Preview Course
View some of our sample questions and get a feel for how your knowledge can build with access to the MedMCQ question bank. Answers, explanations and resource links are located at the bottom of the page.
Paediatrics
Penelope is a 15 month old NZ European female brought into your GP clinic by her father with noisy breathing overnight and this morning. She has had a cold for the past day from her older brother. On examination she has inspiratory and expiratory stridor, and retractions between her ribs visible at rest. She looks quite tired. There is no sign of cyanosis. Which of the following would be most appropriate?
A) Stat dexamethasone 0.15mg/kg and monitor for 1 hour
B) Stat dose prednisolone 1mg/kg and arrange hospital transfer
C) Stat dose dexamethasone 0.6mg/kg and monitor for the next 2 hours
D) Advice humidification ie. rest in a steamy room
E) Paracetamol and ibuprofen regularly and monitor breathing
Mental health
Rangi is a 31 year old Māori male who has just separated from his partner in the past 3 weeks, and it is especially difficult with now organising shared custody of their kids. He is feeling down, struggling to concentrate at work, and not sleeping well at all. He denies any thoughts of self harm. A depression assessment tool indicates mild severity. Which of the following statements regarding mental health in Māori is not true?
A) Māori in rural and urban areas have similar levels of mental health conditions
B) There is no evidence that Māori are genetically predisposed to mental health conditions
C) Higher rates of hospitalisation from mental health are usually due to poor medication compliance when compared to total population
D) Depression and anxiety rates among Māori are as high, or higher, than in the total population
E) All of the above
Men's health
Angelo is a 42 year old man who comes in to see you in the acute clinic feeling nauseous and fatigued. He has been feeling unwell for three days. He has been medicating with paracetamol and ibuprofen. In addition to the above symptoms he has dysuria and some pelvic pain. On examination he has a temperature of 37.1 degrees celsius, heart rate of 86, blood pressure of 128/80. Abdominal examination shows tenderness in the suprapubic area but no renal angle tenderness. Genital examination is unremarkable except for some tenderness in the perineal region. The patient declined to have a digital rectal examination. Given the most likely diagnosis how would you initially treat this patient?
A) Trimethoprim 300mg OD for 14 days
B) ED referral
U) Urology referral
D) Cefalexin 500mg BD for 3 days
E) Doxycycline 100mg BD for 21 days
Surgery
Simone is a 42 year old woman who comes to see you 3 years post Roux-en-y surgery for follow up. Since the surgery she is compliant with dietary changes and has lost 45kg, with a current weight of 84kg. Her hypertension and type 2 diabetes have resolved and she is no longer taking any medication except those prescribed by the bariatric surgeon. Which of the following is not a routine consideration at annual review following discharge from surgical services?
A) Thyroid function tests
B) Vitamin D
C) Iron, B12 and folate levels
D) Full blood count
E) Liver function
Answers and Explanations:
Paediatrics = B
Severe croup can present with inspiratory and expiratory stridor at rest, visible recession and tiredness (suggesting respiratory fatigue).
Urgent hospital transfer required with prednisolone 1mg/kg given stat.
0.15mg/kg dexamethasone can also be used but monitoring for 1 hour is not sufficient,
Humidification, paracetamol, ibuprofen and monitoring alone are insufficient in severe cases.
Note: Cyanosis is not required to indicate severity – work of breathing and stridor at rest are key indicators.
https://www.starship.org.nz/guidelines/croup/
https://gpnotebook.com/pages/ear-nose-and-throat/croup/management
Mens health = A
This is a case of prostatitis.
Treat mild bacterial prostatitis with 14-day oral antibiotics with prostatic penetration.
First-line oral treatment in NZ if mild symptoms and no systemic toxicity is using trimethoprim or Trimethoprim + sulfamethoxazole (ciprofloxacin is also used depending on resistance).
Severe/systemic cases require IV antibiotics and possible hospital admission.
Prostatitis: diagnosis and management in primary care - bpacnz
Antibiotic Guide: choices for common infections - 2023
Mental health = C
While Māori experience higher rates of psychiatric admissions, this is more often linked to systemic issues—such as institutional racism, lack of culturally safe services, and delayed access to care—rather than individual factors like non-compliance.
Structural contributors to poorer mental health outcomes for Māori may include:
- Socioeconomic disadvantage
- Intergenerational trauma
- Reduced access to culturally appropriate mental health services
- Systemic inequities in healthcare delivery and responsiveness
https://bpac.org.nz/BPJ/2010/June/mentalhealth.aspx
Surgery = A
Thyroid function tests are not routinely required unless there are specific symptoms or clinical indications.
Calcium, Iron and B12 are all monitored. Due to the increased risk of malabsorption these deficiencies are common post-surgery.
Full blood count is used to detect anaemia or macrocytosis.
Albumin is a marker of nutritional status