MOCK AKT TEST 2

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?