ACRRM MCQ cheat sheet

Absolute cardiovascular risk: use a validated 5-year risk tool for adults aged 45–74 (35–74 for Aboriginal and Torres Strait Islander peoples); treat when 5-year CVD risk exceeds 15%, with lifestyle intervention at 10–15%.

Acute rheumatic fever diagnosis (Australian criteria): evidence of preceding group A streptococcal infection plus 2 major, or 1 major and 2 minor, manifestations; major = carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules.

Otitis media with perforation: first-line amoxicillin 15 mg/kg/dose (max 500 mg) three times daily for 5–7 days; avoid amoxicillin if perforation has lasted more than 2 weeks (consider ciprofloxacin drops).

Sepsis in rural settings: qSOFA (respiratory rate ≥22, systolic BP ≤100 mmHg, altered mentation) plus suspected infection flags high risk; antibiotics within 1 hour and early retrieval planning.

Iron deficiency anaemia in adults: ferritin <30 micrograms/L is diagnostic; if ferritin is 30–100 with inflammation, use transferrin saturation <20% to support the diagnosis.

Warfarin management: target INR 2.0–3.0 for most indications (2.5–3.5 for mechanical mitral valves); adjust dose by weekly percentage change rather than fixed increments.

Asthma in children: spacer with face mask preferred over nebuliser for acute exacerbations; oral corticosteroids (prednisolone 1–2 mg/kg, max 50 mg) for moderate or severe exacerbations.

Diabetes screening: HbA1c ≥6.5% (48 mmol/mol) supports diabetes diagnosis; 5.7–6.4% indicates prediabetes; repeat confirmatory testing unless symptoms are unequivocal.

Retrieval triage: use a structured tool (e.g., ATS/retrieval priority categories) to communicate acuity; category 1 requires immediate aeromedical response, category 4 may be scheduled within 24–48 hours.

Procedural sedation in remote settings: fasting status (2 h clear fluids, 6 h solids), continuous SpO2 and capnography, and a second clinician dedicated to airway monitoring.

Mass casualty triage in rural incidents: use START/Sieve for adults and JumpSTART for children; red = immediate, yellow = delayed, green = minor, black = deceased or expectant.

Telehealth prescribing: real-time video is required for initial Schedule 8 prescriptions in most jurisdictions; asynchronous store-and-forward is insufficient for opioid initiation.

Cold chain for vaccines: store at +2 to +8 °C; monitor with a data logger; discard if exposed to <0 °C or >8 °C beyond permitted limits per the National Vaccine Storage Guidelines.

Rural obstetric emergency: for postpartum haemorrhage, give oxytocin 5 IU IM plus tranexamic acid 1 g IV within 3 hours; escalate to retrieval if bleeding persists after 30 minutes.

Snakebite in remote Australia: pressure-immobilisation bandage plus splint for elapid bites; do not cut or suck; antivenom guided by clinical features and, where available, venom detection kit results.

Procedural credentialing: rural GPs performing anaesthesia, obstetrics, or surgery require documented logbooks, supervision, and regular skills maintenance under hospital credentialing frameworks.