MAR 2019 - MplusX QBank

Get more from: MplusX Qbank (https://member.mplusx.
com/)
Facebook Page: (https://www.facebook.com/mplusxqbank/)
X-ray picture with compretion of one vertebrae. Old lady complain of her backache. What is your immediate
action?
a. Bed rest
b. Back bandage.
C. Vit D
/
D. Calcium supplements
om
https://www.aafp.org/afp/2016/0701/p44.html
as a junior doctor you should study and analyze infectious complications after surgical operations in your
.c
hospital. You noticed that one surgeon has much more complications that others. What would you do?
A. Report to the head medical doctor.
B. Speak directly to surgeon.
sx
C. Consult senior surgeon before your report.
Report to the head medical doctor.
A mother brings her 3 years old daughter cause of blood stained yellow discharge on underwear..they were on
u
holidays for last 7 days where she plays regularly on sandpit?
1.Stds
pl
2 atrophic valvovagitis
3:Gardenella vaginosis
https://www.rch.org.au/clinicalguide/guideline_index/prepubescent_gynaecology/
r.m
How to prevent cot death (supine position was already mentioned in stem)–
keep baby in separate room,
avoid smoke
no pet in house.
be
A woman develops erthymetaous tender swelling on her left breast after delivering 1 week..she tries to
breastfeed but was unable..
Treatment options were
em
1.Procaine penicillin
2:Fluxocillin
3: ampicillin
Hypertensive retinopathy – fundoscopy

//m
New questions read about

Huntington’s diagnosis
Huntington’s with depression scenario

Paroxetine
s:
Fluxoxetine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430381/
tp
Lady old think worm in plate in rest home

A Purée diet
ht
B resperidine 0.5 mg mixed with dinner
Sudden infant sudden syndrome

1Cot death how to prevent
2Baby in separate room
3No smoking
4No pet
Get more from: MplusX Qbank (https://member.mplusx.com/)
https://www.betterhealth.vic.gov.au/health/healthyliving/sudden-unexpected-death-in-
infants-sudi-and-sids
One new question every word starting from you like you love something
Tengantitalityotherw I forgot very new names never heard about them
/
Some new psych questions
om
Husband and wife elderly both your patient
1. 4 yrs old child. Puffy face, ankle oedema.abd distension .Urineprotein+++,blood+. What Invx first?
A.urine
culture.
B.urine cytology.
.c
C.blood chemistry
D.USG abd
sx
Child with ITP platelet count 35000.what ur next step
A. Steroid
B. Immunoglobuli n
C. Bed rest
u
D. Transfusion
pl
https://www.rch.org.au/clinicalguide/guideline_index/immune_thrombocytopenic_purpura/
r.m
In Australia bush fire are common either accidentally or some people lighting fire
deliberately. Which is true regarding Juvenile pyromania?
A. To conceal the crime
B. Fascinated by fire and fire equipment
C. Done for notoriety or publicity
D. Start the fire & panic when bigge
be
A 54 year old man comes to your clinic complaining of acute painful defecation with
spotting of blood on toilet paper. Which of the following is next appropriate
management?
em
A. Sphincterotomy
B. Topical glyceryl trinitrate
C. Excision
D. Sclerotherapy
E. High fiber diet
//m
Woman 39 wk pregnant, came with heavy bleeding 1000 ml, tender uterus,fetal heart sounds not heared by
Doppler, after resuscitation next step ?
A- CS
B- USG
s:
C-amniotomy
Pregnant 40 w don’t feel fetal movement, ctg normal,not convinced by results, cervix dilated 2cm , head at 1
tp
,cm below ischial spine

A-amniotomy
B- syntocinon
C-CS
ht
D-review In 24 hrs
There was one another question where the mothers was not convinced so in that I choose ultrasound
MVA pt with fracture ribs, wide mediastinum andhoarsness of voice. No Bp or pulse mentioned
What to do
Laryngoscope
Intubation and PPMV
CT chest angio
Girl weight 34 kg , height 162 cm lost much

weight ,exercise ?What will find in history help diagnose
Feeling inferiority
Apparent loss weight
/
Around 47 y old, diabetic on Metformin 1g bid, HbA1c 8
om
FBS 9
?A/C ratio 500(n200-300) What’s next
A- add perindopril
B- glipizide
C- Insulin
.c
Male infertility history of operated cryptoorchidism with seminal analysis shows
low no and poor motility of sperms what next to help in management
FShlh
sx
Testosterone
Karyotype
u
Diabetic type 2 on metformin ,Bp 130/80,Cholesterol 4,Fbs 7.5,Hba1c
Trace protein in urine,6.9
pl
Increase metformin
Add statin
Start ramipril
r.m
No change of treatment-
Box jelly fish bite screaming in pain , what will you give in emergency before
removing the tencteles
IV morphine
Wash with vinger
be
Wash with water

https://lifeinthefastlane.com/tox-library/toxin/box-jellyfish/
em
Picture of hand with change of the colour in winter ANA+ , Anti D-DNA + , next step
in treatment
Hydrochloroquine
Azithroprine
Prednisolone
//m
ECG of Af , patient has family history of stroke , he has hypertention what will
?reduce the risk of stroke
Warfarin
Statin
Ramipril
s:
(Study CHAD score)
Young man has problem in sex with his boyfriend, he wear ladies dresses and
tp
though he was a girl . and that’s why he is wearing ladies dress and taking estrogen
now wants to change his gender ,Treatment
Gender identity disorder
ht
Transvestism .
Body dysmorphic disorder
year young girl , takin ocp, her 2 month ago pap was normal , now come with
vaginal bleeding , treatment
Do pap
Coploscopy
No test
Smear
underwent core biopsy after 2-3 days, developed high grade fever ,
? low abdominal pain , IX
High vaginal swab
Low vaginal swab
Endocervial swab
Blood culture ,
/
Urine pcr
om
24 year man with painful swollen testis , for 2 days , on exam , tender swollen
? spermatic chord , fever + ,, asked investigation and proper management
Urine
.c
Surgical exploration
Chlamydia pcr
sx
Elderly lady came with episode of syncope , on mutiplr drugs including , rampiril
frusemide, etc,,, ECG not very clear ?? Hyperkalemia , labs = k = 5,5 .. other
? normal range , next step
u
Cease ramipril
Resonium .
Insulin dextrose
pl
Ca carbonate
3-4 years old girl. Mother notice some amount of blood in her underwear for 10 days. On
r.m
examination, there is small amount of blood stained in vulva. What is ur first step in the
management? Not developed any pubic hair and no breast development.
a) Report child protective service immediately for sexual abuse.
b) Microsopic blood culture of the Swab from the vulva
c) oral Amoxil (not sure)
be
4-Woman has regular menses from 4-6 wkinterval , pain on left iliac fossa for 3
days ,aggravated while urination, her lmp was 9 days back , she had similar episode 4 wks
back which lasted for 3 days , cause ?
a. Ovulation
em
b. complicated ovarian cyst

c. Endometriosis
d. early PID
e. ectopic preg
//m
11-Man brought to hospital after throwing brick at windows he said last thing he remembers is
leaving work from rural farm
Dissociative fugue
Factitious disorder
Malingering
Disorganised behaviour
s:
(If automatism is given in options choose that)
13-Woman with premenstrual symptoms affecting her marriage and daily life. HER BLEEDING
tp
IS HEAVY. Her husband is also annoyed but she can go out and enjoy with friends. What is the
best treatment option available?
1. Sertraline
ht
2. Evening primrose oil

3. interpersonal
4. coc pill without pill free interval
5. HRT
15-fetus with heart rate of 60. What investigation on mother?

a. anti ro
b. anti smith
c. anti cardiolipin
18-A 7 years old girl with soiling in her underwear, she tells lies about accidents at school and
hide her soiled underpants and cry and quarrels with her brother when he calls her smelly.
What is your diagnosis?
a)Regression
b)Conduct disorder
/
c)Oppositional Defiant Disorder
om
d)Delayed milestones
e)Depression
19-37 ek pregnant lady with mild pre-eclampsia for induction of labour. Bishop score 2.What
will you do?
.c
Elective LUCS
Induction with PGE 1 and ARM after 4 hours
Induction with PGE 2 and ARM after 12 hours.
Urgent LUCS
sx
Syntocinon infusion
u
8 year old boy has left ear pain. O/E He has 39.1 C fever both left and right tympanic membranes are bulging
and there are suppurative tonsils. What is the CAUSE?
pl
A. External otitis B. Otitis media.
C.acute tonsillitis
r.m
Denial farmer question
Child born with bradycardia mcq anti to
Obese bmi35 , lipase inhibitor

be
Cyclophosmaide cystitis mcq
Carbamazepine hypertonic Saline

em
ECG atrial fibrillation
Ecg bradycardia Third degree block

//m
Vancomycin slow infusionrecall
Viral pneumonia chest X-ray
Indian student Tb renal biopsy recall

s:
Chads score calculate warfarin
Cadaveric donor renal transplant recall

tp
Vancomycin slow infusion recall

ht
/
om
Patient had kidney transplant from cadaver. No urine output till the
7th postoperative day, requiring dialysis. What is the cause?
A.Acute rejection
.c
B.Blocked catheter
sx
C.Ureteric obstruction
D.Donor venous thrombosis
u
E.Acute tubular necrosis
pl
8 year old boy has left ear pain. O/E He has 39.1 C fever both left and right tympanic
r.m
membranes are bulging and there are suppurative tonsils. What is the CAUSE?
A. External otitis
B. Otitis media
be
C. Tonsillitis
D. Mastoiditis
em
13-Woman with premenstrual symptoms affecting her marriage and daily life. HER
BLEEDING IS HEAVY. Her husband is also annoyed but she can go out and enjoy with
//m
friends. What is the best treatment option available?

1. Sertraline
3. interpersonal
s:

5. HRT
tp
Chest x ray showing patchy infiltrates and the patient was a chronic smoker n had long
ht
history of cough now came with 2 weeks history of rusty sputum and fever asking diagnosis
:
a.Bronchiectasis
b. Pulmonary Fibrosis
c. COPD
d. Acute on chronic bronchitis

e. Lung cancer
Ecg mild hyperkalaemia , pt on ramipril, presented after syncope. Sodium normal,

potassium 5.5. Next mx?
/
om
1. Insulin and glucose
2. Hemodialysis
3. Rectal resonium
4. Cease ramipril
.c
5. Calcium gluconate .
sx
Child treated for APSGN, parents asking about school exclusion,
u
a. can go now with dietary and activity restrictions
pl
b. can go now without dietary and physical activity restriction
c. He can return after his infection is gone
r.m
5--a case of chronic liver disease presented with ascites and low albumin level. What is the
next appropriate management/
a. lactulose
be
b. albumin infusion
c. salt and fluid restriction
em
d. spironolactone and frusemide

Scenario of infectious endocarditis with prosthetic aortic valve.It was treated but the
//m
murmur persisted.What to do?

4 weekly blood culture or sth like that
Echo
s:
Aortic valve replacement

tp
pt of crohns disese was on sulfasalzine prednisonlone,azathioprine labs given

ht
neutrophils and wbc low hb low, cause

Sulfasalazine
predniosonlne
azathioprine
Q--CT Scan of RCC
Diastasis Recti or Epigastric Hernia...how to differentiate from these following questions???

And when do we choose physiotherapy?
/
om
1)Pic of obese male patient and long tubuler elongatred mass in abdomen from
xiphisternum to umbilicus. Description given that mass becomes prominent when patient
raises his head, asking management?
a) Physiotherapy
.c
b) Herniorhapphy with mesh repair
c) Reduce weight
sx
d) Reassurance
Is it hernia or recti diastasis???
u
pl
A patient with rheumatoid arthritis got a flare up and doctor wants to administer
azathioprine. which screening test should be done before starting this drug?
r.m
a) Tb Gold test
b) Thiopurine methyltransferas [TMT]
C. Anti Acetylcholine inhibitors
be
D. Complements assay.
E. Anti gliadin IgA
em
//m
s:
tp
ht
/
om
.c
sx
14 years old girl lives with family has now become sexually active comes to you for
contraception advice and tells you not to inform her parents. What will u do?
u
A. Give her prescription of contraception
pl
B. Ask her about identity and age of her sex partner
C. Tell her she needs parents’ permission
r.m
D. Inform parents
E. Tell her to use condom to her partner
scenrio of a schizophrenic patient walking naked in streets.which of the following is LEAST

be
effective for this patient.

A.olanzapine
b.quietiapine
em
c.amisulpride
d.clozapine
//m
Man brought by police, who was shouting in street, and walking naked, what is the best
medication to start treatment for this patient?
A-clozapine
b-quietapine
s:
c-amisulpride
d-resperidone
tp
e- olanzapine
ht
may be some mistake:

atient who has HTN with DM & AFon metformin,Statin and started amiodarone 2 weeks
earlier suddenly got swelling at right thigh for 12hourswhich is progressively increasing and
become painful and got fever 37.4.Right thigh size is 4 cm larger than left.Diagnosis?
A)Rhabdomylosis
B)Hematoma
C)DVT
D)Cellulitis
E)drug interaction
Patient underwent Conization for abnormal Pap smear 2-3 days back. Now presents with
/
om
fever 39, pain lower abdomen and tenderness. What’s the most appropriate place to take
a swab?
i. Blood culture
ii. Endocervical swab
.c
iii. High vaginal swab
iv. Low vaginal swab
sx
v. Endometrial swab
u
pl
.. 58 years old man drag left foot reflexes on left lower limb are increased planter flexion and
dorsiflexion are 4/5 and weak ankle movement equivocal planter response Upper limb and face are
r.m
normal
A . Common peroneal nerve
B . Cervical spinal cord
C . L5,S1 nerve root
D . Cerebral cortex
E . Brain stem
be
weakness of left lower limb,power 4/5 weak dorsiflexion and plantar flexion, reflexex exaggerated in
lower limb . UPPER LIMB NORMAL ,where is the lesion ?
em
a. cortex
b. common peroneal
c. brain stem
d. L5 S1
//m
A lady comes to you with weakness of lower limbs. She drags her foot while walking, dorsiflexion
and plantar flexion is weak. Reflexes are exaggerated. Equivocal plantar response. Diagnosis asked?
A. Cervical spine MS
B. Motor neuron disease
C. Spinal canal stenosis
s:
D. Lesion in cerebral cortex
Patient with weakness of the left upper limb, weakness of interosseous muscles and right plantar
tp
response is equivocal, left is increased; reflexes are normal. What investigation will you do to reach
diagnosis?
MRI cervical spine
ht
Ach receptor antibodies

EMG
CT brain
(this question came for twice)
A man comes with clumsiness of hands and tripping over. Upper limb weakness and fasciculation.
Lower limb muscles also has weakness, increased tendon reflexes. Ankle reflex is not increased in
one side. No wasting. No sensory loss is given. What is the initial investigation?
A. EMG
B. MRI Spine
C. CT scan
D. CSF examination
E. Cervical spine X-ray
/
om
Old age Pt. with cataract had improved vision after surgery , in post op. day 4 he wake at
morning with painful eye & blurred vision , what happened to this pt. ?
A) Conjunctivitis
.c
B) Uveitis
C) suture infection & abscess
sx
d) hypopyon
E) Acute glaucoma
u
--young boy washing hands a lot thinking he will get hiv
pl
r.m
---Old lady tripping over MND Q
be
Anorexic girl. What you will notice in her examination?

a. Tachycardia.
B. Hyperthermia.
em
C. Ankle edema
https://www.racgp.org.au/download/documents/AFP/2011/March/201103yeo.pdf
//m
X-ray picture with compretion of one vertebrae. Old lady complain of her backache. What is
your immediate action?
a. Bed rest
b. Back bandage.
s:
C. Vit D
D. Calcium supplements
tp
E, biphospgonate
https://www.aafp.org/afp/2016/0701/p44.html
ht
Patient came from brazil one month ago , now both wife and husband come to you wife
want to conceive but concern about Zika virus , not doing yet sex after coming back . Your
advice ?
1- Zika virus not transmitted through sex
2- use condom
3- Do zika virus serology
4- Reassure , you are not infected
https://www.cdc.gov/zika/laboratories/types-of-tests.html
/
Recall from my exam: as a junior doctor you should study and analyze infectious
om
complications after surgical operations in your hospital. You noticed that one surgeon has
much more complications that others. What would you do?
A. Report to the head medical doctor.
.c
B. Speak directly to surgeon.
C. Consult senior surgeon before your report.
sx
3-month (6 month??) boy normal until 6 week of age. Now, hypotonia in all four limb,
feeding difficult, can’t control head. Sometimes he smile.
u
a) Early cerebral palsy
pl
b) Botulism paralysis
c) SMA
r.m
d) Prader willi
https://www.rch.org.au/kidsinfo/fact_sheets/Spinal_muscular_atrophy/
Another que with similar scnerio, girl drank petrol and arrived hospital.. what will happen in
be
the patient? (Asking diagnosis)

a. Chemical pneumonitis
em
b. Others forgot
pt on multiple drug HR 35 ,,bp 90/80 come to the emergency what to do next??

1.iv Atropine
//m
2.temporary pacing
3.stop offending drug
s:
---HYPYON
tp
ht
3-4 years old girl. Mother notice some amount of blood in her underwear for 10 days. On
examination, there is small amount of blood stained in vulva. What is ur first step in the
management? Not developed any pubic hair and no breast development.
a) Report child protective service immediately for sexual abuse.
c) oral Amoxil (not sure)

a. anti ro
b. anti smith
c. anti cardiolipin
/
om
18-A 7 years old girl with soiling in her underwear, she tells lies about accidents at school
and
.c
a)Regression
b)Conduct disorder
sx
e)Depression
u
https://childpsychologist.com.au/encopresis-soiling-in-school-aged-children/
Assalamualikum… MARCH 16th Melbourne

pl
r.m
1.Old woman came with swelling in the groin near to left lateral tubercle... aggravated by
walking... pain on internal rotation.
a.OA of hip
be
b.Sacroilitis
c.trochanteric bursitis
d.hernia
2.Got this Q .. what test will u perform after trauma in 37 wks pg. all things r normal.pulse
em
and BP o the pt is normal, CTG done.there is no abnormality.what next?

a.kleihauer test
b.Admit the pt
c.USG
//m
3.Scenario of a PE….LMWH therapy was given.what next?

a.increase the dose of heparine
b. IVC filter
c. warfarin
s:
4. pt taking multiple drugs..A ECG is given..(it was seemed bradycardia)

a.stop diltiazem,
tp
b.increase digoxin
5. An old pt was brought by his son in to the hospital,pt is disoriented…he may need further
ht
resuscitation.what will u ask to his son?

a. explain the condition of his father
b.existence of advance care
6.39wks pg lady with RUQ pain, guarding, rigidity,fever, high WBC count. NEXT
appropriate?
a. Laparotomy
b. USG
c. Antibiotic
7.scenario of road traffic accident…CT was given.ASKED dx?

a.pneumothorax
b.haemothorax
/
c.pneumomediastinum
om
.c
u sx
pl
A complicated ct was given where all above 3 features were present..i could not find the
exact CT in google
r.m
8.A man present with swelling infront of the tragus..which is broggin or something(failed to
remember the exact word)..involve masseter muscle…next?(was complicated to me)
a.FNAC
b.USG
9. a boy present with red inflamed ear on the next morning.he was well before. No discharge
be
present..
a. otitis externa
b.allergic reaction
em
//m
10. pt taking venlafaxine..what should b checked

s:
a.ECG
b.electrolyte
tp
11. year old child diagnosed with bacterial meningitis was admitted to hospital.blood culture
taken and iv ceftriaxone started.after 1 day of admission child had a seizure of <1 min
duration.long labs were given sodium and bicarbonate low.all others were in normal range.what
is the cause of seizure?
ht
a.SIADH
b.dehydration
c.adrenal failure
12.Mother on 3rd postnatal day. Afraid her baby would b swapped so she doesn't let the baby
out of her sight.she didn't sleep and spent her time arranging things and praying. On examination
fever 38.9 pulse 120/min. Bp normal. Wat is ur next management?

Take the baby from her
Transfer her to shared room
Admit to ICU
Transfer her to psychiatric unit
14. a young adult brought by his galfnd…he ir disoriented..has hemiparesis..what IX?
a.CT
/
b.MRI
om
15.A 7 years old girl with soiling in her underwear, she tells lies about accidents at school and
hide her soiled underpants and cry and quarrels with her brother when he calls her smelly. What
is your diagnosis?
a)Regression
b)Conduct disorder
.c
c)part of Oppositional Defiant Disorder
e)Depression
sx
16.Patient taking OCPs presented with weakness of right arm tone n reflexes normal cannot
move arm actively asking cause
A. TIA
B. conversion disorder
u
C. stroke
D. malingering
abdominal pain & vomitting. Gfr reduced.

1. Perforated PUD
pl
17. Middle aged man had nephrotic Syndrome. Getting steroid. Now he has Generalised
r.m
2. Renal vein thrombosis
18.Patient had kidney transplant from cadaver.No urine output till the 7th postoperative day,
requiring dialysis. What is the cause?
A.Acute rejection
B.Blocked catheter
be
19.Pic of red infected palm of hand and arthritis.
em
ANA and Anti dsDna positive. Long term management?

A)Methotrexate
B)Hydroxychloroquine
21.An ecg with pt on multiple drug taken with history of dm,hypertension asking cause of AF
a.dehydration
//m
b.ischaemic heart disease

c.hypertensive heart disease
d.high cholesterol
22.patient taking multiple drugs, presents with lethargy and confusion. Which of the combinations
could have caused this:
s:
A. Perindropil and amiloride

B. Perindopril and Thiazide
C. HCT and celecoxib
tp
D. perindropil and amiodarone

https://www.drugs.com/interactions-check.php?drug_list=1830-0,154-0
ht
23. old man….he has h/o #..lab shows low Hb and HIGH ESR..wat next?
a.give vit D
b.give alendronate
c.bonemarrow examinatiom
Perth 12.03.19
Woman with prev episodes of crush fracture, on risedronate. It was stated that patient has
used prednisone, but came to you with another episode of fracture. What appropriate mgt?
1. Change to alendronate
2. Change to IV zolendronic acid
3. Give strontium
4. Give raloxifene
/
om
2. One population, mean systolic BP is 115 and SD is 15 so what will be range of 95%
population’s BP
.c
3. Very Old lady with coxa vera.which of the following will help her in walking?
sx
a-walking stick
b-strap
u
c-brace used in sport
pl
4. A pic of a hand with amputated fingers....asking associated disease:-loud p2
a. A)Bronchiactasis
r.m
b. B)Chronic liver disease
C)Interstitial lung disease
D)Pulmonary hypertension
be
5. patient has rheumatoid arthritis had history of DVT. Now he came with black fingers.
what is the inv
A- ANCA
em
B- Anticardiolipin
C- ANA
D- Anti ds DNa
//m
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315802/
7.
8. Pregnant lady 35weeks with bradycardia,emergency lscs done still baby heart rate is
s:
70...what's the cause

1-anti smith
tp
2-anti ro
3- anti cardiolipin
ht
9. 40 years old man complain from persistent abnormal thoughts that’s making him
washing his hands at least 10 times after touching the key or door. he is on SSRI but
want to try non pharmacological therapy to help him get rid of this thoughts
a. Teach him how to avoid touching the doors or key
b. Explain him that this thoughts is normal to relieve his anxiety

c. Refer him to insight oriented psychotherapy
d. Have psychological evaluation
/
om
9. 14 month old limping (didn’t mention obese) 3 days ago with diarrhea, now child has
37.8 fever, hip pain, but knee, ankle normal exam. All range of movement are okay
A.development dysplasia of hip
.c
B. Perthes
C.septic arthritis
sx
D.transient tenosynovitis
u
11. one 14yo girl, pregnant disclosed to you that the father is her uncle, she said don’t tell
pl
parents. what next to do:
inform child protection
r.m
don’t tell parents
12. then 13 yo pregnant with her 19yo bf, urine preg test negative, whats the next important
thing to do:
be
Give emergency contraception

Counsel about the use of contraception
Report to child protection
em
13. After a night party a girl comes to the ER in the moring with a high fever of 40c, agitated,
decreased consciousness level, muscle rigidity, tremor. What will be the best initial step in
//m
management?
a. I/V infusion
b. Cool blanket and ice pack
c. I/V Diazepam
s:
d. Dantrolene Sodium
(sertraline syndrome)
tp
ht
/
om
.c
sx
14. Status epilepticus child scenario mgt
Give rectal diaz
Give rectal pcm
u
https://www.rch.org.au/neurology/patient_information/rectal_diazepam/
pl
15. nulliparous pregnant on 39 weeks, didn’t feel bby movement for 2 days, you have done
r.m
ctg (ctg pic - for me ctg is normal, with 2 accelerations, and none in the scenario saying about
comorbids, baby is okay etc) what to do
Tel her to come back on next routine ffup
Caesarean section
Admit and observe
be
16. pregnant at 35 wks, complete breech in ultrasound, normal amniotic, fetal weight at 50th
centile, then how to manage
Cs now
em
External cephalic version 2 wks from now

Etc
17. premature child scenario, mother concern if baby is growing okay. growth chart and
//m
weight in different months given, What will you advise mother:

Baby’s growth suboptimal and need review now
Baby’s growth normal
Tell mother to bring baby after a month
s:
18. lady diabetic, sudden onset of facial weakness, with icteric sclera, ear discharge (but no
mention of vesicles) what to do
tp
Famciclovir,
Mri
Prednisone (Ds Bells palsy)
ht
19. then another case for me its clear bell’s palsy. But asking what investigation to do?
Ct scan
Mri
No test needed (A-medex)
https://www.racgp.org.au/afp/2016/november/a-general-practice-approach-to-
bell%E2%80%99s-palsy/
20. case of homonymous hemianopsia, asking when to drive - never
/
35-year-old woman had a serious migraine attack with weakness and numbness of left side
om
limbs and homonymous hemianopsia after 4 weeks she recovered but her vision still
bad.she says she has to drive her daughter to school and she asks you when to drive ?
A-She can drive now
B-After 4 weeks retest her vision and she can drive
.c
C-She can drive only daylight not after sunset
D-She will never be able to drive again
sx
21. case of OSA: man brought by wife, because wife concerned that his husband sometimes
sleep at the lights (cant remember if man here is with other comorbids). What to do?
u
Check hba1c
pl
Report to driving authority
22. Case of chronic schizophrenia, regular medication (depot antipsychotic) and good
r.m
compliance. On his ffup you saw pigmented lesion on his face and u assessed to be
melanoma. U advise that it should be excised but he refused saying it will heal on its own.
next appropriate step
1.explain to him what is melanoma and excision
be
2. do cognitive test
3. do capacity to decide something
em
4. Refer for psych assessment

5. increase dose
So for me, patient is in good condition, I chose 1.
23. case of Afib, old patient, ecg given irreg pulse (, no dyspnea no dizziness, chads score I
//m
checked to be 2. Because of age, diabetic. What to do

Aspirin
Sotalol
Warfarin
s:
Clopidogrel
24. Scenario: woman, given values of FBS, total chole, bmi, waist circumference. what
tp
increase patient’s cardiovascular risk? (Make sure to check the parameters before answering,
I think I didn’t get this)
ht
Cholesterol
Waist circ
Bmi
Fbs
25. case of dysphagia. Barium swallow showing diffuse esophageal spasm. Long term
management. (Age of patient 82y)
a. nifedipine
b. laproscopic cardiomyotomy
c. botulinum toxin
/
om
d. beta blockers
26. man with case of eosinophilic esophagitis but asking best treatment?
A. esomepraszole
.c
B. budesonide
c. helicobacter pylori antibiotics
sx
27. ITP scenario, patient seems well not dehydrated, platelet okay
Strict bed rest
u
Prednisone
28. pregnant hep b exposure, no immunity

Give HBIG and Hep B vaccine
pl
r.m
29. child (with no prev infection and not immunised to varicella) exposed today to a child
with chicken pox
Give varicella vaccine
be
30. woman on 20’s, 2 episodes of post coital bleeding. Pap smear normal 2 months ago.
What next?
hpv test of cervix (this is clear)
em
Chlamydia PCR
repeat Pap smear
colposcopy
//m
31. ct scan – got no idea, but the options are for diverticulitis
32. nulliparous, bishop score 2, htn, asking how to

Pge 1
s:
Pge 2 and ARM after 12-24hrs

Do amniotomy now
tp
Synto after amniotomy

Cs
ht
33. Man got lacerated wound -asking for tetanus prophylaxis
34. Man scenario of urge incontinence asking for mngt

35 Female with recurrent candidiasis 4 times in last 6 months. Clotrimazole vaginal cream
helped controlling the symptoms last 3 times. …white palque… What is the most
appropriate next step?
a. Oral Nystatin
/
b. vaginal nystatin
om
c. fluconazole
36. child -vulvovaginitis
.c
37. child, family hx of travel child played in the sand during trip, now came home vaginal
bloody yellowish discharge? Asking reason for the finding
sx
a. Sexual abuse
b. Monilia
c. Gardnerella vaginitis
u
38. man smoker, tonsillar mass, scenario what’s the diagnosis?
Nasopharyngeal ca
Primary scc
pl
r.m
39. image of hand with index finger distal phalanx flexed, cannot be extended. Asking what
is the reason?
40. image of a woman’s neck with mass at the right neck below angle of jaw, fnac done and
be
malignant cells found. Asking what further investigation to do

Ct scan head
Mri head
Cant remember othe roptions
em
41. orbital cellulitis scenario

Child with eye findings, fever, then eye movt with little bit limitation, that’s why I diagnosed
with orbital cellulitis. Asking what to do next
//m
Antibiotic
Ct scan
Etc
42. picture of man’s back with allergic reaction with pneumonia, given iv cefazolin, then
s:
allergic reaction. Which of the ff is true regarding future antibiotic use:

All penicillin and cephalosporin will be unsafe
All cephalosporin will be unsafe but penicillin is safe
tp
Options Something like this, so study antibiotics

ht
43. Wegener granulomatosis, given antibiotics, now with rashes. (for me rashes are vesicles,
bec its in different stages, some are new, some are dried) what to do
Skin biopsy
Skin swab
Drug allergy test
Etc
44. infant, small head less then normal centile, no cataract, (+) pigmented retina finding,
hepatosplenomegaly. Asking for investigation
urine test for virus
test for deafness
/
om
45. 3 times hx of miscarriage at 6 wks gestation, pregnancy is always confirmed with bhcg.
What’s the cause?
APAS
.c
Chromosomal translocation?
sx
46. couple soon to marry, concerned about cystic fibrosis, if one of them is found to be
carrier, what is the chance that their future children will have the disease
u
0
0.25
0.50
0.25 OF MALE baby
pl
r.m
47. gender dysphoria case – man with boyfriend, man takes ocps, for him he should not be
born a male, and he plans to have sex change
be
Choices are transvestism, normal development, etc
Then I got many long scenario, with elderly patient, health conditions stated, lab results
em
given, and asking for management (so hard for me)

Sometimes urea is high, or urea and crea are high,
ACS/MI – 1 case
//m
MVA cases:
One with normal cxray, but laboured breathing, what’s the cause
One with splenic injury

s:
Sorry these are all I can remember, will add if I remember more. The exam gave me severe
tp
headache.
ht
Woman with prev episodes of crush fracture, on risedronate. It was stated that patient has used prednisone, but
came to you with another episode of fracture. What appropriate mgt?
1. Change to alendronate
2. Change to IV zolendronic acid
3. Give strontium
4. Give raloxifene
Amedex:
Woman with h/o steroid use & previous fracture, taking Risedronate 35mg, has recurrent vertebral fracture in
last 3 months, what next:
a.stop risedronate and change to IV zolendronic acid
/
b.Change to alendronate
om
c.Continue Risedronate
d.Stop Risedronate
2. One population, mean systolic BP is 115 and SD is 15 so what will be range of 95% population’s BP
.c
3. Very Old lady with coxa vera.which of the following will help her in walking?
a-walking stick
b-strap
sx
4. A pic of a hand with amputated fingers....asking associated disease:-loud p2
a. A)Bronchiactasis
u
b. B)Chronic liver disease
C)Interstitial lung disease
D)Pulmonary hypertension
6.
pl
Pregnant lady 35weeks with bradycardia,emergencylscs done still baby heart rate is 70...what's the
r.m
cause
1-anti smith
2-anti ro
3- anti cardiolipin
be
35-year-old woman had a serious migraine attack with weakness and numbness of left side limbs and
homonymous hemianopsia after 4 weeks she recovered but her vision still bad.she says she has to drive her
daughter to school and she asks you when to drive ?
A-She can drive now
em
B-After 4 weeks retest her vision and she can drive

C-She can drive only daylight not after sunset
D-She will never be able to drive again
//m
23. case of Afib, old patient, ecg given irreg pulse (, no dyspnea no dizziness, chads score I checked to be 2.
Because of age, diabetic. What to do
Aspirin
Sotalol
Warfarin
s:
Clopidogrel
24. Scenario: woman, given values of FBS, total chole, bmi, waist circumference. what increase patient’s
tp
cardiovascular risk? (Make sure to check the parameters before answering, I think I didn’t get this)
Cholesterol
ht
Waist circ
Bmi
Fbs
25. case of dysphagia. Barium swallow showing diffuse esophageal spasm. Long term management. (Age of
patient 82yo, so I didn’t choose surgery anyway)
a. nifedipine
b. laproscopiccardiomyotomy
c. botulinum toin
d. beta blockers
26. man with case of eosinophilic esophagitis but asking best treatment?
A. esomepraszole
B. budesonide
c. helicobacter pylori antibiotics
/
27. ITP scenario, patient seems well not dehydrated, platelet okay
om
Strict bed rest
Prednisone
28. pregnant hep b exposure, no immunity

Give HBIG and Hep B vaccine
.c
29. child (with no prev infection and not immunised to varicella) exposed today to a child with chicken pox
Give varicella vaccine
sx
30. woman on 20’s, 2 episodes of post coital bleeding. Pap smear normal 2 months ago. What next?
hpv test of cervix (this is clear)
Chlamydia PCR
u
repeat Pap smear
colposcopy
pl
31. ct scan – got no idea, but the options are for diverticulitis
32. nulliparous, bishop score 2, htn, asking how to

r.m
Pge 1
Pge 2 and ARM after 12-24hrs
Do amniotomy now
Synto after amniotomy
Cs
be
33. Man got lacerated wound -asking for tetanus prophylaxis
34. Man scenario of urge incontinence asking for mngt

em
35 Female with recurrent candidiasis 4 times in last 6 months. Clotrimazole vaginal cream helped controlling
the symptoms last 3 times. …white palque… What is the most appropriate next step?
a. Oral Nystatin
b. vaginal nystatin
c. fluconazole
//m
37. child, family hx of travel child played in the sand during trip, now came home vaginal bloody yellowish
discharge? Asking reason for the finding
a. Sexual abuse
s:
b. Monilia
c. Gardnerella vaginitis
tp
38. man smoker, tonsillar mass, scenario what’s the diagnosis?

Nasopharyngeal ca
Primary scc
ht
39. image of hand with index finger distal phalanx flexed, cannot be extended. Asking what is the reason?
40. image of a woman’s neck with mass at the right neck below angle of jaw, fnac done and malignant cells
found. Asking what further investigation to do
Ct scan head
Mri head
Cant remember otheroptions
42. picture of man’s back with allergic reaction with pneumonia, given iv cefazolin, then allergic reaction.
Which of the ff is true regarding future antibiotic use:
All penicillin and cephalosporin will be unsafe
All cephalosporin will be unsafe but penicillin is safe
Options Something like this, so study antibiotics
/
om
43. Wegener granulomatosis, given antibiotics, now with rashes. (for me rashes are vesicles, becits in different
stages, some are new, some are dried) what to do
Skin biopsy
Skin swab
Drug allergy test
.c
Etc
44. infant, small head less then normal centile, no cataract, (+) retina finding, hepatosplenomegaly. Asking for
investigation
sx
urine test for virus
test for deafness
45. 3 times hx of miscarriage at 6 wks gestation, pregnancy is always confirmed with bhcg. What’s the cause?
u
APAS
Chromosomal translocation?
pl
46. couple soon to marry, concerned about cystic fibrosis, if one of them is found to be carrier, what is the
chance that their future children will have the disease
r.m
0
0.25
0.50
0.25 OF MALE baby
be
30 y-old lady, infertility for 2 years, tsh, lh normal , with history of apendicectomy 12 years back. Undergo
Laparoscopy, Dx?
em
a. PCOS
b. Endometriosis
c. Tubal occlusion
d. Adhesions
e. Uterine fibroids
//m
s:
tp
ht
Similar picture, 83 y-old women with mass in her neck, increase over the months, now with hoarseness,
and difficult swelling. Dx?
a. Multinodular goitre
b. thyroid carcinoma
c. Epidermoid carcinoma
/
d. Parotid mass
e. Brachial cyst
om
.c
u sx
pl
r.m
Treatment?
a. Amoxicillin
b. Drain
c. Surgery
be
em
//m
s:
tp
ht
/
om
.c
sx
u
pl
r.m
be
em
Similar pic .. asking for what determines prognosis ?

//m
a. Diameter
b. Thickness
c. Color
s:
tp
ht
Incidental finding in abdominal CT,upper right kidney calculi 1 cm. Asymptomatic , What to do?
A. Percutaneous biopsy
B. Repeat CT scan after 6 months
C. MRI
D. Renal artery angiography
E. Left nephrectomy
/
om
Nurse works with CMV infection ward with recurrent miscarriage:
a) Cervical incompetence
b) CMV
c) Rubella
d) Genetic disease.
.c
e))Maternal anticardiolipin
sx
CVD risk chart given, 47yrs old man, No DM, smoker, chol-6.4, LDL-1, BP-160/70mmHg, asking 5 yrs
reducing CVD risk?
A.5-10%,
u
B.16-19%
C.20-25%
pl
Patient from nursing care was brought in the ER because of agitation at night, upon waiting to the doctor
fell asleep but after 4 hours the doctor came and become agitated, violent. On Physical exam, extensive
bruising on arms-
r.m
thrombophilia
vwd
elder abuse
HSP case
be
Man 32 y-old asking for ca colon screening , his father die at 44 y-old from colon ca. ///
No screen need
Fob every 2 years
em
Colonoscopy now
Genetic counsuling
studnt came back frm india persistant fever. showerd with bucket of water frm nearby lake.also drinking
//m
water proper sterilized and clean. malaria tested twice.all meds taken including
antimalarials and vaccinations.
• looks for other disease
• b.do thick thin filn now
• do another rapid malaria test
• also smthng abt malaria
s:
tp
18 months baby went 2 month back with her parents to India . Now with cough, no other symptoms,. Vacs
complete. Physical exam normal. . Asking for agent ?
Neisseria T
Pstreptocco
ht
Influenza
Pertrusis
Mycoplasma
Male came from Thailand 2 months ago .. presenting now with marked confusion and marked
lymphadenopathy more at the axillary and inguinal groups (may be mild hepatosplenomegaly .. not sure)
.. CT showed bilateral periventricular lesions (no details mentioned) .. what inv to do next
Test for HIV
Test for IMN
Test for Malaria
MRI of the brain
/
om
1.56 years old woman, h/o menopause, was on HRT for last 4 years, no
menstrual bleeding for last 6 months----
.c
A. Cease HRT
B. Continue HRT
sx
2.38 years old woman, hysterectomy done, now developed osteoporosis, T
score -2.5, Calcium normal------
u
A. Alendronate
B. Estrogen.
pl
3.One person went to Angola, Malaria prophylaxis was given, now presents
r.m
with high fever, two malaria test negative, what to do now……
A. Malaria check peak of fever
B. Another thick and thin film.
be
4. 22years female presents with nausea, pain in right iliac fossa, increased
urinary frequency, no h/o amenorrhoea, Temperature 37.8 F……
A. Urine analysis
em
B. Ultrasonogram
5.Growth Chart -----7 years 30 kg

//m
6. ECG-------
A. SVT with shock
B. AF with shock
C. WPW
s:
D. ST depression with LBBB, what to check--- Trop I

tp
E. Old patient was on antihypertensive medication, ECG could not figure

out, What is the cause of the ECG----
ht
a. Dehydration
b. Antihypertensive medication
7. Patient with h/o melanoma in the past, now presents with frontal headache for
2-3 weeks, Temperature 37.8 F, CT scan given…….
A. Brain abscess
B. Glioma
C. Metastasis
8. 27 years old Known case of Asthma, was on Budesonide, blood test reveals
/
increased Neutrophil, Increased WBC, cause of neutrophilia----
om
A. Hereditary
B. Budesonide
C. Bronchitis
https://www.gponline.com/causes-neutrophilia-
.c
treatment/haematology/leukaemia/article/668537
sx
9. 4 Years old children, urine analysis showed Protein-Trace, Haematuria 1+,
u
After 1 week, urine examination normal, what is the cause of the previous
urinary presentation…..
A. Nephrotic Syndrome,
B. AGN
pl
r.m
C. Benign haematuria
10. Right quadrant pain, Cholecystectomy done before, CT Scan of Left sided
RCC.
11. Recall of DVT------
be
A. Bilateral varicose vein

B. BMI
12. 22 years female, BMI 45, came for contraceptive advice, What is the most
em
important risk factor for the Breast cancer----

A. obesity
B. OCP
(weight is ans)
//m
13. Young female, h/o migraine with aura, came for long term contraceptive
advice----POP
14. Farmer with f/o meningitis, CSF findings are TC-820/cc, Monocytes- 70%,
s:
Polymorph-30%, Cytology showed Gm +ve Rod……

A. Brucellosis
tp
B. Pneumococcus
https://study.com/academy/lesson/aerobic-gram-positive-bacilli-characteristics-types-
examples.html
ht
15. Plumber presents with progressive dyspnoea, X ray shows Interstitial

infiltration, FEV1 50%, FVC 70%, No improvement on Salbutamol….
A. Steroid
B. CT chest
16. Case of incarcerated hernia, patient was agitated after surgery, could not
memorize the PO day, BP less than 70mm Hg, SpO2 86%, X ray Hazy……
A. haloperidol
B. Intubation
C. Ceftriaxone
/
om
17. MVA, patient was on shock, Hoarseness of voice, wide mediastinum what
to do….
A. Intubate
B. Echo
.c
C. CT Angiogram
sx
18. Long flight scenario, Tachypnoea, ----- Pulmonary Embolism
19. MVA case, on CT haemothorax and Pneumothorax, Painful shallow
u
breathing, cause of breathing---Rib fracture.
pl
20. 10 days old infant, Systolic murmur, no sign of cyanosis -----I choose VSD.
r.m
21. SLE with rash on hand, ANA +ve, Anti Ds DNA +ve, Long term
Mangement—
Hydroxychloroquine.
be
22. Patient with ANA+ve, Anti CCP -ve, Anti Ds DNA +ve, Treatment---
Hydroxychloroquine.
em
23. Gout scenario with Heart failure, renal Failure, what to give,
A. Colchicine
B. Naproxen.
24. 20 years male, known case of Type 1 DM, now not going to university, no
//m
social life, went to sleep at night, lethargic, what to check….

A. Mental state examination
B. Thyroid
s:
25. H/O preterm delivery, now baby is apnoeic, Quadriplegia, seems last stage,
parents asked to do what is best for the baby…..what to do?
tp
A. Ethics committee
B. ICU
ht
C. ER
26. H/O trauma, gradual loss of vision, Fundoscopy of Retinal detachment
(curtain).
27. Photophobia, mucopurulent discharge, On Fluroscent examination shows

corneal infiltrate….
A. Chloramphenicol
B. Specialist referral
28. Pain on tibial tubercle----traction apophysitis Osgood schlatters-traction,

asking for treatment------Conservative
/
om
29. Apple core CT scan----Sigmoid cancer
30. Cut off sign CT
.c
31. Perianal hematoma--- External haemorrhoids---Pain and no bleeding
sx
32. Sever pain in anal region, blood on tissue paper, what to be given-----
A. High Fibre diet
B. Glycerine Trinitrate
u
pl
33. Others findings of Internal haemorrhoids----
A. Mucus
B. loose stool
r.m
34. Ovulatory pain recall.
35. Right eye diplopia, dilated pupil, Frontal headache, cause----

be
A. PICA
B. MS
C. Mid Brain Infarct
em
D. 6th Nerve Palsy
36. Hepatitis B statistic question. Core antibody +ve 60, Surface antigen +ve 7,
only surface antigen 12, options were---
//m
A. 300
B. 325
C. 75
D. 50
s:
37. Patient attempted to commit suicide several times, now needs to give
ECT….
tp
A. Mental health Tribunal

B. Under Duty of care.
ht
38. After MVA, patient was very agitated in ED, asking for permission for
smoking otherwise will call police-----Allow him to smoke.
39. Scenario of cholangitis with shock----Percutaneous drainage.

40. Feature of MTX toxicity on bone marrow, Treatment----Folinic Acid.
41. Scenario of Hereditary Spherocytosis, On blood examination count is less,

asking for cause----Parvo virus
/
42. Temporal Arteritis---asking for investigations----ESR
om
.c
sx
1. 39 wks preg lady with pain abd on the right side. Nothing mentioned about the fetus,
u
admitted to hospital, next day pain gets worse, fever increases, wbc 21 000. What to
do?
a.lapascopy
b. laparotomy
pl
r.m
c. usg
d.iv antibiotics
e.forgot
2. 41 + preg woman, with prev hx of lscs for NPOL. Now comes to check ?
be
a. admit to see fetus

b. elective lscs
c ctg in next visit
em
d. induction with prostaglandin

e. forgot
3. 39 wks lady complains no fetal movement for 36 hours , ctg pic given (2 accelarations, I
could see) . what to do?
//m
a. tell her to come in next visit

b. induction of labour
c. usg
d. forgot
s:
4. ecg given, I sould see T tall (not very sure, it was not clear peak T wave) hyperkalemia, 5.5
. pt on ramipril and metformin. Came with syncope. What to do?
tp
a.cease ramipril
b. insulin and glucose
d…others
ht
5. Other many ecgs, I don’t remember now, I thought I would come back to those questions
again, so flagged them, but couldn’t come again (no time )
6. man with mass infront of ear, eye movement affected, what to dofor diagnosis?
a. ct head
b mri head
c. usg
d. fnac
15.pt with diplopia, frontal headache ….pain of moving the eye in different directions
(mentioned..) ?? what is the reason ?\ (don’t remember Q properly, it was a long big
scenario)
/
a, mid brain
om
b. 6th nerve palsy
16. picture of one blue fallopian tube, no adhesions seen. Lady with 12 months amenorrhoea
, wants to concive. Hx of appectectomy in childhood. Husb semen study normal, wife
.c
hormonal study normal. What is the cause of infertility?
a. hydrosalphix
b. adhesions
sx
c…all new options
17, pic of Quincy (like someone shared from yesterday Q, but pic not clear, I could hardly
u
see pus, ), what to do ?
a. Incision and drain
b. Antibiotis
c. Surgery…or something….dont remember
pl
r.m
18.ct pic, many, I cannot remember right now.
19. woman with amenorrhoea12 months, all reports , like fsh , lh normal except, tsh 0.04
(slightly low)Cause?
be
a.pcos
b. premature ovarian failure
c. primary hypothyroidism (yes, hypo they said)
d. pituitary adenoma.
em
Pic of dye in F tube. Only one tube shown in pic.no menses for
12 months. Hx of appendectomy in childhood. Husband and
//m
wife normal med hx. What is the cause of infertility??

Adhesion
Hydeosalphix
s:
tp
Gambling is very popular in Australia. What do you think the reason which influence in this condition?
A Melbourne Cup
ht
B Easy access to gambling

C teen age/ adolescent think that gambling is good for socialize
D marijuana is illegal and not culturally accepted .
39 wks pregnant female cervical dilation 2 cm for past 36 hrs.primigravida. ctg ultasound
normal.pt not satisﬁed still worried what to do.
a. amniotomy
b.csection
c.reassure and wait
/
d.administer prostaglandin
om
old lady known case of breast cracinoma .previously oprated for it.labs given showed
hypercalcemia. asking diagnosis
a. hypercalcemia of malignancy
.c
b.hyperparathyroidism
sx
Farmer develops signs of meningitis. CSF shows increased leucocytes (25% PMN,
75% monocytes), glucose 2.5, protein 0.67. Small gram +ve rods
a) Brucellosis
b) Anthrax
u
c) Listeria
pl
d) Pneumococcus
e) Anthrax
http://conditions.health.qld.gov.au/HealthCondition/condition/14/33/8/anthrax
r.m
A patient with adhesive capsulitis took time off work but now his employers are
telling him to return to work. You examine the patient and his range of movements
be
are better now but the patient is still saying that he cannot go back to work as it will
aggravate the pain further. What will be your next appropriate step as his GP?
a) Arrange Vocational counseling of the patient
em
b) Arrange functional assessment

c) Tell the patient he has to go back to work
d) Speak to his employers and tell them that cannot return
//m
Post cataract surgery, patient develops red eye, photophobia, blurred vision, pain.
Diagnosis.
s:
tp
ht
A) Hypopyon
B) Hyphaema
C) Acute Iritis
D) Glaucoma
/
om
25 years old male has progressive dysphagia for the past 3 months, more with solids
than liquids. He also has intermittent reflux symptoms. He also has allergy and
asthma for which he takes salbutamol and is well controlled. What the diagnosis?
A) Achlasia
.c
B) Eosinophilic esophagitis
C) Peptic stricture
D) Pharyngeal pouch
sx
a man concerned with his counting rituals, is on d verge of expulsion frm his job due
u
to his lateness and impaired work performance. Along with relaxation technqiues,
what is the next appropriate management?
pl
A- exposure and response prevention
B- citalopram
C- olanzapine
r.m
D- diazepam (immidiate relief )
A patient has taken lots of tablets of venlafaxine. Was on depression treatment. One
be
year back she was given psychotherapy as she was irritable (shouting at coworkers)
and anxious. After stabilization of the patient what next to add
A. Lorazepam
B. Risperidone
em
C. Mirtazapine
D. Sodium valproate
scenerio of a schizophrenic patient walking naked in streets. Asking which of the

//m
following will be the least appropriate (didn’t say least effective) for this patient as the
next step of management?
a. olanzapine
b. quietiapine
s:
c. amisulpride
d. clozapine
e. Risperidone
tp
Case of hematemesis (mentioned in the stem) A woman presents to the ED with

ht
epigastric pain and history of vomiting 3 times, streaked with blood. She admits to
drinking 10 cans of beer last night after which she started vomiting. On examination
her abdomen is soft, no guarding or rigidity but there is tenderness in the epigastric.
After the examination, she vomits again. Vomit contains blood. Which one of the
following the next appropriate step in the management of this patient.
A) Esomeprazole
B) Gastroscopy
C) Odansetron
D) LFTs
E) Abdominal Ulrasound
/
Pregnant woman in 3rd trimester presents with RUQ quadrant pain. On examination
om
there is tenderness. She also claims to have vomited a day before. While under
observation she develops rebound tenderness and increased WBCS. What the next
appropriate step?
A) IV antibiotics
.c
B) USG of the Right Hypochondrium
C) Laparoscopy
D) Laparotomy
sx
A child with ADHD. Well controlled with methylphenidate. The parents say that the
medication has significant improved his symptoms but are concerned as the child
u
has loss of appetite. You find that the child is with normal height and weight but the
growth has slowed. Next step?
a)Stop methylphenidate
B)Only give methylphenidate during school days pl
r.m
C) Add multivitamins
be
Woman has one episode syncope. ECG given of hyperkalemia .

Pr prlonged (1st degree HB),..no tall T waves. K 5.5, what is your next step?
A)Cease Ramipril
B)Caclcium carbonate
em
C)Insulin glucouse
D)Pacemaker
//m
12 yr old girl who is taken from her drug abuse parents and now living in fosters
since she’s 2 year old , she likes toys and very proud of her big collection of toys,
plays with her immaginary friend , eat same foods always and very picky, her carer
doesn’t like that , what is the most immediate dange to her?
s:
• 1- drug abuse
• 2-schizophreniform disorder
• 3-sexual abuse
tp
• 4-anorexia nervosa
• 5-OCD
ht
16 years old has hx of heavy menstrual bleeding. No dysmenorrhea. One time

during her menstrual periods, she fainted due to the heavy bleeding and was taken
to ED. What the next appropriate step?
a) Mirena
b) Hysteroscopy and D+C
c) OCP
d) POP
e) Coagulation screen
72 year old man living alone is brought to ED by daughter. He’s so confused and
gave incomprehensible answers to questions and couldn’t follow any commands.
/
There’s no other abnormality on examination. CT was given (clearly
om
infarction).Asked diagnosis.
a) Cerebral tumour
b) Cerebral infarction
c) Cerebral haemorrhage
.c
d) Cerebral tuberculosis
b)
sx
A young girl tries marijuana for the first time. In the following week she exhibits
paranoid behavior. She thinks she is being followed. She feels agitated. Sister has
history of schizophrenic illness. What is the next most appropriate step in the
u
management of this patient? (cant recall the rest of the symptoms but basically the
girl was showing changed behaviour, mood changes, suspicious etc etc and claims
pl
to have only smoked marijuana only one time)
A) Physical examination
B) MSSE
r.m
C) MSE
D) Urine drug screen
A mother comes to you with her child who has been sick since 3 days. She is asking
for a medical certificate as she has missed work for the previous 3 days while taking
be
care of the child, and therefore needs to explain her leave of absence to her
employer. You examine the child and conclude that he does have signs and
symptoms suggestive of a mild URTI. What will you do?
em
a) Refuse to give the certificate as retrospective dating is not allowed

b) Give her the certificate that’s dated today but covers/explains the previous 3
days as well
c) Give her a certificate that’s only for today
//m
d) Don’t give her the certificate because the child isn’t that sick
A 50 years old man says he has to take atleast 3 temazepam to sleep ...otherwise
he is unable to fall asleep without it. He feels anxious and agitated during the day if
he doesn’t use Temazepam. He says he cannot find work but spend his time fixing
s:
old motorbikes. Whats the dx?

tp
a) benzodiazepine Use disorder

b) MDD
c) Adjustment disorder
ht
d) Circadian sleep-wake rhythm disorder
A woman has history of chronic mood disorder and eating disorder. She is
fine now but presents to you saying she usually skips breakfast and then has
large lunch…but then feels guilty during the day for eating such a large meal.
She denies any mood symptoms. What the most appropriate dietary advice
for her?
A) Tell her to start keeping a mood diary
B) Have a balanced diet and healthy lifestyle
C) Eat small regular meals during the day
D) Have a large breakfast
/
om
A teenager girl with history of excessive exercise and workout. She weighed 27kg
before. Now she binge eats but then purges and does excessive exercise. Her
current weight is 32kg. Ht is 162cm. Age was 16 years. What will you find in
examination?
.c
a)tachycardia
b)ankle edema
c)vitiligo
sx
d)hyperthermia
u
You prescribe Olanzapine to a woman. When she goes to buy this medication at the
pl
pharmacy, the pharmacist says to her that this drug can cause diabetes. So the
woman calls you and tells you about what the pharmacist said, and says she wants
to stop the medication now because her mother died of complications of diabetes.
r.m
What will you do?
A) Arrange an early review with her to discuss further about the adverse effects
B) Advice her that she will need to be changed to another antipsychotic
C) Report the pharmacist to some Board for acting beyond his expertise
D) Call the pharmacist and tell him he shouldn’t have said that (something along
be
these lines. Don’t remember exactly)

E) https://www.pharmacyboard.gov.au/codes-guidelines/guidelines-for-mandatory-
notifications.aspx
em
-a man concerned with his counting rituals, is on the verge of expulsion from his job
due to his lateness and impaired work performance. Along with relaxation
//m
techniques, what is the next most appropriate management? (didn’t say immediate
management like in the previous recalls)
A- exposure and response prevention
B- citalopram
s:
C- olanzapine
D- dizepam
tp
4 years old girl with vaginal bleed. Mother noticed some amount of blood in her
ht
underwear for 10 days. On examination, there is small amount of blood stained in

vulva. What is ur first step in the management? Not developed any pubic hair and no
breast development.
a) Report child protective servicae immediately for sexual abuse.
c) oral Amoxillin
D) Examine under anesthesia
A 7 years old girl with soiling in her underwear, she tells lies about accidents at
school and hide her soiled underpants and cry and quarrels with her brother when he
calls her smelly. These signs can be part of which of the following?
a) Regression
/
b) Conduct disorder
om
c) Oppositional Defiant Disorder
d) Delayed milestones
e) Depression
.c
A pregnant woman comes at 41 weeks and 3 days. Antenatal Hx is normal. Her last
sx
delivery was by CS due to failure of progression of labour. CTG done is normal.
What is the most appropriate next step?
A-Elective CS
u
B-Amniotomy
C-Admit her for fetal monitoring
pl
D-Repeat CTG
Post op incarcerated hernia 2nd or 3rd day agitation. She is removing Iv lines, trying
r.m
to get out of bed. Has SOB and O2 sat 88%. Chest xray had bilateral diffuse
opacities. After O2, what is the next appropriate step?
IV antibiotics
Heparin
be
Thrombolysis
Droperidol
Cadaver renal transplant recall. No urine output till 7 th day requiring dialysis. No pain.
em
No fever. What is the cause?

A.Acute rejection
B.Blocked catheter
//m
45 years old man with scrotal swelling. He has had this swelling for 2 years. It
becomes prominent when he is standing or straining. Collapses when he lies down.
s:
Initially it did not cause any problems but now the man complains of dragging
discomfort towards the end of the day. What will you do next?
tp
a) Suggest him supportive underwear

b) Scrotal ultrasound
c) Surgical exploration
ht
d) Doppler ultrasound
e) Tumor markers
• Post partum psychosis.....first step- olanzapine

Shift to psy unit
• Normal ctg 39weeks

• Normal ctg 41 weeks prev c sec due to non progress- admit
Elective c sec, amniotomy
/
• Ctg 40 weeks mother still worried- usg
om
• APH dead fetus... amniotomy
• Parvovirus
.c
• Microcytic hypochromjc anaemia normal ferritin thalassemia
• Diarrhea then uremia and anaemia- HUS
•
sx
Head trauma wants to take daughter home- counsel(q didn’t have counsllin)
• Haemochromatosis- counsel both husband and wife
• Painful anal fissure- warm saline and high fibre diet
u
• Risk of breast cancer – weight or smoking(have a feeling they were asking about
postmenopausal breast cancer so went with weight)
• BZd withdrawal
pl
r.m
• Muscular jerks, yawning like motion and throat clearing- tic or stereotypical disorder
• Breath holding spell – ixwasn’t sure...eeg ecg iron studies ca vit D and CT brain
be
• Prednisolone – adrenal insuff had hypoglycemia and postural hypotn and hypona
and hyperkal
• Went for vacation stopped tablets furosemide
em
• Child Accident came with shoulder pain no neck pain left upper abdo pain but triage
no abN- sec survey , iv cannula, CT brain shoulder x-ray ....went with sec surgery
• Helicopter transfer chest tube
• Peritonsillar abscess but with resp distress so went with intubation not incisional and
//m
drainage....aspiration not in options

• Appendicitis pic with guarding and rigidity next step... laparoscopy iv
antibiotics...went with lap
s:
38 yrs,15 smoker ,premenstrual headache,F/H/O breast carcionoma,most important

tp
contraindication of OCP
• AGE
ht
• SMOKING
• premenstrual headache
• F/H/O breast carcionoma
30-year old lady came for regular antenatal visit at 36 or 38 weeks of gestation (don't remember exactly).
She had no problems and everything was normal except a foetal bradycardia of 60/min. An emergency c
section was done but the infant still had the bradycardia of 60/min. What is the cause?
A. anticardiolipin
B. factor V Leiden
C. Protein C
D. Lupus anticoagulant
E.anti Ro
/
om
Patient with BMI 35. What is the best management for long term weight maintenance together with
exercise?
A. Low CHO diet
B. 4000 kJ/day= 1000 kcal
C. Lipase inhibitor
.c
D. Regular medical review
A patient recently travel to Asia with cough and low grade fever. Pain in epigastrium with
sx
Chest X-ray given. What is the diagnosis?
A. Viral pneumonia
B. TB
u
C. Bacterial pneumonia
D. Fungal pneumonia
pl
Post op incarcerated hernia 1st day aggitation stem fever sob O2 sat 88% xray given after o2 what initial
step.xray had patches! What initial (xray had patches here)
IV antibiotics
r.m
Heparin
Thrombolysis
Droperidol
. pt presented with fever. 38.with mild ascites, gynecomastia , spider nevi, flapping tremors. vitals given.
whats ur initial step of management of this patient ?
be
a. full blood examination

b. LFTs
c. ct scan
d. abdominal USG
em
e. Abdominal paracentesis
Northen queensland jelly fish bite. What to do first?
a) pour vinegar
b) pour warm water
//m
person endoscopy sigmoidoscopy all done now what

s:
Capsule endscopy
Statistic question about a doctor calculating the incidence of hepatitis B in 2009 and 2010 in a population
tp
of 200 people.
2009 2010
ht
heapatis b s antigen nd anti hepatitis b antibody 5 7

hepatis b surface anigen 10 12
hepatis b antibody 40 55
what is the incidence of hepatis b in 1000 people in 2010
A.25
B.50
C.100
D.350
E.400
Hydrosalpinx Pic question
Rural doctor wants to make study about the relation between admission to hospital with rota virus
infection and birth weight , what’s appropriate ?
/
a. RCT
om
b. Case control
c. Cross sectional
d. Cohort
e. Case series
.c
Old age Pt. with cataract had improved vision after surgery , in post op. day 4 he wake at morning with
painful eye & blurred vision , what happened to this pt. ?(Pic of Hypopyon)
A) Conjunctivitis
sx
B) Acute Iritis
C) suture infection & abscess
d ) hypopyon
u
E) Acute glaucoma
lady comes to you with weakness of lower limbs. She drags her foot while walking, dorsiflexion and plantar
pl
flexion is weak. Reflexes are exaggerated. Equivocal plantar response. Diagnosis asked?
r.m
What can be find in the anorexia nervosa?

A. Hypertension
be
B. Tachycardia
C. Vitiligo
D. Ankle oedema
em
spermatic chord , fever + ,, asked investigation and proper management??
Urine
Chlamydia pcr
//m
.A woman gave a birth to a full term baby weighing only 2000 gm with head circumference at 1st
percentile, hepatomegaly and mixed severe jaundice, he has deeply pigmented retina on fundoscopic
examination , and bilateral basal crackles in the lung, wts the causing organism ?
a. CMV
s:
b. Toxoplasma
c. Leisteria
tp
d. Herpes Zooster
e. Rubella
ht
39 weeks pregnant female with Mild Preeclampsia With Bishop score 2. Best MX-
a.PGE2and amniotomy in 6 hr.
b.PGf2 and amniotomy in 12-24 hrs.
c.Syntocinon
d. Emergency LSCS
Normal CTG given Asking what next management. :

A)Reassure and ask her to come after 24 hours
B)Induction of labour
C)C section
D)Reassure and ask her to come in the next visit

/
om
.Woman has regular menses from 4-6 wkinterval , pain on left iliac fossa for 3
days ,aggravated while urination, her lmp was 9 days back , she had similar episode 4 wks
back which lasted for 3 days , cause ?
a. Ovulation
.c
b. complicated ovarian cyst
c. Endometriosis
sx
d. early PID
frusemide, etc,,, ECG given T wave changes seen but not peak T waves?? Hyperkalemia , labs = k = 5,5 .. Rest
u
investigations normal range, next step
Cease ramipril
pl
Resonium .
Insulin dextrose
Ca carbonate
r.m
History of melanoma 3 years ago fully treated, arrive to ED with headache + hemiparesia, non-contrast
brain CT shows very bright white lesion ( looked like a tumour wth regular borders)
intracraneal hemorrhage;
metastatic melanoma;
be
cerebral abscess.
Cerebral Infarct.
Sever pain in anal region, blood on tissue paper, what to be given-----

em
A. High Fibre diet

B. Glycerine Trinitrate
One person went to Angola, took Malaria prophylaxis used bed nets.took bath in local waters now
//m
presents with high fever, Fast malaria test negative, what to do now……
A. Malaria check peak of fever
B. Another thick and thin film
C.Check for other infections.
s:
Patient has acute gout with no h/o chronic renal failure and prev h/0 gout. what should be given-
a. allopurinol
b. naproxen
tp
c. colchicine
d. ibuprofen
e. prednisolone
ht
.MVA pt with fracture ribs, wide mediastinum and hoarsness of voice. No Bp or pulse mentioned.What to
do??
A-Laryngoscope
B-Intubation
C-CT chest angio
Farmer got bankrupt , blaming the government many financial problem, complain of late insomnia, lack of
pleasure , loss 15 kg from his wt through 3 months, any many other symptoms of depression, his family
concern about him and the pt refused to take any medication as he doesn’t believe he is sick, he admit he
is tired and exhausted but not depressed,, wt is the defence mechanism he is exhibiting (Looked like
Denial)
a) Denial
/
b) Reaction formation
om
c) Projection
d) Displacement
e) Rationalization.
.c
Patient who has HTN with DM & AFon metformin,Statin and started amiodarone 2 weeks earlier suddenly
got swelling at right thigh for 12hourswhich is progressively increasing and become painful and got fever
37.4.Right thigh size is 4 cm larger than left.What s d cause of the swelling?
sx
A)Rhabdomylosis
B)Hematoma
C)DVT
D)Cellulitis
u
E)drug interaction
pl
An obese patient with history of dull flank pain, fever and haematuria, CT given of Renal cell carcinoma.
Asking what will increase his risk of DVT if he undergoes an operation?
r.m
a. Nicotine stain of fingers
b. Atrial fibrillation
c. Bilateral varicose veins
d. BMI
e. Spider naevi on chest
be
58 years complaining back pain after gardening o/e tenderness in lumbar vertebrae L3,L4 &
limited flexion & extension, after giving analgesics what is ur next mx?
bedrest
em
continue activity
Spinal xray
corset
MRI
//m
Child ITP Scenario Non blanchable petechial rashes.had a cold few days back. No other abn finding or
bleeding. On FBE Hb n WBC normal.PLATS 35×10 9.Treatment?
A.Strict bed rest
B.Steroids
C.Immunoglobulins
s:
D.Repeat blood tests after a week.
Borderline scenario asking first treatment

tp
OCD scenario asking first treatment

Antisocial scenario asking what history in childhood.
Osteoporosis with gastric problem asking treatment. Iv zolendronic
ht
.
1)A very agitated schizophrenic patient was there, and the doctors admit him involuntarily..
what’s the reason of involuntary admission?
A) Non-maleficence
B) Harm reduction
2) A wife brought his husband who was not eating and drinking anything with severe
melancholic depression.H/O self harm for 3times,likes wrist injury,Neck injury.Now
Suggests for ECT,but patient rufusing for ECT.He’s in ICU and now move to ward.What will
you do next?
/
ECT approval from mental health tribunal
om
ECT approval under duty of care
ECT approval with consent from wife
ECT approval with consent of two doctors
.c
3) scenrio of a schizophrenic patient walking naked in streets.which of the following is
LEAST effective for this patient.
a)olanzapine
sx
b)quietipine
c)amiisulpride
d)clozapine
u
4) salmonella food poisoning outbreak 2 days girl with negative stool culture what to do
pl
next?
a.serology.
b.urine culture
r.m
c.stool culture
d.blood culture
5)One population, mean systolic BP is 115 and SD is 15 so what will be

range of 95% population’s BP?
be
a) 100 to 130
b) 85 to 145
em
6)Rural doctor wants to make study about the relation between admission to hospital with
rota virus infection and birth weight , what’s appropriate ?
a. RCT
b. Case control
//m
c. Cross sectional
d. Cohort
e. Case series
s:
7)Child treated for APSGN, parents asking about school

A- no school
tp
B- After checking others at school

C- Can go now with diet restrictions
D- Can go school, no diet restriction nor physical activity
ht
8) CCF with a.fib patient was taking digoxin 0.125 , bisoprolol, ramipril. left meds for 3
weeks presented with leg edema till knees. chest clear. irregular pulse n vitals given. HTN.
A.furosemide 40 mane
B.spironolactone 20 mane
C.digoxin 5 mg
D. recommence all meds
E. enoxaparin s/c
9)Renal pt with RA she takes ibuprofen and methotrexate to control her disease ,they mention
the time it was years for both of drugs , pt complains of some symptoms , and her labs are
given ALT ,AST GGT all were high , the Q is asking about the cause of this ?
A-Methotrexate induced hepatitis
/
B-Ibuprofen induced hepatitis
om
C-Autoimmune hepatitis
DViral hepatitis
10) young man brought to ED after brawl in bar in which he hit someone. He is alcoholic,
.c
take multiple drugs and aggressive. What in history will you to know if he has personality
disorder?
a. Childhood sexual abuse
sx
b. H/o cruelty to animals in adolescence
c. Drug and alcohol dependence
d. H/o of hitting partner one week back
u
e. H/o depression in mother
pl
11) 4 yr old girls came with mom complain is bloody vaginal discharge on penties
for 10 days on examination bloody discharge on vulva.(exact words)
A. report CPA as sexual abuse
r.m
B .exam under aneasthesia
C .do swab microscopy nd culture
D .stop bubble bath
be
12) A lady comes to you with weakness of lower limbs. She drags her foot while walking,
dorsiflexion and plantar flexion is weak. Reflexes are exaggerated. Equivocal plantar
response. Diagnosis asked?
em

13) Pregnant woman in 3rd trimester presents with RUQ quadrant pain. On examination there
//m
is tenderness. She also claims to have vomited a day before. While under observation she
develops rebound tenderness and increased WBCS. What the next appropriate step?
A) IV antibiotics
B) USG of the Right Hypochondrium
s:
C) Laparoscopy
D) Laparotomy
tp
14) A patient with rheumatoid arthritis got a flare up and doctor wants to administer
azathioprine. which screening test should be done before starting this drug?
a) Tb Gold test
ht
b) Thiopurine methyltransferase
15) Postmenopausal Woman with h/o gastric ulcer with hypertension, BMD showes T score
-2.5 in both vertebra and neck of femur, Ca and Vit D level was normal, asking for
treatment?
a)Strontium
b)Alendronate
c)HRT
d)Vitamine D
e)Calcium
16) 50 yr old man with renal transplant 9 months ago. Presents with respiratory symptoms or
/
fever. On chest xray there is well defined round opacity in middle rt lung. What is the cause?
om
1. Aspergillosis
2.tb
3.pneumocytic pneumonia
4.lymphoma
.c
5.nocardiosis
sx
17) A 30-year-old woman with increasing dyspnea, dry coughs over a few months. She has a
painful lumpy skin lesions on her shins. On examination, there are red, painful, lumpy lesions
on her shins and bilateral ankle swelling. ACE level increased. Which of the following is the
u
best next step to get diagnosis? (No given X-ray)
A. CT scan chest
pl
B. Skin biopsy
C. Blood culture
D. Aspiration
r.m
E. ANA
18) Pt with RA she takes ibuprofen and methotrexate to control her disease for 5 years. pt
be
complains of some symptoms , and her labs are given

protein - 9 (6-8)
albumin - 4 (3.5-5.5)
ALT,AST ,GGT all are raised
em
What is the cause of her symptoms?

A-Methotrexate induced hepatitis
B-ibuprofen induced hepatitis
C-Autoimmune hepatitis
D-Viral hepatitis
//m
19) Cystic fibrosis case, what will be the chance to have disease child if one of them is
carrier?
a) 0%
s:
b) 25%
c) 50%
d) 50% of all male & no female
tp
20)Young woman with history of past 3 early mischarriages at about 7 weeks. She works as a
nurse in renal unit where there was many cases of CMV. Most likely cause of miscarriage ?
ht
A)CMV infection
B) Parental Chromosomal translocation
C)Maternal anticardiolipin Abs
21) A child with fever and hx of sore throat 10 days back . He developed pain in wrist later
developed arthralgia n swelling in ankle joint. skin rash present . what's the most initial step
of management ?
a. ESR
b. Full blood examination
c. throat swab
d. USg
22) A teenager girl with history of excessive exercise and workout. She weighed 27kg before.
/
Now she binge eats but then purges and does excessive exercise. Her current weight is 32kg.
om
Ht is 162cm. Age was 16 years. What will you find in examination?
a)tachycardia
b)ankle edema
c)vitiligo
.c
d)hyperthermia
sx
24) one scenario of epigastric lump from umbilicus to xiphisternum prominent on
cough,strain ,when raised leg or head from bed.what will be most appro mx? Pic was given
u
as,elongated swelling from umbilicus to xiphisternum
a.physiotherapy
pl
b.herniplasty with mesh
c.abdominal binder
d.abdominal trauss
r.m
25) An old man with pain in different joints, aspiration done and revealed positive rhomboid.
Patient disclosed that he is C/O from impotence.
Diagnosis
be
A-Reactive arthritis
B-Rheumatoid arthritis
C-Hemochromatosis
D-SLE
em
https://www.sciencedirect.com/topics/nursing-and-health-professions/chondrocalcinosis
27) Pt with acute gouty arthritis with CRH. What to give?

//m
A) Naproxen
B) Indomethacin
C) Paracetamol
D) Prednisolon
s:
28) old man with nocturia and long hx of dribbling urine problems for 12 months with
median sulcus palpable with enlarged smooth prostate what next appropriate?
tp
A. Urine cytology
B. PSA
C. Bladder scan
ht
D. CT scan abdomen
E. serum creatinine
29) Man with nocturia n urinary frequency n dribbling. mass above the pubic symphysis DRE
showed enlarged prostate with palpable median sulcus palpable.what is the most appropriate
next step? a)Urine cytology
b) PSA
c) Serum creatinine
d) CT
e) urine cytology
32) Pregnant dx with genital herpes, mgt?
/
A)Topical acyclovir
om
B)oral acyclovir
C) IV acyclovir
33) 40-years-old female Patient presents with daily morning stiffness of both wrists for 1-2
.c
hour. She has been suffering from this condition for last 8 years. Lab result shows HB -
reduced, MCV - slightly reduced, ESR - 70. Next Rx?
A. NSAID
sx
B. Prednisolone
C. Hydroxychloroquine
D. Methotrexate
u
E. Etarnarcept
pl
36) Female with recurrent candidiasis.Clotrimazole vaginal cream failed controlling the
symptoms.What is the most appropriate next step?
r.m
A)Oral Nystatin
B)Oral Grisofulvin
C)Oral Kotoconazole
D)Oral Fluconazole
be
E) Vaginal Nystatin
37)Patient underwent Conization for abnormal Pap smear 2-3 days back. Now presents with
fever 39, pain lower abdomen and tenderness. What’s the most appropriate place to take a
em
swab?
1) Blood culture
2)Endocervical swab
3) High vaginal swab
4) Low vaginal swab
//m
5)Endometrial swab
39) 28 year old lady with post coital bleeding one-two separate occasions. Pap smear normal
s:
2 months ago. What next?

HPV serology
Chlamydia PCR
tp
Pap smear
Thin Prep Pap test
ht
Repeat Pap smear
40) A man returned from Asia. Now complains intermittent fever with chills and rigor. He
said that he used mosquito net during sleep at night. He has mild spleenomegaly with
thrombocytopenia.
Rapid Malaria Rest (98% sensitive and 96% specific) is negative. Now what to do?
a. Repeat the test
b. Thick and thin film

c. Draw blood when fever is at peak and test again
d. Test for other infectious disease
e. Test for TB
/
42) 42-year-old patient, overweight, HTN. Both parents died in their 50’s due to cardio-
om
vascular disease. The patient has a HBA1c of 7.5%. What is the most appropriate next step in
management?
A. Metformin
B. Insulin
.c
C. Statin
D. Calculate CVD risk
E. Perindopril
sx
44) Pregnant lady in 35 weeks , complete breech in ultrasound, normal amiotic fluid, fetal wt
u
was also normal. How to manage?
a) CS now
pl
b) External cephalic version from 2 weeks now
c) Amniotomy
r.m
45) Nulliparous pregnant 39 weeks, feeling no fetal movement for 2 days, CTG was given,
looks normal to me, What to do next?
a) Tell her to come back on next routine followup
b) CS
be
c) Admit and observe
46) 40 years old man complain from persistent abnormal thoughts that’s making him washing
his hands at least 10 times after touching the key or door.he is on SSRI but want to try non
em
pharmacological therapy to help him get rid of this thoughts

a) Teach him how to avoid touching the doors or key
b) Explain him that this thoughts is normal to relieve his anxiety
c) Refer him to insight oriented psychotherapy
d) Have psychological evaluation
//m
47) a scenario of borderline personality disorder of a lady having problems at work and home
asking which psychotherapy?
problem solving
s:
dialectical
dynamic
tp
50)Very Old lady with coxa vera.which of the following will help her in walking?
ht
a-walking stick
b-strap
51)Woman on HRT on 6 years. well controlled of her symptoms. DEXA scan show femur -
1.7. Vertebra -1.2. How will u manage her?
A. Continue same treatment

B. Cease HRT
C. Add vitamin D and calcium
D. HRT Change to alendronate
E. Add alendronate
/
om
53) On interview. Asking about the appetite. Patient told “That is concern with food. Food
which does not comes from moon, moon made of cheese. But I came her by bus”. Which of
the following will have in this patient?
.c
A. Depression
B. Dissociation
C. Disorganized behavior
sx
D. Delusion
E. Depersonalisation
u
54)Woman has regular menses from 4-6 wk interval , pain on left iliac fossa for 3 days
,aggravated while urination, her lmp was 9 days back , she had similar episode 4 wks back
pl
which lasted for 3 days , cause ?
a. Ovulation
b. b. complicated ovarian cyst
r.m
c. c. dysmenorrhea
d. d. early PID
e. e. ectopic preg
be
57) Young girl with postcoital bleeding, taking ocp, pap was normal 2 months ago. what to
do next?
a. Do pap
em
b. Colposcopy
c. Nothing to do
//m
62) Patient with h/o melanoma in the past, now presents with frontal headache for 2-3 weeks,
Temperature 37.8 F, CT scan given…….
A. Brain abscess
s:
B. Glioma
C. Metastasis
tp
63) 22 year old female , BMI 32, smoker, on OCP, grandmother had breast ca at age 63 .
Asks her risk of getting breast ca. What will you advise?
a. Change to low dose estrogen
ht
b. Stop smoking
c. Lose weight
d. Mammography
e. Regular breast self-exam
64) Pic showing dupuytren contracture, Farmer with inability to extend his
ring finger, history of cut injury in that fingers (+). He takes 5 beers per
day and 30 pack of smoking per year. What is the cause of his injury?
a.chronic infection
b.his farmer instrument
c.alcohol
d.familial history
/
65) . Case of incarcerated hernia, patient was agitated after 3rd PO day, BP less than 70mm
om
Hg, SpO2 86%, X ray Hazy……
A. haloperidol
B. Intubation
C. Ceftriaxone
.c
66) Right eye diplopia, dilated pupil, Frontal headache, cause----
A. PICA
sx
B. MS
C. Mid Brain Infarct
D. 6th Nerve Palsy
u
pl
r.m
be
em
A 54 year old man comes to your clinic complaining of acute painful defecation with spotting
of blood on toilet paper. Which of the following is next appropriate management?
A. Sphincterotomy
B. Topical glyceryl trinitrate
C. Excision
//m
D. Sclerotherapy
E. High fiber diet
an infant presented with a discharge from the umbilicus. On cleaning a red granulomatous
s:
lesion was see, treatment

a. topical silver nitrate
b. surgical excision
tp
c. steroid ointement
d. antibiotic
ht
18 y lady came with left lower abdominal pain.her menstrual cycle usually is for 4-6 weeks
,she has the same pain 4 weeks before and she had her last menstruation 9 days ago.She
usually has this pain 1 day before her menstruation starts and continues for 3 days and pain
increase with urination.What is the cause of her pain?
a. Ectopic pregnancy
b. Dysmenorrhea
c. complex corpus luteum cyst
d. torsion of ovary
e.ovulation
4 yr old girls came with mom complain is bloody vaginal

discharge on penties for 10 days on examination bloody
discharge on vulva.(exact words)
/
A
om
report CPA as sexual abuse
B
exam under aneasthesia
C do swab microscopy nd culture
.c
D stop bubble bath
39 week pregnancy patient came with blood loss of 100ml, uterus tender, continuous
sx
monitoring going on, suddenly fetal heart sound not heard even with doppler, next step in
management?
a) Amiotomy
u
b) C-section
c) Synto drip
pl
d) Vaginal PG
Pt came from asia travel after 2 weeks trip presenting with low grade fever, cough and vague
r.m
epigastric pain since 2 weeks. X ray was showing marked hilar shadows couldn't c anything
else.
A. Viral Pneumonitis
B. Bacterial Pneumonitis
be
C. Tb
D. Lymphom
A wife brought his husband who was not eating and drinking anything with severe
em
melancholic depression.H/O self harm for 3times,likes wrist injury,Neck injury.Now

Suggests for ECT,but patient rufusing for ECT but pt need immediate ect. What will you do
next?
ECT approval from mental health tribunal
ECT approval under duty of care
//m
ECT approval with consent from wife

ECT approval with consent of two doctors
s:
8- aortic dissection scenario- old man in ed pulsating mass in abdomen. He is in severe pain.
bp 100/60. Everything is prepared for surgery and blood for cross-matching is taken. Next
step?
tp
A- fast Ultrasound
B-Aortography
C-IM Morphine
ht
D-No option for CT
Chest pain 12 hrs pain reduced 4/10 on ecg st depression o2 given nxt
A. echo
B. troponin
C. ct angiogram

a. anti ro
b. anti smith
c. anti cardiolipin
woman 75years is admitted to the hospital following a community acquired pneumonia. She
/
received antibiotics and was recovering. on the 4th she suddenly develops rigors,high grade
om
fever,bibasal crackles was mentioned only on examination.What is the most likely diagnosis?
A. Hosp acquired pneumonia
B. Iv cannula related bacteraemia
C. Empyema
.c
D. Pulmonary embolism
scenario of mother gave birth at 38 weeks to 2500kg who has heptatomegaly, dec head
sx
circumference..pulmonary interstitial infiltrate and pigmented retina ask about the inx to
reach Dx.
u
a) audiological assessment
b) urine culture for viruses
pl
c) CT scan of the head
d) liver biopsy
r.m
Post opt pt oliguria wz indwelling catheter.fever 38.5.There was generalized abdominal pain.
most appropriate mx?
A. And xray
B.blood culture
be
C. S electrolyte and creatinine
Post menopausal women“ T score -2.5, normal serum calcium level. Pt also has some git
problem. What will you prescribe her?
em
A. HRT
B. Oestrogen
C. Alendronate
D. Stratonium
//m
5-An old lady was reported to have change her personality,this happened after she lost her
husband a year ago,she was found digging in a neighbourhood and was brought to de GP,she
accused de neighbours of a trying to harm her. What is needed to assess for immediate
action?
s:
A. Thought form
B. Orientation
C. Mood
tp
D. Delusion
ht
A 7 years old girl with soiling in her underwear, she tells lies about accidents at school and
a)Regression
b)Conduct disorder

e)Depression
Woman with premenstrual symptoms affecting her marriage and daily life. She was
depressed. Her husband is also annoyed but she can go out and enjoy with friends. What is
/
the
om
best treatment option available?
1. Sertraline
3. interpersonal
.c
5. HRT
sx
frusemide, etc,,, ECG shows first degree heart block. Hyperkalemia , labs = k = 5,5 .. other
? normal range , next step
u
Cease ramipril
Resonium .
pl
Insulin dextrose
Ca carbonate
r.m
? spermatic chord , fever + ,, asked investigation and proper management
Urine
be
Chlamydia pcr
Young man has problem in sex with his boyfriend, he wear ladies dresses and
though he was a girl . and that’s why he is wearing ladies dress and taking estrogen
em
now wants to change his gender ,Treatment

Gender identity disorder
Transvestism .
Body dysmorphic disorder
//m
Box jelly fish bite screaming in pain , what will you give in emergency before
removing the tencteles
IV morphine
Wash with vinger
s:
Wash with water
Diabetic type 2 on metformin ,Bp 130/80,Cholesterol 4,Fbs 7.5,Hba1c

tp
Trace protein in urine,6.9

Increase metformin
Add statin
ht
Start ramipril
No change of treatmen
Girl weight 34 kg , height 162 cm lost much
weight ,exercise
?What will find in history help diagnose
Feeling inferiority
Apparent loss weight
A man comes with clumsiness of hands and tripping over. Upper limb weakness and
fasciculation. Lower limb muscles also has weakness, increased tendon reflexes. Ankle reflex
/
is not increased in one side. No wasting. No sensory loss is given. What is the initial/ Best
om
investigation? (2 QS)
A. EMG
B. MRI Spine
C. CT scan
.c
D. CSF examination
E. Cervical spine X-ray
sx
Man brought by police, who was shouting in street, and walking naked, what is the best
medication to start treatment for this patient?
u
A-clozapine
b-quietapine
pl
c-amisulpride
d-resperidone
e- olanzapine
r.m
e- olanzapine
A patient with rheumatoid arthritis got a flare up and doctor wants to administer azathioprine.
which screening test should be done before starting this drug?
be
a) Tb Gold test
b) Thiopurine methyltransferas[TMT]
D. Complements assay.
em
E. Anti gliadin IgA
Pic of obese male patient and long tubulerelongatred mass in abdomen from xiphisternum to
umbilicus. Description given that mass becomes prominent when patient raises his head and
cough impulse also present asking management?
//m
a) Physiotherapy
b) Herniorhapphy with mesh repair
c) Reduce weight
d) Reassurance
s:
a case of chronic liver disease presented with ascites and low albumin level. What is the next
appropriate management/
tp
a. lactulose
b. albumin infusion
c. salt and fluid restriction
ht
d. spironolactone and frusemide

Chest x ray showing patchy infiltrates and the patient was a chronic smoker n had long
history of cough now came with 2 weeks history of rusty sputum and fever asking diagnosis :
a.Bronchiectasis
b. Pulmonary Fibrosis
c. COPD
d. Acute on chronic bronchitis
/
e. Lung cancer
om
Patient had kidney transplant from cadaver.No urine output till the 7th postoperative day,
requiring dialysis. What is the cause?
A.Acute rejection
.c
B.Blocked catheter
sx
Patient with h/o melanoma in the past, now presents with frontal headache for 2-3 weeks,
u
Temperature 37.8 F, CT scan given…….
A. Brain abscess
pl
B. Glioma
C. Mets
r.m
Case of incarcerated hernia, patient was agitated after surgery, could not memorize the PO
day, BP less than 70mm Hg, SpO2 86%, X ray Hazy……
A. droperidol
B. Intubation
be
C. Ceftriaxone
Gout scenario with Heart failure, renal Failure, what to give,

A. Colchicine
em
B. Naproxen.
A 55-yeor-old man presents with a six-month history of increasing dysphagio for solid food. He has a
previous history, going back over many yeors, of gastro-oesophogeal reflux. He has managed his reflux
with antacids but, since the dysphagia started, his reflux has not been so troublesome. Which one of the
//m
following is the most likely diagnosis?

A. Corcinoma of the oesophagus. B. Achalasio of the oesophagus. C. Peptic oesophogeal stricture. D.
Poraoesophageal hernia. E. Ulcerative oesophagitis.
s:
tp
ht

MAR 2019 - MplusX QBank

Uploaded by

Copyright:

Available Formats

You might also like

MAR 2019 - MplusX QBank

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

MAR 2019 - MplusX QBank

Uploaded by

Copyright:

Available Formats

Get more from: MplusX Qbank (https://member.mplusx.

Hypertensive retinopathy – fundoscopy

New questions read about

Huntington’s with depression scenario

Lady old think worm in plate in rest home

B resperidine 0.5 mg mixed with dinner

Sudden infant sudden syndrome

,cm below ischial spine

Girl weight 34 kg , height 162 cm lost much

Wash with water

(Study CHAD score)

b. complicated ovarian cyst

(If automatism is given in options choose that)

2. Evening primrose oil

15-fetus with heart rate of 60. What investigation on mother?

Child born with bradycardia mcq anti to

Obese bmi35 , lipase inhibitor

Cyclophosmaide cystitis mcq

Carbamazepine hypertonic Saline

ECG atrial fibrillation

Ecg bradycardia Third degree block

Vancomycin slow infusionrecall

Viral pneumonia chest X-ray

Indian student Tb renal biopsy recall

Chads score calculate warfarin

Cadaveric donor renal transplant recall

Vancomycin slow infusion recall

friends. What is the best treatment option available?

4. coc pill without pill free interval

d. Acute on chronic bronchitis

Ecg mild hyperkalaemia , pt on ramipril, presented after syncope. Sodium normal,

d. spironolactone and frusemide

murmur persisted.What to do?

Aortic valve replacement

pt of crohns disese was on sulfasalzine prednisonlone,azathioprine labs given

neutrophils and wbc low hb low, cause

Q--CT Scan of RCC

Diastasis Recti or Epigastric Hernia...how to differentiate from these following questions???

scenrio of a schizophrenic patient walking naked in streets.which of the following is LEAST

effective for this patient.

may be some mistake:

D. Lesion in cerebral cortex

Ach receptor antibodies

Anorexic girl. What you will notice in her examination?

the patient? (Asking diagnosis)

pt on multiple drug HR 35 ,,bp 90/80 come to the emergency what to do next??

15-fetus with heart rate of 60. What investigation on mother?

Assalamualikum… MARCH 16th Melbourne

and BP o the pt is normal, CTG done.there is no abnormality.what next?

3.Scenario of a PE….LMWH therapy was given.what next?

4. pt taking multiple drugs..A ECG is given..(it was seemed bradycardia)

resuscitation.what will u ask to his son?

7.scenario of road traffic accident…CT was given.ASKED dx?

10. pt taking venlafaxine..what should b checked

fever 38.9 pulse 120/min. Bp normal. Wat is ur next management?

abdominal pain & vomitting. Gfr reduced.

ANA and Anti dsDna positive. Long term management?

b.ischaemic heart disease