FRACGP Core Knowledge and Fundamentals 2

Question 1

A 58-year-old man presents with a 3-month history of fatigue, weight loss, and night sweats. Examination reveals splenomegaly and a WBC of 120 × 10⁹/L with predominantly mature lymphocytes. The MOST likely diagnosis is:

Accepted Answer

Chronic lymphocytic leukaemia

Answer

CLL is the most common adult leukaemia, characterised by mature small lymphocytes, splenomegaly, and an indolent course in older adults.

Question 2

Which of the following antihypertensives is CONTRAINDICATED in bilateral renal artery stenosis?

Accepted Answer

ACE inhibitors

Answer

ACE inhibitors block angiotensin II–mediated efferent arteriolar constriction, which is the compensatory mechanism maintaining GFR in bilateral renal artery stenosis, risking acute renal failure.

Question 3

A 34-year-old woman in her second trimester presents with pruritus and jaundice. LFTs show elevated ALT and elevated bile acids at 42 µmol/L. The MOST appropriate management is:

Accepted Answer

Ursodeoxycholic acid and monitoring of fetal wellbeing

Answer

Intrahepatic cholestasis of pregnancy is treated with ursodeoxycholic acid to reduce bile acids and fetal risk, alongside close fetal surveillance.

Question 4

According to Australian immunisation guidelines, at what age should the meningococcal ACWY vaccine be routinely given as a booster for adolescents?

Accepted Answer

14–16 years

Answer

The Australian immunisation schedule recommends meningococcal ACWY vaccine at 14–16 years (Year 10) as an adolescent booster.

Question 5

A 72-year-old man on warfarin for AF has an INR of 8.2 with no active bleeding. The MOST appropriate immediate management is:

Accepted Answer

Withhold warfarin and administer oral vitamin K 1–2 mg

Answer

For a supratherapeutic INR >8 without bleeding, guidelines recommend withholding warfarin and giving low-dose oral vitamin K to reduce the INR safely.

(FRACGP) Fellowship of the Royal Australian College of General Practitioners Practice Test

(FRACGP) Fellowship of the Royal Australian College of General Practitioners Practice Test

FRACGP Core Knowledge and Fundamentals 2