Question 1
GeneralA 50-year-old smoker with established CAD wants to quit. The most appropriate evidence-based pharmacotherapy for smoking cessation is:
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Same patient, different medicine
Stop translating American medicine.
The exam is set in Australasian practice. So is the bank. Here is the same clinical question answered by a bank referenced to US practice, and by us.
Snakebite first aid
First aid for a snakebite to the leg.
A US-referenced bank
Pressure immobilisation is discouraged. North American pit-viper venom is locally cytotoxic, so bandaging it in place does more harm.
MedQVault · Australasian
Firm pressure immobilisation over the whole limb, then splint it and keep the patient still. Australian elapid venom is neurotoxic and clots the blood, so slowing lymphatic spread buys time and costs nothing.
Cited: Therapeutic Guidelines: Toxicology; ANZCOR first aid
Pneumonia antibiotics
Empirical antibiotics for a well adult admitted with community-acquired pneumonia.
A US-referenced bank
Broad by default: a respiratory fluoroquinolone, or ceftriaxone with a macrolide, sized to US resistance.
MedQVault · Australasian
Benzylpenicillin or amoxicillin, with doxycycline or a macrolide for atypical cover. Local pneumococcal resistance is low enough that narrow is the right call.
Cited: Therapeutic Guidelines: Antibiotic
Paracetamol overdose
N-acetylcysteine for a significant paracetamol overdose.
A US-referenced bank
The three-bag acetylcysteine schedule over 21 hours, still the default in most US references.
MedQVault · Australasian
The two-bag regimen. It drops the early high-concentration infusion and the anaphylactoid reactions that come with it.
Cited: Austin Health paracetamol poisoning guideline; Therapeutic Guidelines
Rural retrieval
A time-critical patient at a small hospital three hours from a tertiary centre.
A US-referenced bank
Ground ambulance to the nearest hospital, inside a dense network of trauma centres.
MedQVault · Australasian
Aeromedical retrieval. A critical-care team flies out and the patient flies back, because the nearest suitable hospital can be hundreds of kilometres away.
Cited: State retrieval services (RFDS, Adult Retrieval Victoria)
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