FRACGP Core Knowledge and Fundamentals 3

Question 1

A 5-year-old boy presents with a widespread vesicular rash, fever, and intense pruritus. His mother reports he received the first dose of varicella vaccine 2 months ago. The MOST appropriate next step is:

Accepted Answer

Symptomatic treatment and advise isolation until all lesions crust

Answer

Breakthrough varicella in vaccinated individuals is usually mild and self-limiting; management is symptomatic with isolation until lesions crust to prevent spread.

Question 2

Which spirometry pattern is MOST consistent with a diagnosis of asthma that responds to bronchodilator therapy?

Accepted Answer

Obstructive pattern with ≥12% and 200 mL improvement in FEV₁ after bronchodilator

Answer

Asthma is confirmed by a reversible obstructive defect showing ≥12% and ≥200 mL increase in FEV₁ post-bronchodilator according to GINA criteria.

Question 3

A 68-year-old woman with type 2 diabetes and CKD stage 3b (eGFR 32 mL/min/1.73m²) needs glucose-lowering therapy adjustment. Which agent should be STOPPED or avoided at this eGFR?

Accepted Answer

Metformin

Answer

Metformin is contraindicated when eGFR falls below 30 and should be used with caution below 45 mL/min due to lactic acidosis risk.

Question 4

A 28-year-old woman presents at 10 weeks gestation with nausea, vomiting, and a uterus larger than dates. Her β-hCG is markedly elevated and ultrasound shows a 'snowstorm' appearance. The MOST likely diagnosis is:

Accepted Answer

Complete hydatidiform mole

Answer

A complete hydatidiform mole presents with a markedly elevated β-hCG, snowstorm ultrasound appearance, and uterus large for dates due to trophoblastic proliferation.

Question 5

In the management of an acute gout flare in a patient with CKD stage 4, which of the following is the PREFERRED first-line anti-inflammatory treatment?

Accepted Answer

Low-dose colchicine (with dose adjustment) or prednisolone

Answer

NSAIDs are contraindicated in advanced CKD; low-dose colchicine (renally adjusted) or oral corticosteroids are preferred for acute gout in this setting.

(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 3