Professional Practice I

1. In order to implement your intention to skilfully explore patients’ beliefs and offer help with their suffering, you will need at least four skill sets.
Which one this is not one of the four skill sets?

Non-judgemental exploration

Specific inquiry at times of suffering

Demonstration of Understanding and Respect

Suggesting / offering help

Unprofessional gestures

non-judgmental exploration
Physicians’ own religious (or anti-religious) beliefs can distort their perceptions of patients’ experience, as well as their interviews and relationships with patients.
Specific inquiry at times of suffering
Start by asking the patient to describe their experience of the illness in general terms before moving on to ask how this experience links up with their religious beliefs, how they interpret their suffering, and what role prayer or other practices plays in their efforts to cope.
Demonstration of Understanding and Respect
Inviting patients to dialog about religion and spirituality at times of suffering is a complex process, and requires special attention to context, relationship and non-verbal signals.
Suggesting / offering help
Many patients have the potential to receive help through religious and spiritual resources within their community.
Suggesting / offering help
Many patients have the potential to receive help through religious and spiritual resources within their community.

Explanation

non-judgmental exploration
Physicians’ own religious (or anti-religious) beliefs can distort their perceptions of patients’ experience, as well as their interviews and relationships with patients.
Specific inquiry at times of suffering
Start by asking the patient to describe their experience of the illness in general terms before moving on to ask how this experience links up with their religious beliefs, how they interpret their suffering, and what role prayer or other practices plays in their efforts to cope.
Demonstration of Understanding and Respect
Inviting patients to dialog about religion and spirituality at times of suffering is a complex process, and requires special attention to context, relationship and non-verbal signals.
Suggesting / offering help
Many patients have the potential to receive help through religious and spiritual resources within their community.
Suggesting / offering help
Many patients have the potential to receive help through religious and spiritual resources within their community.

2. A patient’s illness is defined as...

The natural history and pathophysiology of a patient’s particular diagnosis

A patient’s mental instability

Symptoms and beliefs about a patient’s affliction, taken in his/her personal and social context

3. • Magical thinking; circular reasoning
• Sees 1 or 2 aspects at a time; may ignore the whole of the situation This is an example of a child's cognitive development.
Which group does the examples illustrates?

Toddlers (15 months – 2 years)

Preschool children (3 – 5 years)

School-aged children (6 – 12 years)

Adolescents (≥ 13 years)

4. A patient's result of liver function test has normal transaminases level but an increase of Alkaline Phosphate (AP) and Gamma-Glutamyl Transpeptidase (GGTP).
What is the most important aspect to consider?

Acute pancreatitis

Gilbert's syndrome

Choleostasis

Carcinoma of the liver

5. What is the correct approach to children who are Adolescents? (≥ 13 years)

Usage of jokes & riddles

Discuss issues, school, activities

Sitting at the child’s eye level

Perform a normal adult consultation

Sitting at the child’s eye level- more for toddlers
Usage of jokes & riddles-more for school-aged children
Treat them as an adult- doesn't build the rapport with them (attention seekers)

Explanation

Sitting at the child’s eye level- more for toddlers
Usage of jokes & riddles-more for school-aged children
Treat them as an adult- doesn't build the rapport with them (attention seekers)

6. Marasmus can also occur in adults with these risk factors, excluding...

Cancer patients

Starvation patients

Immune-compromised patients

Anorexia Nervosa patients

7. Which of these are not the factor that can affect the Aboriginals to access the health services?

Transportation

Language

Private health insurance & Government health cards

Availability of complimentary medicine

Availability of complimentary medicine is a choice not a factor that affect Aboriginals to access the health service.

Explanation

Availability of complimentary medicine is a choice not a factor that affect Aboriginals to access the health service.

8. What is the criteria for early or immediate discharge consideration for patient with upper gastrointestinal bleeding after endoscopy?

Low frequency of high risk stigmata seen on endoscopy with Rockall scores more than 2

Age less than 45 years and lack of significant/ multiple co-morbidities

Presence of hemodynamic instability/ shock

Good social support and ability to return home promptly after getting Rockall score less or equals to 2

9. What is not the secondary cause of malnutrition?

Inadequate intake of nutrients

Increased requirements of nutrients

Altered utilisation of nutrients

Increased excretion of nutrients

10.

What are the other symptoms that may arise to these children?

Hypothermia

Anorexia Nervosa

Patchy and scaly skin

Very severe weight loss

A & D- Signs of Marasmus

Explanation

A & D- Signs of Marasmus

11. • Can distinguish what is internal and external to self
• Cause of illness is a person, object, or action external to the child: “you get a cold from not wearing a hat”; “you breathe too much air in your nose.” This is an example of child's concept of the cause of illness.
Which group does the examples illustrates?

Toddlers (15 months – 2 years)

Preschool children (3 – 5 years)

School-aged children (6 – 12 years)

Adolescents (≥ 13 years)

12. Which is not one of the diagnostic tool to detect Otitis Media?

Audiogram

Otoscopy

Tympanometry

Audiometry

The audiologist plots the loudness (in decibels) on an audiogram.

Explanation

The audiologist plots the loudness (in decibels) on an audiogram.

13. Who is more at risk of malnutrition?

A young comatose patient in the hospital

A man who just had a positive result of Coeliac's disease

A 5 month old infant who is still breastfed only

A young patient who is diagnosed with psychosis

Recommend duration of breastfed is up to 6 months

Explanation

Recommend duration of breastfed is up to 6 months

14. A 23 year old man has an acute onset of infectious diarrhoea.
After consultation, these are the details you gathered:
-Occur less than one week
-Recent travel to Alice Springs
-Watery and explosive diarrhoea
-Recent anoreceptive sex
-No recent medication

Which one of these following hypothesis is the least important to consider?

Traveller's diarrhoea

Clostridium difficile infection

Viral gastroenteritis

Sexually transmitted gastrointestinal infection

Food poisoning

He does not state the exposure to antibiotics, so Clostridium difficile infection is ruled out. It is usually acquired in hospital during or after antibiotic therapy
Anoreceptive means having anal sex

Explanation

He does not state the exposure to antibiotics, so Clostridium difficile infection is ruled out. It is usually acquired in hospital during or after antibiotic therapy
Anoreceptive means having anal sex

15. Which of these statements are FALSE about ROTAVIRUS?

Produces an enterotoxin which stimulates intestinal secretion, leading to a secretory diarrhoea

Commonest cause of childhood diarrhoea, normally toddlers

Can be immunised by RotaTeq or Rotarix

Enveloped, double-strand RNA in 11 segments

it is non-enveloped, double-strand RNA in 11 segments, icosahedral, double capsid virus. It appears as a 60-80nm wheel with radiating spikes

Explanation

it is non-enveloped, double-strand RNA in 11 segments, icosahedral, double capsid virus. It appears as a 60-80nm wheel with radiating spikes

16. How can health professionals help people cope with chronic illness?

Recognition of Health Professional’s role in cure rather than healing

Increase the consultation time for people with chronic illness

Pairing new patients with recovering patients

Give written pamphlets for ways of coping and management

Paired patients experience ↓ pre-op anxiety, ↑ physical activity, shorter hospital stays

Increased consultation time doesn't help if clinicians did not enhance therapeutic relationships

Explanation

Paired patients experience ↓ pre-op anxiety, ↑ physical activity, shorter hospital stays

Increased consultation time doesn't help if clinicians did not enhance therapeutic relationships

17. F- Gathering lab-tested evidence
G-Establish existence of outbreak
H-Verify the diagnosis
I-Control disease
J-Communicate
K-Prepare for field work
L-Evaluate hypotheses
M-Refine case definition/hypothesis
N-Perform descriptive epidemiology
O-Define and identify cases
P-Develop hypotheses Arrange the steps in outbreak investigations orderly from beginning to the end.

P, H, G, K, O, N, L, M, I, J

H, G, K, O, N, P, L, M, I, J

P, H, G, K, O, F, N, L, M, I, J

H, G, K, O, N, P, L, F, M, I, J

1. Verify the diagnosis
2. Establish existence of outbreak
3. Prepare for field work
4. Define and identify cases
5. Perform descriptive epidemiology
6. Develop hypotheses
7. Evaluate hypotheses
8. Refine case definition/hypothesis
9. Control disease
10. Communicate

Explanation

1. Verify the diagnosis
2. Establish existence of outbreak
3. Prepare for field work
4. Define and identify cases
5. Perform descriptive epidemiology
6. Develop hypotheses
7. Evaluate hypotheses
8. Refine case definition/hypothesis
9. Control disease
10. Communicate

18. Which of the following options is a crucial step in developing a culturally sensitive collaborative action and follow up plan for a patient?

Determine how strongly a patient adheres to his or her explanatory model of illness

Discount your own preconceptions, since these will interfere with fully patient-centered care.

Explain the biomedical model in depth, defining biomedical jargon so that patients will understand.

Repeat your plan in simpler and clearer terms when it appears that patients do not fully understand.

A is correct. Patients will only adhere to a plan that is inconsistent with their explanatory model after you have explored the strength of their beliefs and made compromises/ adjustments together that allow them to align with the plan. B It is important to be aware of your preconceptions; but the goal is to reach a compromise, not to compromise your own values. C Explaining the biomedical model helps many patients, but you will lose trust with many others unless you are responding specifically to their questions/concerns (tell-ask-tell) D Repeating your plan more clearly helps many patients, but you will lose trust with many others unless you are responding specifically to their questions/concerns (tell-ask-tell.)

Explanation

A is correct. Patients will only adhere to a plan that is inconsistent with their explanatory model after you have explored the strength of their beliefs and made compromises/ adjustments together that allow them to align with the plan. B It is important to be aware of your preconceptions; but the goal is to reach a compromise, not to compromise your own values. C Explaining the biomedical model helps many patients, but you will lose trust with many others unless you are responding specifically to their questions/concerns (tell-ask-tell) D Repeating your plan more clearly helps many patients, but you will lose trust with many others unless you are responding specifically to their questions/concerns (tell-ask-tell.)

19. What is the function/ name of the communication behavior illustrated by the following question referring to the role of religion and spirituality in a patient’s life?,
“Would prayer or meditation be helpful for you in these times?”

Demonstration of understanding/respect

Non-judgmental exploration

Suggesting/offering help

Specific inquiry

Unprofessional gestures