MAR 2018 - MplusX QBank

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1. You are treating a psychiatric patient(opposite gender) . had good improvement, eventually
u r attracted towards patient and patient is interested in you too.
/
What will you do?
om
Slowly decrease his treatment and ask him to go to other doctor,
Stop seeing him and refer him to another dr and say him u cant treat him anymore,
treat him and after hour arrange a date
2. 9 year old girl brought by parents and concern about her recurrent upper and lower
.c
respiratory tract infection, examination she was pale other than that she looks Ok.
Ix shows low hb low mcv low mchc,
x
Asking what to do?
Genetic councelling
us
Dietary iron suppliment
pl
3.Ct picture like this. With sob and chest pain complain:asking management.
r.m
be
em
//m
s:
tp
ht
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4 . ecg clear with senario asking about treatment the idea of question is chads score the
options
a.aspirin
b. warfarin
5. ecg shows block and patient presented with light headness asking what is next
/
beta blocker
om
b.digoxin
holter
echo
.c
6.year old with croup admitted was improving. A day before discharge developed strior, chest
retraction, fever 39 chest auscultation low breath sound, trachea tug and all child looks ill.Cause
Epiglotitis
x
Bacterial tracheitis
us
bacterial Pnemonia
Pneumothorax
Rsv
pl
r.m
be
em
//m
7.Picture like this asking for school exclusion

s:
Can send now

tp
Send after starting antibiotics for 2 days

ht
8.Africa return man came with fever. He had taken all the travel medication drank strerilize water
use bed net. Took shower every day with local lake.
Check for malaria.
Dengue
Stool for parasite
9.Known case of ckd, htn on medication. Multiple.
Now was lethargic and blood picture k high (6.2) urea creat both high other than that all normal
/
value, gfr 20
om
Which drug cause so,
Spironolactone
.c
Acei
x
10.Young nurse with H/o of past 3 early miscarriage.She works as a nurse in the renal unit where
us
there was many cases of CMV..Most likely cause of Miscarriage?
A. CMV infection B.Chromosomal abnormality C.Maternal anticardiolipin Ab
pl
11.Breast feeding mother with mastitis lt breatscenario
I&d
r.m
Feed lt breat first
Throw the milk from lt breast

be
12.13 year old boy started soiling his pants since few weeks. was Ok before. he has mild
developmental delay (something happened 3 months back. dont remember but not mentioned
about sexual assault)why is this?
em
sexual abuse. behaviour problem
13. 16 year old gal came for hpv vaccine as she hear about that in school,
//m
Give her vaccine,
Ask parent before vaccine
Ask her to come back when she is sexually active

s:
tp
14. Old age man, on multiple drugs (including ACEI), experience three syncope after sexual
intercourse got out from a bed and went to a toilet.
• Vasovagal syncope
ht
• MI
• Stroke
15.acute glaucoma scenario ask to diagnose

16. 4 drug interaction questions
17. toddler diarrhea treatment
/
om
18.1 month diarrhea what to give . Lomotil
x .c
us
19. digoxin toxity ecg
pl
1. Patient recently diagnosed with Huntingtons Disease, he has been drinking, and acting erratic. The
r.m
police have brought him to ED as he was caught drink driving. What is your best next management?
a. Detoxification in ER
b. To refer him to Huntington support group
c. To send to drug and alcohol clinic
d. Admit and detoxify
be
2. What you will screen before introducing infliximab in a patient with Crohn disease?
a. QuantiFERON-TB Gold test
em
b. FBC
c. LFT
d. ECG
e. Urine cytology
//m
3. 58 year old woman after lifting some heavy thing , develops pain in the right buttock and
tenderness in her back at L4-5, has difficulty and restrictions of movement in extension and flexion
and rotations , what will you give beside analgesic?
s:
A- spinal xray
B- spinal mri
C- bed rest
tp
D- referral to orthopedics
E- keep active
ht
4. Old lady with back pain after falling, complaining there is pain in her rt lumbar region radiating
upto toe,on exam there was no neuro deficit,wat will be your mx?
a.Xray
b. Mri
c. Continue activity
5. Old man with back pain. Xray given which shows collapse of L4 or L3 as well as osteopenic bones.
Lumbosacral xray was done. On DRE examination prostate was found irregular. Which of the
following is the next best step?
a. MRI
/
b. PSA
om
c. DEXA
d. Bed rest
6. A 30 years old woman with increasing dyspnea, dry cough over few months with painful lumpy
skin lesions on legs and shins. On examination, there are red, painful, lumpy lesions in leg and
.c
bilateral ankle swelling. ACE level increased. Which of the following is the best next step to get
diagnosis? (No X-ray given)
x
A. CT scan chest
B. Skin biopsy
us
C. Blood culture
D. Aspiration
E. ANA
pl
7. Female Patient on sertralin, oxazepam, and daily drinking of one unit alcohol, after hospitalization
devolved agitation tremor, restlessness and paranoia
r.m
i think vitals were normal and there is no fever
A.. Alcohol withdrawal
B.. Serotonin syndrome
C..Benzdiazipines withdrawal
be
8. 40 yr fit n healthy woman came to OPD with incrasing jaundice, itchy skin n dark color urine for a
week otherwise no symptoms. On exam: she is obviously jaundice and scratch marks present.
4 weeks ago, she has URTI and treated with Amoxil-calvulonic acid, no other history of
em
hospitalization and no medication hisrory.

Lab value
ALP 410
BIL 80
//m
AST 150
ALT 180
GGT increased
USG: biliary USG IS NORMAL.
s:
what is your management for the patient?

a. Activated charcoal
b. Observation
tp
c. N acetyl cystein
d. Prednisolone
ht
e. Ursodeoxycholic acid (UDCA)
9. A schizophrenic patient admitted involuntary. He wanted to sue hospital against his admission. He
briefs that God wants to swim across Pacific Ocean. And he says other ppl in his religion have same
belief. What's most important justifying his continuing involuntary admission.
a. His poor insight

b. His belief at risk
10. Middle yr old man recently arrived from Africa with complaint of haematuria and splenomegaly
Hb is 8 . He tested malaria that was negative 3 days before he left from Africa .
/
a. recheck malaria immunoassay
om
b. schistosomiasis
c. giardiasis
11. 20 yr aboriginal man, alcoholic, smoker, drug abuser visits ur clinic with delirium, hypervigilence
after attending a party. What is first investigation?
.c
A. Alcohol level in blood
B. Urine drug analysis
x
C. Alcohol breath test
D. Blood sugur
us
E. Urea and electrolytes
12. CVS risk chart plotting for Non Smoker, 62 yrs aged Man, Diabetic, Cholesterol ratio 6.4, Systolic
pl
BP 182 mmhg.
13. 8yr old child brought by his mother , he complained from episode of staring suddenly that occur
r.m
along with fidgeting of right hand and movement of right arm head twitching to right side,
sometimes chewing and lip smacking each episode last for 60-90 second then the child remain dizzy
and confused for 1-2 minutes after the episode . These occurs in 3-4 days and then the child back to
his normal activity and behaviour for several weeks. what is the most likely diagnosis?
be
A- Temporal lobe epilepsy

B- Juvenile myoclonic epilepsy
C- Absence seizure
D- other don’t remember
em
14. H/O DVT HTN with DM patient on Warfarin, metformin, Statin. Recently started Amiodarone.
After 3 days pt got swelling at right thigh for 2 days and become painful and got fever 38. Right thigh
size is 4 cm larger than left. Diagnosis?
//m
A)Rhabdomylosis
B)Haematoma
C)DVT
D)Cellulitis
s:
E)drug reaction
15. Child (3-4 year) with fever 39C and history of cough unwell for 3 days. I think he has wheeze but
tp
minimal lung signs on exam. CXR given. Asked which investigation wud u do for further assisting in
diagnosis?
ht
a. pneumococcal PCR
b. pleural aspirate
c. blood culture
d. FBC
16. 50 years old male patient has sudden retrosternal chest pain and severe vomiting proceed by
pain. He has hypertension and controlled with thiazide. On examination, dullness lower left lung and
reduced breath sound on left lower zone of lung. Which of the following investigations to reach
diagnosis?
A. CT chest
B. Gastrografin swallow
/
C. Ultrasound
om
D. Echo
E. Chest Xray
17. Patient with RA she takes ibuprofen and methotrexate to control her disease, they mention the
time it was years for both of drugs, patient complains of upper abdominal pain, and her labs are
.c
given ALT, AST, GGT, even bilirubin all were high, which of the following cause this condition?
A. Methotrexate induced hepatitis
x
B. Ibuprofen induced hepatitis
C. Autoimmune hepatitis
us
D. Viral hepatitis
E. Alcoholic hepatitis
pl
18. Case of community acquired pneumonia was treated and got well on day three after giving 2
antibiotics (IV augmentin, oral roxithromycin) and given enoxaprin. On day five patient started
having fever 39F, chills and rigors associated with crepitation in right lower zone. Foul smelling
r.m
purulent white nasal discharge.
a. Empyema
b. Hospital acquired pneumonia
c. Drug hypersensitivity
be
d. Iv cannula bacteremia
e. Pulmonary embolism
19. Aboriginal lady has mitral stenosis and dyspnea for 6 weeks. On chest auscultation bilateral basal
em
crepts. Fever was 38. cough sputum. Chest xray given with bilateral mid zone opacities. Asked
diagnosis.
a. Pulmonary hypertension
//m
b. TB
c. Lymphoma
d. Left ventricular failure
s:
20. A 52 yr lady says to you her job makes her feel like she is a bull tied in a cage. She works longs
hours to support her family. Now comes to you for advise as she has had a Dexa showing -2.5
osteoporosis. Her serum ca is normal. What will you next?
tp
a. Ask her to join the gym

b. HRT
ht
c. Give Vit D
d. Alderonate
e. Zolendoric Acid
21. Child got superficial abrasions and lacerations after falling in a garden bed. He has h/o DTPa
vaccinations. Most app step after cleaning the wound?
a. give Tetanus toxoid and topical antibiotic cream

b. give tetanus toxoid and oral penicillin
c. give tetanus toxoid and immunoglobulin
d. DTPa and
/
e. DTPa and immunoglobulin
om
22. old lady with back pain ans T score showed osteoporosis, lady has esophageal ulcer and
dysphagia, what will you prescribe to her?
a. Alendronate
b. Ca vit D
.c
c. I/V Zolindronic acid
d. NSAID
x
23. An elderly woman on polypharmacy GFR was 6 weeks back came with dyspepsia,
us
was put on Olanzapine and antacids and is now presenting with confusion, loss of
appetite and nausea.
Sodium 129, k 5.3, calcium 3, phosphorus high, creatinine high, urea very high and
pl
bicarbonate 20, what is the reason for the confusion?
a) Uremia
b) hypernatremia
r.m
c) hyperkalemia
d) hyper calcemia
e) metabolic acidosis
be
24. Woman after death of her husband due to prostate cancer, lives alone, 6 weeks later loss of
appetite , thinks he died because of her infidelity . She had similar episode after the death of her
child. Prompt treatment asked?
a- Risperidone
em
b. venlafaxine
c. ECT
d. temazepam
//m
25. 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
management?
a. I/V infusion
s:
b. Cool blanket and ice pack

c. I/V Diazepam
d. Dantrolene Sodium
tp
26. A man was prescribed Selegiline for parkinson's. He was on Sertraline 100mg per day for
ht
depression and was well controlled on it. He developed abdominal pain and diarrhea. His BP was
high. What is the next appropriate step?
a. Stop Selegeline
b. Stop sertraline
c. Decrease the dose of sertraline
d. Decrease the dose of Selegeline
e. Stop both sertraline and selegiline
27. A 26 yrs autistic boy with mood disorder. He loves to stay alone. His relatives brings him to you,
During interview he gets agitated and goes out of the room. After a while he comes again in the
room. What will be the best pharmacological Rx?
/
om
a. Sodium valproate
b. Lithium
c. Sertraline
d. Resperidone
e. Olanzapine
.c
28. Mother Hep C positive, she comes for pre pregnancy councelling. What to avoid during
x
pregnancy to avoid transmission?
a.breastfeeding
us
b. vaginal delivery
c. Antivirals in pregnancy
d. Fetal scalp sample
29. Fournier’s gangrene initial management?

a. Wound debridement
pl
r.m
30. Lady comes on 10th post partum day with c/o pain in perineal tear which was stitched
immediately after delivery. On examination, a 2cm x 1cm x 0.5cm stitched area is now devoid of
sutures. No discharge. What will u do?
be
a. do nothing
b. antibiotics
c. stitch under LA
d. Stitch with excised margin
em
e.Keep the wound clean
31. 7 days old infant presented to you complained with poor feeing and bile stain vomiting. His birth
was at 38 weeks gestation and weight 2600g. He is breastfeeding with no immediate post natal
//m
complications. The child has a history of passing meconium on day 4 of birth. Now, he had mild
jaundice and abdominal distension present. What is the appropriate diagnosis?
a. Hirschsprung's Disease
b. Meconium Ileus
s:
c. Duodenal Atresia
d. Necrotizing Enterocolitis
e. Volvulus
tp
32. 7 day old neonate with jaundice started in day 4. Fully breastfed ..No vomiting. No change in
ht
stool color. Total bilirubin 240/conjugated bilirubin 120.What will be the advice?
a.USG abdomen
b reassure and review in 1 wk
c. stop breastfeeding and review
d. phototherapy
33. 39 weeks pregnant lady came with labour pain..she was put in left lateral position having oxygen
mask in place.iv fluids with syntocinon is running. Ctg was done which shows heart rate of 140 which
dropped to 70 and came back to 140 in 2min.asking next appropriate treatment.
a. Fetal scalp sampling
b. Continuuous ctg monitoring
/
c. Stop syntocinon
om
d. C section
34. 39 weeks pregnant lady came with labour pain..she was put in left lateral position having oxygen
mask in place.iv fluids with syntocinon is running. Ctg was done which shows heart rate of 140 which
dropped to 70 and came back to 140 in 4min.asking next appropriate treatment.
.c
a. Fetal scalp sampling
b. Continuuous ctg monitoring
x
c. Stop syntocinon
d. C section
us
35. Pt comes with H/O of unilateral temporal side headache for last 4 hours. He didn’t experience
such type of headache before. He is also complaining of mild neck pain of same side. Pain is not
pl
subsiding by taking regular pain killers. Pic of the pt is given below. What will be the next step in
management?
r.m
be
em
a. CT head
b. ESR
//m
c. Temporal artery biopsy

file:///C:/Users/hush/Desktop/31958563_10156509304812941_1503438772090437632_n.jpg
d. CXR
e. Visual evoke potential test
s:
36. A study wish to make a relation btw the fatigue in track car driver in high ways & the incidence of
tp
MVA happen. wt is the most suitable method to carry out study?

a. cohort
b. case control
ht
c. RCT
d. cross sectional
e. case study
37. Two groups are being studied for risk reduction for some disease with aspirin use. Tables are
given
as follows.
Aspirin used aspirin not used
Got disease and not got disease
Used aspirin Not used aspirin
/
Got disease 10 20
om
Disease free 990 980
Calculate NNT for this?
a. 10
b. 100
c. 1000
.c
38. 38 year old woman, smoker, come for contraception, she is in a relationship with her long term
x
partner, they do not want a baby and prefers to take pill. what would you give?
a. MIRENA
us
b. High dose COCP
c. POP
d. Barrier
pl
39. Patient with decreased Hb with cyclical menorrhagia. Hysteroscopy and D and C done. Both
normal. Wts next
r.m
a. MIRENA
b. progesterone from day 15-25 of cycle
c. oral tranexamic study
be
40. 24yrs old with dysmenorrhoea and menorrhagia asked to do investigation but she insist she
wants medication
a. mefenamic acid
b. tranexamic acid
em
c. ocp
d. iucd
41. Woman with a history of hysterectomy and DVT. Now complaining of hot flushes and insomnia.
//m
What will you give her?

a. Oral low dose estradiol
b. Transdermal estradiol
c. Progestogen only pills
s:
d. Hrt
e. sertraline(paroxetine)
tp
42. 9 yrs old with type 1 diabetes. on small n intermediate acting insulin. every morning high glucose
levels. what to do ?
ht
a. check blood glucose levels at 3 am

b. check early morning insulin levels
c. increase the evening intermediate insulin
d. give insulin before breakfast
e. give another dose before sleep
43. 12 year old girl at foster care. she's having difficult time in school in reading n writing . she has a
collection of her own toys and plays with them with her imaginary friend. her foster parents/ carers
are irritated bacons because she's picky at food. what immediate danger to her? (not future in
Question)
a. OCD
/
b. sexual abuse
om
c. drug abuse
d. Anorexia nervosa
e. schizophreniform psychosis
44. Patient with RA she takes ibuprofen and methotrexate to control her disease, they mention the
.c
time it was years for both of drugs, patient complains of upper abdominal pain, and her labs are
given ALT, AST, GGT, even bilirubin all were high, which of the following cause this condition?
x
a. Methotrexate induced hepatitis
b. Ibuprofen induced hepatitis
us
c. Autoimmune hepatitis
d. Viral hepatitis
e. Alcoholic hepatitis
pl
45. A patient with spiking fever, Shortness of breath and was inserted prosthetic heart valves 3
months ago. And diagnosis as due to Staph aureus IE, and given Flucloxacillin for treatment. The
r.m
fever subsides after 2 weeks of treatment, but SOB still persists, diastolic murmur at the left sternal
edge. What will you do for investigation?
a. Transthoracic Echo
b. Chest xray
be
c. Troponin
d. Blood culture for every week
e. CT scan
em
46. A man presents with bradykinesia, rigidity, given risperidone for visual hallucinations, he also
complaints of fluctuating forgetfulness and signs of parkinsonism. What is the diagnosis?
a. Lewy body dementia
b. Parkinson’s disease
//m
c. Alzheimer’s disease
d. Drug induced psychosis
e. Frontal lobe lesions
s:
47. Patient with weakness of the left upper limb, weakness of interosseous muscles and right plantar
response is equivocal, left is increased; reflexes are normal. What investigation will you do to reach
diagnosis?
tp
a. MRI cervical spine

b. Ach receptor antibodies
ht
c. EMG
d. CT brain
48. Patient with weakness of the left upper limb, weakness of interosseous muscles and right plantar
response is equivocal, left is increased; reflexes are normal. Which will be the best initial
investigation?
e. MRI cervical spine

f. Ach receptor antibodies
g. EMG
h. CT brain
/
49. Young aboriginal male presents to you with insomnia, fear of darkness and seeing “mamu”. He
om
has been having these symptoms after the death of his mother. Which of the following should be
next step in his treatment?
a. give him benzodiazepine
b. consult to aboriginal health worker
c. urine drug screen
.c
d. antipsychotic
e. drug and alcohol abuse counselling
x
50. A woman came for interview asked about appetite she said one doesn't get cheese from
us
moon and I came by bus What is diagnosis
a. Behavioral problem
b. Dissociation
pl
c. Depression
d. Delusion
e. Depersonalization
r.m
51. What’s the most important marker in finding health risk of obesity?
a. BMI
b. waist circumference
be
c. waist hip ratio
52. Women on multiple drugs one of them was digoxin, she presented with central abdominal pain
and tenderness. Her pulse was irregular. Apart from a contrast abdominal ct what is appropriate
em
next investigation?
a. Abdomen USG
b. Serum Lipase
c. Serum lactate
//m
d. Digoxin level
e. INR
53. Teenage girl (around 16years) with anorexia nervosa BMI 13 refusing tube feeding. On which
s:
occasion tube feeding can be given without her consent?

a. consent from her parents
b. permission from director of hospital
tp
c. recommendation of two psychiatrist

ht
A young male travelled to Asia and upon arrival he developed a of cough and mild fever as well as
epigastric pain for a duration of 2 weeks, what is the likely cause? X ray given
a. viral pneumonitis (exact words)
b. pneumonia pneumococcal
c. fungal infection
d. tuberculosis
55. A 6 month old child came with recurrent upper respiratory infection. The immunization history
reveals that the child has received his hepatitis B vaccination at his birth and no further
immunization history at 2 and 4 month of age due to recurrent upper respiratory infection. Now the
child has fever 37.8 and clear nasal discharge. What is your management regarding immunization?
/
a. Give hepatitis B immunization and institute catch up schedule
om
b. Give hepatitis B immunization and recommence standard schedule
c. Investigate underlying cause of URTI
d. Give hepatitis B immunization after fever subside
e. Give hepatitis B immunization at now
.c
56. A primigravida lady 32 weeks of gestation smokes 30 cigarettes per day comes to your clinic with
the complaints of mild pedal edema and SOB.On examination lung is clear, O2 saturation is 90%.
x
What will be your next step of management?
a. V/Q ratio
us
b. CXR
c. ECG
d. ECHO
pl
e. CTPA
57. A 25 yrs old man comes to your clinic. On examination you find systolic murmur in left sternal
r.m
border. His elder brother died at the age of 40. What is your dx?
a. HOCM
b. MS
c. MR
be
d. TR
e. Hyperthyroidism
58. A girl going on a low-cost travel. Past history of polio, MMR at young age. What vaccine are you
em
going to give her?

a. Polio
b. MMR
c. Polio, MMR, dTpa, tetanus
//m
d. Polio, MMR, tetanus
59. Grandfather had Huntington, now mother come with daughter for Huntington genetic testing.
Your advice?
s:
a. Arrange Genetic counselling of daughter

b. Arrange counselling whole family
c. Genetic counseling of mother & daughter
tp
d. Wait till the girl becomes 16 then test her

ht
60 Pt has chest pain for 4 hours, now relieve 4/10. He is taking ramipril atovastatin aspirin
now no murmur , no dyspnea , BP normal. What should be the next step after giving O2..
/
om
x .c
a. Morphine
b. Clopidogrel
us
c. Thrombolytics
d. Nitroglycerine
e. Frusemide
pl
61. Prostate cancer last two years PSA was 1.5mg/ml, now PSA is 3.8mg/ml, then 12 slides of biopsy
done and only one foci showed adenocarcinoma. Gleason score is 4. How will you manage this
r.m
patient?
a.TURP
b.radical prostatectomy
c.active surveillance
be
d.EBRT
e. Androgen therapy
62. 50 old man , ( liver disease scenario with gynecomastia , swollen parotid glad and testes, agitated
em
, confused ) High temperature 39 , ascites moderate . What to do next ?

a. FBC
b. Abdominal paracentesis
c. Check ammonia level
//m
d. Abdominal USG
63. Primigravida gave birth at term to 3200g baby,normal vaginal delivery without any complications
and there was slight meconium staining of liquor.Baby was normal at birth with normal heart
rate.After 1 minute,suddenly stopped breathing.HR decreased.Cyanosed.Noresponse on
s:
stimulation.What is the most appropriate next step?

a. Intubate
tp
b. Bag and mask ventilation.

c. Nasopharyngeal aspiration of meconium
ht
64. A woman works at a part-time job (OFFICE CLEANER), and complaints of early morning headache,
frontal & bilateral, dull in character, varying in intensity, she takes paracetamol & ibuprofen, which
only cause relief for 2-3 hours. What is the cause?
a. Drug rebound headache
b. Migraine
c. Tension headache
d. Cerebral tumor
e. Pre-menstrual headache
65. A young man complaint, he noticed a swelling in his groin after lifting weight yesterday, on
/
examination there was 1cm defect in inguinal area with fat protruding in the inguinal canal. On
om
ultrasound, the defected is protruded from deep inguinal ring. What will be the next appropriate
treatment?
a. Reassurance
b. Herniorrhaphy
c. Open repair with mesh
.c
d. laparoscopic herniorrhaphy
x
66. An old lady who gets beaten up by his drug addict son. best advice to keep her safe?
a. tell her that u have to inform the police
us
b. urge her to go to the police
c. tell her to go to the refuge center
d. tell her its her right to inform the police
pl
e. send the son to correctional facility
67. Patient with BMI 35. What is the best management for long term weight maintenance together
r.m
with exercise?
a. Low Carbohydrate diet
b. 4000 kJ/day
c. Lipase inhibitor
be
d. Regular health care review and follow up

e. Surgery
68. Young man with tibia fibula fracture. Pt had deep laceration over fracture site. After giving
em
tetanus whats the next appropriate management.

a. Debridement
b. Internal fixation
c. External fixation
//m
d. antibiotics
71. A woman brings her husband after prostatectomy, he has become extremely angry, becomes
aggressive over trivial things.what wil help u to identify the problem ?
s:
a. history of drug abuse

b. history of domestic violence
c. worsening of symptoms at night
tp
72. Pic of dupyetrens contracture scenario was 63yrs old farmer complaining difficulty to do works
ht
due to his hand deformity,he is smoker,drinks 4 cans of beer a day, he had cut injury to this same
finger one yrback,was delayed in healing,wat is the cause of it?
a. Alcohol
b. Smoking
c. Because of farmer
d. Cut injury
73. XRAY of a pt went saudan and now c/o cough anorexia sputum typical xray of tuberculosis given
asking first step in management?
a. antibiotics oral
b. isoniazide rifampicin ethumbutol and pyrazinamide
/
c. admission in isolation
om
d. bronchodilators
74. A girl with depressive symptoms and when asked said “what’s the meaning of life. What’s most
important in management
a. liaison with father
.c
b. discuss safety plan with her and parents
x
75. 23 yr female epistaxis, headache, malaise, dizziness, LABS: Hb-8.5 Ca-1.9 INR-1.5 Ferritin ↓
a. Iron
us
b. IV calcium
c. IV Vit K
d.blood transfusion
pl
76. old patient found unconscious at home brought by son to emergency department . the patient
was taking tablets methadone, oxycodone , others , patient has constricted pupil on examination
r.m
which of the following drugs level you want to measure?
a. methadone
b. oxycodone
c. cocaine
be
d. Ciprofloxacin ear drops

e. Paracetamol
77. A pt came with loin pain and hematuria what is the most app step ?
em
a. CT abdomen
b. IVU
c. USG
d. xray
//m
79. A scenario of COPD. Patient was treated with augmentin and some other antibiotcis. Was on
inhaled salbu and ipneb 8 hourly and oral prednisolone 30mg/day. Was not getting better. Had
yellow sputum. Became dyspneic. ABGs done. pH 7.35. pCO2 50. pO2 80. HCO3 35. What to do as
s:
the most appropriate next step?

a. Bronchodilator 4 hourly
b. Change augmentin to ceftriaxone
tp
c. Change oral predniosolone to IV hydrocortisone

d. Admit in ICU for intubation
ht
e. CPAP
80. Woman was on trifluperazine .she was ok before with some hand rigidity. She couldn’t find her
doctor after trip.now complain of voice in head.tx
a.Trifluperazine
b. Resp depot
c. Quetiapine
d. Haloperidol
e. Clozapine
81. Patient developed gynecomastia and nipple milk discharge while on amisulpride, what to do
/
a. Change to aripiprazole
om
b. Change to clozapine
c. Change to Haloperidol
82. 50 years old lady , otherwise well. Coming with presenting complaint of palpable mass slight to
right away from midline. Not attached to peritoneum .
.c
a. GIST
b. Retroperitoneal Sarcoma
x
c. Ovarian Carcinoma
d. Endometrial Ca
us
83. Incisional hernia scenario…..this guy had midline incision and developed a swelling on the
incision line…no picture given….asking what will help you diagnose it?
pl
a. Ask the patient to stand and cough
b. Ask the patient to lie down and cough
c. Ask the patient to lie down and raise the head to chest
r.m
be
em
//m
s:
tp
ht

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7.Picture like this asking for school exclusion

Can send now

Send after starting antibiotics for 2 days

Check for malaria.

Stool for parasite

9.Known case of ckd, htn on medication. Multiple.

Throw the milk from lt breast

sexual abuse. behaviour problem

Give her vaccine,

Ask parent before vaccine

Ask her to come back when she is sexually active

15.acute glaucoma scenario ask to diagnose

16. 4 drug interaction questions

17. toddler diarrhea treatment

hospitalization and no medication hisrory.

what is your management for the patient?

e. Ursodeoxycholic acid (UDCA)

a. His poor insight

A- Temporal lobe epilepsy

a. Ask her to join the gym

a. give Tetanus toxoid and topical antibiotic cream

b. Cool blanket and ice pack

e. Stop both sertraline and selegiline

29. Fournier’s gangrene initial management?

e.Keep the wound clean

c. Temporal artery biopsy

MVA happen. wt is the most suitable method to carry out study?

What will you give her?

a. check blood glucose levels at 3 am

a. MRI cervical spine

e. MRI cervical spine

c. waist hip ratio

occasion tube feeding can be given without her consent?

c. recommendation of two psychiatrist

going to give her?

d. Polio, MMR, tetanus

a. Arrange Genetic counselling of daughter

d. Wait till the girl becomes 16 then test her

, confused ) High temperature 39 , ascites moderate . What to do next ?

stimulation.What is the most appropriate next step?

b. Bag and mask ventilation.

d. Regular health care review and follow up

tetanus whats the next appropriate management.

a. history of drug abuse

d. Ciprofloxacin ear drops

the most appropriate next step?

c. Change oral predniosolone to IV hydrocortisone

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