AMC EXAMS AUSTRALIA ,AUSTRALIAN MEDICAL EXAMS,MCQS,CLINICALS.

■ A systematic approach to screening well women has contributed to a decline in incidence and mortality from cervical cancer in Australia. ■ There is still room to improve participation in screening in Australia: older women and women of low socioeconomic status are less likely to be adequately screened. ■ Indigenous women have not benefited from improvements in mortality through cervical cancer screening. ■ Exposure to wart virus infection (HPV) is a normal part of sexual activity. ■ During the acute phase of infection, Pap smear show the changes of a low-grade squamous cell abnormality. ■ Most women clear the HPV infection and the low-grade abnormality resolves. ■ Persistent infection with high-risk HPV subtypes carries the possibility of developing high-grade squamous cell abnormalities. ■ The new NHMRC guidelines on the Management of Asymptomatic Women with Screen Detected Abnormalities use evidence from the Pap smear registries, new understandings of the epidemiolo...

PSYCHIATRY 1.A lady with a previous divorce now comes to you with a seductive behaviour a. Narcistic b. Histrionic c. Borderline 2.In Australia bush fire are common either accidentally or some people lighting fire deliberately. Which is true regarding pyromaniacs? a. Done for notoriety or publicity b. To hide their acts c. As they like to play with fire d. Set fire and get panic attacks e. For satisfaction 3.Depersonalization may occur in a. Schizophrenia b. Ecstatic religious experience c. Depression d. Post traumatic disorder e. All of the above 4.A middle aged lady present to you with nausea dyspepsia abdominal distention. She had a past history of going to many doctors and being treated for many disorders. she has been treated by a rheumatologist for aches and pains, cardiologist for her palpitations and gave her propanolol without improvement , a neurologist for her epilepsy. On examination you find a tense anxious woman in spite of her daily dose of benzodiazepine. There are scar...

Fungal/yeast 1 Candida (oral or oesophageal) 2 Tinea infections (corporis, cruris, pedis, interdigitale etc) 3 Pityriasis versicolor 4 Seborrhoeic dermatitis (especially when severe or recalcitrant) 5 Pityrosporum folliculitis Viral 1 Herpes zoster 2 Herpes simplex 3 Viral wart infections 4 Molluscum contagiosum Bacterial 5 Staphylococcus aureusimpetigo, chronic folliculitis Mycobacterial 6 M tuberculosis Infestations 7 Scabies (especially Norwegian scabies) Other 1 Psoriasis 2 Kaposi’s sarcoma 3 Acne All of these skin conditions can occur without HIV, but consider HIV particularly if they are recalcitrant, recurrent or atypical.

Acute HIV-related conditions that may present in the emergency department 1. Community acquired bacterial pneumonia. People with HIV, regardless of their level of immunosuppression, are more at risk of bacterial pneumonia. They have similar signs and symptoms to the non-HIV-infected population, eg fever, cough, dyspnoea, increased respiratory rate and sputum production. 2. TB presents with malaise, weight loss, night sweats, fever, cough, sputum production (may be blood-stained), and lymphadenopathy. 3. Pneumocystis pneumonia (PCP) presents with exertional dyspnoea, fever, dry cough, normal auscultation. X-ray typically shows perihilar shadowing (ground glass haze), but may be normal. 4. Cryptococcal meningitis. This presents with headache, with or without classical signs of meningism. Occasionally rapid progression occurs, and the patient may present in coma. 5. Cerebral toxoplasmosis. This may present with headache, fever, lethargy and confusion, progressing to fits and coma.

Treatment of status epilepticus in hospital. 1.Immediate measures Secure airway Give oxygen Assess cardiac and respiratory function Secure iv access Give lorazepam 4 mg iv or diazepam 10 mg iv Repeat after 10 mins if no response 2.In hospital Take blood for electrolytes, LFT, calcium, glucose, clotting, AED levels and storage for later analysis Measure blood gases Establish aetiology Give thiamine or 50% glucose solution if indicated Within 30 minutes In patients with established epilepsy: give usual AED orally, NG or iv 3.In patients with new-onset epilepsy or if seizures continue: fosphenytoin (18 mg/kg phenytoin equivalent), up to 150 mg/min with ECG monitoring or phenytoin 18mg/kg, 50 mg/min with ECG or phenobarbital 15 mg/kg iv, 100 mg/min Longer than ITU may be necessary minutes Anaesthetise with EEG monitoring Midazolam, phenobarbital, propofol, or thiopentone most commonly used Non-convulsive status Augment or reinstate usual AEDs Consider ...

1.Haemophilus influenza -Smokers, COPD 2.Mycoplasma --------Young, otherwise healthy patients 3.Legionella --------Epidemic infection in older smokers, particularly when located near infected water sources, such as air-conditioning systems 4.Pneumocystis jiroveci (formerly carinii) pneumonia HIV-positive persons with 5.Coxiella burnetti (Q-fever) Exposure to animals, particularly at the time they are giving birth 6.Klebsiella Alcoholics 7.Staphylococcus aureus Following viral syndromes or viral bronchitis, especially influenza 8.Coccidioidomycosis Exposure to the deserts of the American Southwest, particularly Arizona 9.Chlamydia psittaci Exposure to birds 10.Histoplasma capsulatum Exposure to bat or bird droppings, spelunking (recreational cave exploration) 11.Bordetella pertussis Cough with whoop and post-tussive vomiting 12.Francisella tularensis Hunters, or exposure to rabbits SARS, Avian injluenza Travel to Southeast Asia 13.Bacillus anthr...