Sept 2020 Recall

1. a baby with a pink lump on her umbilicus, no pain, no redness, baby eats well and gains
weight. The appropriate topical mngt:
A. Fusidic avod
B. Silver nitrate
C. Hydrocortisone
D. Anti fungal
E. Table salt

2. A child with ADHD , ON methylphenidate with insomnia, best mngt

A. Increase dose
B. Reassure
C. Change dose to lixme something

3. A man playing football when he felt a snap, and could not plantar flex his foot
A. Achillis tendon rupture
B. Dvt
C

4. 54 year old woman with thick creamy discharge from one duct on her left breast.
Diagnosis?
A. Duct papilloma
B. Ca breast
C. Duct fistula
D. Mastitis

5. 4 weeks old baby with non billous vomiting, eating well and not gaining weight, most
appropriate invex
 A. Abd uss
B.
6. A 25yr old man with dizziness, headache and horizontal nystagmus. He had history of
urti few days ago
A. Acoustic neuroma
B. Vestibular neuritis
C. Menniers dz

7. A baby presented to A&E after he that fell from his bike, hit his head and loss
consciousness. He xould not remember what happened. Appropriate invex
A. Reassure
B. Urgent ct scan
C. Xray of the head

8. A man that had surgical procedure and was being discharged. His fasting blood sugar has
consistently been high for the past 2days, his glycated haemoglobin is 60. His BMI is 32.
What medication do you prescribe
A. Metformin
B. Sulphonylureas
C. Reassure
D. Repeat FBS

9. A woman with 4days hx of blurry vision and red eye, her anti depressant was recently
changed from fluoxetin. What to do
A. Refer urgently to optician
B. Refer urgently to ophthalmologist
C. Prednisone

10. A woman who presents with tiredness and lethargy for 3weeks. She was diagnosed with
RA 12 years ago and has been on methotrexate and naproxen twice daily. Her hb is low,
MCH id low, others are normal. Cause of her lo hb
A. Anaemia of chronic dz
B. Side effect of methotrexate
C. Chronic bleeding
 11. A woman that has shoulder and hip pain. Limited range of movt in her shoulder, but no
mzle tenderness. Xray of her wrist shows thicked calus. What medication to give
A. Nsaid
B. Prednisone
C. Pcm

12. A woman with metastasis to the vertebra, codeine medication is not helping anymore,
reacted to ibuprofen some time. Most appropriate next step
A. Naproxen
B. Diclofenac
C radiotherapy

13. Medidation to give a woman with osteoporosis to prevent further bone fracture
A. Alendronate
B. Steroid

14. Ecg question on a 25yr old man with light headed headedness and PR of 190, carotid
massage is not helping, what to do next
A. Iv adenosine
B.iv amiodarone
C. Dc

15. And eye picture of a woman with high BP, the diagnosis
 16. An asthmatic boy with breathlessness, already on steroid, salbutamol, and ipratr. Next
best medication
A. Iv mgso4

17. A girl that has breathlessness, rash and swollen lips, with wheezing. Allergic to peanut
and ate something at a party. Most appropriate
A. Iv adrenaline
B. I'm adrenaline

18. 8 week week old well breastfed child with persistent prolonged jaundice.
Investigation?
Phototherapy
Liver function test with conjugated bilirubin.

19. A girl with menorrhagia, dysmenorrhoea and irregular menstrual period. Not sexually
active. Best medication
A.COCP
tranexamic acid

20. A man with alport syndrome, and a health pregnant partner. Scan confirmed baby is
male. What's the chance of baby developing alport

21. 5 week old child with difficulty in breathing, mild fever, wheeze ?? What is the best mgt?
A Nebulised saline
B admit and monitor feeds
 22. A man that had rta with multiple bruises. Had ORIF of femur fracture, and developed
breathlessness 12hours later. Cause
A. PE
B.fat embolism

23. A child with worsening headache photophobia, vomited 4 times, with fever of 38.1, NO
RASH. What is the most appropriate investigation?
A Blood culture
B Lumber puncture
C FBC
24. A man previously chest drain, started having breathlessness after the drain was
removed.decrease spo2. What to do
A. Prescribe antibiotics
B. Call senior surgeon
C. Put chest drain

25. A boy with features of renal failure 2 weeks after having sore throat
A. Post infective glomerulonephritis
B. Ig A nephritis

26. A question on left sided facial pain, sharp that radiates from jaw to head. Diagnosis

27. Dementia with hx of atrial fibrillation and hypertension

A. Dementia
B.Vascular dementia
C.Lewy body
 28. 16 year old girl with menorrhagia, dysmenorrhea and irregular period
A.Tranxanemic
B.Mefenamic
C.cocp
D.ius

29. Question about vertigo with facial something

Cnt remember

30. Hungtintons’s percentage

31. Image on TB, where to send the patient

A-Direct positive pressure
B-Negative pressure
C-Infectious dxs dept

32. Question on what to give to a pregnant woman with constipation

There was no lactulose in d option

33. Two questions about urinary incontinence

A. Pelvic floor exercise
B. Urinary cathether
(No bladder training in options)
1. The question on a woman with stress incontinence. She has four children. Initial mngt
A. Pelvic floor exercise
B. Oxybutinin

2. Question on a 62 Yr old mam with incontinence and excoriations. He has a pelvic mass
protruding. What to do
A. Urethral catheter

34. Question on woman that had breast cancer therapy+axillary clearance plus swelling
A- Lymphoedema

35. 10 year old boy, systolic murmur

A-atrial septal defect
B-tof
C- vsd

36. A boy fell from his bike, he couldn’t remember the event, however, investigations and
vitals are stable
(No reasure in d options)
A-observe within 4 hrs and discharge
B-24hrs observance

37. A baby with clindactyly, single palmar crease, had systolic murmur. What is the cause of
the murmur?
A VSD
B ASD
C PDA
D pulm stenosis
 38. 50 year old woman, had hot flushes, night sweats, she is a smoker and takes alcohol with
well controlled HTN. Mgt?
A HRT
B clonidine
C

39. A 30 year old woman has hot flushes, night sweats and mood swings. Her lmp was oaths
ago. Diagnosis
A. Premature ovarian failure
B. Menopause

40. A patient has received 15 units of blood transfusion, what is the electrolyte abnormality?
A Hypokaelamia
B Hypocalcemia
CHypomagnesemia
D Hypernatremia

41. A 23yr old girl who has not seen her period for 6mnths. Preg test is negative, incteade
testosterone

42. Another questions on a girl with no public hair, breast and axillary hair. She is short. No
history of gene abn in her family

43. Question on what to give to a depressed man( no fluoxetine, no sertraline in f options)

A-citolapram
B-quietipine
(There's one on a depressed man with previous MI. Setraline was in the options)

44. Question with some controversy-the protein in urine was recorded as 1.5grams( not
microgram)
A-pre eclampsia
B-gestational hypertension
C-chronic hyper

45. Question on an autistic boy had refused treatment, what to do

A- hold a best interest meeting
B-discharge him
C-get a court order

46. 80kg man to receive 0.5% of lidocaine. Safe dose to give is 3mg/kg. He already received
20mls. How many mls left to give him

47. Question on pelvic repair and becam breathless after a while

A-fat embolism
B-other options can’t remember

48. Patient who jus had a surgery, and diabetic. Lifestyle hasn’t helped. Bp-high. Hba1c
high-60, bld sugar of 11. No eGfr amongs the tests done
What to give( very dice one)
A- metformin
B-rainproof
C-gliptins
D-
 49. A woman started vomiting few days after chemotherapy + tingling sensations in d hands
A-chemotherapy induced neuropathy
B-hypocalcemia

50. Question on a px that feels pain in fingers and pain whenever she is in d cold( Rh.pheno)
A-beta blocker
B-nifedipine
C. Plim rose oil

51. Question on epileptic ma with learning disabilities. He has been refusing his medications,
and had fit. Best way to manage him. The patient also has no capacity
A. Court order
B. family meeting or so
C. Convert medication or so
D. Give medications via NG tube

52. a pregnant female at, nearly, 38wks gestation with painful vaginal bleeding, TVUS
showed fetal heart rate of 180, options
A. placenta previa,
B. Vasa previa,
C. placental abruption

53. A child who had nephrotic syndrome and had been on prednisolone for 2 weeks came in
contact with chicken pox person a day ago. Most appropriate step.
A. Stop prednisolone
B. Reduce dose of prednisolone
C. Give varicella immunoglobulins

54. A man who suffered trauma to the hand following which he’s unable to flex the
metacarpophalangeal and proximal interphalangeal joints of middle finger. What
structure was involved
A. Flexor digitorium profundus
B. Flexor digitorium superficialis
C. Ulna nerve

55. Neonate with a pinkish soft wet lump on the umbilicus. Treatment.
A. Silver nitrate
B. Fusidic acid
C. Topical miconadole
D. Hydrocortisone

56. A question on dripping of blood per rectum afte defecation. No pain + constipation. What
test to arrive at diagnosis?
A-cystoscope
B-proctascopy

57. Patient with several episode of acute pancreatitis in the past. Presented with floating
stool.
Investigation to do.
-Fecal elastase

58. Ethics question on a lady who had a previous history of DVT/PE(dont remember). Had a
surgery and following surgery developed a DVT. She was previously on clopidogrel but
was stopped 10days to surgery. What to do (think husband wanted to know what
happened)
A. Disclose full information to husband and apologize
B. Disclose full info and do not apologize
C. Contact ethics liaison something

59. There was a question with a lady with blood on tissue and once the blood trickled out. An
investigation showed an ulceration and granuloma. Also has some inflammation of some
sort at the anal region.
A. Ulcerative colitis
B. Crohns

60. There was a question with a man who had inflammatory changes of the lower
oesophagus. And had a history of hiatus hernia.
A. Barret oesophagus
B. Achalasia

61. 3 yr old boy who has eczema. It’s controlled by emollients. Developed lesions on the
face, mouth ulcers and around the eczema lesion. Treatment?
A. Antiviral
B. Antibacterial
C. Antifungal
D. Corticosteroids
E. No treatment required

62. A 17 year old girl with amenorrhea. Short among her peers. No secondary sexual
characteristics. No family history of genetic abnormalities. most likely diagnosis
A. Turners
B. Panhypopituitairsm
C.Gonadla dygenesis
 63. A child who had nephrotic syndrome and had been on prednisolone for 2 weeks came in
contact with chicken pox person a day ago. Most appropriate step.
A. Stop prednisolone
B. Reduce dose of prednisolone
C. Give varicella immunoglobulins

64. A patient with painful red eye, irregular pupil, flourecein test negative.
Diagnosis?
A. Anterior Uveitis
B. Glaucoma

65. A 2 day old baby whose mother is worried about hearing problems because she had
deafness and on bilateral hearing aid.
What investigation?
A. ABR
B. Distraction test
C pure tone audiometry

66. Osteoarthritis patient with pain, has peptic ulcer and on PCM but still having pain.
What is the next mgt option?
A. Codeine
B. Ibuprofen
C. Naproxen
D. Tramadol

67. A px underwent TURP what kind of electrolyte imbalance will u find

A-hypokemia
B-hyponatremia
C-hypermag etc

68. 50 yr old old woman who hasn't seen her period for 8 months, having serious hot flushes,
insomnia, a smoker.Rx:
A.Clonidine
B.HRT (estrogen & progesterone)

69. A woman caught shoplifting by police and she started cutting herself with objects.
Police is asking you for the woman's medical records;
A. Inform police to apply officially to the hospital
B.Ask patient's permission before giving her medical information
C. Refuse to giving out any information.

70. A young lady with foul smelling vaginal discharge, having vulvovaginitis PH 4.5, no
lower abdominal pain, cervix was normal, what's causative organism?
A.Chlamydia
B.Gardnerella
C.Candida

71. A man having Osteoarthritis on pcm, he started NSAID gel topical but stopped, he has
gastric ulcer, what to use to handle his pain?
A. Naproxen
B. Ibuprofen
C. Tramadol
 72. A man that present at emergency very aggressive, what to use to call him down?
A. Holoperidol
B. Lorazepam
C. Diazepam

73. A child from Bangladesh that always refuses to eat her food in school likes drinking milk
only in school, she present with tiredness. Hb 6.7 MCV 68 . What's the cause of her
symptoms?
A. Thalassemia
B. Dietary insufficiency

74. A question on a 16 week pregnant woman who was worried about hereditary transmitted
disorder and needed a test to check. Can’t really remember all details. What test to
perform?
A. Amniocentesis
B. Chorionic villus sampling
C. Preimplantation test

75. There was this question on a man that had sudden visual loss for some minutes, can't
remember the full details, what artery has the defect
A. ACA
B. Post cerebral artery
C. Post inferior cerebral artery
D. Middle cerebral artery

76. A 2day old baby whose mother is worried about hearing problems bc mother had
deafness and on bilateral hearing aid, what investigation to do
A Audiological brain stem response
B distraction
C condition brain stem response

77. A pregnant woman at 24wks with constipation already on high fibre diet with increased
fluid intake but still constipating, most appropriate mgt.
A phosphate enema
B glycerin suppository
C sena
D ispahulla huxa

78. A hypertensive with uncontrolled hope a pics of hypertensive retinopathy asking for
diagnosis
A hypertensive retinopathy
B diabetic retinopathy

79. A diabetic with post op blood glucose of 11, glycated hemoglobin of 60 , BMI of 28 and
already done life style modification with 2kg weight loss , ACR of 2.4 asking for the next
management option
A metformin
B sulfoniureas
C ramipril
D aspirin

80. ECG of atrial fibrillation asking forgiveness mgt

A Metroprolol
B DC shock

81. A patient with sudden visual loss for 30mins and resolved what artery affected
A PICA
B PCA
C ACA
D MCA
82. A patient with painful red eye, irregular pupil, flouricein test negative diagnosis?
Anterior uveaitis
83. A patient with osteoporosis what is the most appropriate mgt
A bisphosphonate
B steroids
C NSAIDs

84. Osteoarthritis patient with peptic ulcer on pcm but still having pains what is the next mgt
option
A codeine
B ibuprofen
C Naproxen
D tramadol

85. A female patient whose mother had breast Ca and investigations shows she has BRACA
1, what is the mode of inheritance ?
A x-linked
B Autosomal dominant

86. A 21yrs old whose father has Huntington chorea asking of the possibility of the 21yr old
getting it
A 0%
B 50%
C 25%
D 100%
 87. A man with Alport dz, wife is pregnant with a male child asking for the possibility of him
passing to his son
A 0%
B 50%
C 25%
D 100%
88. An 8wk old child who is well breastfed with prolonged jaundice what is the next mgt
option
A physiotherapy
B liver function text & conjugated hemoglobin

89. A child with fever, mouth ulcer, rash on hands and palms
A coxakie virus
B staph areus
C streptococcus pneumo

90. A 5wks old with difficulty in breathing, wheeze, mild fever what is the best mgt
A nebulised saline
B admit and monitor feeds

91. A child that fell from the bicycle presenting to the emergency with loss of consciousness
for 10mins and vomiting, what is the most appropriate investigation
A CT of the brain
B MRI
C reassure
D x-ray of the head
 92. A child with worsening headache, vomited 4times, photophobia with fever of 39.1 what
is the most appropriate investigation?
A blood culture
B FBC
C lumber culture

93. A child with projectile vomiting, eager to feed and has lost weight, what is the most
appropriate investigation?
A ABD Uss
B ABD x-ray

94. A child with clindactily, slanting palpebral fissure, single palmar crease and a systolic
mumur, what is the cause of mumur
A ASD
B PDA
C VSD
D PS

95. A Patient with BPPV and halpikes has already been done, what is the treatment?
A eplys
B others

96. A 50yr old who smokes and takes alcohol with well controlled hypertension with hot
flushes, night sweats what is the mgt?
A Estrogen and progesterone HRT
B clonidine
 97. A young girl with irregular and heavy menstrual bleed and not sexually active, most
appropriate mgt
A COC
B Transcemic acid

98. A patient with oligomenorrhea, obese, high FSH and LH, diagnosis
A PCOS
B POF
C hypothyroidism

99. A 35yr old with amenorrhea, hot flushes , night sweats, diagnosis
A CAH
B POF
C PCOS

100. A patient with weakness, lethargy, abdominal pain, bp of 95/64, hyperkalemia

and hyponatremia what is the deficient hormone
A addisons

101. A patient who has received 15units of blood transfusions, what is the likely
abnormality
A hypomagnesamia
B hypernatremia
C hypocalcemia
D hypokalemia
E hypermagnisemia
 102. A pregnant woman at, nearly, 38wks gestation with painful vaginal bleeding,
TVUS showed fetal heart rate of 180, options
A. placenta previa,
B. Vasa previa,
C. placental abruption