Page 1 of 2: NZREX questions (April 2008)

mailman0519 · Credits: 267 My Scrapbook

Hi, everyone
I've just passed the NZREX. I want to thank all the members of this forum because the information that I found here really helped me a lot.
I'm going to post the exam questions that I've managed to recall. I hope they will be helpful to those who are going to sit this exam later.
There were 16, but I can only recall 15.
There should be only 2 questions in the communication, 3 in the physical examination and 4 in the history-taking catergory, but I have 3, 4 and 5 questions respectively . No. 3, 5 and 11 might belong to the prioritisation/acute serious conditions categories (in dynamic form).

<Communication>
1.Woman says she wants to use oral contraceptive pills.
Help the woman make a decision. (Explain benefits, risks, clarify if she has any of the risk factors, etc)

2.Woman worries about her dad who has just undergone an elective surgery for abdominal aneurysm, now in ICU connected to a ventilator. Explain what aneurysm is , future management (extubation, transfer to general ward etc). Address the daughter's distress and guilt as she is the one who talked her father into this. Reassure she did the right thing.

3.Explain a gastrocopy+biopsy report (duodenal ulcer). Positive urea breath test too. Includes diagnosis, treatment, etc. The patient's worried about having cancer.

<Physical examination>
4.A boy has just had an asthma attack.

5.A young woman had a termination procedure , now has vaginal bleeding ,fever, dizziness, abd pain. Examine the actress and then, using a dummy, do a pelvic examination (bimanual and speculum). Findings will be given by the examiner. Give diagnosis and treatment plan (retained tissues cause infection)

6.Old man suffers from rt ankle pain after excercise. He has great pain when lateral ankle is palpate and limited ankle inversion.

7.Young man has sorethroat and a neck lump. I think it's infectious mononucleosis. Check ears, eyes, throat, neck, liver spleen.

<Take history>
8.Woman complains tiredness. Duration: 6 months. Onset: after divorce. Has most symptoms of depression.

9.Man has chronic cough. Hemoptysis, smoker. No TB risk factors. Most likely lung cancer.

10.Woman complains unilateral subacute hearing loss. Vertigo(?), tinnitus. I think it's Meniere's disease.

11.Man has acute severe occipital headache after exercise. FH: sister had 'stroke' around 30, had operation and recovered. Could be SAH. The examiner asked about plan (CT), what to do if CT negative (LP if still suspect SAH?)

12.Young woman, has vomitting. Most likely anorexia nervosa. Has amenorrhea, on diet, exercise vigorously etc.

<Static stations>
13.Interpret X-ray and choose plan: have to determine whether there's fracture of fibula, skull, wrist, ribs and/or pneumothorax.(Prioritasation?)

14.differentiate different types of anemia :IDA, chronic disease, vitb12 deficiency etc.(Tests/procedures?)

15.Pyelonephritis: interpret lab data ,diagnose, choose plan.(Acute serious conditions?)

I reckon none of the patients was real.

One very useful tip is : At the communication stations, always ask the actor if he has any questions . They will ask you to explain things that you forgot to explain (eg.'Do I have cancer? Can my father talk after extubation?)

I spent some time before the exam trying to memorize some important lab numbers, because in Taiwan we use different units. But it's totally unnecessary because all abnormal numbers will be highlighted.

Books: Murtagh's General Practice, Tally&O'Connor's Clinical Examination and an OSCE book.
My background: Trained in Taiwan. Have two years of work experience (resident of the internal medicine department).

All the best.

lilsmiles8 · Credits: 3006 My Scrapbook

Hi congrajulations Mailman,
Thanks for writing ur exam experience & guidelines for the exam. How did u feel about the exam overall? Are the examiners quiete strict ?
Could u pls explain us like how the exam conducted & how much time u had to invest at each station.Did u get breaks inbetween.
How were ecgs? Could u pls tell us what qs came in the multple choice qs?
Thanks

mailman0519 · Credits: 267 My Scrapbook

Most examiners were nice. A few were kind of 'cold'. One nice examiner kind of reminded me when I made a silly mistake. (I said 'The 'respiratory' rate is 72/min' after I measured a patient's pulse rate, and he said' respiratory rate??'). So I'd say, just treat them like ordinary people.

I think the level of difficulty was moderate. To me , the difficult parts were 1)the questions involving O&G, pediatrics, orthopedic knowledge (luckily these were the minorities) and 2)communication (mainly because English is not my first language). All the other questions were easier for me, because I have two years of work experience in Internal Medicine Department. Therefore, I guess it really depends on individual experience and abilities. My opinion is, you need a balanced skill ,because they do test you on different aspects of medicine. Find your weakness and improve it. Don't let it jeopardise your overall performance.

It was held at the outpatient department. There were 16 stations (in 16 isolated rooms). We had 10 mins for each station, and 2 mins in between to read questions. There was a 6-min break after 8 stations. I didn't notice any clock in the rooms, but personal timers (eg non-electronic watches) are allowed. At the history stations, it'd be better if you can allow some time for the examiners to ask what your D/D is, even if the question doesn't state you'll be asked. 30 seconds is enough.

This time, there were no ecgs.

I don't understand your last question. I passed USMLE step1 and step2CK before sitting NZREX. If that's what you mean by 'MCQ'.

lilsmiles8 · Credits: 3006 My Scrapbook

Thats really nice of u to pen down all ur exam points.
I aapreciate ur efforts to recall ur exam events & share with us.
BY MCQ i meant that, heard there are stations composed of multiple choice qs , where u have to tick mark the most likely answer.Am not sure.....
Could u pls tell us what were the cases?
Could u pls give me ur notes as i assume that it would be of no use to u now....U can contact me on lilsmiles8 AT ya hoodot com.
Thanks

mailman0519 · Credits: 267 My Scrapbook

I see what you mean know.
All the questions in the 'static' stations (13,14,15) that I mentioned were in MCQ form.
Most of them ask you to choose 'one' most suitable answer. A few require choosing more than one. (eg, choose four appropriate tests that you want to order)
You can download some sample questions from the Medical Council Website.

lilsmiles8 · Credits: 3006 My Scrapbook

Thanks for such nice explanation. I should really appreciate your efforts & kindness as so far no one has really been genuine & kind to share their exam exp & knowledge.
may god bless u
Thanks again for guiding us.

mindy · Credits: 965 My Scrapbook

ni hao mailman

i just want to know where is the venue for the nzrex? i have just passed my amcq part 1.

mailman0519 · Credits: 267 My Scrapbook

It was held at the outpatient department of the Northshore Hospital, Auckland . I think they might not hold the exam at the same place all the time. But I'm not sure.

mindy · Credits: 965 My Scrapbook

thank you..

mindy · Credits: 965 My Scrapbook

ni hao mailman,do you have talley? ohya, can i have ur contact no please? i wanna ask some questions. thank u..

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