activities & has
been crying all the time. Her mood is worse in the morning & (especially
during the attacks of low mood) she has impaired short term memory How do
you manage this pt?

109. A 29 year-old teacher consulted you regarding what he describes an


intensive fear before giving class in the secondary school. He tells you that
is only matter of time before he makes a real major mistake. What is the
most likely diagnosis in this patient and his management ?D/D?

110. A 20 yr old girl comes to you with h/o not able to focus on her studies and
she is crying. She is having her university examination in a couple of days.
Her brother committed suicide 6 mo back. Discuss how would you manage
her?
111. Man with drug abuse, malingering to get morphine.

112. 34 yr old lady new pt from interstate, complains of Migraine headach, ask
for Pethidine
How to manage?
She insists on getting Pethidine ?
113. ROLE PLAY 64 Yr old man, DM uncontrolled, comes for the lab results after
3 reminder has been sent. HbA1C:9, TG:3, CHol:5, Mx? How you increase his
compliance?
114. 55yrs ols Renni,an obiriginal man come for prescription ofdrug.He has h/o
CVA 3 weeks back.He is a bus driver,insisted to go back driving.you are in a
Monday very busy schedule.
115. sterilization request from mum for 14yr old mentally disable daughter.

Recent Exam: May, JUNE 2014:


Dr.Sheharyare:
116. 15 yrs old aboriginal boy who is accompained by mother with complaints that
child is not being himself lately. He is being rude and different.

117. 17 yrs old female presented with mother, migrated from sudan3 wks ago with
lower abdominal pain(unplanned teenage pregnancy)
118. 42 yrs old man with severe chest pain at 4 am , took aspirin and Mylanta. You
are home visiting doctor at 7 am . ecg which shows st depression in 2,3,avf, other
tests including cardiaz enzymes are normal, how will you proceed further ? How will
you manage this patient whose pain is subsided now.?
119. 22yrs old female 6 yrs after marriage presented with 6 wks og geastation. How
will you manage?
Dr.Rakshanda:
120. 7 yrs old boy with hip pain
121. 51 yr old postmenopausal symptoms with depressed mood( right breast mass)
122. 50 yrs old male with asthma with bad cough taking salbutamol puffer.
Dr.Antoninas:
123. 65 Yrs male with end stage disease asking for mercy killing
124. 35 yrs old female with chest pain for 2 months duration
125. 2 month old child with fever with rash
126. 38 yrs old female with 11 wks pregnancy with bleeding per vaginum.
Dr.Ambreen:
127. 17 yrs old female with amenorrhea caught vomiting by mother(bulimia
nervosa)
128. 47 yrs old male with SOB and palpitation last evening while watching TV(AF)
129. 18 yrs old female patient with P/H of 5 yrs of headache associated with
photophobia, phonophobia, and nausea and vomiting
130. Child with previous h/o anaphylaxis, presented to practice after eating nuts.
Dr.Munaza:
131. 7 yrs old male child with knee pain(Asked about rheumatic fever)
132. 18 yrs old female with amenorrhea for past 3 months (Anorexia nervosa)
133. 45 yrs old male past h/o SURGERY OF SPINE C/O Sob, and chest pain , severe
9/10(?Pulmonary Emboli)
134. 85 yrs old elderly terminall ill patient asking for euthanisa.
LATEST QUESTIONS:
135 .47 yr old man comes to see you with complaints of difficulty breathing and
speech after cleaning his house with chlorine. It was a role play.
136

. 28 yr old woman with a day hx of vaginal bleeding and lower abd.pain

137 .47 yr abo male comes to see you to discuss his LFT and hepatitis B profiles
result
Hep b surface antigen +ve
Core antigen positive
Anti core antigen antibody -ve

He has a a girl friend


Interpret result to the patient and management
138
ago

.68 Yo man with headache on and off, had been hit by a metal piece 10 days

139 .58yo lady with chest pain on exertion. She had a breast lump on
examination, had been taking HRT for 5yrs. Was asked breaking bad news, effect of
HRT on chest pain and management.
140 . 4yo boy with mother, fell in bathroom had abdominal pain, ddx, on
examination many bruises, child abuse case, management
141

. 28yo lady with pv bleeding, it was either threatened / ectopic

142 . 65 yo female with back pain, with h/o breast cancer...secondary metastasis,
asked investigation, ddx, management
143

. cut in the wrist (same question from clinical handbook)

144

.28 YO with pv bleeding

145 .18years old with severe headache on and off for last 5 years with vomiting
i ruled out resp infections, trauma, tumour ....it was fronto parietal...on either side,
abt half day...now getting severe
i managed as migraine, they asked red flags for migraine and the differential
diagnosis
they asked about acute and chronic management of migraine
146 . 42 yrs old working in day care and has left lower chest pain...it was herpes
Zoster eruption . I was asked differential diagnosis, management and causes of this
apart from day care...immunosuppression, chemotherapy, steroids etc
147 . 28yrs old lady married for 6 years unable to conceive....the issue was male
factor...abnormal sperm morphology and the management
148 . 4yo child with fever of 40 and sorethroat, difficulty in swallowing....was
asked not to take history, only do examination, and management
149 . 45 YRS Old aboriginal female with DM and HT with 3 months h/o bloody
diarrhea with abdominal pain (NOT IBD)
150

. 64 Yrs old with lower abdominal pain and urinary frequency at night.

151

.69 yrs old femal with deformity of right wrist joint.

152 .young child after playing football presented with leg pain. Pins and needle
sensation in two fingers.(? compartment syndrome)
Questions from dr chinedu:
153
154
155
156

. 7 yr old aboriginal boy with discharge ear


. 19 yr old boy with pain, redness in eye r/o foreign body
28 yr old with 10 was amenorrhea threatened abortion
. 26 yr old with htn 150/102 lifestyle related

Dr. Parastoo
157 - A 35yo male with back pain in the L side and L abdominal pain , radiating to
L testicle
DDX? And Hx and management?
158 - A 4yo boy with abdominal pain due to fall in the bathroom (child abuse)
159 - A 30 yo woman ,married for 6y, c/o infertility
160
- A 55yo woman c/o bilateral shoulder pain and hip pain and stiffness in
the morning
DDX? Management?
Dr.Vishal
161
162
163
164

7Yr old aboriginal boy with ear discharge


Chest pain with h/o spinal surgery
10 yr old boy with seizure, on further quest , rash present
Stroke with facial nerve palsy

Dr. Saman Sh October 2014


165 The first case was a 45 yrs old guy coming to your practice with chest pain
shortness of breathe >> it was a case of STEMI , anterior MI.
166 The second one which I didnt answer well was a n 80 yrs old lady wuth DM ,
HTN,OA ,obesity on many medications( nifedipine, atenolol, ramipril , glibenclimide,
metformine, ibuprofen, hydrochloritiazide, amiloride) u were asked to go and visit
her at her place because she think she has flu . 3 doctors has prescribed the meds
for her and she hasnt been seen by any dr in the past 9 months. >> was a
complicated one ! Cause I didnt actually know wht they want from me
167
Third case: a lady pregnant at 36 wks, known case of placenta previa .
Advices in general , blood tests at this wk (hemoglobin sooo important to them) and
wht u will tell the pt about her problem
168
the last case was a child I think 6 yrs old with history of asthma ,brought to
practice by his mom with an acute attack ,asking about what you look in physical
exam ,management and if your supervisor wasnt available what would you do?
November 2014
169.
2 month old child with fever & severe dehydration.
170.
18 yrs old girl with 3 months amenorrhea & BMI 16.

171.
172.

20 yrs old with 12 weeks gestation & itchy vulva, whitish discharge.mi
60 yrs old male, acute abdominal pain radiating to back.

Leila shah mohammadi


6 December 2014
173.
66 year old man with acute left leg pain since morning=>ischemic pain
174.
8 year old boy swallowed a coin with abdominal pain=>appendicitis
175.
24 year old lady 6 week post partum with pink vaginal discharge and
depression
176.
88 year old man with SOB worse in one month=>heart failure
Dr Harpreet Singh
12 dec 2014
177.
32 year old lady has fallen on out stretched hand and is complaining of
pain at the base of the thumb x5 days
178.
15 year old male with alc n ecstasy consumption having delusion of
Samoan Monster in your practice his pulse rate is 160, respiration rate is 28
n his limps are clammy n sweaty temp is 35 C. Has been already taken to
treatment room already by the heavily pregnant nurse? (how will you
manage , what will his ecg show, what danger he is in?)
179.
22 yrs old 28 weeks pregnant lady presents with bad smelling
discharge per vagina, with itching? What if the discharge is white what will
you do?The swabs you took came out inappropriate from pathology, will you
prescribe the lady?At this time (28 wks) what else would you do, while she is
here?How will you examine this pregnant lady? Show us, what will you
check!! Would you do a pap smear on her if she is due
180.
A 2 months old baby has presented with high grade fever 39 not
coming down with intra rectal Panadol. The babys 5, 7, 9 year old siblings are
all having high grade fever with flu symptoms. How will you manage this
baby? How will you lower the temperature in this baby, How will you check
how much dehydrated the baby is? If not taking breast how will you provide
fluid ( and which One) to this baby ( Mother doesnt have breast pump at
present to pump milk and feed the baby with a syringe)?What if the
fontanella are bulging?Whom will you ring if you want to transfer this baby to
hospital. Where the baby needs to go in the tertiary hospital.