Gen med/ Derm/ MH/ Obgyn

Question 1

RACP 2022a 20.
A 34 year old woman with a history of bipolar disorder is 8 weeks pregnant. She has experienced at least 6 episodes of manic psychosis with suicidal
ideation and high risk taking behaviour in the past requiring admission to psychiatric unit and titration of medications. She has been stable on lithium for a number of years. What is the most appropriate medication to manage her symptoms of bipolar disorder while pregnant?
a. Carbamazepine
b. lithium
c. haloperidol
d. valproate

Question 2

RACP 2022 53.What is the best antipsychotic to use to avoid photosensitivity reactions?
a. Aripiprazole
b. Clozapine
c. Ziprasidone
d. Olanzapine

Question 3

RACP 2022 55.What increases risk of Stevens-Johnson syndrome in carbamazepine use?
a. HLAB5801
b. HLAB1502
c. CYP3A4 polymorphism
d. CYP2B6 polymorphism

Question 4

RACP 2022a 67.(Past question) What clinical feature is pathognomonic for narcolepsy type 1?
a. Cataplexy
b. excess daytime sleepiness
c. Response to stimulants
d. Sleep paralysis

Question 5

RACP 2022b 4. What cell type produces testosterone in the testes?
A. Granulosa
B. Leydig
C. Sertoli
D. Theca

Question 6

RACP 2022b 17. Lactose is broken down into glucose and what other product?
A. Fructose
B. Galactose
C. Sucrose
D. Mannotose

Question 7

RACP 2022b 20. What are the primary metabolites of testosterone?
A) andostenedione and estrone
B) dihydrotestosterone and oestradiol
C) progesterone and DHEA
D) pregnenolone and something

Question 8

RACP 2022b 44. Abnormalities in which neurotransmitter are seen in narcolepsy type 1?
A. Orexin
B. NMDA
C. GABA
D. Noradrenaline

Question 9

RACP 2021a Q5. Which class of drugs is first line treatment for the management of obsessive compulsive disorder?
A. Benzodiazepines
B. MOAIs
C. SSRIs
D. SNRIs

Question 10

RACP 2021a Q7. Which of the following histological findings is most consistent with bullous pemphigoid?
A. Granular IgG in the cell space and basement membrane
B. Granular IgG in the basement membrane
C. Linear IgA along the basement membrane
D. Linear IgG along the basement membrane

Question 11

RACP 2021 Q14. A 27 year old male with a 2 year history of Crohn’s disease is commenced on infliximab. He develops the
following rash across his neck, upper back and forearms:

What is the most likely diagnosis?
A. Dermatitis herpetiformis
B. Granuloma annulare
C. Psoriasis
D. Subacute cutaneous lupus

Question 12

RACP 2021a Q33. What are the two other Rotterdam criteria for PCOS, in addition to an ultrasound finding of polycystic
ovaries?
A. Increased LH:FSH ratio and clinical evidence of hyperandrogenism
B. Increased LH:FSH ratio and primary infertility
C. Oligo/anovulation and clinical evidence of hyperandrogenism
D. Oligo/anovulation and insulin resistance

Question 13

RACP 2021 Q45. A 40 year old woman presents with a long history of somatic symptoms including headache, chest pain,
lethargy, abdominal pain and paraesthesias. She is very worried about what her symptoms might mean and is
only briefly reassured after consultation. Repeated investigation has not shown any cause for her symptoms. She
continues to present, and describes herself as “sickly” and “never well”.
What is the most likely psychiatric cause of her symptoms?
A. Delusional disorder (somatic type)
B. Factitious disorder
C. Hypochondriasis (illness anxiety disorder)
D. Somatisation disorder (somatic symptom disorder)

Question 14

RACP 2021a Q59. A 24 year old male presents with intrusive neurological symptoms and frequent nodding of his head. His
symptoms subsequently changed to right arm swinging and sensation of frequent need of swallowing. His mother
also reports symptoms suggestive of OCD.
Which of the following is the likely diagnosis?
A. Huntington disease
B. Wilson disease
C. Tourette syndrome
D. Neuroacanthocytosis

Question 15

RACP 2021 Q64. Which of the following symptoms is most consistent with type 1 narcolepsy?
A. Daytime somnolence
B. Cataplexy
C. Relieved by stimulant
D. (Rhubarb)

Question 16

RACP 2021a Q86. An 80 year old man presents with depression, particularly complaining of insomnia. His background is
significant for frequent falls, hypertension, peptic ulcer with bleeding, and previous electrolyte disturbances when
unwell. Which of the following medications is most appropriate?
A. Mirtazapine
B. Venlafaxine
C. Citalopram
D. Benzodiazepine

Question 17

RACP 2021a Q90. An 80 year old woman present 3 months post loss of late husband with poor sleep and low mood. She lives
with her daughter. She is not eating or drinking. She is quoted as saying “it is not worth living without him”.
What treatment is the most likely to give rapid improvement of symptoms?
A. Antidepressants
B. Antipsychotics
C. Bereavement psychotherapy
D. ECT

Question 18

RACP 2021o 70. Inhibition of which neurotransmitter would cause positive psychosis
symptoms?
a. Dopamine
b. GABA
c. Noradrenaline
d. Serotonin

Question 19

RACP 2021o 73. 26F at 28/40 gestation presents with fever, neck stiffness. LP high
lymphocytes and Protein. Culture gram + cocci . Ceftriaxone is commenced and
Benzylpenicillin added. What organism is the benzylpen to cover?
a. Listeria
b. H. Influenza
c. Staph aureus
d. Strep. Pneumonia

Question 20

RACP 2021o 102. What is the effect of plasma volume expansion in pregnancy in a woman
with normal cardiac function
a. increased venous pressure
b. no change
c. Decreased venous pressure
d. decrease then increase venous pressure

Question 21

RACP 2020a 38. Which drug is indicated for management of eclampsia?
A) Leviteracetam
B) Diazepam
C) Magnesium Sulphate
D) Midazolam

Question 22

RACP 2020a 50. 28M was commenced on treatment 10 days ago fior a new onset psychosis. The treating team
are concerned as he is becoming more agitated, pacing the hallways, fidgeting and unable to sit
still. The patient describes an overwhelming feeling of restlessness. Changes in which of the
following neurotransmitters is likely to cause this?
A) Ach
B) Dopamine
C) Glutamate
D) Serotonin

Question 23

RACP 2020a 74. Clozapine therapy may be complicated by myocarditis. What is the predominant cellular
infiltrate seen in clozapine-associated myocarditis?
A) Giant cell
B) Eosinophil
C) Lymphocyte
D) Neutrophil

Question 24

RACP 2020 27. Which antidepressant is most associated with cholinergic side effects?
A) MAO Inhibitors
B) SNRIs
C) SSRIs
D) Tricyclics