RACP question of the week.
Week of 26 October 2026. Have a go, then see the reasoning behind every option.
A 10-year-old boy arrived in Australia 2 years ago; his immunisation history is unknown. Over 6 months his school performance and behaviour have deteriorated, and he now has repetitive jerks with brief head drops occurring every 5 to 10 seconds. Fundoscopy shows a pale, oedematous area at one macula. His EEG shows high-amplitude slow-wave complexes recurring every 5 to 10 seconds, synchronous with the jerks, on a slow background. Which result would best confirm the diagnosis?
Try 20 free questions.
RACP-style questions, marked with a reason for every option. Free account, no card.
Earlier weeks
A term boy, well at birth, becomes lethargic and vomits on day 3, progressing to poor responsiveness. He is tachypnoeic. Results: plasma ammonia 520 µmol/L, venous pH 7.49, pCO2 28 mmHg, bicarbonate 22 mmol/L, glucose 4.6 mmol/L, lactate 2.0 mmol/L and no urinary ketones. Which is the most likely diagnosis?
A 13-year-old boy with Crohn disease started azathioprine 3 weeks ago after normal TPMT activity was confirmed. He now has severe epigastric pain radiating to his back, with vomiting. Lipase is 9 times the upper limit of normal, and ultrasound shows no gallstones. He recovers with supportive care. What is the best plan for azathioprine?
A 3-day-old boy born at 37 weeks to a mother with pregestational diabetes had a venous haematocrit of 0.71 on day 1. Today his nappy is stained red, urine dipstick shows 3+ blood, and a firm, smooth mass is palpable in the left flank. His platelet count has fallen from 160 to 48 × 10^9/L, his creatinine has risen from 62 to 88 µmol/L, and his blood pressure is normal for age. Which investigation will best confirm the most likely diagnosis?
A 4-month-old girl is brought in because she cries when her left leg is moved. Her father says she rolled off the change table yesterday. She has good head control but has not yet rolled over. An X-ray shows a spiral fracture of the left femoral shaft. She has a 1 cm bruise on the back of her left ear and no other injuries on examination. What is the most appropriate plan?
More free reading: how the RACP exams are marked →