Professional Documents
Culture Documents
Jun 2022
Jun 2022
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A 37yr old woman with persistent nausea & vomiting. Has well-controlled chronic hypertension &
hypothyroidism. Dry mucous membranes & CRT is delayed. Thyroid diffusely enlarged. Urinalysis
positive for ketones. US reveals 8-wk intrauterine twin gestation. Risk factor for current sx?
a/ Chronic hypertension
b/ Hypothyroidism
c/ Multiple gestation
d/ Maternal age
3-wk-old girl is brought due to apnea & cyanosis. Mother reported multiple episodes of gagging and
gasping for air past 48h. Child cough harshly while feeding and stop breathing. Has a weeklong
history of clear rhinorrhea & increasing cough followed by episodes of emesis. Empiric
pharmacotherapy?
a/ Amoxicillin
B/ Azithromycin
17yr-old boy complains of intense left flank pain that radiates to the groin. Experienced "so many
times since childhood." His uncle has same problem. Urinalysis shows hexagonal crystals. Urinary
cyanide nitroprusside test is positive. Cause?
b/ Parathyroid adenoma
50+-yr-old man comes due to a cough. 40x-pack-yr smoking history but quit a mth ago. Experienced
weight loss, anorexia, constipation, increased thirst & fatigue, which he attributes to depression.
Lost his wife 4 mths ago. Oxygen saturation is 92%. X-ray reveals a hilar mass in the left lung. Next
step? Urea 17, Creat 17x.
b/ Emergency hemodialysis
c/ Saline hydration
55-yr-old man has difficulty achieving & maintaining erection. Medical history includes hypertension
& hypercholesterolemia, for which he takes amlodipine & atorvastatin. Drinks 2 or 3 glasses of wine
daily. Frequently driving grass cutter. BMI 45. Responsible for increased hematocrit?
a/ Carboxyhemoglobinemia
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54yo lady Para 2. comes for evaluation of leakage of urine. Had 3 UTI treated with antibiotics. BMI
33. No leakage with Valsalva & the vagina is dry & atrophic. A 2-cm tender anterior vaginal mass is
present & palpation expresses a bloody discharge from the urethral meatus. Cause?
32-yr-old man comes for routine check. Recently placed on probation for poor work performance.
Misses work at least once a wk because he stays up all night playing poker online & lost a lot of
money. Started borrowing to pay bills. Explanation for behavior?
b/ Bipolar disorder
c/ Gambling disorder
52-yr-old man comes due to upper extremity weakness, pain in his shoulders & upper back since
shoveling snow 3 wks ago. Has hypertension & hypothyroidism. Moderate weakness of left shoulder
abduction. Decreased sensation to light touch & pinprick on the left lateral forearm. Next step?
65-yr-old man returns for follow-up 10 days after receiving a subacromial corticosteroid injection for
right-sided rotator cuff tendinopathy. Has type 2 diabetes mellitus & gout. Mild swelling in the
lateral right shoulder. Range of motion is limited in multiple axes due to significant pain. ?iatrogenic
cause. Next step?
a/ Image-guided aspiration
15-yr-old girl underwent menarche at age 12. Menses consist of 4 days of light bleeding. Past 3 mths
developed malaise & dizziness 2 days prior to menstrual period & had associated, continuous lower
abdominal pain that radiates to her thighs. Resolved on the 2nd day of menses. Next step?
a/ Copper IUD
b/ GNRH agonist
c/ Nsaids
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28-yr-old man with progressively worsening shortness of breath. Has 2 prior hospitalizations for
asthma, one of which required intubation. Uses budesonide-formoterol inhaler twice daily.
Prominent bilateral inspiratory & expiratory wheezing & prolonged exhalation. Risk factor?
a/ Age
b/ Characteristics of wheezing
14-yr-old girl with hand tremors. Occurs at rest or during activities & can be interrupted only by
either grasping an object or clenching the hand. Patient has flat affect. Low-frequency tremors at
rest. Tremors cease during exam, but at the end, a bilateral coarse tremor observed. Diagnosis?
a/ Cerebellar tremor
b/ Essential tremor
c/ Functional tremor
7-yr-old boy is brought for an annual checkup. Has no friends & prefers to play computer games by
himself or organizing card collection. Moved to a new school this yr because being bullied. Unusual
food rituals. Poor eye contact & answers in a polite but formal manner. What to do next?
34-yr-old woman with a rash & pruritus. Had sore throat for several days & took amoxicillin left over
from 1 yr ago. Itchy rash developed 20-30 min after the 1st pill. Multiple urticaria & mild
excoriations over the upper & lower extremities & upper body. Tonsils mildly erythematous. Next
step?
a/ Administer IV glucocorticoids
b/ Administer IM epinephrine
29-yr-old gravida 1 para 1, comes for a preconception visit. After delivery 2 yrs ago, she was
diagnosed with peripartum cardiomyopathy with a left ventricular ejection fraction of 21%. Recent
echocardiograms consistently show 28%. Patient like to attempt another pregnancy. What do you
say to her?
a/ "Another pregnancy poses significant risk to ur health & I cannot recommend that you get
pregnant."
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b/ "Given the improvement in your symptoms & cardiac function, you can now safely carry another
pregnancy to term." (exact same words)
24-yr-old woman comes due to a mth of progressive exertional dyspnea. Exam shows mucosal pallor
& bilateral cervical lymphadenopathy. CXR reveals bilateral mediastinal lymphadenopathy. Cause?
a/ Immune-mediated hemolysis
6-yr-old boy with new-onset chest pain. A wk ago, he developed a low-grade fever with nasal
congestion & a dry cough. Had paroxysms of coughing. Clear rhinorrhea. Posterior oropharynx &
tonsils are erythematous. Mild swelling of the neck & crepitus over the anterior chest. Next step?
a/ Bronchoscopy
b/ Chest x-ray
4-yr-old boy is brought for worsening ear pain that started after completing a course of antibiotics
for otitis media 2 wks ago. Recurrent ear infections since infancy. Left tympanic membrane is
bulging, erythematous & opaque. Left mastoid is tender, erythematous & swollen. Next step?
b/ Lumbar puncture
44-yr-old obese woman undergoes an open cholecystectomy for complicated acute cholecystitis.
Receiving IV hydration, hydromorphone & antibiotics. Oxygen saturation is 89% on room air. Cause
of hypoxemia?
a/ APO
b/ Alveolar hypoventilation
16-mth-old girl with breathing problems. Simple febrile seizure at age 11 mths & an upper
respiratory tract infection 6 wks ago. Learning disorder in her older brother. Has a brief period of
hyperventilation followed by hypoventilation. Repeatedly twists her fingers & has an unsteady gait.
Diagnosis?
a/ Dilated cardiomyopathy
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42-yr-old man comes due to an itchy rash. Rash began 3 mths ago during summer & since then has
enlarged & spread across his back, chest & abdomen. Exam reveals scaly, annular plaques.
Potassium hydroxide microscopy of skin scrapings from one of the lesions shows segmented hyphae.
Next?
b/ Hepatitis C serology
68yo man fall down. become forgetful, forgets to go to bathroom, urinated on himself. history of
hypertension and osteoarthritis. MMSE score 21 of 30. findings?
14yo boy rash lasting 3 weeks. red spots on arms and legs that itched. lost 3.6 kg in 4 months.
conjunctival pallor and an erythematous. Fecal occult blood testing is negative. next step?
a/ ASOT
b/ Colonoscopy
44yo man slashed on thigh. intoxicated and distress. deep laceration wound. patient repeatedly uses
offensive language toward the treating physician. physician's ethical duty?
b/ Duty to treat all patients when the patient-physician relationship has been established
7yo boy, 2 days sore throat & malaise. no cough or nasal congestion. tonsils are swollen. Small,
tender anterior cervical lymph nodes are palpated. next step?
a/ ASOT
c/ Throat culture
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32yo primigravid woman at 21 weeks gestation. discharge turned bloody. no abdominal pain or
heavy vaginal bleeding. scant blood. bulging bag is protruding through the cervix. Nitrazine testing is
negative. diagnosis?
a/ Abruptio placentae
b/ Cervical insufficiency
65yo woman 2-month shortness of breath. no chest pain, palpitations, or syncope. takes
chlorthalidone and lisinopril for chronic hypertension. ECG shows left atrial enlargement.
predisposing factor?
a/ Alcohol use
65yo man, postprandial epigastric pain. smokes 1 pack of cigarettes daily and drinks alcohol
occasionally. Fecal occult blood test is positive. next step?
a/ CT scan
b/ Exploratory laparotomy
60yo man chest pain. pain occur when he walks quickly or climbs stairs. coronary artery bypass
surgery 7 years ago. hypertension and hyperlipidemia. Treadmill stress test develops chest pain. pain
relief?
a/ Coronary vasodilation
36yo primigravid woman at 34 weeks gestation found unconscious. increasing nausea and vomiting
and frontal headache. history for migraines. abdomen is nontender, and uterine fundus measures 34
weeks gestation. CT scan of the head reveals bilateral frontal lobe edema. next step?
a/ CT venography
b/ Lumbar puncture
45yo man, altered mental status. agitated and disoriented. takes aspirin for chronic arthritis and
famotidine for acid reflux. smoked for 25 years and drinks heavily. Urinalysis shows square,
envelope-shaped crystals. cause?
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a/ DKA
37yo woman, gravida 2 para 2, dysuria, suprapubic pain, and increased urinary frequency. sexually
active with a new male partner. has a history of sexually transmitted infection. no costovertebral
angle tenderness. mild uterine prolapse. next step?
a/ Contraception modification
a/ Acalculous cholecystitis
29yo woman, cramping abdominal pain. history for Crohn disease that required an ileocolectomy 3
years ago. has type 2 diabetes, morbid obesity, and generalized anxiety disorder. smoked for 15
years.
a/ Cigarette smoking
b/ Diabetes mellitus
66yo man, prostate cancer. painful, bony metastasis in the pelvis, treated with hormonal therapy
and radiotherapy. insomnia due to pain. drug monitoring program database reveals no irregularities.
recommendation?
a/ "Bone pain is especially difficult to treat. Let's try a medication called calcitonin."
c/ "I'll prescribe naloxone in case of overdose and talk to your family about how to use it."
35yo man, sharp pain in the low back radiating to the posterior aspect of the left calf and foot.
Lifting the left leg to 60 degrees with the knee held straight causes burning pain. next step?
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28yo woman, depressed mood, disorganized behavior, and hearing voices. worsening auditory
hallucinations. preoccupied with paranoid delusions. no suicidal ideation. diagnosis?
a/ Delusional disorder
c/ Schizoaffective disorder
68yo woman, decreased vision in the left eye. history of ovarian cancer and treated with
chemotherapy. admitted to the hospital with small bowel obstruction. had floaters and progressive
blurring of the vision in the left eye. no eye pain or headache. cause?
a/ Cerebral metastasis
b/ Drug-induced glaucoma
c/ Fungal endophthalmitis
23yo woman, gravida 1 para 0, light vaginal bleeding. no nausea, vomiting, or pelvic pain. diagnosed
with type 1 diabetes mellitus at age 5 and has an insulin pump. Ultrasound shows a twin intrauterine
gestation. next step?
b/ Cerclage placement
29yo man, epistaxis requiring anterior nasal packing. Often headaches and fatigue. ECG shows
normal sinus rhythm, high-voltage QRS complexes, downsloping ST-segment depression, and T wave
inversion in leads V5 and V6. next step?
Police brought agitated patient from street. What will u do? Scenario is little changed but same
meaning.
c/ SSRI
d/ TCA
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The young boy got football injury to the face and he got especially black eye on right side and came
to ED and he got upward grazed horizontally and cheek numbness on ipsilateral side
A 17-yr-old female has not started her period. She is 4 ft 10, has no breast budding & pubic hair. The
examinations all are normal. What is your appropriate investigation to reach diagnosis?
a -karyotype
c -TSH & GH
d usg ( my answer )
e. prolactin
18-year-old girl came with father with a with 10 week pregnancy she don’t want you to tell this to
her father she has right arm fracture and not speaking in front of her father what in history suggest
physical abuse by father? H/O of # arm. ( the same questions )
5. 68-year-old lady on multiple drugs blood sugar 5.7 . all LFT including GGT are slight raised above
normal which were given in the scenario, creatinine , and lipid are all in normal ranged. Asprin 81
onc a day, metformin 1 g once a day, amlodipine 10 mg once a day , atorvastatin 20 mg are given to
this patient, what will you next.
b/ give metformin
History of resection of colon cancer few years before now presented with nausea and vomiting and
abd pain? Her abdomen is descendent and tense but not guarding
Little long sentence and ask the first appropriated investigation in ED?
b/ Usg
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c/ Ct
a/ Lung -crepitations
d/ pulmonary embolism
Scenario of a man came to you after travelling over sea for diarrhea 3 weeks without bloody
diarrhea and no fever but malaise . stool culture done and showed that Salmonella and the
management for this patient is
No azithromycin in here
a/ No antibiotic
b/ Metro ( my answer)
d/ Dissoluble sulphonamide
Patient complained and already done in stool culture on 3rd weeks showed salmonella.
DDH x-ray
Management of DDH
b/ Surgery
Four-year-old with haemangioma on face and pic is from the JM. it is present from birth time plus
not increase in size asked treatment—Reassure.
pic is given
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15-year primary amenorrhea with thelarche and got suprapubic swelling and Dx?
b/ Septate vagina
d/ Atresia vagina
19-year-old man with BL lower limb swelling ankle swollen plus bruised. what will you do for
appropriate investigation?
a/ CT Angio
Alcoholic with motor weakness with absent ankle joints without sensory involvement and no
cellebellar signs and
Peripheral neuropathy
Gb $ *
Four-year-old swelling on lateral side of neck? Cystic Hygomna and pic is given. Investigation asked?
US of neck
25-year-old girl come for STI screening. What you will check?
Chlamydia
Giardiasis
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Amoebasis
E. coli
Shigella
Atropine
Pilocarpine
Oestrogen
Urine test
cystoscopy
Rickets
Osteomalacia
Borderline personality
Migraine
a/ Age,
c/ breast ca
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d/ dysmenorrhea
Hypertension and haemophilia plus traumata leg has closed fracture tibia swollen neck newer
vascularities impact IV access done next management?
b/ fasciotomy
c/ IV antibiotics
Eight weeks pregnant and abdominal pain plus slight vagina bleeding ultrasound show no sac BHCG
positive next management?
Chest pain to back SOB white mediastinum heart rate 114 blood pressure 170/100 after analgesia
next treatment?
a/ TEE
b/ Ct PA
c/ IV nitroprosamide
d/ Iv alteplase
old man come, with weight loss within one month with jaundice call cholestatic picture. Diagnosis?
a/ choledocholithiasis
c/ CA pancreas ( my answer )
d/ Hyadatid cyst
Patient with anxiety symptoms divorce after physical violence with history of court order and all
exam normal. Diagnosis?
a/ PTSD
b/ Panic attack
c/ malingering
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23 ur old MVA in ER laceration at tibia which is clearly deformed foot well perfused next step?
a/ IV antibiotic
b/ fracture reduction
c/ Lavage
d/ surgical debridement---
The old woman with No trauma knee pain symmetrical moderate swelling noted for meteor local
features initial treatment?
a/ Paracetamol
b/ Glucosamine
c/ Chondiotin
d/ Sulphate
e/ Indomethacin
Colon screening? 51 year patient no symptom brother 53 years colon cancer diagnosed
a/ Colonoscopy now.
Surgeon commits mistake perforates intestine switcher it tells register to not inform patient what
will you do?
c/ APHRA
25-year daughter with intellectual disability patient with three children, mother wants to get her
sterilize. Has history of migraine not on medication was little menstrual bleeding what to do next?
a/ Sterilization procedure
b/ hysterectomy
d/ no treatment
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Pregnant mother exposed to varicella by other child with a rash 24 hours no previous exposure or
immunity next step?
a/ Serology
b/ vaccine
c/ acyclovir
New intern senior invites for dinner offers cocaine to him and other colleagues no duty in the next
few days what will you do?
a/ Nothing
c/ tell baord
glomerular nephritis
What to do?
epley
Patient on warfarin 5 mg , and sc enoxa 1ml/kg 12hours for one day and pain and swelling not relied
on leg and INR 1.7 , mx?
Patient with melanoma coming with headache with nausea and vomiting in early morning
Indication for CT
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a. Headache
15,Young girl, first cervical cancer screening. Hpv negative, LSIL what to do? Repeat at 12 months
Endometrial CA- 45 year old with BMI 40 what is the highest risk factor
DM
b/ smoking
c/ nuliparity
patient with chronic smoker for 40 years and smoked 20 cigarrete per day with presenting Radiating
pain along UL with intrinsic muscle wasting what to do first investigation?
a/ MRI,
Old woman with headache, ESR 110 , but no visible on temporal arteries, no jaw claudication in this
case and What is the best feature to suspect Temporal arteritis?
b/ jaw claudication
c/ Headache
Low back ache osteoporosis with fracture L4 L5 with anaemic leukopenia increase protein increase
ESR diagnosis?
a/ Uremic osteodystrophy
G1 po with 10 weeks pregnant with palpitation and tremors TSH is 0.1 and free T3/T4 is normal and
no underlying disease and treatment ?
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Reassure
a/ propanlol
b/ carbamazepine
15% pneumothorax with smoker aged 25 years and ask initial treatment?
a/ Reassure
b/ needle thoracotomy
c/ chest drain
Septic arthritis case positive diplococci in aspirated fluid and ask treatment?
a/ Fluclox
b/ Vancomycin
c/ Benzoylpenicillin
The young guy wants to go oversea and ask advice for vaccine for salmonella before he leaves ?
a/ trsdVaccine
b/ Doxycycline
STI Diagnosed chylamdia and gonorrhoea positive with urethral discharge on RX what is next step?
a/ Provision of condom
b/ Contact tracing
a/ To research
b/ To prevent spread
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Mother came with 4 years old child and said there is Meningococcemia case who attends from
Monday to Wednesday in class .her child only attends on Friday to Saturday and she concern about
transmitting about this meningococcemia and wants to get antibiotics for prophylaxis?
a/ Give antibiotics
b/ Nothing
b/ Primary tu
c/ Liver cyst
X ray of hand given and I see no facture but patient came with swelling and painful
a/ IV antibiotics
b/ Lavage
c/ Reduction
Mental retarded patient 20 years plus mother request for sterilisation patient has three children?
a/ Refer to court
b/ do sterilisation
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Breastfeeding Baby got jaundice on Third day and to reach on diagnosis and no serum bilir given ?
a/ ABO incompatibility
b/ G6PD deficiency
GP already Lady with advise not to drive at night time and only ask day driving for her eye disease
and noticed driving on the road at night time ?
b/ talk to patient
Young guy felt chronic knee joint pain especially on lateral side while playing football and ask DX
b/ Fracture
70 male, recent travel to jarkata for 3 days golfing with his wife and complained now rash, fever,
joint pain and malaise. They didn’t go to anywhere except staying in hotel
a/ HIV/
b/ syphilis serology/
c/ malaria
Mother brings her baby after 2 weeks of birth and on brest feeding , baby has jaundice, total
bil.350(<200), conjugat
a/ G6PD def./
b/ neonatal hepatitis/
c/ ABO incompatibilicy
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patient presented with anxiety symptoms. History af job discontinued due to absence. Stealing and
75#75 years old Prostatomegaly, TURP resection showed 5% low grade cells.
How do you diagnose vertical transmission after 36weeks of pregnancy and already on hepatitis C
viral therapy. and ask HCV investigation for baby?
1 yr old, ant fontanelle bulge, 24 hrs of fever----. Meningitis asking investigation for the cause
Chest x ray
Ct
79.Black Snake bite - 4yr old- conscious, no cns effects- treatment for first aid in ED
- compression bandage
HRT rx going on for a woman-6 yrs now, came for repeat hrt, next advise-
85 years old lady with 1cm lower pole kidney mass- surveillance my answer
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Patient said that a surgeon whom do Elective cholecystectomy for her and patient know that
surgeon has a lot of complications after surgery and want to change the surgeron. What next?
Short of breath after coughing in a teenager boy. He was dyspnoic at GP, so GP referred him to ED
with CXR (15% pneumo right side) but he feels fine now when he got to ED. Next?
c/ Needle drain
d/ Tube drain
5 y/o Child with meningitis: blood culture shows Gram -ve diplococci. Tx?
a/ penicillin-answer
b/ Cefotaxime
c/ Ampicillin + Genta
Patient frequently abuses drug, He is on multiple drugs for epilepsy & depression for 1 year. Comes
to ET after seizure episode: confused & disoriented. Pupils dilated, no nystagmus, BP 105/60. Cause?
a/ post-ictal stage
b/ BDZ toxicity
c/ TCA toxicity
d/ Carbamazepine toxicity
Chronic smoker wants to quit smoking but cant and what u will give to quit
a/ Nicotine replacement
b/ Bupiro
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Patient came with walking pain relive by rest , cant walk more than 200 m , feeble pulse , htn , dm ,
smoker , what next step ?
a/ MRI,
b/ CT angio ,
c/ doppler,
Patient came with recurrent OE with glumet , 25 year old , today came with painful ear and
discharge , topical abx improve pain and fever , follow up , discharge came out , DDx ?
a/ OM media my answer
b/ OM externa
c/ Perf TM ,
74 yo , HTN , AF , no ischemia , will underwent prosthetic valve repair post 5 days , what to give ?
a/ clopidogrel,
c/ aspirin
Adult patient c/o breathlessness, hoarseness, wheeze on examination, no allergy history or asthma ?
b/ pneumonia ,
c/ pneumothorax
PROM at 29week , taken swab and abx prophylaxis , gave steroid , did ctg baby well , USG no liquor ,
height fundal lower than 29 ( 1 week lower ) , what to do ?
c/ give tocolysis ,
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Neonatal jaundice, 3 weeks baby came with , mom noted jaundice on sclera , otherwise good wt
gain , breast feeding well
a/ Abo ,
b/ g6pd ,
c/ biliary atrasia ,
Old age man 75 yo , p/w abdomen and epigastric pain radiate to back , loss of weight and appetite ,
h/o perforated duodenal ulcer ---almost look like Myanmar question.
a/ Cancer pancreas ,
b/ cholecystitis ,
c/ CA OF GB
Pt 7y, diff in swallow, high fever, b/l joint pain, large tonsil. Dx ?
Scarlet fever
Bromoctiptine===my answer
Radiotherapy
Transphenoidal
Single Mother saw her 17 years old son wearing his girlfriend underwear/ female clothing in my
scenario . what to advice?
he is homosexual hiding
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(old recall I got this one in exam ) Mother comes asking you about her 17 year old son because she
saw him wearing his girlfriend's underwear.
She is divorced and her son lives with her. Your advice regarding her son's behavior:
the infant is crying all the time and neglected by parents who ask sleeping pills for the baby and they
don’t want to hear its cry
Give drug
Reassure
Nothing
Myelofibrosis
peripheral facial palsy all sensations are normal. Point for dx for facial palsy
Salivation
pregnant lady with previous CS, Now delivered vaginally presented with 1000ml bleeding after
syntocine given Dx? Baby had tachycardia and resuscitated. Placenta delivery complete. Dx?
Cervical rupture
uterine rupture
uteroverted uterus
Coagulopathy
Retained placenta
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Folic acid
Paracetamol
Colixemab
4 months milestone's?
Reassure
mammogram
USG==my answer
Teenager on fluxetine since 2 yr.Now mother say She is happy in her new school & she Saw on TV
that fluxetine is bad. She Want to stop?
Psychiatry assessment
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stop
Young male, with appendectomy, has tattoo and gone for transfusion for operation He comes for
operation he comes for advice for screening before operation
Smoking
Pt post treatment with non Hodgkin lymphoma, presents with 38.9 fever, coughing, sat 94 shortness
of breathing, decreases air entry, crepitation at base, apart from covid, next investigation to confirm
diagnosis.
Blood culture
Pt came after mva , chest ct given hypotension 90/30, tachycardia, sat 94 resp distress, dull over rt
chest, everything normal in ct shows heamothorax, most appr in initial step in ED
Pericardiocentesis
Repeat ct
Chest tube
MVA, present with hemothorax , drained 1.5lit blood immediately, sat normal, hypotension 90/60
indication for thoracotomy -----amount of volume in the drain ===my answer
Intubate (next)
Thoracotomy (best)==
aboriginal Pt admitted to hospital , asked for smoking, he thinks he was owner of land on which
hospital was build
Ask senior
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Refuse
Give to smoke
Psychia assessment
Baby 3y anaemia s/s, spherocytosis, hb4.5, splenomegaly, fatigue, refuse eating, pallor,
Ferrous sulphate
Splenectomy
Pt female, fear of partner leave her,h/o multiple partner to reach diagnosis, wat to look for.pt seeks
assurance from people
Drug absuse
Underlying – Hepatitis C; treated with one anti-viral (not given brand name, just giving targeting
action) , Presenting – lots of melanotic frackles (naevi) in foot. What to check before surgery?
C. do excision
Middle age man - presenting with vomiting clear fluid with partially digested foods for months, had
loss some weights. His wife noticed yellow coloration of his eyes. He had history of duodenal ulcer
off & on. On examination - succussion splash is elicited. What is the diagnosis?
A. CA head of pancreas
B. Cholangiocarcinoma
C. Chronic DU
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Patient got pneumothorax & chest drain was done. But the drain was inserted to the correct position
but mal replacement
How to manage?
Young male after an episode of severe bout cough developed chest pain. After 12 hours, he went to
ED. It revealed 15% pneumothorax, & where they gave him morphine after analgesia. What initial
management will you do?
A. Reassurance
6 years old girl with hereditary spherocytosis(AD) came with marked pallor and palpable spleen,
history of URTI last week lasting for 3-4 days.
WBC – normal
Platelet – normal
a. Adeno virus
b. Cytomegalovirus
18 years old girl with MCP and PIP joint pain, ANA is 1/160 homogeneous pattern – asking
treatment. No other skin menifestations.
A. Paracetamol
B. Hydroxychloroquine
C. Methotrexate
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D. Prednisone
E. Salfasalazine
Long scenario but just ask Best method for smoking cessation ( I got this one exactly)
C. Verinicline
D. Bupropion
Trachoma recall. About 5 cases with 20 something contacts in 240 people community. How will you
mgt after treating the index case? ( I got this one exactly )
C. treatment of contacts
35 years old woman with overdose of medications & found collapse presenting at ED. Taken history
– took all 3 bottles of amitriptyline, sertraline & another drug (cardiac one, I’m not sure). After
stabilization, got ECG. What’s the cause of this presentation? ( I got exactly this one )
Following ECG is nearly similar one (sorry, I can’t find identical one in Google) – Real ECG is far more
chaos & complicated.
B. Sertraline – prolonged QT
Middle age man with sudden chest pain, dyspnea & cough. History smoking & alcohol drinking
present. OE – crackles are present right lung bases.
ECG not given.In ECG, I found only QIII & T III; NOT SI - & no PVC investigation for initial
A. CTPA
B. V/Q Scan
C. D-Dimer
D. CT chest
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Woman with seeing visual flashes on & off for few months; & found shimmering light in front of her
vision now; presenting with global headache. Nausea & vomiting present. She had some few
premenstrual head ache present.
B. Migraine
C. GCA
A. Unilateral Headache
B. Jaw Claudication
E. Papilloedema
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