RAPP/ Psych/ ED Sem 10 2006 Exam Questions
RAPP/ Psych/ ED Sem 11 2007 exam questions
OSCES:
1) ED station: patient w diazepam OD, do vitals, assess and record GCS; talk about how u would mx aw in this patient
2) patient w OA, thinking abt surgery. take a hx about symptoms, previous treatments, and address concerns. prescribe a walking stick, and tell the patient how to use it
3) talk to NUM of a nursing home about patient, Mr Black, who has been having difficult behaviour. take a hx, and u’ll be asked questions about it (BPSD or delirium)
4) someone presents for annual health checkup, but had a fall 6w ago. Do a gait and balance assessment (no need to do vestibular assessment), talking abt what the tests mean along the way. answer questions: what r the factors that contribute to falls? what diseases causes falls?
Written:
(5min)
1) name the key symptoms of bulimia
2) list the qualities of affect that can be elicited on the MSE
3) lady loses consciousness, now in ED, no pain and conscious. what are ur differential dx?
4) elderly lady post hip operation, has urinary incontinence. what are the possible causes?
5) what are the factors that you have to look out for when doing an MMSE on a 90 year old man?
6) what are the major side effects of Lithium?
(15min)
1) discuss the differences between acute pain, chronic pain and cancer pain
2) 52yo diabetic man had a below knee amputation for non healing ulcers 3 weeks ago. now has intractable pain. what are the causes of pain? how would you assess and manage the pain?
3) 18 year old starting to perform badly in school, increasing withdrawn over last 6 mths. parents are worried. what are ur DDX? how would you assess and manage this patient?
4) 65 year old man was taking care of his wife who died of metastatic breast cancer 2 months ago. He is sleeping poorly and losing weight. what r ur DDX? how would you assess him? what features on MSE would help differentiate between your DDX?
5) 83yo lady who has confirmed Alzheimer Dementia (MSE of 23/30). post hip operation, she thinks the nurses are Japanese and are going to send her to the concentration camp. (she used to be a nurse and was sent to concentration camp during the war). What syndrome is she experiencing? what is your assessment and management of this?
6) Male comes into ED having had his right hand stuck in a machine at work. His hand is swollen and the little finger seems to be hanging off a tendon. Describe your assessment of the injury, focusing on the examination of the hand. how would you manage this patient next?
(20min) – given scenarios and asked questions on them:
1) 22 year old female patient with lacerations on arm comes into ED, past hx of self harm behaviour, 8x last 18months. what is your most likely dx? what other features would this patient have? what comorbid disorders would she have? how would you manage her?
2) 20 year old man was at a party. ‘friend’ said there was ectasy and speed at the party. was becoming aggressive and irritable at the party. At ED, he is aggressive, labile, sweaty. given vitals (hypertensive, tachycardia...). what are the causes of his aggressive behaviour? what are the features of a stimulant toxidrome? what would you do before you can safely take a hx and mx him? what is the relationship between amphetamine use and psychosis?
3) 34 year old man with schizophrenia, living with mother. he is becoming irritable. case manager thinks he has been decreasing compliance in medications over past 3 mths. what aspects of the hx would you like to ask regarding decreasing compliance to medications? what on hx and MSE would u ask to assess if he is a risk to his mother?
RAPP/ Psych/ ED Sem 10 2006 exam questions
OSCE:
1) 52 year old female with hx of urinary incontinence, interprete bladder diary
2) hx of collapse (ED), put cardiac monitor on, asked abt drugs for the various arrhythmias
3) 10 week post op amputee review – Pain management issues, physio, secondary risk prevention)
4) Death and breaking bad news to relatives
Written:
(5 min)
1) what are the components of a developmental/ personal history
2) what are the criteria for admission under the Mental Health Act
3) What is the difference between financial enduring power of attorney and an administrator
4) 1 venomous creature and mechanism of toxin and outline emergency management
5) Name the 4 different routes of administration of pain relief, and a pro and con for each
6) Outline the rehabilitation of a patient recovering from a fractured hip
(15 min)
1) Patient presents with a FOOSH, pain in wrist, elbow and shoulder. Name three likely fractures. Outline the emergency management. How to assess whether neck needs imaging?
2) What are the issues with managing a patient with a developmental disability, with regards to rehabilitation, geriatrics and palliative care?
3) 38 year old male Scz with formication asking for cream, assessment, history, management?
4) usefulness of MMSE?
5) 17 year old female brought in by mum who complains of her being too thin. What history questions would u ask and what is the managment? (Anorexia/ bulimia)
6) 58 year old female, palliative care for breast cancer (mets to bone), depressed, which antidepressant would u use and why and what is it’s side effects profile? when is it beneficial to tell patient?
(20 min)
1) 83 year old male had a recent fall, # NOF. During rehabilitation, seems uncooperative, not himself. What are the likely causes of this? 3 differential diagnosis, how do u manage this?
2) scenario: male, gambling late at night, found perfect formula for winning at casino, elevated mood, ?pressure speech (bipolar?), what is the management? what history questions?
3) paracetamol OD, alcohol OD, sleeping tablet OD: management in ED, history, psychiatric history
Trudy Cheng2007