Professional Documents
Culture Documents
COMPILATION PART 1 - APR 14 New-2
COMPILATION PART 1 - APR 14 New-2
First of all, I would like to thank all universities for contribution! Team work is so important.
Hope can keep it up until we graduate even we become family medicine specialist in future..
SHARING IS CARING!!!!
MEDICAL
Q 12. 38 years old man presented with muscle weakness for 3 months. On examination BP is
140/90 mmHg and there is purplish striae noted on the abdomen. What is the appropriate
investigation?
Q14. 50yo man c/o right sided weakness. Bp:160/100.pr90 regular. Power 4/5 rul/rll
hyperreflexia.ct brain small hypodense area at internal capsule.allergic to aspirin. Appropriate
treatment
A. Cea
B. clopidogrel
C, heparin
D. Warfarin
E, streptokinase
Q 20. 68 years old women presented with bilateral knee pain for 6 months
Investigations normal
A) Acetaminophen
B) Ibuprofen
C) Glucosamine
D) Chondroitin sulphate
E) Topical
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Q 22. 45yo male c/o epigastric pain for 1 week. Urease test positive in private GP. What is ur
next step of management.
A) do H. pylori serology
C) MMT
D) OGDS
E) start H2-antagonist
Q . 76 years old gentleman with COPD, presented with sore throat, joint pain and cough. No
SOB.
O/E afebrile. Blood pressure normal. throat injected. No cervical lymph node palpable. CVS
and Lungs normal.
what is ur diagnosis?
A. acute bronchitis
B. pleurisy
C. mycoplasma pneumonia
E. pneumococcal pneumonia
Q25. 37 yo woman recently diagnosed with PTB and started on fixed dose combination
therapy, noted to be jaundiced. O/E vitals sign stable, icterus, palpable liver 2cm nontender.
Deranged LFT with ALT 200, bili 30. AntiTB withheld.
What is the next mx?
a) Do coag profile
b) Order USG liver
c) Repeat LFT in 2/7
d) Give vitamin E
e) Give Essential
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Q26. 26 years old SLE patient with right groin pain for 2 months. She appeared to be cushingoid
clinically on T. prednisolone 10mg od. Right hip Xray appeared to be normal. What is the
next step of investigation
A. Bone density scan
B. CT scan
C. MRI
D. Ultrasound
Q27. 40 years old lady with Hypertension and Type II diabetes; blood pressure 130/80 with
following lab results
- urine microalbuminuria +ve
- Total Cholestrol 5.3
- HDL 1.2
- Triglycerides 3.4
- Creatinine 110
- LDL 2.3
28. A 45 year old man presenting with history of muscle cramps and fatigue. On examination,
vital signs are stable. Physical examinations are unremarkable. Below is his biochemistry
results:
A. Serum magnesium
B. Serum parathyroid
C. Serum albumin
D. Thyroid function test
E. Serum phosphate
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Q29. A 29 yr old female, previously healthy presented for her pre-employment check. She is
asymptomatic, not taking alcohol, no high risk behaviour, no history of blood transfusion.
BMI is 31.No jaundice. There is hepatomegaly. Ultrasound showed enlarged hyperechoic
liver. No other abnormality. ALT to AST ratio is raised. Other investigations are normal.
What is the best management?
Q 31. 60 years old man presented with unsteady gait and giddiness. BP sitting 140/90 and
standing 110/60. on examination he had small shuffling gait . The most possible diagnosis for
him.
A. Alcohol polyneuropathy
B. Cerebellar disease
C.
D.
E.Parkinson disease
Q .32yo malay man, coming for follow up. He is well. No active complaint. His results as
below :
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Q. A 40 YEAR OLD LADY PRESENTED WITH PROGRESSIVE FATIGUE OF UPPER
AND LOWER LIMBS TOGETHER WITH THE BILATERAL EYE WEAKNESS THAT
SEEMS WORSENING FROM DAY TO DAY AND INCREASING IN INTENSITY
THROUGHOUT THE DAY. NO FAMILY HISTORY AS SUCH AND NO PRIOR
HISTORY OF ILLNESS.
O/E : BILATERAL PTOSIS AND PROXIMAL WEAKNESS OF UPPER LIMB
POWER AND TONE ARE NORMAL
Q34. 32 y.o woman presented with severe diarrhoea and muscle weakness. She was
diagnosed with Grave’s disease 6 months ago. However she missed her medications since 2
weeks ago.
On examination the patient was anxious, having tremor, BP: 160/100, PR: 120, T: 39 degree
There is goitre with bruit. CVS: presence of flow murmur
A. Dexamethasone
B. Lugol’s iodine
C. Enalapril
D. Propylthiourecil (PTU)
E. Propanolol
Q37. 56 year male,presented with right sided abdominal pain with fever,chill and rigor for
2days.on examination: T: 37.8 BP:128/78 HR:104.there is right flank tenderness.
Investigation:
URine; protein:trace
: nitrate/keton : - ve
: leuco; +ve
Microscopy; RBC: 2 /HPF
: WBC; 1/HPF
;Bact/cast/others:nil
Q 38. A teenage girl presented w fever last week. Pt was pale. FBC – neutropenia, normal Hb
and platelet. BMA normal. No organomegaly/lymphadenopathy. What is the diagnosis?
A. AML
B. ALL
C. Bacterial infection
D. …
E. …
Q 39. A 54-year-old male with no past medical history is found to be in atrial fibrillation
during a consultation regarding a sprained ankle. He reports no history of palpitations or
dyspnoea. After discussing treatment options he elects not to be cardioverted. If the patient
remains in chronic atrial fibrillation what is the most suitable treatment to offer?
A. No reatment
B. Warfarin
C Dabigatran
D. Aspirin + Dipyridamole
E Aspirin
Q. 32 y/o man came in with swinging fever, night sweats, rigors and jaundice for 10 days. He
had a history of jungle trekking 2 months ago.
He looked lethargy and pale with mild tender hepatomegaly. Temp 39 degrees, Bp 110/70
and HR 116bpm.
Q .45 yo lady, presented with facial puffiness and pedal edema. investigation was as below.
she is also known case of rheumatoid arthritis on gold therapy.
urine protein 2+
albumin 19
T.cholesterol 5.2
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Q42. RVD patient, presented with right hemiparesis; noted lymphadenopathy; CT showed
left sided enhancing lesion. What is the most appropriate management?
A. Toxoplasma IgM
B. Lymph node biopsy
C. …
D. …
E. …
Q44. 35 years old, Abdominal pain, blood and mucus in the stool. Arthralgia, loss of weight 5
kg. On examination mild pallor, nodules skin bilaterally. Lower abdominal tenderness.
What is your diagnostic test/ best management? (tak sure soalan nk apa.. tak ingat..)
A.
B Barium enema
C. Colonoscopy
D.CT Abdomen
E Ultrasound abdomen
Q45. 78 yo lady complain of no bowel opening x 2/12 with last BO a week ago. She also has
painful defecation. On exam noted perianal skin tags and impacted stools. What is the
management?
A. Liquid Paraffin
B. Lactulose
C. Fibre supplement
D. Glycerin enema
E. Oral bisacodyl
Q47. 17yo girl with Type 1 DM complaints of vomiting and epigastric pain since morning.
She is stable on regular insulin. She just recovered from acute exacerbations of bronchial
asthma. On examination she is febrile BP 100/60 P110/min and dehydrated
Q48. 48-year-old male who is a known case of peptic ulcer disease currently diagnosed to
have osteoarthritis of the knee. which of the following is preferable for his painful knee?
A:Aspirin,
B:Naproxen,
C:Diclofenac,
D:Paracetamol,
E:Prednisolone
Q49. In chronic Hepatitis B patient, the most sensitive and specific investigation for
surveillance HCC is:
a) Alpha-fetoprotein
b) Hepatobiliary ulstrasound
c) Liver transaminase
d) CT scan liver
e) Viral load
Q50. 45 years old man had constipation for 1 year with occasional loose stool for 3/12. BP
130/80, PR 70bpm. Abdominal examination is normal. What is your next management?
a. colonoscopy
b. stool culture
d. sigmoidoscopy
e. barium enema
Q51. A 16 years old girl, come with history of fever, rhinorrhea and cough. Came with
complaint of joint pains. Initially had history of left knee and elbow pain which resolved. The
pain then migrating to the right knee at presentation. What is your diagnosis?
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A. Systemic lupus erythematous
C. Reactive arthritis
E. Septic arthritis
Q54. 65 years old man with hypertension on treatment presented with breathlessness and
exertional dyspnoea for 3 days.His BP 160/95, regular heart rate 100bpm. He is mildly
tachypnoeic. Spo2 93% under room air. JVP is raised. Lungs bilateral crepitations. What is
the most appropriate investigations for him?
A. CXR
B. ECG
C. ECHO
D. Pulse oxymetry
E. Cardiac marker
Q55. 28 year old woman, develop sudden onset of abdominal pain and diarrhea, 1 hour after
eating rojak at mamak stall. Her friend who also eat together with her at the mamak stall also
develop similar symptoms. What is the most likely aetiology for the above symptoms:
a) Enterotoxigenic E.coli
b) Shigella
C) Salmonella
d) Staph aureus
e) Vibrio cholera
Q57. 46 y/o, Hypertension, c/o severe diarhhea for past 3 days. He was afebrile and have
reduced urine output. His Blood pressure was 125/70, P 102
Investigations was:
Na 140
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K 5.4
Urea 20
Creat 320
a. Dialysis
b. B. Oral resonium
c. IV Normal saline
d. ORS
e. Anti diarrheal drug
Q. 50 years old gentleman presented with painless hematuria. physical examination as well as
bone and lung scan are normal. diagnosis of renal cell carcinoma was made by biopsy of the
local mass. what will you counsel to patient about treatment option?
A. chemotherapy
B. radiotherapy
C. immunotherapy
D. hormone therapy
E. surgical resection
Q. 70 years old.fever n urti.social drinker.confused and can see yellow spiders. what is dx?
A. Delirium
B. Delirium tremens
C. Dementia
D. Alzheimers ds
E.---
Q. 55 year old was admitted for stroke. His BP maintained at 155 -150/99-90mmHg. What is
the best antihypertensive for him?
A. ACE-I
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B. ARB
C. CCB
D. Thiazide
E. B-blocker
Q. 28 year old lady underlying SLE presented with SOB and chest pain. She had cough, but
no fever.on examination, RR – 18/min, BP – 90/80mmHg, with soft heart sound. ECG – ST
elevation all lead.
A. CXR
B. Cardiac syntigraphy
C. Holter
D. Stress test
E. Echocardiogram
Q. 40 yr old lady came to the office for check up. She had history of PTB 20 years ago and
completed treatment. She was asymptomatic and was well.
A. Sputum AFB x 3
B. Mantoux Test
C. ESR
D. Right lateral decubitus CXR
A. HUS
B. DIVC
C. Pulmonary embolism
D. Peritonitis
E. Thoracic aorta aneurysm
64. 18 years old sexually active woman complaint of persistent copious and frothy vaginal
discharge since 4 months ago. It is associated with pruritus and dysuria. On examination, her
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vulva appeared erythematous and excroriated. SE revealed punctuate haemorrhage ulcer at
cervix with greenish discharge.
A. Gram stain
B. HVS C&S
C. Pap smear
D. KOH test
E. Sterile wet mount test
65. 25 y/o man presented with penile lesion for 4/7. Noted single painful ulcer, irregular
border about 1cm in diameter with slough base.
A. Bechet’s disease
B. Chancroid
C. Herpes Simplex
D. Lymphogranulomatous venereum
E. Syphilis
A. ALL
B. AML
C. CML
D. CLL
E. MDS
72. 24 y/o man, recently diagnose with epilepsy. What is the side effect of medication that
should be emphasized on the patient?
A. Dizziness
B. Acne
C. Gingival hyperplasia
D. Rashes
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Q99. 30 yo came for AEBA.took sabutamol mdi 2x in 1 hr. O/e tacypneic rr28. Spo2 93% on
5 liter/o2. Bp 110/70 pr 120bpm. Auscultation: generalized ronchi.pefr 60% bpv. Appropriate
next step
A. iv adrenalin
B. iv hydrocort
C. iv theophyline
D. sc terbutalin
E. High flow mask
OBSTETRIC
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Q5. G5P4 at 36 weeks came with regular abdominal pain for 6 hours.
BP is 120/80, HR is normal.
Abdominal examination revelaed singleton fetus, fetal head at the mother’s right flank.
A) Cardiotocograph
B) Urinalysis
C) Vaginal examination
D) Ultrasound
E) Full blood count
8. Primid at 35w POA presented with bilateral leg swelling. Previous BP was normal. Her BP
was 140/90mmHg,PR – 80/min. examination was unremarkable.
Urine – no protein.
10. 30 years old G2P0+1 at 18w POA, with Blood Group A-‘ve. She has history of abortion
2 years ago and was given anti-D immunoglobulin.
Q13. 30 years old primigravida at 26 weeks is referred for uterus smaller than dates. She is
sure of dates and regular menses. On examination, BP 128/82 and uterus at 22 weeks.
Ultrasound scan shows head circumference at 26 weeks and abdominal circumference at 22
weeks.
A. Amniocentensis
B. Order chromosomal analysis
C. Order MGTT
D. Order umbilical artery doppler
E. Screen TORCHES
Q14. 48 year old woman having regular menses with abdominal pain and lethargy for 4
days.On examination noted bulky uterus.
A. ultrasound pelvis
B. thyroid function test
C. dilatation and curretage
D. pipelle sampling
E. hysteroscopy
A. Avoid pregnancy
B. Off OHA and start insulin
C. Off OHA
D. Off pioglitazone and increase MTF dose
E. Advice weight loss
Q23. A woman is found to have oligohydramnios at 30/52 POA. What is the most likely
cause?
A. Duodenal atresia
B. Placental chorioangioma
C. Oesophageal atresia
D. Diabetes
E. Renal agenesis
Q 24 38yo lady, 1/52 copious frothy greenish malorodious vaginal discharge. + vaginal
soreness +dysparenia. What is the expected finding of examination?
Q. An 18-year-old female presents to her GP as she has missed one of her Microgynon 30
pills yesterday morning. She has taken Microgynon for the past 2 years and is currently 4
days into a packet of pills. She had sexual intercourse last night and is unsure what to do. She
took yesterday's pill and today's pill this morning. What is the correct management?
A. Advise condom use for next 7 days
B. Perform a pregnancy test
C. Omit pill break at end of pack
D. No action needed
E. Emergency contraception should be offered
Q. 38 years old primigravida at 35 weeks POA came for routine antenatal follow up. Noted
BP 140/90mmhg, mild pedal oedema, reflex normal, urine protein normal. What is the most
appropriate next step?
A. BP monitoring
B. LFT/ FBC/ PT/ PTT
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C. Admit, refer
D. Start methyldopa
E.—
Q. 31 years old married female come to gynae clinic. she is unable to conceive for few years.
her menses irregular and associated with dysmenorrheal.
ultrasound showed uterus retroverted and adnexa cyst.
Q19. 60 y.o lady with no known medical illness and no drug history was recently diagnosed
with overactive bladder. She was not responded to bladder training. Examination revealed
normal abdominal and vaginal examination. What is the most important drug to start?
Q. 25 years old primigravida in active phrase of labour for 8 hours. ARM was done 3 hours
ago. contraction is 2-3 times per 10 minutes in moderate strength.
O/E: height is 166cm. Per abdomen is singleton , cephalic with EFW 3kg.
what is the cause of aove problem?
A. cord prolapsed
B. maternal pelvis dispropationate to fetal weight
C. fetal malposition
D. poor maternal effort
E. poor uterine contraction
Q. 18 weeks Pregnant woman with BP 140/80, persistent proteinuria; ufeme protein trace.
What is the diagnosis?
A. Pre eclampsia
B. Gestational hypertension
C. Eclampsia
D. chronic renal disease/failure
E. …
A. abruptio placentae
B. uterine rupture
C. placenta praevia
D. premature labour
E.---
Q. 24 years old presented to ED. Her LMP was 1 week ago. presented with abominal pain
with tenderness on palpation. cervical excitation positive
A. cervicitis
B. cystitis
C. appendicitis
D. Pelvic inflammatory disease
E. ovarian torsion
Q. 30 yo malay lady, G2 P1 at 30weeks POA, referred to you for uterus smaller than date.
She do not have any medical problem.
b) decrease ratio FL to AC
c) increase ratio HC to AC
d) oligohydramnios
e)polyhydramnios
Q21. 35 year old para 2+2 c/o amenorrhea for 6 months with ERPOC done the last 2
pregnancies with the latest one complicated with transfusion and endometritis. She has no
other complaints. She looks well, thin and pink. Abdominal and vaginal exam are normal.
FSH 16.3
LH 21.4
TSH 2.9
Prolactin 8.3 (all 4 normal)
What is the most likely diagnosis?
A. Asherman syndrome.
B. normal physiological response
C. PCOS
D.premature ovarian failure
E. Sheehan syndrome
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Q22. 36 years old G5P3+1@28wk presented with headache and epigastric pain for the past 3
days.her BP: 160/100mmhg, BMI: 30kgm2.systemic examination unremarkable.her urine
protein 1+ve
What is your next step of management?
A: ultrasound abdomen
B: renal profile and SUA
C: start on Aspirin
D: commence on MgSo4
E: start her on antihypertensive drug
Q 29. 18yo, single pregnant at 8month pregnancy. she had her first pap smear done and the
result showed Atypical Squamous Cell of Undetermined Significant.
A. Repeat
C. HPV testing
D. Endocervical currettage
E. Repeat 1year
Q30. 23 years old, Lady, Left Iliac fossa pain for 2 days. Regular menses and LMP 6 weeks
ago. V/S stable. On examination mild tenderness at left iliac fossa.
A. B HCG
B. B. Transabdominal Ultrasound
C. Transvaginal Ultrasound
D. Urinalysis
E. Urinary Pregnancy Test
Q31. 39 yo Para 2 with last child birth 3 years ago. She has DM on T Metformin 1g BD and
Gliclazide MR 60mg OD. FBS 8mmol/L and HbA1C 8.5%. She has IUCD inserted 3 yrs
ago. She wants to conceive. What is the best advice?
Q32. 26yo, G2P1 at 28w, had a contact with her daughter who is having chicken pox. She
doesn’t recall of having chicken pox before this but definitely remember that she previously
had a contact with her sister who had chicken pox when she was young.
B. give Acyclovir
C. give VZIg
D. Reassuarance
E. Vaccination varicella
c) MOGTT
d)---
e)---
Q35. 32 years old lady, nulliparous and has irregular menses since menarche. She is married
for 5 years. She is otherwise well. BMI is 30kg/m2 . BP: 124/70. PR: 80bpm. There is
extensive hair over her legs and arms.
a) Cushing’s syndrome
b) Diabetes Mellitus
c) Hypothyroidism
d) Idiopathic hirsuitism
e) Polycystic Ovarian Syndrome
Q36. 43 years old para 5 had PV bleed that wet her sarong. She gave birth via SVD at 12 H
ago. Labor prolong due to poor contraction. Baby weight is 3.8 kg. She is pale, T 37.8, BP
110/82 PR 84, P/A Soft non-tender.
a. coagulopathy
b. endometritis
c. retained placenta
d. uterine rupture
e. uterine atony
Q39. 36 years old, nulliparous with h/o 3 consecutives miscarriage. Previous karyotyping
done and normal. She has recurrent fever and arthralgia.
A. Antiphospolipid ix
B. Repat karyotyping
C. Echocardiogram
D. Abdominal ultrasound
E.--
Q40. 45 years old Para 2 with no known medical illness. She has normal regular menses, no
intermenstrual bleeding, no dysmenorrhea. She had bilateral tubal ligation 10 years ago. Her
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sister recently diagnosed with endometrial carcinoma. She came to seek advice whether she
needs screening for endometrial carcinoma. What is the most appropriate screening test for
her?
A. Endometrial biopsy
B. Hysteroscopy
C . Ultrasound
D. Pap Smear
E. CA 125
Q41) 28 year old, primigravida at 16 weeks POA come for booking. Following are the
results:
Hb 9.0
MCV 75
MCH low
MCHC low
Platlet: 400
TWC: 8
c) serum ferritin
d) serum iron
e) Hb electrophoresis
Q42. 40 years old, G3p2@12 wk POA came to screen for Down Syndrome. Her previous
children were well. What is the investigations to be done:
b. Quadruple test
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c. Triple test
Q43. G1P0@ 20 week with hyperthyroid on T. Carbimazole 15mg daily. Her BP 125/80, P
100. Her investigations are:
TSH 0.8
T4 24
a. Reduce to 10 mg daily
b. Increase to 20 mg daily
c. Continue same treatment
d. Start on T. Propanolol
e. Change to PTU
45. 23, primid at 38w POA had contraction 1:10 for 1H. Patient is in distress
VE: Os 6cm
CTG : Reactive
50. 26 year old woman at 12 weeks POA with severe vomiting and weight loss for 2 weeks.
O/E she is mildly dehydrated. BP – 100/70mmHg , PR – 110/min. urinanalysis showed
ketosis. She was given IVD and metoclopromide and had a little improvement. Other
investigations as below
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fT4: 25.5 (9.1 - 24.4)
Hb : 11.8
A.
B. Ginger root powder
C. Ondasetron
D. Promethazine
E. Vit B6 (pyridoxine)
PAEDIATRIC
Q7. 4 month old boy, constipation since birth. Only pass motion 2/7 after birth. Since then no
soil in diapers. Rectum examination - empty rectum.
What is the Likely diagnosis?
A) functional constipation
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B) Hirschprung disease
C) hypocalcemia
D) hypothyroidism
Q. 4 weeks old boy has history of constipation since birth, only opens his bowel on day 2 of
life, come in with similar problem, not soiling his diaper, most likely diagnosis will be:
A. hypocalsemia
B. Hypothyroid
C. Hirshsprung
D. Intestinal obstruction
E.—
Q. You are examining D1 of baby. baby was delivered term, spontaneous delivery, birth
weight 3kg. Apgar score 9 in 1 minute, 10 in 5 minute. You noted cephalohematoma 4x3cm
at the parieto-occipital region. Mother informed you that baby is sucking well. BO and PU
are normal.
What is your appropriate management?
A. take FBC
B. take serum bilirubin
C. reassurance
D. observe hematoma until size reducing
E.do skull x-ray
Q35. 8 years old girl was brought in by teacher for frequent dropping pencils asoociated with
blank stare. What is the criterion for the diagnosis?
Q.4yo boy, can only speak few 2 word phrases. there is no dysmorphic features on
examination. what is the next most appropriate step?
A. audiometry
B. brainstem evoked response
C. otoacoustic emission test
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D.
E.
Q30. A 8 year old boy presents with two days history of pain on micturition. On examination,
he is clinically well and mild suprapubic abdominal tenderness. Urinalysis as below:
Leucocyte esterase 2+
RBC negative
Protein negative
Nitrite negative
Q. 5 years old girl presented with vomiting 1 day ago. She is unable to tolerate food and
drinks. O/E: she is crying with tears, good capillary refilling time. Her temperature is 38
degree celcious. What is your appropriate management?
A. Advise probiotic
B. prescribe antibiotic
C. prescribe ORS
D. reassurance patient and come back on next day
E. refer for admission
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Q22. A child with leukemia currently on chemotherapy. He hasa sibling who is
currentlydiagnosed with Varicella zoster infection
A) Admit to ward
B) Isolate patient
C) Give vaccine to patient
D) Give varicella IgG
E) Prophylactic acyclovir
Q31. A 5 yr old girl known case of Asthma complaining of nocturnal cough and wheezing for
2 days. She has been having exacerbation twice a week for 2 months. She is on Fluticasone
50mcg od.
Q. 4 m/o presented with crying for 2/7. Funduscopy revealed retinal haemorrhage.
A. Coagulation profile
B. CT brain
C. UFEME
D. LP
E. Reassure mother
51. 4 yr old presented with h/o fever x 2/7. On inspection noted multiple nodules over post
auricular area with maculopapular rashover neck area.
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What is the possible diagnosis?
A. Erythema nodosum
B. Measles
C. Roseola infantum
D. Rubella
E. Scarlet fever
52. 14 year old girl came for primary amenorrhea. The breast was developed however, there
was widely space nipple, with skin folds at neck. Lung and CVS findings were normal.
However, the pulse of the LL was slower than the UL.
A. AS
B. MR
C. Coartation of Aorta
D. MS
E. PS
60. 7 Year old girl presented with SOB x 1/7. On examination her BP was 130/90mmHg, zpr
– 72/min, SPO2 94% under RA. There was periorbital swelling and mild pitting edema of
foot. Chest revealed reduced air entry from mid zone to lower zone with fine crepts
bilaterally.
Urinalysis:
A. IV Furosemide
B. IV Ig
C. Bed rest
D. Oral Nifedipine
E. Spironolactone
61. 3 yr old presented with 1 week history of perianal itching mostly at right side. There is no
fever, vomiting, diarrhea. His weight and appetite was normal.
On examination, the perianal area was red and excoriated. Anal tone was normal.
Q87. 5 yo boy with walking difficulty, has calf hypertrophy, limb girdle weakness and
waddling lordotic gait
What is the likely diagnosis?
a) Duchenne muscular dystrophy
b) Motor neuron disease
c) Guillian barre syndrome
d) Spinal muscular atrophy
e) --
Q. 18 month old weight at 50th centile. during the next check up she weighted at 25th centile.
she is otherwise a happy child. father is jobless. she has 10 siblings at home.
what is the most likely diagnosis?
A. GH deficiency
B. emotional deprivation
C. inadequate nutrition
D. child abuse
E. (cant recall this option)
Q86. 6 y.o boy presented with fever for 1 week with multiple joints pain. It started with
lower limb then upper limb. He had history of sorethroat 2 weeks ago.
On examination: Temperature was 39 degree, BP: 120/80, RR: 20. The left elbow was
swollen and tender and presence of multiple subcutaneous nodules on the elbow. There was
multiple erythematous rashes with pale centre on the limbs.
WCC: 12
Hb: 11
ESR: 35
A. Benzathine Benzylpenicillin
B. Corticosteroid
C. Aspirin
D. Erythromycin
E. NSAIDS
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Q. 8 years old, malay, girl. No known any medical illness before. C/O fever for 4 days
associated with headache. No URTI symptom. On examination, not plae, not in respiratory
distress, no bleeding tendency.
T: 37.2%
Bp : 80/64
PR: 80/min
Q 88. 2 year old girl brought in by her parents pale but no jaundice. She has no koilonychia
or angular stomatitis. Abdominal exam showed no hepatosplenomegaly.
Hb is 10g/dlr
Rbc 5.6 (upper limit 5.4)
Mcv 62.6
Mch 20.5
Mchc 32.6
Ferritin 142 ( upper limit. 200)
Q90. Infant presented with fever, develops rash after fever settled. Had simple febrile seizure.
What is the diagnosis?
A. Meningococcal septicemia
B. Adenovirus
C. Roseola
D. measles
E. …
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Q91. A 5-year-old girl is brought to GP due to a high temperature. On examination she is
noted to have an evolving purpuric rash. What is the most appropriate course of action?
A. IM Benzylpenicillin
B. IV cloxacillin
C. …
D. . …
E. …
Q94. A 3 yr old boy presented with fever, red tongue, rashes. What is the diagnosis?
A. Kawasaki disease
B. …
C. …
D. …
E. …
Q96. 8 year old boy come with scrotal swelling for 3 days. He also presented with bilateral
facial puffiness, ankle oedema and ascites. What is the most likely diagnosis:
a) Interstitial nephritis
b) FSGS
e) Membranous nephropathy
Q97. An abandoned newborn baby was brought to you for feeding intolerance. His sucking is
good but will vomit after small amount of milk. His weight is 2.5 kg, appear dehydrated. He
has upslanted eye brow with flat nasal bridge. Abdomen not distended and no mass palpable
a. Biliary atresia
b. Duadenal atresia
c. Pyloric stenosis
d. Intestinal obstruction
e. Intussesception
Q98. 5 y/o came with h/o lip smacking for 10 secs, about 10 times per dy for past for 4
months. Most possible diagnosis is :
a. Absence seizure
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b. Benign Rolandic seizure
d. Partial seizure
100. 4 year old child presented with cough and noisy breathing for 2 days. On examination,
she has a stridor and hoarse voice. Pharyngeal wall was erythematous without exudates. CXR
given.
A. Diphtheria
B. Epiglotitis
C. Foreign body
D. Larygomalacia
E. Croup
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OSCE 1st year part one exam in May 2014
1. CVS
- mitral regurgitation
- VSD
-prosthetic mitral valve
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2. Respiratory
- bronchiestasis
- lung fibrosis
- pleural effusion
3. Abdomen
- hepatomegaly
- spleenomegaly
- hepatospleenomegaly
-kidney transplant with scar
5. CNS
- right or left paralysis/ paresis with Right or left CVA
6. Obstetric
- uterus larger than date
- uterus smaller than date
10. A 21 years old single lady come to you and said that : Dr, I don’t want pregnant”. She just
had unprotected SI on 3am with her boyfriend. please procede your counselling.
* * hint: counsel ECP, explore history and screen for STD, counsel other contraception
methods
11. You are a medical officer in emergency department. A patient referred from health center.
A 54 years old gentleman with underlying hypertension on antihypertensive medication. He
is not compliance to medication. he complained of headache.
O/E comfortable
BP 160/100mmgh
12. A 35 years old lady comes to review her result. Please procede your counselling and
management
LFT
Parameters are normal except ALT mildly raise
These below questions I accidentally found from internet. Just wanna share to you all…
HAPPY STUDYING….
1. A 11 month old infant is referred to you. The infant cannot sit up or stand up, but crawls
and plays with objects, understands plenty of words and commands. The somatic growth is
apparently normal. After careful examination, the infant’s psychi development I found to be
normal and no organic neurologic disease is excluded. What should be your advice to
parents?
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B. to elevate the dose of regular vitamin D
C. although the infants’s hip joint have been found to be normal in a physical examination, x-
ray of hip joint is ordered
2. A 2 week old infant is bought to your office. Two days ago the baby vomited. The baby
also has diarrhea. The mother tells you that the infant’s appetite is good. He ableto voids
large amount of the urine (the nappy is always wet). On observation the infant is alert. What
is your most likely diagnosis?
A. sepsis
B. gastroenteritis
C. intestinal malrotation
E. overfeeding
3. A breast-fed baby is developing well. The baby’s mother has no problem with lactation. At
what age would you introduce vegetable puree to the diet?
4. A 12 month old infant is admitted with complaints of diarrhea and exsiccosis for the last
three days. During general examination a week before admission the infant is found healthy
and weighed 10kg. For the last few days the body temperature has been 39 degree. Baby pass
BO 10-12 times daily. The baby did ot pass urine last 18 hours. O/e dry skin, reduce turgor
skin, sunken eyes. What is your next step?
B. do UFEME
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C. Take blood for ions and urea nitrogen and start 20ml/kg half saline
D. do blood culture.
5. A 3 week old well developed , breastfed infant is still jaundice. What is your most
appropriate management?
A. admit to ward
B. send to phototherapy
C. do blood exchange
6. A 39 years old nulliparous woman present one week delay of last menses. The patient has
never taken any contraceptives and was married 6 months ago. She has always had a regular
cycle. O/E, cervix is soft and bluish purple clor. Adnexa mass is not palpable. Which of the
following methoid is suitable for earliest possible recognition of pregnancy?
B. ultrasound
E. progesterone withdrawal
7. A 19 year old nulliparous woman in her 35th week of pregnancy presents with nausea,
blurred vision and a weight gain of 4.5kg per week. Her BP is 160/110mmHg. Which of the
following test is most suitable for fetus assessment?
C. sonographic cephalometry
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E. oxytocin challenge test
8. 18 years old unmarried girl admitted to ICU with shaking chills, 39.4 degree fever,
80/40mmHg BP, moderate vaginal bleeding, abdominal tenderness and history of loss of
conscious twice. The pelvic examination denoted slightly enlarge and softened uterus. What
is your most appropriate step?
B. blood culture
D. UPT
E. emergency laparoscopy
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