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INTRODUCTION PACK

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2013
ros.org
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#usmle smle
bryology y #u
#neuroem
#neuroembryology #usmle log
bryo
roem 2013
#neu www.neuros.org

These flashcards are helpful for

R
E FFE #USMLE
T IM RY O #MBBS
D O
M ITE UCT #PGexams
L I D
RO #Internship
INT
$3 ONLY #medicalstudent
FOR A PACK WORTH $35
 INTRODUCTION
Neuros is a unique social network that brings to medical students and profes-
sionals, a taste of both social networking & learning. At Neuros, one can
connect with others socially as well as intellectually. Apart from users contrib-
uting to the knowledge pool, the team at Neuros creates quality answers,
charts, mnemonics, flashcards, illustrations & MCQs too.

These 40 flash cards are an introductory set to the yet many more categorized
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Once you are doing going through these flashcards - do signup & be a part of
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 INTRODUCTION
A lot of hardwork was put in the creation of these flashcards, please donot put
them for free download at other forums, websites or torrent sites. Its a humble
request.

This set of Flashcards belong to:

NAME: Atif Gazali

COUNTRY: Malaysia
PROFESSION: Medical

2013
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 CONTENT
The flashcards contain the following:

Anatomy
Dermatology
Electrolytes
Microbiology
Pulmonology
Cardiology These include illustrations,
Neurology
Physiology
mnemonics, charts, MCQs
GIT medicine
Pharmacology
Rheumatology
Micrbiology
Endocrinology
MCQs

2013
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 ANATOMY #01

What brain structures

are derivated from
the following:

Prosencephalon

Mesencephalon

Rhombencephalon

#neuroembryology #usmle
2013
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 ANATOMY #01

#neuroembryology #usmle
2013
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 DERMATOLOGY #02

In which conditions, do you see these types of face

rashes?

#rheumatoloy #musculoskeletal #usmle

2013
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 DERMATOLOGY #02

HELITROPE RASH MALAR/DISCOID RASH

seen in DERMATOMYOSITIS seen in SLE

#rheumatoloy #musculoskeletal #usmle

2013
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 ELECTROLYTES #03

How would you work up a case of Hypernatremia, to

distinguish causes.

Hypernatremia is high levels of Sodium in the

body. The normal range is: 135-145 meq/L

#sodiumlevels #endocrinology #usmle

2013
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 ELECTROLYTES #03
INITIAL TEST: WATER DEPRIVATION
POSITIVE NEGATIVE

DIABETES INSIPIDUS OTHER CAUSES

SWEATING
BURNS
ACCURATE TEST: ADH LEVELS FEVER
DIARRHEA
DIURETICS
HIGH LOW

NEPHROGENIC CRANIAL
ALSO GIVES POSITIVE RESPONSE TO ADH

#sodiumlevels #endocrinology #usmle

2013
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 MICROBIOLOGY #04

What do you know Cytoplasm

about Entamoeba
Histolytica?

- Source of Infection Ingested RBCs

- Route of Infection Central Karyosome
- Clinical features
- Lab Diagnosis
- Motility
Pseudopodia
- Treatment

#amoebiasis #usmle
2013
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 MICROBIOLOGY #04
Infection with Entamoeba Histolytica affects humans &
primates. About 50million of the world’s population is
infected by the parasite.
Source of infection: Cysts in contaminated water
Route: Ingestion
Clinical features: Vomitings, Bloody Diarrhea & Abdomi-
nal pain (RUQ) & Liver abscess
Lab Diagnosis: Stool exam, Serology (ELISA, RIA)
Motility: Progressive & Directional using Pseudopodia
Treatment: Metronidazole

#amoebiasis #usmle
2013
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 PULMONOLOGY #05

What is the treatment of Asthma?

#asthma #mnemonic #medicalstudent #mbbs

2013
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 PULMONOLOGY #05

A - adrenergic agonist
S - steroids
T - theophylline
H - hydration
M - masked O2
A - anticholinergics

#asthma #mnemonic #medicalstudent #mbbs

2013
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 ANATOMY #06

BASE

CUBITAL

BRACHIO
FOSSA
PR
What are the contents of ON
the cubital fossa? AT
OR

RADIALIS
TE
RE
S
APEX

#upperlimb #medicalstudent #mbbs #PGexams

2013
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 ANATOMY #06

The contents of the fossa are:

1) Medial nerve
2) Termination end of brachial artery
3) Tendon of biceps & Bicipital aponeurosis
4) Radial nerve

#upperlimb #medicalstudent #mbbs #PGexams

2013
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 CARDIOLOGY #07

What are the stages of Heart Failure?

According to NYHA classification

#dyspnea #medicalstudent #mbbs #PGexams

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 CARDIOLOGY #07

1
MILD ORDINARY PHYSICAL ACTIVITY DOESNT CAUSE
DYSPNEA, FATIGUE OR PALPITATION

MILD
2 COMFORTABLE AT REST, BUT ORDINARY PHYSICAL
ACTIVITY CAUSES DYSPNEA, FATIGUE OR PALPITATION

MOD
3 COMFORTABLE AT REST, LESS THAN ORDINARY
ACTIVITY CAUSES DYSPNEA, FATIGUE OR PALPITATION

SEV
4 UNCOMFORTABLE AT REST, UNABLE TO CARRY OUT
ANY PHYSICAL ACTIVITY WITHOUT DISCOMFORT

#dyspnea #medicalstudent #mbbs #PGexams

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 NEUROLOGY #08

A person comes to the ER with

complains of sudden onset of uni-
lateral headache, tearing eye and
rhinorrhea.

What is the most likely diagnosis?

#headaches #usmle

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 NEUROLOGY #08

The most likely diagnosis is Cluster Headache which is

characterized by unilateral headaches associated with
tearning eye & nose. The eye may also turn read. This con-
dition is associated with Horner syndrome.

The best way to treat it is 100% oxygen therapy in the ER

#headaches #usmle

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 PHYSIOLOGY #09

Try to recall some of the causes of LOW & HIGH ESR

Eythrocyte Sedimentation Rate

#hematology #infections #usmle #medicalstudent #mbbs #PGexams

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 PHYSIOLOGY #09

LOW ESR HIGH ESR

Polycythemia Inflammation
Leukocytosis Infections
Sickle cell Cancer
Abnormal proteins Autoimmune

*Temporal arteritis
Polymyalgia
Rheumatica

Hr
FIGURE: ESR TIMELINE
#hematology #infections #usmle #medicalstudent #mbbs #PGexams

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 GIT MEDICINE #10

What does pain in the left iliac region indicate?

What is the most common cause in the elderly?

#abdominalpain #usmle #medicalstudent #mbbs #PGexams

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 GIT MEDICINE #10
Esophagitis
Peptic Ulcer
Perforated Ulcer Spleen Abscess
Gallstones
Pancreatitis Acute Splenomegaly
Cholangitis
Spleen Rupture
Hepatitis
HYPO HYPO
Liver Abscess
CHONDRIAC CHONDRIAC
Cardiac Causes Appendicitis (early)
Lung Causes Mesenteric adenitis
EPIGASTRIC
Meckel’s diverticulitis
Lymphomas
The most common cause
TRANSPYLORIC PLANE

in the elderly is: Ureteric Colic

Pyelonephritis
RIGHT UMBILICAL LEFT Ureteric Colic
Pyelonephritis
LUMBAR LUMBAR

Diverticulitis TRANSTUBERCULAR PLANE T 10

HYPOGASTRIC

RIGHT ILIAC LEFT ILIAC

Appendicitis Diverticulitis
Crohn’s Disease Ulcerative Colitis
Testicular Torsion
Caecum Obstruction Urinary Retention Constipation
Ovarian Cyst Cystitis Ovarian Cyst
Ectopic Pregnancy Placental Abruption Hernias
Hernias

#abdominalpain #usmle #medicalstudent #mbbs #PGexams

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 PHARMACOLOGY #11

What dangerous drug interaction effect does

Warfarin & NSAIDs produce, given together?

#druginteractions #usmle #medicalstudent #mbbs #PGexams

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 PHARMACOLOGY #11

inhibit
s CO
X-1
/ C tting factors
s of clo
hesi

OX
ynt X . Protein C & S
NSAIDs s I IX
WARFARIN

-2
ase
d II VI
Anti-inflammatory/Anti-analgesics cre
de
+
an anti-coagulant

BLEE ING HYPOCOAGULABILITY

#druginteractions #usmle #medicalstudent #mbbs #PGexams

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 RHEUMATOLOGY #12

What antibodies are associated with:

Rheumatoid arthritis - SLE - Drug induced lupus

Polymyositis - Dermatomyositis - Scleroderma - CREST
Sjoogren syndrome - Mixed connective tissue disease

#autoimmunediseases #antibodies #usmle #medicalstudent #mbbs #PGexams

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 RHEUMATOLOGY #12

RF (Rheumatoid Factor) Anti-Jo-1

Anti-CCP (Citrullinated protein)
Anti-scl-70 ANA
ANA (Anti Nuclear Antibody)
Anti-dsDNA Anti-centromere
Anti-Sm
Anti-Ro ANA
Anti-histone Anti-LA ANA

Anti-Jo-1 Anti-RNP ANA

#autoimmunediseases #antibodies #usmle #medicalstudent #mbbs #PGexams

www.neuros.org
 MICROBIOLOGY #13

Flagellae
What do you know
about Giardia Lam- Edge of Sucker
blia? Nuclei

- Source of Infection
- Route of Infection
- Clinical features Nuclei
- Lab Diagnosis Axostyle
- Motility
- Treatment Flagellae

#giardiasis #greesystools #usmle #mbbs #PGexams

2013
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 MICROBIOLOGY #13
Infection with G.lamblia is found worldwide, more com-
monly in tropics. It effects mostly children, tourists and
the immuno-compromised
Source of infection: Cysts in contaminated water
Route: Ingestion
Clinical features: Vomitings, Fatty foul smelling Diarrhea
& Abdominal pain
Lab Diagnosis: Stool exam, Jejunal biopsy & Endoscopy
Motility: Falling leaf
Treatment: Metronidazole
#giardiasis #greesystools #usmle #mbbs #PGexams
2013
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 PHARMACOLOGY #14

What dangerous drug interaction effect does

Spironolactone & NSAIDs produce, given together?

#druginteractions #usmle #medicalstudent #mbbs #PGexams

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 PHARMACOLOGY #14

competiti
ve in
hib
ito
rt
of aldos o
renin - angio-
tero of the
ivity
ACE INHIBITORS
ne

bi
system
SPIRONOLACTONE act dosterone

nd
ing
he l
ce t sin - a angiotensin-converting
steroidal antimineralocorticoid du ten
+
re enzyme inhibitors

+
HYPER K ALEMIA
#druginteractions #usmle #medicalstudent #mbbs #PGexams

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 ANATOMY #15

What is the difference between

Right & Left Gonadal venous drainage?

#reproductivesystem #usmleHY #medicalstudent #mbbs #PGexams

2013
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 ANATOMY #15

Left Gonadal Drainage

Left ovary/testis -> Left gonadal vein -> Left renal vein -> IVC

Right Gonadal Drainage

Right ovary testis -> Right gonadal vein -> IVC

#reproductivesystem #usmleHY #medicalstudent #mbbs #PGexams

2013
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 GIT MEDICINE #16

A 35 year old male comes to the ER with severe epigastric pain

that radiates to the back like a spear. The patient is suspected to
have acute pancreatitis. What are the common causes of this
condition?

#abdominalpain #usmle #medicalstudent #mbbs #PGexams

www.neuros.org
 GIT MEDICINE #16
GET SMASHED

GALLSTONES
ETHANOL (ALCOHOL)
TRAUMA
STEROIDS
MUMPS
AUTOIMMUNE
SCORPION BITE
HYPERLIPIDEMIA
ERCP
DRUGS

#abdominalpain #usmle #medicalstudent #mbbs #PGexams

www.neuros.org
 MICROBIOLOGY #17

What do you know Flagellum

about Leishmania Basal Granule
Donovani? Kinetoplast

- Source of Infection
- Route of Infection Cytoplasm
- Clinical features
- Lab Diagnosis
- Motility Nucleus
- Treatment

#medicalstudent #usmle #mbbs #PGexams

2013
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 MICROBIOLOGY #17

Important cause of visceral leishmaniasis.

Source of infection: Phlebotomus (Sandfly)
Route: Bite (Promastigote)
Clinical features: Recurrent fevers & Striking spleno-
megaly
Lab Diagnosis: Isolation from blood/spleen & Serology
(PCR/DAT/Antibody titres)
Motility: Flagellar
Treatment: Sodium Stibogluconate & Amphotericin B

#medicalstudent #usmle #mbbs #PGexams

2013
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 ENDOCRINOLOGY #18

How are thyroid hormones regulated in the body?

#hormoneregulation #medicalstudent #usmle #mbbs #PGexams

2013
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 ENDOCRINOLOGY #18
ANTERIOR PITUITARY GLAND

TSH HORMONE

EDBACK
TSH RECEPTORS ON

E FE
THYROID GLAND

IV
AT
EG
N

THYROID HORMONES

#hormoneregulation #medicalstudent #usmle #mbbs #PGexams

2013
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 NEUROLOGY #19

How would you differentiate between:

1) Wernicke’s Aphasia
2) Broca’s Aphasia
3) Conduction Aphasia
4) Global Aphasia
5) Transcortical Sensory Aphasia
6) Transcorticol Motor Aphasia

#aphasia #mbbs #medicalstudent #PGexam #usmle

www.neuros.org
 NEUROLOGY #19

FLUENCY REPETITION COMPREHENSION OTHER FEATURES

IMPAIRED IMPAIRED LIMB APRAXIA

WERNICKE’S APHASIA YES

YES BUCCOFACIAL APRAXIA

IMPAIRED
BROCA’S APHASIA IMPAIRED

IMPAIRED YES
CONDUCTION APHASIA YES

IMPAIRED IMPAIRED IMPAIRED

GLOBAL APHASIA

TRANSCORTICAL SENSORY APHASIA YES YES IMPAIRED

TRANSCORTICAL MOTOR APHASIA IMPAIRED YES YES

#aphasia #mbbs #medicalstudent #PGexam #usmle

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 ENDOCRINOLOGY #20

What does the following syndromes comprise of:

1) MEN 1
2) MEN 2a
3) MEN 2b

#syndromes #medicalstudent #usmle #mbbs #PGexams

2013
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 ENDOCRINOLOGY #20

MEN 1 MEN 2a MEN 2b

Prolactin Pituitary Mucosal

adenoma neuromas

Parathyroid Parathyroid Marfanoid

Calcium
hyperplasia hyperplasia body habitus

Pancreatic Medullary Medullary Calcitonin

Gastrin tumors thyroid Ca thyroid Ca
Urinary Me-
Pheochromo Pheochromo
tanephrines
-cytoma -cytoma
MENIN GENE RET PROTOONCOGENE

#syndromes #medicalstudent #usmle #mbbs #PGexams

2013
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 PULMONOLOGY #21

An African American woman

comes to the clinic with com-
plains of shortness of breath,
cough & easy fatigue. On
examination there is fine
rales on auscultation of lungs
and red tender nodules on
the tibia. Chest xray shows
the following picture. What is
the most likely diagnosis? www.neuros.org

#dyspnea #usmle #medicalstudent #mbbs

2013
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 PULMONOLOGY #21
Sarcoidosis is an idiopathic inflammatory disorder, mainly in the lungs. Always suspect this
when the clinical vigenette speaks of an African American woman with dyspnea and chest
xray of bilateral adenopathy.

CLINICAL PICTURE : Ethnicity: African American, Gender: Females, Asymptomatic, Dyspnea on

exertion, Cough, Easy Fatigue,Fine rales on lung auscultation - NO WHEEZING, Eyes: Uveitis /
Keratoconjuctivitis, Parotid enlargement, Sicca syndrome, Cardiac: Restrictive cardiomyopa-
thy, heart blocks, Nerve: Facial palsy Aloplecia - very rare, Skin: Erythema nodosum, Lupus
pernio

DIAGNOSITC TESTS : Though dignositc tests are done, remember that this disease is a disease
of exclusion.
Chest Xray (Initial) - Bilateral hilar adenopathy - Angel wing sign, Lymph node biopsy - MOST
ACCURATE, Elevated ACE levels, Hypercalcemia & Hypercalciuria, PFT - restrictive picture -
decreased FEV, FVC, TLC, DLCO and normal FEV1/FVC, Brochoalveolar lavage - shows helper
cells

TREATMENT : Aysmptomatic patients donot need to be treated, Symptomatic patients respond

well to Prednisone (Glucocorticoids)

#dyspnea #usmle #medicalstudent #mbbs

2013
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 MICROBIOLOGY #22

What do you know Microneme Conoid

Dense Granules
about Toxoplasma
Gondi? Golgi Body

- Source of Infection
- Route of Infection Rhoptry
- Clinical features Mitochondrion
- Lab Diagnosis Nucleus
- Motility
Rough Endoplasmic Reticulum
- Treatment

#medicalstudent #usmle #mbbs #PGexams

2013
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 MICROBIOLOGY #22
An obligate intracellular sporozoan, causing CNS infections
such as encephalitis. Is also a member of the TORCH com-
plex.
Source of infection: Cyst in cat feces (mainly) or meat
Route: Contaminated excreta, food or airborne spores
Clinical features: Headache, seizures & abnormal gait
Lab Diagnosis: Sabin-Feldman Dye test, CFT & HA
Motility: Upright twirling, Helical rotation, and Circular glid-
ing
Treatment: Pyrimethamine + Sulfadiazine, Spiramycin, Clin-
damycin & Cotrimoxazole.
#medicalstudent #usmle #mbbs #PGexams
2013
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 ANATOMY #23

What Structures pass through foramen ovale?

#mnemonics #usmle #medicalstudent #mbbs #PGexams

2013
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 ANATOMY #23

M : MANDIBULAR NERVE
A : ACCESSORY MENINGEAL ARTERY
L : LESSER PETROSAL NERVE
E : EMISSARY VEINS

FORAMEN OVALE

MALE
#mnemonics #usmle #medicalstudent #mbbs #PGexams
2013
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 CARDIOLOGY #24

Guess the cause of this murmur:

S1 MC S2

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #24

MITRAL VALVE PROLAPSE

LATE SYSTOLIC MURMUR
LATE SYSTOLIC CRESCENDO MURMUR THAT FOLLOW
A MIDSYSTOLIC CLICK.
HEARD LOUDEST AT S2
COMMON CAUSES: MYXOMATOUS DEGENERATION, RF
CHORD RUPTURE

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #25

Guess the cause of this murmur:

S1 S2 OS

#murmurs #medicalstudent #mbbs #PGexams #usmle

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 CARDIOLOGY #25

MITRAL STENOSIS
DIASTOLIC MURMUR
LATE RUMBLIING DIASOTLIC MURMUR THAT FOLLOWS
AN OPENING SNAP
COMMON CAUSE: RHEUMATIC FEVER
CHRONIC MS LEADS TO LA DILATION

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #26

Guess the cause of this murmur:

S1 S2

#murmurs #medicalstudent #mbbs #PGexams #usmle

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 CARDIOLOGY #26

MITRAL/TRICUSPID REGURGITATION
HOLOSYSTOLIC MURMUR
MITRAL - HEARD BEST AT APEX, RADIATES TO
AXILLA.
COMMON CAUSES: IHD, MVP, LV DIALATION

TRICUSPID - HEARD BEST AT TRICUSPID AREA

RADIATES TO RT STERNAL BORDER
COMMON CAUSES: RV DIALATION OR
ENDOCARDITIS

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #27

Guess the cause of this murmur:

S1 S2

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #27

PATENT DUCTUS ARTERIOSUS

MACHINE LIKE MURMUR
CONTINUOUS MACHINE LIKE MURMUR
HEARD LOUDEST AT S2
CAUSE: CONGENIATAL PDA

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #28

Guess the cause of this murmur:

S1 S2

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #28

AORTIC REGURGITATION
DIASTOLIC MURMUR
IMMEDIATE HIGH PITCHED BLOWING MURMUR
SX: BOUNDING PULSES & HEAD BOBBING
WIDE PULSE PRESSURE
COMMON CAUSES: AORTIC ROOT DILATION, RF
BICUSPID AORTIC VALVE

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #29

Guess the cause of this murmur:

S1 EC S2

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 CARDIOLOGY #29

AORTIC STENOSIS
SYSTOLIC MURMUR

CRESCENDO - DECRESCENDO MURMUR THAT FOLLOW

AN EJECTION CLICK.
RADIATES TO CAROTIDS / APEX
COMMON CAUSES: AGE RELATED CALCIFICATION
BICUSPID AORTIC VALVE

#murmurs #medicalstudent #mbbs #PGexams #usmle

www.neuros.org
 ENDOCRINOLOGY #30

Recall the signs & symptoms of Hyperthyroidism.

#syndromes #medicalstudent #usmle #mbbs #PGexams

2013
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 ENDOCRINOLOGY #30

MOIST PALMS
insomnia
heat intolerance

WEIGHT LOSS

TACHYCARDIA
muscle weakness
SOFT NAILS
menstrual irregularity

exophthalmos
irritability
infertility

goitre

HAIR LOSS
DIARRHEA

#syndromes #medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #31

A young woman comes to the clinic complaining of pain in her neck & shoul-
ders since a few weeks. She is having difficulty sleeping, and suffers from
occassional headaches. On questioning she agrees to stiffness & fatigue
also. During physical examination, she tells you to be gentle as she has
some tender points that trigger pain, especially on the lateral epicondyle
and medial side of her knee. You order a round of tests that include ESR,
CRP, RA, ANCA & CPK - all which return normal. How will you treat her?

a) Steroids
b) Ciprofloxacin & Doxycycline
c) Refer her to an orthopedic
d) Amitriptyline
e) Allopurinol
f) Placebo, she is a hypochondriac

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #31

Correct Ans: Amitriptyline

The patient is suffering from Fibromyalgia, which is best treated

with Amitriptyline.

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #32

A young African American teenager comes to the ER with complains of

headache, confusion, nausea, vomiting & abdominal pain. He came to the
ER directly from a BBQ party, which was at a friends's basement. His HR is
110/min & RR is 24/min. His skin shows a pinkish hue. What is the diagno-
sis?

a) Sicke Cell Crisis

b) Cyanide Poisoning
c) Food Poisoning
d) Carboxyhemaglobinemia
e) Thalassemia

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #32

Correct Ans: Carboxyhemaglobinemia

Due to buildup of CO in an enclosed place "BBQ in a basement".

The other clues are the symptoms and the pinkish hue.

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #33

A patient comes to your clinic for regular check up. Before leaving he asks
you about risk factors for pancreatic cancer, as he is concerned because his
father had one. Which of the following is not a risk factor for pancreatic
cancer.

a) Chronic pancreatitis
b) Obesity
c) Alcohol
d) Family History
e) Smoking

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #33

Correct Ans: Alcohol

Gallstones & Alcohol are two risk factors exclusively for Acute
pancreatitis & not pacreatic cancer

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #34

A mother brings her 2yr old girl to the clinic complaining of diarrhea &
tummy ache. You diagnose it as gastroenteritis. The mother also tells you
that many other children at the day care center had similar symptoms.
Which organism is the most likely causative agent?

a) Giardia lamblia
b) Botulinum toxin
c) Clostridia difficile
d) Rotavirus
e) Reovirus
f) Entamoeba histolytica

#medicalstudent #usmle #mbbs #PGexams

2013
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 MCQs #34

Correct Ans: Rota Virus

Rota virus is the most common cause of gastroenteritis in infants

and children upto 5 years of age.

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 MCQs #35

A 40 year old woman comes to the clinic complaining of a 3kg weight gain
and decreased libido for the past 2 months. She also states that she has not
had a menstrual period this time. On examination white milky discharge is
noticed from her nipples bilaterally. You order lab tests, and notice an
abnormal increase in the prolactin levels. What is the most appropriate
treatment?

a) Steroids
b) Mastectomy
c) Breat massage
d) Bromocriptine
e) Metoclopramide

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 MCQs #35

Correct Ans: Bromocriptine

This patient is suffering from prolactinoma, Bromocriptine is a

dopamine agonist. Dopamine suppress production of prolactin.

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 MCQs #36

A man in his 40s, who works at the factory, comes to the clinic with com-
plain of pain in his shoulder and unable to lift his shoulder. After a thorough
examination and a few imaging studies, the diagnosis of rotator cuff injury
was made. Which of the following muscle's tendons donot form part of the
rotator cuff?

a) Supraspinatus
b) Infraspinatus
c) Teres major
d) Subscapularis

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 MCQs #36

Correct Ans: Teres Major

The muscles that make up the rotator cuff are: Supraspinatus,

Infraspinatus, Subscapularis & Teres minor.

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 MCQs #37

Which of the following is a sign of fracture of the middle cranial fossa of

skull?

a) Bottle's sign
b) String sign
c) Donut sign
d) Battle's sign
e) Bird beak's sign
f) Omega sign

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 MCQs #37

Correct Ans: Battle’s sign

The sign is called Battle's sign, which indicates a fracture of the

middle cranial fossa. It is also called as mastoid ecchymosis.

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 MCQs #38

A 30 year old man, who works as a farmer, comes to the clinic with an itchy
annular skin lesion on his back. On examination you also note a few hypo-
pigmented skin lesions. The patient complains of sweating alot as he works
under the hot sun, and believes this is what has caused the lesions. Which
of the following tests would you order to confirm your diagnosis:

a) Gram's stain
b) CBC
c) Acid fast stain
d) Dark field microscopy
e) KOH & microscopy
f) ELISA

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 MCQs #38

Correct Ans: KOH & microscopy

The patient has a fungal skin infection. The itchy annular lesion
along with hypopigmentation highly suggests it. Working out in
the hot sun, and excessive sweating are the other clues.

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 MCQs #39

A middle aged woman comes to the clinic with complains of palpitations

and a episodes of dizziness and syncope. After examination a diagnosis of
Atrial fibrillation is made. Which of the following is the most commonest
cause of atrial fibrillation

a) Diabetes
b) Hypertension
c) Aortic stenosis
d) Mitral value regurgitation
e) Proponolol

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 MCQs #39

Correct Ans: Aortic Stenosis

Atrial fibrillation increases in frequency with aging and typically

occurs in people who have underlying heart disease. Almost
any heart disease can increase the risk of this abnormal
rhythm, but the most common causes are:

Hypertensive heart disease due to chronic high blood pressure.

A heart attack (myocardial infarction, or MI), Heart failure,
Heart valve disease, such as mitral regurgitation or mitral
stenosis.

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 MCQs #40

A 52 year old man comes to the ER with complains of lower back pain. He
works in a storage warehouse. On examination the straight leg test is posi-
tive at 60 degrees. There is no vertebral tenderness. Heart and lung exami-
nations are normal. Which is the next best step in management of this
patient.

a) Cervical X ray
b) Spinal MRI
c) Emergent surgery
d) NSAIDs & Rest
e) Spinal X ray
f) Lumbar Puncture

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 MCQs #40

Correct Ans: NSAIDs & Rest

This is most likely a case of disc herniation, in which the first

step of management is NSAIDs & Rest of not more than 2-3
days. Early mobilisation is advised. MRI maybe advised, but is
not the NEXT BEST STEP in management.

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