RACP question of the week.
Week of 26 October 2026. Have a go, then see the reasoning behind every option.
A 32-year-old woman is 14 months post partum. At 3 months post partum she had a painless thyrotoxic phase with low technetium uptake and negative TSH receptor antibodies; thyroid peroxidase antibodies were 850 IU/mL (below 35). At 6 months her TSH was 9.8 mU/L and she started levothyroxine 50 micrograms daily, which was stopped at 12 months. Six weeks after stopping, her TSH is 2.1 mU/L with a normal free thyroxine. She may want another child in a few years. Which follow-up is most appropriate?
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RACP-style questions, marked with a reason for every option. Free account, no card.
Earlier weeks
A 52-year-old man has had three episodes of generalised urticaria with light-headedness over eight months; during one, paramedics recorded a blood pressure of 80/50 mmHg. Each began 3 to 5 hours after an evening meal, and two woke him from sleep. The meals were lamb shanks, beef lasagne and pork dumplings. He regularly eats toast, chicken pasta and fish without symptoms, and did not exercise after any of the meals. He drinks two glasses of wine most evenings. He takes no regular medicines and is well between episodes. Which test is most likely to confirm the diagnosis?
A 70-year-old woman with COPD (FEV1 42% predicted) plans a 14-hour flight. Her resting oxygen saturation at sea level is 93% on room air, and she does not use home oxygen. A hypoxic challenge test breathing 15% oxygen gives an arterial PaO2 of 46 mmHg and SpO2 of 84%, with no symptoms during the test. What is the most appropriate advice?
A 79-year-old woman in Queensland is unconscious after a large stroke, and a decision about a feeding tube is needed. She has no advance health directive, no enduring power of attorney and no tribunal-appointed guardian. She has lived with her de facto partner in a close and continuing relationship for 10 years. Her adult son, who lives nearby, has been her unpaid primary carer for two years, attending daily to manage her medicines and meals. The son and the partner disagree about the feeding tube. Who is her statutory health attorney for this decision?
A 43-year-old man has 2 years of slowly progressive weakness and wasting of his right hand and left foot, with cramps. Sensation and sensory nerve action potentials are normal, and reflexes are reduced in the affected limbs. There are no upper motor neurone or bulbar signs. Motor nerve conduction shows focal conduction block in the right ulnar and left peroneal nerves away from usual entrapment sites. Cerebrospinal fluid protein is 0.5 g/L. What is the most appropriate treatment?
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