FACRRM Practice and Application 2

Question 1

A rural GP is the only doctor within 200 km when a patient presents with acute ST-elevation MI. The nearest PCI-capable hospital is 3 hours away. What is the most appropriate initial management?

Accepted Answer

Administer thrombolysis immediately if no contraindications

Answer

In STEMI with >2-hour expected transfer time to PCI, thrombolysis is the preferred reperfusion strategy if no contraindications exist.

Question 2

During an outreach clinic in a remote Aboriginal community, you identify a child with rheumatic heart disease. Which ongoing prophylaxis is most strongly recommended?

Accepted Answer

Monthly benzathine penicillin G injections

Answer

Benzathine penicillin G given every 28 days is the gold-standard secondary prophylaxis for rheumatic fever/rheumatic heart disease.

Question 3

A farmer presents with confusion, excessive salivation, miosis, and bradycardia after working with pesticides. Which antidote should be administered first?

Accepted Answer

Atropine

Answer

Organophosphate poisoning causes cholinergic toxidrome; atropine competitively blocks muscarinic receptors and is the primary antidote.

Question 4

You are conducting a telehealth consultation for a patient 400 km away who describes symptoms consistent with appendicitis. What is the most appropriate next step?

Accepted Answer

Arrange urgent retrieval to a surgical facility

Answer

Suspected appendicitis requires urgent surgical evaluation; delay risks perforation, and telehealth cannot replace physical examination and definitive surgery.

Question 5

A 60-year-old male in a rural community is found to have a blood pressure of 170/105 mmHg on three separate readings. He has no other comorbidities. Which agent is most appropriate as first-line pharmacotherapy?

Accepted Answer

Amlodipine

Answer

Calcium channel blockers such as amlodipine are recommended first-line antihypertensives for uncomplicated hypertension in most guidelines including Australian guidelines.

(FACRRM) Fellowship of the Australian College of Rural and Remote Medicine Practice Test

(FACRRM) Fellowship of the Australian College of Rural and Remote Medicine Practice Test

FACRRM Practice and Application 2