@ smlerecallss (telegram)

highlighted are my answers, words that are in (apostrophes ) are exact words of
paper. I am not sure about the ans I choose specifically in patient safety, ethics
category so read them and confirm urself.

Always read question first then go to abstract, this will save time and help u to find ans
form abstract
Abstract
a research is conducted btw the patients, group A being washed with soap & water and
Group B washed with chlorine dioxide chemical. And then the data compared with
groups which has less chances of composite infection (UTI, catheter related infection
etc) means combined rate of infection that usually occurs in hospital admitted patients.

1) a female patient with asthma came to doctor for routine examination, she takes ocps.
She was admitted frequently for asthma exacerbation in past and taking inhaled
albuterol, sometimes oral prednisone as needed for exacerbation. Currently she is doing
fine, came to dr ,said her husband wanted us to conceive so I wanted to stop my ocp
now, dr responded ok we r stopping ur ocps, but u might need more frequent need of
prednisone.
now asked, dr was inspired form which information from the abstract that can be
applied to this patient
I choose this info can’t be evaluated form this abstract.
other options she will have less chances of having infection if admitted

some weird option, can’t be related to question asked as this patient is currently not
admitted and
abstract was done on composite infection occurs in hospital admitted patients

@ smlerecallss (telegram)
2) Next q ARR was asked data was given in abstract it was easy
a 1/25-24
b 1/24*25
c 24/25

3) question was abt the interpretation of abstract that which statement is correct
according to this abstract cant recall more

4) 40 A patient has dementia, he has given his living will that he must be on DNR and do
not give him NG tube, now he is admitted in hospital for some reason, his wife came and
asked that patient needed NG tube he is so weak plz give him ng tube. Dr has
maintained Iv line given specific treatment as needed? What is ur response?
a as patient has given his living will he cant be given NG
b give him ng as his wife has requested

5) A veteran women lived in village. sometimes she get drunk and do sky shooting at
back yard, watching this kind of act of her wife, her husband left the home along with his
children. This type of sky shooting incident has happened 3rd time in this village. This
village area is full of veteran’s people and there was clinic where all these veterans goes
for medical visits. Now question asked what should be done to decrease this type of
incident.?
a refer this women to substance abuse treatment program
b giving training of locking the weapon to all patient coming to clinic
c perform substance abuse screening in all veteran patient coming to clinic
6).What is the name of the paying system that ensure the most efficient prevention with
less amount of money spent (something like that)?
what it is!
- Per capita with deducible
- Per capita without that deducible. -
Fee for service with something.
Fee for service without that something.

@ smlerecallss (telegram)
Confirm urself,

7) question was such that two operation Theater were working simultaneously, there
was some operation going in OT A and OT B, a nurse with draw blood sample for cbc
form patient in OT A and anthologist withdraw sample for coagulation panel form
patient in OT B. both samples brought to reception. An “ordering” picked the samples
and dropped it to laboratory, after some time laboratory technician sent back the lab
report to receptionist, receptions confirmed the reports on phone mentioning the name
of patient & type of reports. Then gives the reports again to ordering saying these are
“lab reports” deliver to operation theatres. And as he delivers the reports, after some
time patient in operation theater B started bleeding. Now question asked what should
be done to avoid this type of error.?
a there should be specific color for sample bottle for each operation theatre
b nurse or ordering must take a single sample to reception or Operation theatre at once.
c each operation theater must have separate phone so that lab technician can call and
tell reports directly to OT
d ordering or nurse must repeat the name of patient and type of lab upon each turn
while giving or receiving reports

I took option d thinking on each time receiving or giving the labs ordering or nurse must
have closed loop type of communication to avoid this type of error.
further confirm urself

@ smlerecallss (telegram)
8. a patient came to emergency referred from opd. Patient says opd physician use to
move out for a while during my visit and his mouth stinks of alcoholic smell as he return
back, I think he is addict. Emergency nurse physician says this patient is Narcissist and he
use to do these type acts to acquire attention, don’t believe on him. Emergency
physician did his mental evaluation (I was not able to understand his mental evaluation
results, it was mentioned in scenario either is mentally ok or not) and then dr document
that evaluation given appropriate management, discharged patient. You as emergency
physician what is ur responsibility now?
a observe opd physician for his behavior
b report the event to lisenceing board came to Raval singh
c go to opd physician along with emergency nurse and ask him details or inquire him.
d leave his statement as he is narcissistic patient

9. a young patient came to emergency e is drowsy due to alcohol intoxication, they

stabilized him in emergency, during mid-night patient asked nurse that we want to go to
bathroom, they told him the way , and he went there, bathroom for fee, he fall down
there and got trauma to head, he was already so much drowsy due alcohol abuse,
question asked what should be done to decrease the risk of fall?
a give him walker
b nurse must go with himself till washroom and give hi, support
c catheterize the patient

10. A female patient with quadriplegia was being cared by nurse, as she cant move his
body she was lying on balloon mattress to avoid the pressure ulcer or sores, patient also
cant tell about his urinary flow, nurse use to catheterize her so that she remain dry and
her sores can be avoided, nurse also said that its very difficult for her to catheterize this
patient again and again as she cant freely moves patients legs. Now question asked
what is indication in this patient for cauterization?
a to keep patient dry to avoid pressure sores/ulcers
b to avoid urinary stasis induced uti
Raval singh said; to avoid overburdening the nurses etc

other options were easily ruled out & cant recall more.

@ smlerecallss (telegram)
11. poor recall but its like this that some error happened in hospital not sure its same or
I am mixing, but its like doctor prescribed drug to patient A and B, and precscibtion got
exchanged bcz both patient have same name and one patient died and then they were
trying something to avoid that error they were doing some process, they explained first
step of that process and asked what is being discussed?
a senital event
b root cause analysis

I suggest study PDSA cycle, FMEA(failure mode effect analysis) and root cause analysis,
properly. Read there steps too. They asked one question in which on step was described
and I have to pick, so u must know the definitions Root cause analysis step by step for
example steps are ( 1 Collect data 2 Create causal factor now chart 3 Identify root
causes 4 Generate recommendations & implement change 5 Measure success of
changes)
12. a surgery was about to start in OT, a new resident was asked to put a cvc (central
venous catheter)in patient, but he was not able to perform that, attending surgeon
asked the anesthesiologist to take over, as we don’t have enough time we can’t wait
that much time, anesthesiologist taken over, got sterilized first then put cvc in the
patient, a medical student was observing this surgery he then saw that anesthesiologist
has touch his sterilized hand down the table, and broke the sterilization, you as student
what is ur nbs in this event ?
a leave it for now tell the surgeon afterward abt this event
b inform to the patient after surgery
c do nothing consider it as ur learning experience
d immediately inform the attending surgeon .

13. a female patient came to hospital for delivery, he has already 2 children. Baby was
born everything was normal next day in parental care room she was changing the diaper
of baby and baby was crying, she get frustrated so she “slapped the baby” now watching
this situation what is NBS here?
a report for child protecting services
b call hospital security
c asked nurse to check the documents if patient has child abuse history

@ smlerecallss (telegram)
14. a male patient came to u for some reason or some reporting, he is divorced and he is
currently in his second marriage. In his past life he was having 15 sexual partners, all
were dx with gonorrhea and were treated. Now patient says to dr plz do not mention
this information of (15 sexual partners) in my medical record, what will be physician
response?
A all right, as u say we will not mention it in medical records
b sorry sir this is not possible it is mandatory to mention In medical records
c alright but what is ur concern regarding not mentioned this info in medical records
d if y don’t allow us to mention this info in medical record we wil not be able to provide
u any health care anymore.

15. a patient was admitted to hospital he was given opioid for some reason, his mother
said that it was patients wish to not put him on any tube or intubation, now respiration
rate was 8, o2 was low, patient sister is intern in the hospital, as she came to see him,
she immediately says, he is dying, intubate him. what is NBS in management?
a decrease the dose of opoid, even if patient feel pain
Patient is in hospice care and previously his resp rate was 24 now 8 and patient is still in pain so
b intubate him now D
c provide the treatment to comfort the patient
d increase the dose of opioids
16. a patient having OA, he was given oxycodone + acetaminophen as outpatient
treatment, he completed the medicine in 20 days. Medicine was given for a month,
earlier pain was 2/10 and now he says pain is 6/10 what is next best step In
management
a given benzo
b give muscle relaxant
c add long acting opid and decreased the dose of current regimen
d increase the dose of current med
e replace the current regimen with hydromorphine.

read the opioid pain management for outpatient treatment. Uw only mention inpatient
opoid management

@ smlerecallss (telegram)
17. a homosexual man came to u, he have started anal intercourse with his 3 male
partners, his hiv test is pending, what will recommend him beside using condom. ?
a zidovudine options were in next step
b double therapy
c triple therapy for 28 days if u revive anoreceptive sex

note=name of hiv drugs were mention in options,

18. long scenario, diabetic patient came for visit she is normotensive , proteinuria +VE,
NBS in management
a ace inhibitors

19. they observed in the hospital that at many occasion they missed the pre-operative
antibiotics, they full filled all the procedure before starting operations, time out was
properly carried out at every surgery, everything is verified.
now what should be done to decrease this error?
a surgeon must do time out before surgery
B anesthiologist do time out before surgery
c confirm form pre-surgical ward/room nurse abt antibiotic
Head surgeon looks better to me

20. A question given in the form of History

patient: 7 or 8 years old boy
chief complain: sleeps a lot during school
others: he sleeps wells during night awake once during night but sleeps agains. 8 hours
total sleep,
but takes naps a lot, patient has hx of allergy too.
snoring: mild
weight: obese
family Hx: father is diabetic and asthmic
examination= tonsils 3+

other findings were also mentioned

@ smlerecallss (telegram)
NBS in management

a polysomnography
b tonsillectomy

21. a 6 or 7 year old boy came with complain of urine continence, earlier he use to bed
wet twice in night but as he is admitted to 6 grade now he bed wets 4 times, since six
moths. He is dry during the day. He don’t go to his friends home as he feels
embarrassed and he thinks he might do that there too. He father has achieved dryness
when he was of 8 year old

a adjustment disorder
b micturition delay

22. a female patient came with incontinence, she said she cant feel anything and all of
sudden she urinate.it was not related to cough or running or valsalva, upon examination
she has suprapubic mass. . she has hx of relapsing & remitting MS.
asked she has urinary incontince due to
a neurogenic bladder
b detrusor instability
c stress inconstinence
23. a school going boy is brought to dr, mother says as he returns backs his underwear is
wet, having mild diarrhoea, upon examination we find masss in rectum, (examination
finding was clear that patient is having constipation)how u will treat this patient
I dx it as childhood constipation.
a leporlide
b poly ethyle glycol

24. a 56 year female patient came on routine visit, we did mammography, pic was given
of memograph in which calcification was crystal clear, upon examination the mass was
not palpable, and then we did ultrasound we find the mass. What is ur NBS in
maganment
a follow up after 2 weeks
b ultrasound guided core biopsy
c needle guided excisional biopsy

@ smlerecallss (telegram)
I did u/s guided biopsy as mass is not papable so cant prick the needle blindly

25. A pic based question, patient was having sore in lower lip, it was painful, patient also
have hx of these score in past, previously they were small now it is larger, his mother has
also hx of cores, asked what will be sequalae

a no sequale
b sq cell carcinoma of mouth (tongue or something)
c encephalilitis
d gingival related complication.

26. patient has nodule on gluteal fold, pic was given of gluteal fold, nodule’s upper skin
was removed, base was yellow like pus, there were hairs in nodule also, no erthyema of
surrounding skin & no fluctuant. Patient says he feels a lot of pain when he sits. So what
is ur NBS in management:
Clear cut pilonidal sinus in gluteal cleft

a incision & drainage

b excision of nodule

others options easily ruled out

27. a 28 year female patient came to doctor said I have painful mass in my right breast,
when doctor performed examination lump was non tender in upper outer quadrant,
rubbery, moving, NBS in management
a ultrasound of Right breast
B bilateral mammography

28. a patent diagnosed with depression was given citalopram, after 3 weeks came to dr,
said this drug is not working I am still feeling low, other 3 depressive symptoms
mentioned which were not improved and I have decreased my libido, due that I am very
much frustrated.
what is NBS in management

@ smlerecallss (telegram)
a continue the same drug for next 3 weeks and follow up
b change citalopram to venlafaxine
c change citalopram to bupropion
d change citalopram to sertraline
e add sildenafil to current drug regimen

28. patient has dermatomyositis and he is at increased risk of

gastric carcinoma

29. question again given in form of Hx pattern

patient : 5 year old boy

chief complaint : 101 fever since 3 days, pharyngitis with exudate, conjunctivitis.
Mother given amoxicillin at home and boy developed rash, and she stopped the drug.
After 2 days boy still has fever so she brought her to emergency
family hx.: Mother father and other siblings r healthy

examination: boy has cervical lymphadenopathy, erythema of hand & palm and sole
emergency physician diagnosed this patient as “mucocutaneous lymph node syndrome”
and started treatment aspirin and IVIG, and boy again developed Rash.
asked why this happened:
a emergency physician misdiagnosed this patient because of “diagnostic bias”
b avoidable event bcz of aspirin
c avoidable event bcz of IVIG/
d unavoidable event bcz of aspirin
e unavoidable evebt bcz of IVIG

cant recall there were many option, may be combined option like
avoidable event due to both aspirin or IVIG or unavoidable due to both aspirin & ivig

@ smlerecallss (telegram)
confirm urself either reaction happened due aspirin or IVIG and either it avoidable or
unavoidable event. Option A was easily rule out bcz dx was correct as per hx and clinical
features.

30 African American women came for routine examination. I did hep c screening but she
don’t have any other features.s he was normal overall. Poor recall. No option of hep B.

study screening of infectious disease like when to do HPV, Hep B, HEP c, or hiv
The USPSTF recommends screening for hepatitis C virus (HCV) infection in adults aged 18 to 79 years.

31. a 25 yeald old female patient came to dr said my mother is diagnosed of

osteoporosis at age 60, what should I do to avoid this risk. Her bmi was 22, She take half
pack of cigarette in a week, she drinks 2 to 4 glass of wine per week, she use to go for
walk for 30 mints with her dog daily. What is recommended?
a zolendrinic
b calcitrol
c calcium & vitamin D Risk factors
Cigarette smoking
d smoking cessation Malabsorption, malnutrition (e.g., a vegan diet low in calcium and vitamin D), anorexia [8]
e alchohal cessation Low body weight
Family history of osteoporosis [9]
f do dexa scan

I cant recall properly but smoking was more then alchohal in this patient.

@ smlerecallss (telegram)
32. a 22 year old male, he was recruited in south easteran (dubai) area for 6 months,
since he went there he started a pack of cigrete daily, now he came back to usa for 2
month and as he returned he started drinking 4 cane of bear daily. His bp is 150/90 and
160/92 (bp is exact 100% sure). Dr asked do u have hx of bp, he rplied I have never had
HTN earlier. What is cause of this.
a smoking
b alcohol
c essential HTN
d pheochromocytoma
e RAS (confirm this question)
33. a couple came to infertility clinic said they are unable to conceive despite having
unprotect-able intercourse for a year. Husband have a child form his first marriage.
Female was young 24 year old. What is NBS in infertility workup
a FSH level
B GNRH level
c Semen analysis
d postcoital examination
e hysterosalpingography/ or laparoscopic something

34. a young boy was riding bicycle, he got hit by handle of cycle into his abdomen, he
has severe pain in epigastric region , amaylase was 400 and lipase was 500. Bp was
normal What is NBS in management
a Nil per oral
b endoscopy
c ct scan

35. patient came to emergency, hit by car, patient was in static car and got hit by
another car form back, injured his chest. his ct was normal, ecg was normal x ray was
normal
bp and o2 saturation was normal. No any chest pain, Patient was stable. what is NBS in
management ?
a observation with ecg telemetry
b observation only

@ smlerecallss (telegram)
c Echocardiography
d serum troponins
I diagnosed it as cardiac contusion, read this topic properly.
If Fast i'll do that, otherwise observation only or discharge

36. combined q
a female patient came to colicky abdominal pain that radiate to shoulder, pain is for
more then 6 hours. They did ultrasound of RUQ and find pericolic fluid and gall bladder
wall thickness, CBD was normal and a mass in middle lob of liver what is NBS in dx?
a hida scan
b ct scan
c ERCP or MRCP
37. next q they did CT scan and found finding of 2 cm scar, focal nodular hyperplasia
(read the finding they explain the finding of ct scan)patient also takes ocps, and she is
obese too
patient was given iv fluid and antibiotic and was stabilized for acute cholecystitis, what
is NBS in management
a open cholecystectomy with liver mass excision
b laparoscopic cholecystectomy
c open cholecystectomy without liver mass excision
38 it was long scenario patient has some carcinoma they were take out the lymph node
located at junction of arch of aorta and pulmonary artery, as they dissected the lymph
node, a small artery was oozing at that location which was not visible they tried to find
deep at that location and ultimately found it, &they cauterized it and bleed stop now
this patient is at increased risk of
A Hoarseness
b diaphragmatic dysfunction
c vagus nerve related option

no any pic was given in this q, it was descriptive, i tried to make It as simple possible.
Question asked about which nerve is at risk of damage in doing surgical procedure at
that location. Recurrent laryngeal, phrenic, vagus. 2 other option of symptoms of that
specific nerve cant recall. Study locations and clinical significance of that anatomical
locations of nerves.

@ smlerecallss (telegram)
 Suppurative parotitis
Risk factors • Elderly,
dehydrated, postsurgical
39 a female patient operated for hysterectomy after 2 day she developed pain•in left
Decreased oral intake
(eg, NPO
parotid gland (it was unilateral), it was tender to touch and having fever 101, what is perioperatively)
• Medications (eg,
most likely dx anticholinergics)
• Obstruction (eg, calculi,
a suppurative parotitis neoplasm)
b mumps Clinical presentation •
Firm, erythematous
c sialoliadenitis pre/postauricular swelling
• Exquisite tenderness
40 a female patient has galactorrhea, her calcium was high she is at increased exacerbated
risk of. by chewing
and palpation
a gastrinoma • Trismus, systemic
b pheochromocytoma findings (eg, fever, chills)
• Elevated serum
c medullary thyroid ca amylase without
pancreatitis
Management • Ultrasound
or CT scan (eg, ductal
41. patient has rectal or anal abscess, incision and drainage was done which antibiotic
obstruction,uabscess)
• Hydration, oral hygiene
will prescribe now • Antibiotics
a amoxicillin and vancomycin • Massage (ie, milking
pus out of gland)
b cipro and amoxicillin • Sialagogues
c metro and amoxicillin
d ciprofloxacin and metronidazole
e
42. patient has feature of anaphylaxis, his tongue and lips started to swell, what is NBS in
management?
a iv epi
b intubation
c give Oxygen

cant recall if there was treachstomy was there or not,

43. a patient with recurrent hx of angioedema feature, what nbs to confirm the dx?
a check c1C4inhibitor level
level- new question in UW

44 a male patient was doing breakfast with her wife, all of sudden he dropped his spoon,
his tongue deviated, was not able to talk it happened since 40 mints, came to
emergency, ct was given it was normal what is NBS?
a iv heprin
b ib alltepase

@ smlerecallss (telegram)
c aspirin
d warfarin

45 .a female patient has gone for surgery of head of femur after one day (24 hours) in
post op, she developed pulmonary embolism symptoms what is nbs in management ?
A iv heparin
b enoxaparin The treatment of phlebitis will depend to
some extent on the severity of inflammation and presence of
c IVC filter a thrombus. Moderate
d warfarin phlebitis will usually resolve itself. A
patient with phlebitis with a VIP score of 2
e iv alteplase or more will require their cannula to be
confirm urself removed or resited.
The initial treatment for any form of
phlebitis is to stop the infusion and
46. a patient has gone for cardiac catherization through brachial artery, now she
remove the PVC (Webster et al, 2010). This
developed erythema at arm, skin of arm become red,should veinsbewere painconsideration
done with full, catherial
for the
patient’s needs; if, for example, the patient
artery is oozing a little . what is NBS in management is haemodynamically unstable, the PVC
a doppler ultrasound remove should
the catheter should
only be be right
removed once a new PVC
has been sited.
b treatment options can’t recall more. An affected limb should be elevated to
minimise inflammation and an antiinflammatory cream or gel
47 .patient had gone for unilateral mastectomy, picture can bewasdirectly
given of arms one arm was
applied to the area (Reis et al, 2009).
swelling compared to other, it was clear in pic that arm is swollen. analgesics
Anti-inflammatory What is NBS can bein
Picture given prescribed to treat both the inflammation
management?
and the pain associated with phlebitis
a compression therapy if no purpuric lesions are found.

48. patient has gone for some orthopedic surgery and developed cholesterol embolism.
Developed petechial rash and other finding were given easily identifiable as cholesterol
embolism. NBS in management?
a supportive treatment
b heparin
c aspirin

statin also

@ smlerecallss (telegram)
49 a Diabetic patient came for routine visit she is normal, blood sugar was 150 or 170 ,
blood pressure was normal, they found trace proteinuria on dipstick. Now to be done to
confirm this finding ?
a micoalbumin dip stick
b urine analysis
C 24 hour urine
d urine albumin to creatinine ratio

50 a mother brought her 7 year old child to physician said he has flu like symptoms,
patient use to go garden with his brother and mother, they recently went to garden two
days back. Upon examination you find a rash in arm, when u further examine his leg u
find a erythema margin rash on back of leg (Lyme rash defined clearly) his brother is
fine. What is most appropriate NBS?
a doxycycline
b amoxicillin
c observation
d serology

51 sebroic keratosis two pic; one pic with only one lesion, other pic with widespread lesion on back
diagnosed asked
keratocanthoma pic diagnosis

dx asked osteosarcoma. X ray was given 8 year old boy

52 a patient came to doctor for visit he used to take antipsychotic drugs, these days his
writing has become small, he feel difficulty to turn his head to left or right, when doctor
asked him to move upstairs on examinations table, he takes a lot of time to move
upstairs. His ocular movement is normal. What is most likely diagnosis?
A supranuclear palsy
b drug induced parkinsonism
c dementia with Lewy body
d

@ smlerecallss (telegram)
53 a pic given of African boy, head shown with tinea captis treatment asked
a topical clotermazole
b topical flucanzole
c oral terbinafine

54 13 year old boy limbing due to pain, upon examination internal rotation of hip elict
pain, knee joint is freely moveable. X ray was normal (cant recall which x ray was
mention hip or knee) bmi was 95 percentile. Most likely dx?
a slipped capital Raval said he was not obese

b transient synovitis
c leg calve parthes disease
d septic arthritis
55 a female patient having ectopic pregnancy, u can easily dx abt ectopic pregnancy, but
she is having postural hypotension, when she standing her bp was 100/90 and when she
lie is 90/70. What is NBS in management? has free fluid
a laparoscopic surgery
b methotrate no option of bHcg
c misoprostol
56 a female patient came to dr for visit she got pregnact by IVF, she is on 10th week of
gestation, ultrasound showed a sac in uterus and a cyst in ovary, now they said they
have removed that cyst it was corpus leutum cyts, after removing they asked this patient
is at increased risk of which of following?
a spontaneous abortion

cant recall more option confirm urself, read the topic

57 a patient was stabbed in chest or (may be any other kind of trauma to chest) was
taken by ambulance, in the way to hospital his Bp was 90/60 and they gave him iv fluids,
as he reaches to emergency at hospital his BP and pulse were not delectable, JVP is
raised, trachea was centrally placed. What will be NBS in management?
a fast abdomin Thoracotomy is performed when
Thoracic surgeon is available in 45 min
b thoracotomy Patient has not responded with IV fluids or has pulselessness for more than 15 min
c thoracostomy signs of life present in field or hospital
It should be E-fast not just fast

confirm urself, if there might be option echo or fast of chest what will u do first, I cant
recall properly. But this vinette is almost same, learn management in this type of
situation.

@ smlerecallss (telegram)
58 a female came to dr and said she feel very anxious when she has give presentations in
the office, she has been upgraded to post of manager where she has to give
presentations, she further added that she had never performed or participated in stage
programs at school too, now on next day she has to give personation and asks u if any
medicine can help, what will u prescribe?
a benzo drug was given
b propanol
c ssri drug was given
59 a male patient came to health care provider, said he was doing his job in army, but
they were not able tp understand me, neither I use to follow there commands, there dr
also given me some drug for sleep, that I cant recall said the patient, its been 8 month.
And now they have fired me from army due to not understanding. Upon examination
health care provider find flat effect, although there were no halluciations but dr said
patients seems to respond “internal stimulli” . what is most likely dx?
a drug indced psychosis or (something)
b depression
c sczhophrenia
60 a female student came to u said as i have episodic hypoglycemia and as I eat food I
feel fine
glucose was 65 and c peptide was 0
a exogenous insulin
b insulinoma
c excessive sulfonurea

61 a patient starting doing job in some factory (name was mentioned there, cant recall
proper name of factory) since start of job for first 2 weeks or months he felt dysnea,
shortness of breath cough, chest tightness, x ray pic was given it was normal. after some
time his symptoms have decreased in severity. What is most likely dx?

a berylliosis or byssinosis
b asthma occupational asthma seems right
c copd
d asbestosis
study all occupational lung disease u can have anyone, remember RF it will easy to ans
then

@ smlerecallss (telegram)
62 cant recal age but most probably 2 weeks old, baby brought to routine visit, dr
examines him and find one testies swollen, it trans illuminate on light what is NBS
a keep examining it on each child well examination probably hydrocele
b surgery

63 a women came on parental visit on 20 weeks gestation his alfa fetoprotein is

increases in triple screening, she concived through ivf, she has not gone through any
screening or prenatal visit earlier. What is NBS ?
a quadriple screen
b aminocenthesis
cvs
Cell free feral DNA(should be)
cant recall if there was ultrasound as option or not confirm urself
64 a pregnant patient came to visit and we did ultrasound, found cystic hygroma and
septate into it what is most likely dx?
a microdeletion of x
other chromosocal abnormality related options to down Edward klineflter etc

65 a female patient 38 weeks of gestation with presented to u with severe features of

pre-ecmlampisa, proteinuria +ve, -2 station, 2 cm cervical dilation, rupture of membrane
has not occurred. They have observed the patient for 4 hours but no any progress what
is next best step in management
a c section
b induction of labour
66 another question it was on pprom, ferning test +ve, patient was on 36 or 37 weeks of
gestation, patient not progressing NBS in management
a induction of labour Management
b c section
• <34 weeks (reassuring): latency antibiotics, corticosteroids
c betamethasone • <34 weeks (nonreassuring): delivery
• 34 weeks: delivery
d mgso4
may be option of penicillin cant recall

read management of PPROM properly accordings to weeks.

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67 a patient have undergone D&C and now complain of not conceiving, they have done
intercourse for an year what is nbs in diagnosis
a hysteroscopy

68 a patient was having iud since 9 year, they were inconsistent usage of condoms, now
having some issue cant recall more
study iud infection related management .

69 a 55 year old patient came to you complain of early satiety, upon examination spleen
was enlarged lab showed
basophilia, melanocytes=5, metamyelocytes=5 and other findings too no lap score was
mentioned.
most likely dx
a cml
b cll
c all
d aml
70 a boy presented with some symptoms ECG was given I dx as third degree block
Patient with bradycardia plus AMS, unstable patient, Acute heart failure:
what will u give him? IV atropine
a atropine if refractory: give Transcutaneous pacing, IV epi or dopamine
if no reponse yet go for transvenous pacing
no option of pacemaker

read properly 1, 2, and 3 degree blocks with different ecgs, and its management, exam
ecgs r typical I was not able to recognize them with surety

71 patient came to u in labour, contractions have started as she reach hospital a gush of
fluid was pass and CST was given, easy to dx, variable deceleration asked what us the
cause?
a cord compression
b placental insufficiency
c

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72 a patient has hx of depression and he took ssri daily as prescribed . his wife has
brought him to dr and said these days he have been staying in room for 2 hours and
cleaning his gun a lot. When dr interview patient, patient said he is keenly waiting for his
son’s birthday party, and wanted to celebrate it with surprises. What is immediate next
best step?
a change the ssri
b admit to hospital
c removal of weapon from the home.

I cant remember if there was option to inquire patient about suicidal thoughts
73 female patient came having swelling in joints of arms, not relived with nsaid
what will u give her for long term
a colchicine
b methotrexate
c allopurinol

74 a male patient came to u said he is having pain in ankle, he has starting running now,
they took x ray of ankle joint there no any fracture, but swelling and osteophytes were
described, there is no stress fracture they clearly mentioned that, Nbs in manament
a I did some stretching exercise option

75 a boy came to you, he is tall, having small testies and gynecomastia how will u
confirm the dx?
a genetic analysis
b hormone level

76 a 58 or 56 year old female patient came to y, 15 year ago she was diagnosed with LSIL
and biopsy was taken that time, they don’t mention any of biopsy result, they said now 3
year back she went for hysterectomy due to abnormal utrine bleeding, which screening
she will need further? had 3 normal last pap smears
a do once a pap smear and if it is normal stop it
b continue pap screening of vaginal cuff
c no need of screening now if tottal hysterctomy

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77 a mother brought his child to dr, said they went to garden were a lot of flowers, and
bushes, boy wears a t shirt an pic of arm was given, what is most likely dx
A spirotichosis
b contact dermatitis
c lyme

I cant find appropriate pic, but u will easily dx it as contact dermatitis,

I did it wrong due to same type of q in biopsy, must check all pics based questions

78 a patient came to he is having glove stove pattern neuropathy(it was explained), he

has been drinking heavy since 11 years. What is the cause?
a thiamine deficiency
should have been normal MCV and normal methylmalonic acid.
b b12 deficiency
c alcohol induced neuropathy
d

79 a 25 year old man came to shows bullae like vesicle on body I dx it as dermatitis
herpetiformis, I think pic was also given, he don’t have another hx, they did biopsy and
find Iga deposition what is most likely dx

a celiac disease
b chrons disease
c hsv infection
d bullous pamphegoids.
80 A baby brought to phyiscan , upon examination u find hemihyperplasia and tongue
enlarged. What will u screening further
a abdominal ultrasound

81 a patient present with seizures there were cutaneous lesion on body

most likely dx, it was easy and simple
tuberos sclerosis
neurofibromatosis
sturge weber syndorme

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82 dr asked him to do something, and he takes a lot of time to release it form his hand
most likely dx
myotonoc dystrophy

83 MVR murmur radiating to axilla, cause asked I did papillary muscle rupture
cant recall more read MVR causes
this q was not abt Myocardial infraction related complications

84 a patient presented to u with CHF, he was on ace inhibitors, patient has developed
edema in legs, crackles in heart, s3, creatinine 5 and hyperkalemia
what will y prescribe now?
a furosemide
b hydralazine
c spironolactone
d thiazide
85 a patient has missed 2 time dialysis and ecg was given and all leads were inverted,
(check that ecgs with inverted leads), I think it was hyperkalemia but I was not able to
recognize ecg fully
a calcium chloride
b glucagon
c normal saline
86 a patient presented can recall what were his cause but his creatinine was 10 and I did
dialysis

87 a boy came to y with chest infection his LDH was 600, plural protein to serum protein
was 6, “ph is 7.1” what is ur futher management ?
a intubate
b chest tube

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88 a female came to u with complain of pain in trapezus muscle and glutal muscles no
other finding, other finding were normal,
a polymalgica rhumatica 50 se upar umar m hoga. fibromyalgia thyan khape!!
b sle fibro is not in option A done
c polymyocytis

weired question confirm urself

89 pt has eye, operation for penetrating injury now complains of blurred vision. IOP 40
and cupping is seen, cause?
a corneal edema
b glaucoma
c wound dehiscence

90 two girls were brought in emergency; they were hit by car. All emergency steps were
done like x ray fast etc. one girl was minor, and she had a fracture of arm. Both girls
were stabilized. Hospital tried to contact with parents of minor girl for consent so that
they can proceed for further management, but they could were not able to make a
contact. What should be done in the case of minor for further management.
a take the consent form the parents of another girl
b proceed with treatment this is not in options
c take consent form the friend
d give appropriate emergency treatment as needed
dance club eposure
91 patient has brought to dr by his wife said that these days he listen tv with increased
voice, he is not able to understand what ever his children says to him, upon examination
air conduction is greater then bone both side. On left the not able to listen on
whispering test, when tuning for is placed on head it is deviated to left what is NBS?
Rinnes and weber point to one side of
A audiometry
other option: hearing air

92 combined q
a patient came to u he is having rhinorrhea, pain In checks, green mucos,since 3 days he
said this happens with him since 3 years eveytime this happen he need to take
antibiotics and get it relived, but now his symtopns become severe what is most likely dx
a acute rhino sinusitis
b chronic sinusitis
c Rhinitis medicamentosa

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93 next we given him symptomatic treatment like anti-allergic, pseudoephedrine but his
system has not improved now having fever 102, and serve pain in check thick green
mucus, what tx u will give?
A amoxicillin clavunic
b levofloxacin

94 3 year old baby brought by his mother said he is having pneumonia in left lower lobe
and relived with antibiotic, it happened with him 4 times in past in same location and
again happened now, chest x ray was normal nBS
a reassure
b chest ct
C. Rigid bronchoscopy
95 a patient came to u, he has tumor in lung and does smoking a lot, now along with
other Symptoms he is very much thirsty, no S/S abt polyuria or other findings.
what is cause of this finding
a hyponatremia
b hypernatremia
Hypercalcemia should be the right option.
other electrolyte options confirm urself
96 a mother brought his child to emergency said I saw him playing with my
acetaminophen bottle, it was opened, she don’t know how many baby has taken, they
did gastric lavage there what is nbs charcoal given, lavage not done

A acetaminophen level
B. Lavage

97 a 22 year old patient taking antipsychotic, mentioned that he is doing eye blinking,
shoulder shrugging and throat cleaning. Time was not mention, what Is most likely dx?
a Tourette syndrome for this it should be a 1 year history
b tardive dyskinesia

98 a 8 year old boy came to well child examination when he was asked to stand up, he is
not standing, he don’t want to show his penis to doctor. his mother said since 4 year he
has being more interested in girlish things like clothes, makeups and everything, she add
that he recently said to his mother If possible then remove my penis and get my breast
enlarged. What is NBS?
A do a operation, remove his penis and convert into female genitalia
b given hormonal medicine so that he develop breasts
c send him on some therapy where he copy your behavior
d reassure that this is normal adolescence behaviors

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99 A patient has single kidney, other kidney was nonfunctional, which surveillance u will
Patients with unilateral kidneys are at risk of CKD
do?
a HTN Do serial Ultrasounds to check for compensatory hypertrophy
if you don't find the evidence of hypertrophy: check yearly urine protein and Blood pressure
If anyone of them start to rise Go for serum creatinine. If BP and/or serum cr is high; manage them
other options, check urself what to be done if person has single kidney, what are
recommendations for him.
100 case on ADHA, delusion syndrome

case on social anxiety disorder tx asked: ssri

101 a ptient has prosthetic knee joint infection came to u in 2 weeks what will be
organism ? Early onset
Time to onset after surgery
a s. epidermis <3 months
b group b aglactia Presentation
gram -ve should be right • Acute pain
c e coli • Wound infection or breakdown
looks like • Fever
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3993098/ Most common organisms• Staphylococcus aureus
no option of S. areus • Gram-negative rods (Pseudomonas aeruginosa)
• Anaerobes
102 pda question copy paste free 120 new
keep the headphone on 100% at the start of exam, even if u heart clear sound on voice
testing, I put it on 70%, but I was not able to listen murmer clearly.
Delayed onset
3-12 months
• Chronic joint pain
• Implant loosening
103 organism asked og diarrhea campylobacter better option • Sinus tract formation
• Coagulase-negative staphylococci (s.epidermis)
a histology pic given on infectious disease • Propionibacterium species
• Enterococci

104 24 year old girl comes to y, she is already vaccine up-to-date. she is having sexual
partners aked u to give me HPV vaccine, q asked why u will not give her this vaccine?
poor recall
a age is not indicated
b she cant be given bcz she has multiple sexual partners
C. Give her vaccine

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105 a patient came to u with ulcer and tender bilateral lymph nodes in inguinal area?
a azithromycin
b ceftriaxone answer should have been DOxy bec q is taking us to
LGV
Chlymadia LGV: Doxy or erythro
Chancroid: azithromycin, Im ceftriaxone single dose of both

106 a 8 year girl come to u with complain of severe itching in vulva and perineum, she
has felt blood 3 times during itching what is most likely dx?
a pin worm infection
b contact dermatitis
c candida infection

107 hiv patient admitted in hospital , his leukocytes count is 200 and platelet count Is
9000. What is NBS in management better option is biopsy?
a granulocytes stimulating factor
b other antibiotic options

108 patient taking anti thyroid drug what complication will develop= agranulocytosis

109 a patient presented to colon ca they removed it by surgery and patient was normal,
now they were screening him with cea, table was given now asked what is most likely
cause.
that table shows X axis level of cea and y axis yeas, after 5 year cea level started to raise.
Cause asked?
a reoccurrence of primary ca recurrence
new tumor
is not in option

b metastatic to liver
110 long hx:
patient having triglycerides 865, ldl 58. What will u give?
Raval said 890
a niacin
b fenofibrate
c statins

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111 a 35 female has presented with virlization, with clitromegale, it occurs in just 6
months, earlier she was normal, DHEAS was 5 point more then normal, and testosterone
was at upper border line.
a steroid abuse
b adrenal ca
c ovarian ca
112 a young female patient said she is having severe pain in epigastric since 3 days, on
scale it was 8/10, respiration was 11 or 12. BP was 110/70 She has use nsaid since a long
time. What will do ?
a replace nsaid with acetaminophen & discharge him.
b endoscopy not from these. sould have been give PPI and replace NSAIDs

c Raval says she is having exam or something

113 a patient came for routine visit came in fall what will u give ?

a influenza

114 a patient wanted to visit Africa asked which prophylaxis u will give
a hep A
and typohoid for all travellers

115 a patient has htn taking lisnoperil, she is having cough for 6 six month what is next
best step?
a stop the drug or switch to receptor blocker

116 a patient came to u having MI now taking anti angina medicine, statins, aspirin and
lisnopril, labs shows hyerkelmia and raised creatine, asked with which anti HTN drug u
will replace now ?
a amlodipine
b Beta blocker
c switch lisinopril to calcium channel blocker

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117 a Dietetic patient came to present with PAD, they shown u the pic of toe it was red
and epithelial skin was black, they did doplar u/s at ankle, the artry was hard and was
not able to detect pulse? NBS
a aspirin
b surgical debridement of toe bec its black
c atrial revascularization

118 a patient came to dr said as I eat shrimp I had urticarial rash for 3 hours that
resolved and then I develop abdominal pain after 4 hours that again resolve, this always
happen when I eat shrimps what is most likely dx?
a anaphylaxis
b shrimp allergy This one! because abdominal pain is likely due to Non IgE mediated Enterocolitis like disorder
c asthma

119 a patient having marfan syndrome, having shortness of breath x-ray was given
a spontaneous pneumothorax

120 a patient with copd having recurrent infection x ray was normal. Nbs
a ct scan chest

diabetic patient

121 a patient said I have a lot of pain in arm, active and passive movement is reduced
and was stiff, lidocane infection in the joint didn’t relieved the pain, x ray was given it
seemed to me normal NBS?
everything adhesive capsulitis
a MRI
B. Xray
No testing indicated
all diagnostic options

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122 a patient has gone for lambectomy L4-5, in past now having pain a lot in back what
will do next ? Lots of neurologic symptoms
a MRI

123 a 34 month old boy presented to y diagnosed with UTI with ecoli as organism,
treated with antiniotic what is nbs ?
a u/s
b cystourethrogram Do this when you get 2 febrile UTI, >39C fever + Unusual Pathogen, CKD, Abnormal US:
scarring of renal parenchyma or Hydronephrosis

124 accident happened, child brought to u he was lying in mothers lap, u examined his
testes were normal, there was blood at meatus ? NBS
retrograde urethrogram

125 a patient presented with small bowel obstruction he is having hx of chrons disease,
he haven’t gone under any abdominal surgery what is the cause?
a strictures
b enteroenteric fistula I did this but correct is Strictures .further confirm
c adhesions
d intussusception
126 a female patient with pain in RUP, it is tender, x ray was given spiral shadow in RUP.
What is most likely dx no xray with him, patient with intestinal obstruction, abdominal pain nausea vomiting has history of gallstones
a gallstone ileus

127 a patient has chrons disease has gone multiple surgery of intestine now presented
with u the complain of excessive weight loss, most likely Dx?
a small bowel syndrome aka short gut syndrome
B. crohns disease-- ruled it out because he had normal ESR

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128 a patient has recently undergone laparoscopic cholecystectomy, after few days he
says he is having pain in entire abdomins, lFTS were deranged, alkaline phosphatase was
elevated, ultrasound done cbd was normal. What is mostly dx?
a bile leak if CBD dilated stone milando

cant recall more option, study complications of post cholecystectomy.

129 a pregnancy patient came to u on 10 week of pregnancy which vaccine will u give?
a influenza

130 a pregnancy patient came to u, she was already vaccinated for Tdap in previous
pregnancy which vaccine u will given now ?
a Tdap

131 a mother brought his son to dr and said his maternal grandfather has hemophilia,
asked how much chances does my son have for hemophilia ?
a0
b 25
c 50
d 75
e 100%

I have 2 question where I did endometrial biopsy.

132 a person live in some village and he eat three type of meat pig and other three type
of meats, 2 or 3 weeks diarrhea which is orgasnism ?
a tean solinum undercooked pork
b b cereus
Poultry, unpasteurized milk (natural gut flora in birds)
c hominis Contact with infected persons or infected animals (e.g., pigs,
Campylobacter option was there too- should have been
dogs, cats)
correct.
133 a patient was diagnosed with bacterial vaginosis or chlamydia cant recall properly,
they did test and slides (pic) was given(check out microscope pic both disease) and ask
what recommendation u will give to patient?
a do not, do sex before having first dose of antibiotic not in option
b use condom probably
Asx and nonpregnant don't treat. Treat if sx he says

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 don't do sex until symptoms resolve
Douches kar
most probably it was clue cell on slide. Check out recommendation in stds.

134 child 10 year old with allergic rhinorrhea uses nasal saline drops, oral antihistamine.
O/e nasal turbinate were swollen, present with nose bleeding. Cause?
a nose picking
b antihistamine
c nasal saline

135 a patient was presented with croup he was given with racemic epinephric but he
was responding on it, what will u give?
Patients with severe croup should
a give o2 with cpap Intubation should have been correct always be hospitalized
Inhaled racemic epinephrine
Reduces airway swelling, faster
onset than with dexamethasone
136 a patient has gun shot wound, he is stable nbs ? Dexamethasone
Humidified air or oxygen if necessary
a fast IV fluids to prevent dehydration
Intubation is indicated when airway
b ct abdomen compromise is imminent (required in
d laparotomy < 3% of infants with severe croup)
[12]
Wound has entry exit point. NBS fast or
probably fast was not in option
CT?

137 a patient went to visit India, he has already taken atovaquone proguanil, as he
returned back presented with retro-orital pain, LFTS were deranged platelets count was
90,000, total wbc count was 3700, in which lymphocytes were elevated , what is most
likely dx?
a hepatits A
b dengue fever
c malaria

138Ganglian cyst, aspiration and steroid injection done, it again reoccurred? NBS
a surgical excisiom KD had similar question but 1st time occured; reassure was answer.
b splint
c compression

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139 A 47-year-old woman with end-stage renal disease comes to the physician because
of increased shortness of breath since her
last hemodialysis 2 days ago. Her pulse is 88/min and regular,
respirations are 26/min and slightly labored, and blood
pressure is 176/110 mm Hg. Examination shows jugular venous distention
and pitting edema below the knees. Diffuse
crackles are heard. Cardiac examination shows no murmurs, rubs, or gallops.
Laboratory studies show:

Serum
Na+ 138 mEq/L
Cl- 100 mEq/L

Arterial blood gas analysis on room air:

pH 7.30
PCO2 28 mm Hg
PO2 88 mm Hg
HCO3- 14 mEq/L

Which of the following is the most likely acid-base status of this patient?
do winter formula: Expected PacO2= 1.5 x HCO3 +8+/-2

(A) Metabolic acidosis, respiratory compensation

(B) Metabolic acidosis, uncompensated
(C) Metabolic alkalosis, respiratory compensation
(D) Metabolic alkalosis, uncompensated
(E) Respiratory acidosis, renal compensation
(F) Respiratory acidosis, uncompensated

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 (G) Respiratory alkalosis, renal compensation
(H) Respiratory alkalosis, uncompensated
(I) Normal acid-base balance

140 A little boy has swollen coin, father has tried Halmuch maveioir but it was not taken
out, little boy is brought to doctors office, little boy is standing on examination table,
playing with stethecope, dr performed endoscopic removal of coin and asked abt
sequalae, x ray was given

Ans no sequale

PAtient has thrombocytopenia and infections?

A. do wasp gene testing

GOOD luck

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