AKT Mock Exam Questions

62 year old Rebecca Johnson presents with a 3 to 4 months history of recurrent history of colicky type pain in the left lower quadrant of her abdomen. She experienced symptoms of pain associated with altered  bowel habits mostly diarrhoea, sometimes constipation. Her clinical examination today showed vitals of temp 37, HR 80/min, regular. Her abdomen showed mild tenderness associated with mild guarding.

Her most likely diagnosis is:-

39-year-old Basil Drew presents to you with a history of severe retrosternal chest pain of 30 minutes duration, worse with respiratory effort, accompanied by marked shortness of breath and a feeling of faintness. On examination his BP is 110/65, he has a tachycardia of 130 beats/min, there are no bruits or abnormal respiratory sounds. Basil’s ECG is normal apart from the tachycardia, and his chest X-ray is normal.

What is the most appropriate diagnosis for Basil?

Madison brings in Jane, her eight year old daughter to see you today. Jane presents with about 12 months history of recurring generalized abdominal cramps and discomfort. She is otherwise healthy and well with no other symptoms of appetite or weight change, vomiting or change in  bowel habits.. Madison states that she is worried about Jane as she has been missing a lot of schools. Her symptoms have been always worse during the weekdays but she never complains during the weekend. You performed a physical examination on her today and this has been normal.

What is the most likely diagnosis of Jane’s presentation?

Anthony Johnson is a 75 years old patient of yours who has history of benign prostatic hypertrophy (BPH). You have recently referred him to see a urologist and he has been consented for a transurethral resection of the prostate (TURP).

He consulted you today as he wants to know more about the common adverse outcome of this particular surgical procedure.

You mentioned to him that the most common adverse outcome of this procedure is:-

Mrs Johnson is a 78 years old patient of yours. You have not seen her for a while. She came and saw you today complaining of a sudden reduced left eye vision. On examination. her visual acuity in the left is restricted to hand perceptions and movements only. Her right eye is otherwise normal with 6/6 vision. She stated that she has had some intermittent headache and depressive like symptoms for the past few months prior this happening. She has no history of diabetes and you measure her BP today and it is normal.

What is the likely cause of her visual loss that would require immediate medical investigation and treatment to prevent  blindness in the other eye? 

Mum brought Anis, a 1 year old boy to see you today. Mum noticed that he has been quite unsettled last night, crying a lot. He has been refusing breast feeding today and vomited a few times and mum noted some red coloured looking stools while changing his nappies. On examination today, Anis looks unwell and pale. Examination of the abdomen reviewed a very tender abdomen. You thought you could feel a mass as well. You advised mum to bring him to the nearest emergency department for a review.

You suspect a diagnosis of:-

Dad brought James Atkins. a 10 years old boy to see you today. You have not seen him for a while. Dad mentioned that he was complaining of a very “sore” tummy since yesterday, worsened this morning. He has lost his appetite, vomited a few times and starting to develop loose bowel motion. He felt hot and cold constantly at present.

On examination, he is febrile with a temp 39, looks pale and dry in the mouth and lips His abdominal examination revealed a tender RIF region with percussion and rebound tenderness.  You decided to refer him to the nearest emergency department for a formal review.

You suspect a most likely diagnosis of:-

You received a call to see Haiti Johnson, an 85 year old aged care resident. She complains of 2 days of losing appetite associated with vomiting, intermittent abdominal pain, described as on and off spasm. You noted her past surgical history including a midline laparatomy 20 years ago. You suspect she has a small bowel obstruction. You referred her to the nearest emergency department for a surgical review.

Which of this following are the most common cause of her small bowel obstruction (SBO)?

Tim Johns, aged 49 years old, a successful architect came to see you today. He complains of a sudden onset of central epigastric like pain associated with instant nausea. He stated he felt better when trying to sit forward but also noticed that he does discomfort around his upper back. He mentioned of similar presentation a while ago but it did resolved.

On examination today, he looks anxious and sweaty. His abdomen is tender around the epigastrium with minimal rebound tenderness and guarding.

You suspect he most likely has:-

You are seeing John Hapman, a 10 years old Indigenous boy who was brought in by his grandmother. He has a few days history of fever and joint pains mostly in the legs and wrists. Prior to this, he has been complaining of sore throat a well.

You suspect he has Rheumatic fever.

Which one of the below is a MAJOR criteria used to diagnose Rheumatic fever?