My recalls

Plz pray for my result..

I was so lucky this time.. There were recalls except few new
questions..
My advice abot amc
Hope 4 da best n be ready for the worst. As there are some
candidates who got just 5 recalls..
Do hb as much as u can.. 2-3 tym
J. M is a must..
Ct MRI X rays practice is very imp.. There were 6 x rays
3 ct scan 1 ecg was in my exam.. 2-3 pictured
Special thanks to our study gang... It was really very great
experience..

Exam starts with 2 sample questions... Same for everyone

1.melanoma eye pic
2.
baby after 6 hours of delivery develops jaundice. Cause
A) Neonatal sepsis
B) Hemolytic anemia
C) Beast feeding

& exam started with the very first q

1.Old man came with his wife. he gets confuse sometimes and
forgetful. He still drives, sometimes at night . mmse
26/30 .what are you gonna do about it?
a- Cease driving at night (my ans)
b- Repeat mmse after 3 months
c- MRi of brain
d- ask for more social and mental activities

2
. .8 days old infant presented to u complained with poor
feeding and bile stain vomiting his birth was at 38 weeks
gestation and weight 2600g he is breast feeding with no
immediate post natal complications.The xhild has history of
Meconium passing on day 4th of birth now he has mild jaundice
and abdominal distension and is irritable on examination
abdomen distended and tender what is appropriate diagnosis?
A)Meconium Ileus
B)Hirschsprungs disease
C)duodenal atresia
D)necrotizing enterocolitis
E)volvulus

3..40 year old lbp-after gardening wat u will do beside

analgesia..
Continue activity

4.58 year old lbp-sciatica... Observe

5 picky at food
Q bank q
Schizophreniform psychosis
40.12 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 because she's picky at food. what
immediate danger to her in future ?�a. OCD b. sexual
abuse�c. drug abuse�d. Anorexia nervosa�e.
schizophreniform psychosis

6.100% aspirin stats question increase asked

Study on Aspirin effects on preventing MI on 100 people. Of
those who took aspirin of the 100 ppl only 1 person had a MI.
Of those who didn't takeaspirin 2 ppl had MI. What is the
increase in relative risk given by aspirin
1%
10%
100%
200%

7 Lead level 0.72 normal was.0.32 given

- educate mother

Mother living in mining town comes with her daughter for

normal blood test. Her daughter’s
test show lead level 0.72 (‹0.32)
what will be your next appropriate step?
a.Assess IQ testing of child
b.educate mother about environmental risks- (i choose)
C chelation therapy (might b ans)

in children: Blood lead level of 5 µg/dL or 0.24 µmol/L or

greater requires further testing and monitoring. The source of
lead must be found and removed. A lead level greater than 45
µg/dL or 2.17 µmol/L in a child's blood usually indicates the
need for treatment.

8. Woman feels she has worms in her stomach because of a

recent volcano eruption in indonesia. Previously on
trifluorperazine but stopped due to hand stiffness. Wat to give
now- quietepine

9Travel to asia-xray-tb, viral pneumonia

Beautiful x ray was there..
10 hematuria and abdominal pain(renal stone) -ct scan

11 drug rebound headache Headache all day every day 6-

8months history. Drugs only mildly relieve- very clear
scenerio..she took morphine codeine n over the counter
medicines but was jst relieved by 2 hr & recur again
drug rebound

12 Child with incomplete vaccine fever 37.8- give vaccine and

catchup
13. Travel india wat vaccine
Woman 25 years old is going to travel to India presented asking
advice about
vaccination. She has previous 1 dose of polio vaccine , had DPT
at birth, 2 and 4
months age , 1 dose of MMR at 13 month , and tetanus booster
at 15 year age. What
vaccines should she received before travel?
A-MMR, diphtheria and tetanus
B-polio, diphtheria and tetanus
C-polio, MMR, diphtheria and tetanus
D-polio, MMR
E-MMR

14Old lady..lives alone. Confused brought by daughter. Wat

initial in mmse chq
orientation
52. He forgets where he keeps his things easily gives up task
What to check in mental state examination?
a) Orientation
b) Hopelessness
c) Hallucination
d) insight
15.xray given. Scenario old man. Many drugs. 40 year smoking
history. 4 years back angioplasty. History of dvt. Now with sob,
cough, basal crackles. No fever. Cause- left heart failure(xray
went with this), copd
16. Aboriginal mitral valve stenosis. Xray given- pulm htn
See x ray... Bilateral rounded opacities n peribronchial shadows
were there)
 1

17
Anorexia nervosa- feeling of inferiority
Scenario of anorexia nervosa
Bellet dancer.. Bmi 16. asking for what you will ask in history?
Feelings of guilt
Feelings of inferiority
18A young girl stopped belley dancer ,stopped attending the
school, fight with the father, falling grades, scenario looks like
she is having depression. Saying wats the meaning of life etc
Liasie with father,
discuss safety plan with patient and parents,
CBT,
tell school

19. Orbital floor fracture- loss of sensation of cheek

- A man is brought to the ER after brawl hit to the side of left
eye. On examination, you have found an orbital floor fracture.
Which of the following is the accurate predictor of this
diagnosis?
A. Sub conjunctival haemorrhage
B. inability to open his mouth
C. loss of sensation of his cheek
D. decreased visual acuity

20. Not putting frequently suffeciently

Most Common cause of low milk production
Low fluid intake
Less adequate baby feeding
Baby is not put on breast feeding frequently

21 PAD
a man with history of limb claudication on 100 meters relieved
by rest, on examinations there was absent left femoral pulse
and absent dorsalis pedis pulse , ABI done and it was 0.25..
what is the most appropriate test leading you to the diagnosis?
A-Arteriography
B-Ct angiography
C-compression Doppler ultrasound
D-MRI
E-X-ray

22 PAD scenerio.. Pt was not fit for surgery.. Wat u will do to

reduce his symptoms..
Reduce smoking
Supervised exercise

23
history of hysterectomy and dvt- transdermal estrogen
Woman with a history of hysterectomy and DVT. Now
complaining of hot flushes and insomnia. What will you give
her?
a. Oral low dose estradiol
b. Transdermal estradiol
c. Progestogen only pills
d. Hrt
e. sertraline(paroxetine

24
9 mn old irritable screaming bile stain vomiting and diarrhea.
Her sister is suffering frm gastroenteretitis.usg shows shadows
in right upper quadrant.what next to do?
A. Air enema(my ans)
B.urine culture
C.stool culture
D.observe

25
55 yrs old menopause 3 month back
Osteoporotic with gerd- -2.5 in femurn vertebra
strontium(no option of zolindronic)
There was option of hrt.. I choose that out of exclusion
Osteoporisis.. Fracture x ray(i guess)
T score -2.5
Gerd was there
Menopause for 3 months
Optiins were
Alendronate
Strontium(yes it was there)
Hrt
No option of
zoledronic acid
26 Lady had fracture. On inv found out severe osteoporosis-
alendronate
25 osteoporosis..
Big q with x ray eratic meals etc was there in description. ca vit
d was normal..long labs were given t score was -2.5
Ans was alendronate

27. Copd with respiratory distress in ed. Sats 88% on oxygen.

Heavy smoker with chronic cough presented to u dyspneic and
speak in phrases..on examination bilateral wheeze with basal
crackles, xray show hyperinflated lungs with flat diaphragm
what investigation should you perfrom?
a) Spirometry
b) Pefr
c) Ct chest
D abgs
28 Hutchinson freckle pic- local excision

hutchinson's freckle on face for the past 6 years, size is

increasing now, next step of management?
A. Local excision. (ans)
B. Excision with a 2 cm margin.
C. Fluorouracil cream
D Review in 12 months

29. Mother bringing baby 5 times- A lady presented with her

baby 5 times in 2 weeks at 10 weeks following delivery - all
normal, established breastfeeding, baby growing well on 90th
percentile......What relevant info will you ask the mother?

Past obstetric history

. premorbid personality
history of psychosis
.Thoughts of harming her baby

30. Weight loss. Dre with irregular prostate-trus

31 Post op oliguria. No catheter. No fever. Fluid given- serum
electrolytes

32 Post op olig-fever and catheter- blood culture

33 Child with urti. Found gluxose and ketones in urine. Rbs was
9. Follow up with- hba1c

A child 6 YEARS old with history of asthma presented with

upper respiratory tract infection , urine examination showed
very high serum glucose and ketonuria of 2+.
what is the most appropriate test to follow up this child?
A-HbA1C
B-serum creatinine and electrolyte
C-FBS->
D-OGTT .-> not done in children
E-Blood gases

34
An old woman taken many tablets, now unconscious, pinpoint
pupil, his son brought her to hospital, and also tablets she
might have taken, methadone, oxycodone, buspirone patch
A-methadone(ans)
B-oxycodone
C-buspirone

35cld mild ascites flapping tremor.fever. Inves asked

Abd paracentesis
.pt presented with fever. 38.with mild ascites, gynecomastia ,
spider nevi, flapping tremors. vitals given. whats ur initial step
of management of this patient ? a. full blood examination b.
LFTs (hepatic encephalopathy) c. ct scan d. abdominal USG e.
Abdominal paracentesis

36 Poorly controlled Diabetic control lady with Type 1 diabetic

with mild renal impairment asking about risk of diabetes for
baby (very clearly mentioned)
A. IUGR
B. Macrosomia (its right )
C. Renal agenesis D. Intrauterine fetal demise E. low Birth
weight

37. Young girl. High inr etc Celiac. Wat to give-vit k

38Restless leg syndrome

inv-iron study

A 55-year-old woman presented with discomfort in her both

legs with an urge to move for last 4 months.She remains awake
at night due to creeping and sometimes electric current-like
sensations.Her current medication include paracetamol,
oxycodone and multivitamins.Blood tests show normal renal
function, normal electrolytes and slightly low haemoglobin.
What will you do next?
a. Cease oxycodone
b. Fluoxetine
c. Iron studies
d. Mirtazapine
e. Morphine

39 Gynaecomastia with antipsychotic. What to give-

Aripripazole

40..Couple coming for infertility. Wat to ask husband-how mxh

alcohol he drinks
.couple comes for infertility evaluation.female already has a
kid.on evaluating the male for infertility,what is the relevant
question .
a.how much alcohol do u consume
b.chicken pox history.
c.marijuana use
d.ecstasy and other drug use

41..Couple inferitlity. Male with absent vas def. - check cf im

both male female
Couple come for infertility problem for the last 12 months. On
testing examination and tests of the female are unremarkable.
Male has azospermia. And bilateral absence of vas deferens.
Which of the following is most appropriate before the starting
the treatment of infertility?
a. No testing required as they can not have a child
b. Testing of both male and female for cystic fibrosis
c. Refer for IVF
D.serum fsh and lh for male

42. Mother hep c- avoid fetal scalp electrode

A pregnant with hep C comes to you for advice ,what will

reduce the risk of transmission of
hep C to her baby
C sec
Breastfeeding
Avoid Fetal scalp electrodes sampling

43 Mother hep c- anti hcv at 18 months

10. You want to know the Hep C in newborn baby born to
HepCpositive mother. How to investigate?
- Antibody of baby at birth
- Antibody of baby at 18 months
- Antibody of baby at 12 months
44
4- 14 year old girl came to GP , living with parents.started
sexual activity.asking for contraception.dont want you to
inform her parents.what next you will do?
1-call parents & tell them
2-prescribe OCP
3-ask age & identity of her partner
4-give her OCP & advice partner to use condoms.
.
45
brother hemachromatosis- check only mother not kids
A mother comes with hemochromatosis in brother. she has
2 kids aged 2 and 5 yrs respectively. Wants advice regarding
screening
A. screen only mother
B. mother n kids
C. ask her to come with husband
D. Screen only children
46Treated for h.pylori-
resistance to amoxicxilin
, resistance to metronidazole
A man with peptic ulcer who is taking triple therapy (PPI,
amoxicillin, metronidazole) for 6 weeks but urease breath test
was positive for H.pylori
what is the reason?
a. resistance to metronidazole
b. resistance to amoxicillin
c.unreliable urea breath test

47Methotrexate induced hepatitis clear stem

. 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
C- Autoimmune hepatitis
D Viral hepatitis

482 min synto questions stop synto

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 4 min. asking
next appropriate treatment.
A. Fetal scalp sampling
B. Continuuous ctg monitoring
C. Stop syntocinon
D. C section

49 4 min synto questions stop synto

week pregnant have labour induced , synto given , cervix 8cm
dilated , fetal head at ischial spine level , CTG show HR drops to
70/min & came back to 145/min in 4 min. Asking next ?
A. Cease Syntocinon
B. Fetal scalp pH
C. CS
D. Ventous Delivery
E. O2 to mother

50
New to me but old in amedex..
9month child crying a lot ..1 episode of billious
vomiting...tender abdomen on inspection, no mention of fever,
his elder 2 yr brother has urti/gastro
a. csf
b. mri
c. laprotomy
d. admit and observe
e. Usg i choose (i forgot)

51.Chlamydia is asymptomatic scenario

52.Student with penile discharge. Had sex with new partner but
partner has no symptoms. Inv- first catch urine pcr

53..40) Huge epigastric hernia picture of a 56 year old man

which extends from umbilicus to xiphisternum. He looked
morbidly obese and had a waist circumference of 110 cm
Asking for appropriate management for the patient.
A. Weight loss therapy
B. Abdominal binder
C. Herniorraphy with mesh repair
D Hernioplasty
E. Observation and Reassurance
 54..drug
interaction i
choose
4 cm hematoma
q.. Amiodarone was recently added.. No hist of dvt

54.Patient with HTN,DM,was on

warfarin,perindopril,statin,metformin.1wk agonstarted
amiodarone. Now presents with right thigh swelling,temp
37.9,tender,red thigh is 4cm bigger. No h/o dvt..asking cause of
swelling
A aterial embolus
B cellulitis
C dvt
D drug reaction

55 empyema q
Old woman 75years is admitted to the hospital following a
community acquired pneumonia. She received antibiotics and is
well on the 5th after discharge she suddenly develops rigors,
chills and high grade fever. Had crepitations on chest. What is
the most likely diagnosis?
A. Hosp acquired pneumonia
B. Iv cannula related bacteraemia
C. Empyema
D. Pulmonary embolism

56
RA scenerio
Stiffnes for 1-2hrs for 8 yrs
Anemia
I choose methotrexate
.female pt comes with wrist pain & stiffness for 1-2 ,this
condition for last 5-6 years,on lab inv high ESR,what is the best
mx? Anemua was also there
a.NSAIDs
b.Prednisonone
c.methotrexate

57. Mva with hemopneumothorqx ct given... patient having

painful breathing so taking shallow breaths because of pain.
Wat to do-morphine (no mention of paradoxical breathing or
breathing difficulty)

58.
. A patient with a painless neck swelling moves with swallowing.
hoarseness and difficulty in breathing at night…gradually
increased over 3 weeks. O/E smooth swelling in the anterior
triangle of neck . dullness of percussion at upper sternal border.
most likely dx?
MND goitre
papillary carcinoma
anaplastic cancer. I choose this..
haemorrhage in nodule of MND
follicular CA
59
18 month baby. Diarrhea for 6 weeks. Stool tests normal. First
copious watery diarrhea now undigested food particles in stool.
Wat to do-
Gluten free diet, lactose free diet, reduce red meat in diet

60
A postmenopausal woman, on HRT since 6 years,requesting for
continuing hrt as her symptms are well controlled. now DEXA -
1.2 in femur as well as vertebrae -1.7. Calcium and Vit D
normal. What to do?
a) Continue same treatment
b) Stop HRT
c) Stop HRT and give Ca and Vit D
d) Stop HRT and give Alendronate
61.Scaphoid fracture xray (from middle)- compression screw
.58 year old man presented with severe lower back pain and
tenderness in the lower lumbar, he has weight loss of 10 kg and
on examination, there was tenderness over L4-L5 vertebra, On
DRE the prostate was enlarged and irregular, what is the most
appropriate test that lead you to the diagnosis?
A-PSA
B-PET SCAN
C-spinal CT
D-spinal MRI
E-ultrasound

59-60 psa qz
#BPH
man presented with poor urine stream and nocturia for 6
weeks. DRE showed Prostate enlarged 6 cm n median sulcus
palpable. what will u do next?
a. urine cytology
b. PSA
c. bone scan
d. mRI
e. IVU

60
.
#urology
Man with urinary retention mass above the pubic symphysis
DRE showed enlarged prostate with palpable median sulcus
palpable Catheter inserted what is the most appropriate next
step?
A-trans rectal ultrasound
B-PSA
C-MRI
D-CT
E-urine culture
I wish one of them will b right ans...
They were very confusing... Plz decide ur ryt ans before sitting
in exam n Stick to it... as recalls are these 2-3 & they will come
in exam.. I got all of them i guess😆

62
6 weeks baby for check up. Pansystolic murmur left sternal
edge. Wat inv- echo
63
Hb scenerio... Infarction

64 A scenario
of an aboriginal
woman
presents with
mitral stenosis,
shortness of
breath,
low grade fever, malaise for 6 weeks. Bilateral basal crackles
a) TB
b) LVH
c) Pulmonary HTN

65
Which topical drops u use for this eye?
Steroids. Other options were pilocarpine timolol n cipro floxacin

66
COPD scenario,lots of findings,comes with acute
exaggerbation,co2 increase but o2 normal,no
hypoxia,hypercapnia present,antibiotic given already,whats
next?
a.ventilation
b.cpap
c.change antibiotic

67 Scenerio was of smoker 20 pack... Cough n some

non specific headache (for confusion)
finding u hv to see from pic (given)
Ptosis n miosis in pic like below
68 Man with h/o cut 2 weeks back at finger while farming
Drinks 4 cans of alcohol.. Smoker..
Wats the underlying cause of this condition?
A
smoking
B Alcohol *my ans...
C familial (i was about to choose)
D vibrating tool injury...
69 Stress incontinence scenario ,,,,e cough or sneezing ....best
next invest,
Ct
Urodynamic studies
Urine analysis
Cystoscopy

70..child had history of nocturnal enuresis..

child came with hematuria 2 days after upper respiratory tract
infection. The child
is then recovered and came to follow up after 2 weeks and the
urinalysis shows non
glomerular RBC +. What is the appropriate investigation?
1. Urine cytology
2. Serum electrolytes and creantinine
3. Renal USG
4. Doppler renal vein
5 Dmsa

depression q... Asking about suicide ideation

71 #feb 2018
DM 1 pt after garden injury developed swelling of ring finger, it
was tender esp on flexor side pt had problem with extension of
the finger. Patient kept the finger in slight flexion.. What to do
as definitive treatment ?
A. IV cephalothin(exact wording)
B. Iv flucoxacillin
C. Surgical exploration
D. Iv cephalothin with physiotherapy
E. Iv flucoxacillin with physiotherapy

81. Post menopausal 8months.hb q

- cyclical hrt
A 51 years old woman had her last menstruation 8 months
back. She is complaining of hot flushes and insomnia. Which
preparation is best for her?
a) Cyclical HRT
b) Continuous HRT with 12 days progesterone
c) OCP
d) Estrogen patches
e) continuous progesterone 30 days

82. Indigineous child. 6 weeks bilateral ear discharge. Tx- cipro

drops
32.3yr old boy with ear discharge for 6 weeks no fever asking
treatment after ear toilet
amoxil
ciprofloxacin
some ear drops
83 mamu q.. Aboriginal counsellor
Young aboriginal male presents to you with insomnia, fear of
darkness and seeing “mamu” . He 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-involvement of aboriginal health worker
C-urine drug screen
D-antipsychotic
E-CBT

84 non accidental inj

mother brings her 7 months old son with complaints of
bleeding from mouth and gums. On
examination torn frenulum, old bruises on shins and forehead.
No hepatosplenomegaly. No
petechiae. Dx asked
a. factor 8 deficiency
b. non accidental injury
c. won willebrand disease

85 female whose son was drug dealer.. Wat to do for her safety
(clearly mentioned word safety)
Urge her to go to refuge centre

86..Old man. Afib. Abdominal pain. Wat other test with ct-
serum lactate
A scenario of an old man with history of atrial fibrillation and
now comes with severe abdominal pain. What other than CT
angiography will you do?
a) CT abdomen
b) Serum lipase
c) Serum lactate

87 Poor urine flow and nocturia... dre prostate enlarged with

sulcus- psa i choose

88Know case of chronic liver disease , comes with bilateral

parotidomegaly , gynaecomastia , spider naevi , left
supraclavicular lymph node enlargement ,moderate ascites ,
what clinical feature favours need for further investigation?
A. Bilateral parotidomegaly
B. Gynaecomastia
C. Spider naevi
D. Left supraclavicular LN enlargement
E. Ascites

89Pt with active RA on methotrexate with chronic

pyelonephritis ,feels tired and lethargic labs done showed the ff

Hb 9.5 g/dl
Mch low normal
Serum iron decreased
S.ferritin normal
Tibc decreased
What is treatment of choice
A. packed RBCs
B. iv iron
C. low dose corticosteroid
D. erythropoietin injection

90 There was a patient who undergone stress echo for ischemic

cardiac disease.his results came positive.
Positive predictive value 55%
Negative predicive value maybe 90 something
Chances of patient having the cardiac disease
I chose 55%.
A 55
B90
C 45
D35

91.temporal lobe epilepsy recall

.8yr old brought due to behavior changes. Noticed to have
blank stare, with fidgeting of right hand, head twitching to right
side, sometimes chewing. These occurs in clusters for 3-4 days
in a week, for 3O to 60 Post ictal confusion for 30-60 sec s,then
symptoms free & back to
normal for several weeks. Dx
A- absence seizure
B- Juvenile myoclonic epilepsy
C- Temporal lobe epilepsy
D- Tourette syndrome
92 treatment of temporal lobe epilepsy ethosuxamide
Phenytoin
Na valproate

93 inguinal hernia in child

Open mesh repair
Herniorrhaphy

94.ect major depression. Anhedonia etc ect i choose..suicidal

ideation was asked in some mdd scenerios
95..dmsa recall
. A child with left kidney smaller than the right, what is the best
measurement for renal function?
a. DMSA dimercaptosuccinic acid to see anomaly scar tissue
due to vesico reflux
b. DTPA
c. IV urogram
d. USG

96.waist circumference.. Best indicator of health in obesity

97) CT given - haemopneumothorax. Painful shallow breathing.

O2 given by face mask, what's next?

1. Morphine
2. Intubate
3. Drain

98..cpap copd
recall long one
Ph was normal
Other values were not normal
Saturation was 88%
99
.4 gleason score active surveillance
A 74 year old man is being screened for prostate Ca. His PSA 2
years ago was 1.5ng/ml; now PSA is 3.8ng/ml. Only %5 of
biopsy done showed adenocarcinoma, Gleason score is 4. How
will you manage this patient?
a. TURP
b. Radical prostatectomy
c. External beam radiation therapy
d. Androgen therapy
e. Active surveillance

100 thyroxine was low

Tsh was normal (normal levels were given in q)
Hypothyroidism.. mRi recall

101 foot drop level asked L5

with foot drop after lithotomy position ?

102I came frim moon... Recall

Delusion i choose
. 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? A. Depression
B. Dissociation
C. Disorganized behavior
D. Delusion
E. Depersonalization

104 Lady with bmi 35. Management of the pt after diet and
exercise regimens failed to improve.
Involve in sports
Low carb food always
lipase inhibitor

105 acute mania

106vaccine & catch up

107 sarcoidosis ace increased skin biopsy

emg recall 2 tym ...fasciculations

. Patient with frequent tripping of right foot; weakness of

interosseous muscles; right foot drop; right plantar response is
equivocal, left increased; reflexes are normal. What
investigation will you do to reach diagnosis?
A. EMG
B. Ach receptor antibodies
C. MRI cervical spine

108 emg again same recall.. (lucky me)

109 hb q left leg

Farmer came with left swelling in a groin. U did fnac and it
shows squamous cells. Where is the lesion
A- Left leg
B- Anus
C- Rectum
D- Testis
E- Penis
110hb q rct vit d

116 htn pop

A 40yrs old woman on cocp for 8yeaes. She is a smoker and her
BP is high. She doesn't want to get off pills. What is your
advise?
A. Stop pills and rely on condom
B. Copper IUD
C. Implanon
D. POP

117 mafenamic acid recall dysmenorrhea & menorrhagia

4 Young girl presented to you with heavy menstruation since 2
years. She also complains of pain during her periods. She is pale
on examination.You told her that multiple investigations are
required but she refused and asked for something to help with
the bleeding.
A. Ocp
B. Tranexamic acid
C. Mafenamic acid
D. Mirena (long term)

118 40 yrs iucd anemia & menorrhagia

11.A 42yo woman who smokes 20 cigarettes/d presents with
complains of heavy bleeding and
prolonged menstrual period. What is the most appropriate tx for
her?
a. Tranexemic acid
b. COCP
c. Mefenemic acid
d. IUCD
e. Norethisterone

119

120scenerio with labs

Na 120
K 5.5
Rest normal
hyponatremia cause of confusion
Other options were hyperkalemia
Hypercalcemia etc

121

122 worsening symptoms at night alzheimer

123 pnemonia atypical scenario.. Initial inv blood culture
124 ecg chest pain for 2 hrs mi scenerio (sweating diaphoresis)
Oxygen was given
thrombolysis
125 diverticulitis ct treatment ab n bowel rest (same pic except

labelling ofcourse)
126ctpa i chooe in 3rd post op day
Saturation was 88%
History of femur fracture.. On 3rd pod he developed agitation &
sob... Lung was clear on physical examination.. (no mention of
alcoholic)
Cxr
Ctpa
Blood glucose

127
Serousanginous discharge wound dehiscence hb q
pt with h/o hemicolectomy for diverticulitis and colostomy
done since 5 days , now there is serosangenous discharge(key
word) came around the colostomy , the wound edges are
hyperemic ,erythematous asking for diagnosis :
a-wound dehiscence
b-wound haematoma
c-small intestinal fistul

128.Serous fluid from episiotomy tear. Leave it

Lady comes on 10th postpartum day with pain due to perineal
tear.Now on examination there is perineal wound that is 2 cm
long,1cm wide and 1 mm deep.It was clean just serous
discharge was there...
What to do next?
Apply local antibiotics
Put on oral antibiotics
Simply keep the wound clean
Suture the wound under local anaesthesia
Suture the wound after cutting the edges

129
Ca sigmoid q..
History of appendicetomy & cholecystectomy presented with 3
wk history of abd pain, distension. X-ray shows dilated
ascending colon, transverse colon & descending colon, no air.
Rectum is empty. A- Sigmoid volvulous B- Adhesive IO C- CA
Sigmoid
1.Ca sigmoid scenario- without ct i choose adhesion obstruction
there
130
New qz
neonate found apnea in sleeping brought by parents to ER no
HR apnea with no bruises his death is pronounced next
Mention on his death paper as cot death(sids) my ans but its
wrong
Inform child protection cervice
Refer him to forensic autopsy
Call the coroner (right ans.. Jm)

131
new question was...... several ppl in a city has abdominal
pain,watery eyes;nausea, vomiting. There is a recent work with
open coal seam. What to do next?
1. Inform health authority
2. Inform environmental protection authority
3.check CBC,blood biochemistry lead n iron levels i think

(co poisoning... Check carboxyhb n all in blood)

132New
17 girl has dyspareunia, worry about endometriosis because
sister has infertility because of this. Examination: nodule on
ligament on vaginal palpationand some other description, what
is important to diagnose endometriosis:
nodule on uterosacral ligament,
dyspareunia,
menorrhagia,
family history

133
New q
Anaphylactic patient in ed. Rmo gave 1mg adrenaline iv. And
nurse has it ready and is about to give. Wat to do-
Ignore, tell the dr and nurse abt it, tell nurse to give im

134
9.History of appendicectomy and cholecystectomy. Presented
with 3 week history of abdominal pain, distension. X-ray shows
dilated ascending colon, transverse colon, and descending
colon. No air. Rectum is empty. (very clear ct was there with
apple core appearance)
1. Sig volvulous
2. Adhesive IO
3. Ca sigmoid colon
 135 52 yrs
Female with
stress
incontinence.
Pelvic exercise
done . Feeling
little better
with exercises
there was little incontinence now but still embarrassed. What to
do next for this woman..
Imipramine
weighted vaginal cones
colposuspension

135
New
AV nipping q
Old aged male with bp, 170/80
Then on recheckin 140/80
Description was there (on exam of fundus of eye there was AV
Nipping)
Wat u do

A review after one week (chk bp)

B 24 hr bp monitoring (i choose)

Reassure
Rest i forgot...

136.child with fever drowsiness n cold extremities

Rash was mentioned asking treatment
Iv cefatholin
Iv gentamicin
Oral penicillin
Oral roxithro was there

137
Parents came with 6 mnth old child.. Saying that they need
medication to sedate her.. Baby was irritable.. U chkd baby
there was also florid napy rash..father was schizophrenic who
fails to comply drug treatment
Inform child protection

138..Middle insomnia q
Man awake after sleep in middle of night.. He lost interest in
outdoor activities etc...
Major deoressive disorder Was diag

139 Borderline person disorder(clear)

Dialectal therapy

scenario with female patient always angry, and cant control

herself, unstable relationships.. Self harm was there, treatment
was asked
1.anger management
2 dialectal behavioral therapy no medications on options(my
ans..)
Psychoanalytical therapy
Interpersonal therapy was also there

140
New
cluster headache ..scenerio
Pt with headache with ptosis Unilateral, in the periorbital,
retro-orbital, Sudden, peaking in 10-15 minutes lasting for 5
minutes ..
What is Imp to make diagnosis ¿
Confirm with 100% oxygen by face mask
Rest i forgot.. Sorry

Oxygen (8 L/min for 10 minutes or 100% by mask) may abort

the headache if used early..(medscape)
141
new q lumbar back pain
Pt came with back pain & tenderness in L4 L5 region.. On
gistory it was found that he used to be ivdrug abuser & there
was history of hap c
asked inv
cxr i choose
Mri
Ct scan
Observe
Rest i forgot..

142 neck swelling in rt supraclavicular l. Nodes.. There was hard

swelling.initial Invest was asked..
I choose fnac
Rest were colonoscopy
Gastroscopy

143 check insulin at 3am (somogyi effect recall)

girl with type 1Dm ,on intermediate insulin at night, short
acting insulin in the morning, her parents concerned about her
high glucose levels of 15 at morning, what next? �A)increase
intermediate insulin at night
B)increase short acting insulin in the morning
C)prevent fruit in evening �D)measure glucose levels at 2am
and 3am

helpful n quick link to solve this question:

http://www.webmd.com/diabetes/tc/dawn-phenomenon-and-
the-somogyi-effect-

144
Incomplete abortion recall
pregnant woman at 12 wks gestation presents with heavy
bleeding had an ultrasound Nuchal translucency at 11 wks Abd
rigidity, tenderness .maternal hypotension and tachycardia.
Asking diagnosis
A. incomplete abortion
b. threatened. Abortion
c. Ectopic pregnancy
d. Placenta previa
e. molar pregnancy
145
Down synd diagnostic inv at 16 weeks asked.
Amniocentesis
.15 wks pregnant comes for definitive diagnosis of Down
syndrome
a) amniocentesis
b) CVS
c) nuchal fold thickness
d) serum screening
146 jaundice q direct bilirubin 120
Usg of biliary tree

7 days old with jaundice started on fourth day of delivery with

total bilirubin 240 & conjugated 120, asking cause?
A. Hemolytic
B. Biliary atresia
C. Breast Milk Jaundice

New
147 jaundice hb direct 6
Breast milk jaundice was right there
7 days old with jaundice started on 4th day of delivery with
total bilirubin 240 & conjugated 6,(yes it was 6 )blood groups
were same of baby & mother..
asking cause?
A. Hemolytic
B. Biliary atresia
C. Breast Milk Jaundice(i choose that)
DAbo incompatibility
E rh incompatibility

148.refuse to witness recall

Q You are intern. Patient wishes you to witness
her will in the presence of lawyer.
What should you do?
1. Witness the will
2. Refuse to witness(ans)
3. Ask surgical register if he can do it
4. Seek legal advice

149adhd patient developing symptoms of mania

Excessive gambling.. Insomnia.. Spending money in pathological
gambling bla bla bla
Options were
Psychosis
Mania
Rest i forgot
Diag was asked
I choose mania

Patient was found unconscious.. He ate all things from

washroom cabinet. Wife left him (long stories were there)
Options
Drug screen i choose
Blood alcol levels
Rest i forgot sorry

150
A child with fever and hx of sore throat . 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

Remember in prayers.. & All the best.. 😊😊