ANSWERS
Chlamydia treatment & alternative
A. Uncomplicated genital or pharyngeal
B. Ano-rectal - CORRECT ANSWER✅✅✅CAD - Chlamydia = Azithromycin & Doxycycline
A. Azithromycin [1g; PO; STAT]; Doxycycline [100mg; PO; BD] - for 7 days
B. Azithromycin [1g; PO; STAT & Q7days]; Doxycycline [100mg; PO; BD] - for 7 days (21 days if
symptomatic)
Gonorrhoea treatment
A. Uncomplicated genital and anorectal - CORRECT ANSWER✅✅✅CAG(s) - Ceftriaxone &
Azithromycin for Gonorrhoea
Ceftriaxone [500mg, i.m. STAT] - in 2mL of 1% lignocaine
+
Azithromycin [1g, PO, STAT]
Age groups for routine chlamydia screening - CORRECT ANSWER✅✅✅•RACGP: Routine chlamydia
screening to all women <25yrs and offering to women <30yrs who live in areas of high prevalence
•RANZCOG: all women <30yrs old if they are at risk due to local prevalence
•RACGP Australian guidelines recommend against routine population based screening for gonorrhoea,
only in circumstances of high-risk.
Surprising Fact re undescended testes - CORRECT ANSWER✅✅✅Corrected via orchidopexy
This doesn't eliminate the increased chance of reduced fertility and ^testicular cancer
DDx: 1st trimester bleeding
GA9, single episode of vaginal spotting overnight. No abdominal pain. On examination, Anastacia looks
well. Her temperature is 36.9 °C, BP 118/70 mmHg, HR 70/min regular. Examination of her abdomen
,reveals no tenderness, masses or guarding. The remainder of her examination is normal. - CORRECT
ANSWER✅✅✅Inevitable (complete) miscarriage
Ectopic pregnancy
Threatened (incomplete) miscarriage
Peri-gestational haemorrhage (including chorionic and subchorionic haemorrhage)
Anembryonic pregnancy (Group:1)
Missed miscarriage (Group:1)
Half-marks for:
Blighted ovum (Group:1)
Hydatidiform mole (Group:2)
Molar pregnancy; trophoblastic disease (Group:2)
Miscarriage
Vaginal trauma
Nil marks for: Cervical polyp, Cervical erosion; ectropion
Endometritis, Implantation bleed
a). In which trimester are iron needs highest?
b). How much iron is required in total? - CORRECT ANSWER✅✅✅a) Third trimester
b) 1000-1200mg
What timepoint is anti-D given? - CORRECT ANSWER✅✅✅28 & 34wks & within 72hrs of delivery
(& if problems along the way. 250IU 1st tri, 625IU 2nd & 3rd tri)
Ejection Fraction
i). Normal
ii). Borderline HF
iii). Severe HF - CORRECT ANSWER✅✅✅i). Normal = 50-75%
,ii). Borderline = 41-50%
iii). Severe <30%
Heart Sounds
i). Where/how is an S3 gallop best heard?
ii). What can it indicate?
iii). Can it be normal? - CORRECT ANSWER✅✅✅i). Patient in L) lateral decubitus. Listening with bell
of stethoscope at the cardiac apex
ii). HF, cardiomyopathy, severe AV (mitral or tricuspid) regurgitation
iii). Yes - youth, pregnancy, athletes
https://youtu.be/_i2D1KZkN1w
Heart Sounds
i). Describe an aortic stenosis murmur
ii). Where is it best auscultated? Rx?
iii). What can it be caused by?
iv). Associated sign - CORRECT ANSWER✅✅✅i). Crescendo-decrescendo systolic ejection murmur
ii). R) of sternum, 2nd intercostal space. Rx to carotids
iii). AV calcification. Bicuspid AV
iv). Weak and delayed peripheral pulses
https://youtu.be/pgDWz1JybzE
RFs for BRCA1/2 mutation (x6) - CORRECT ANSWER✅✅✅Multiple relatives affected on same side of
family
BrCa <40yo
BrCa & OvCa in the same woman
Bilateral breast cancer
BrCa in males
Ashkenazi Jewish heritage (central & eastern Europe)
, Average - 1.5x risk BrCa.
> Give 5 situations that count in this category
> Relative risk over lifetime
> What screening advised? - CORRECT ANSWER✅✅✅1. Nil F/H
2. 1x 2nd-degree relative at any age
>50yo (any of the below):
3. - 1x 1st-degree
4. - 2x 2nd-degree
5. 1x each side of family, 1st or 2nd degree
Relative risk = 1/8
Advice: 2-yearly mammograms from 49-74. Breast awareness
Moderate risk of BrCa
> Give 3 situations that count in this category
> Relative risk over lifetime
> What management advised? - CORRECT ANSWER✅✅✅1. 1x 1st-degree <50yo
2. 2x 1st-degree, any age
3. 2x 2nd-degree, same side family (1x <50) + (1x any age)
Relative risk = 1/4
Advice: Refer to familial cancer clinic. Individual plan, which may include annual imaging (mammogram,
U/S, MRI) from 40yo and clinical exams
High risk of BrCa - 3 scenarios
> Relative Risk - CORRECT ANSWER✅✅✅Relative with high-risk BrCa gene mutation