Preganant Lady With EBV Exposure OldrecaFll
Preganant Lady With EBV Exposure OldrecaFll
Preganant Lady With EBV Exposure OldrecaFll
162.Old 50 year lady her daughter is going to be pregnant. Vaccination for that old lady
a)Variceela
b)Pertusis tetanus diphtheria
c)Influenz
d)Pneumecocal
e)Hiv
answer isb
84.16 yrs old gal bmi 32 , is starting her sexual life and has come to u for advice on
contraception . u will screen her for ?
a) chlamydia
b) pcos
answer is b she is not sexually active so best option out of 2 is pcos.but keep in mind that v got 3
options missing so must luk out for them also
77.old recall with jvp 4cm.diastolic murmur in aboriginal heavy drinker, leg edeme , cause?
Alcoholic cardiomyopathy, corpulmonale
answer- alcoholic cArdiomyopathy
2
B. Do bone scan
C. Excise theses nevuses
D. Refer to dermatology
E. Regular skin exam - i think annually
326.a man feel that see waves are rolling toward him then he is observed to stare blankly and
irresponcively asking diagnosis
iv are EEG - Specific frontal lobe assesment
Answer is eeg
moment
B. Azithromycin
C. Ciprofloxacin
D. High dose trimethoprimsulphamethoxazole
E. Amoxycillin/clavulinic acid
A young woman presented with high fever, cough, sore throat,weakness, myalgia, headaches and
chills for the last 2 days. The most probable diagnosis is
A. The common cold
B. Influenza
C. Croup
D. Acute bronchitis
E. Exacerbation of COPD
1.
a pt with heart failure on many drugs stop medication for 2 weeks now came with odema upto knee,chest was clear and with sinus
tachycardia what to give?
1.digoxin
2.metoprolol
2 middle aged female with signs and symptoms of heart failure , lower limb edema and pulmonary crackles with
shortness of breath , presented to you, on ECG - FOLLOWED by a period of Asystoly or no pulse and after that the
rythm restored again)
during this period of asystoly the patient was normal and stable with no increased signs BP 120/84 what should be done
next
A)continue monitoring
B) give amiodarone
C)give lidocaine
d) give furosamide
======
K1 recalls 15th Sep 2015-09-15
Every body, let me give you some relieve before read these recalls: by the greate teamwork
5
of Amedixans, my MCQ exam was one of the easiest exam in all of my medical exams
3 year old comes with recurrent UTI, what investigation we should do to assess the renal scarring?
DMSA / DTPA
1.
A Nuclear Medicine DTPA or MAG3 Renal Scan is performed to look at the blood
supply, function and excretion of urine from the kidneys. The test can find out what
percentage each kidney contributes to the total kidney function.
same child what to do after confirmation of recurrent UTI -> cystoureterogram (PUV assessment
1. 1. A youn guy has noticed with a massin his right testis, sono given, what is the most
6
- varicocele
- epididymo-orchitis
- swollen testis with trivial injury
- gynaecomastia (teratoma)
2. a lady fear of going outside specially in large crowded spaces, loves to stay at home
and sometimes her friends visit her at her house. Diagnosis?
A agoraphobia
B social phobia
C.OCD
Agoraphobia is defined as anxiety and/or avoidance associated with situations where
help may not be available or where leaving the situation may be difficult or
embarrassing in the event of panic symptoms or a full blown panic attack. Commonly
feared situations include crowds, shopping malls, driving, public transportation, and
being away from home
The anxiety or phobic avoidance should not be related to another mental disorder such
as:
social phobia (eg, avoidance limited to social situations because of fear of
embarrassment),
specific phobia (eg, avoidance limited to a single situation like elevators),
obsessive-compulsive disorder (eg, avoidance of dirt in someone with an obsession
about contamination),
posttraumatic stress disorder (eg, avoidance of stimuli associated with a severe
stressor)
separation anxiety disorder (eg, avoidance of leaving home or relatives).
3. female 34 anxious about breast ca bcz read in magazine some celebrity got ca at
32.no positive sign and symptoms.no family hx
A)mammo
B)usg
C)MRI
D)reassure that no more inv is needed at this time
E) put her on breast screening program(but didnt said by now or from 50 years of age)
It is recommended that women aged 5069 years attend the BreastScreen Australia
7
Program every 2 years for
screening mammograms
Unmarried women presented with slight lower abdominal pain.On USG 6 cm SOLID
mass beside uterus.whats your DX
1.Teratoma
2.Mucynous cystadenoma
3.Corpus luteal cyst
2.
4.Endometriosis
4.
5. Old patient with iloischial abscess, has this problem recurrent many times, what s the
cause?
A. Anal fistula
B. Diverticular disease
C. Crohns bcz of reccurance
D. Diabetic
E. Immunodeficiency disorder
6- pregnant woman 10 weeks starts to have pain in the right iliac fossa specially when
she stands up or cough she had appendectomy when she was 12 year old , No
rebound tenderness and guarding. wts most likely the diagnosis
a. Round ligament pain .get better with walking
b. Complex ovarian cyst
c. Unrupture Ectopic pregnancy
d. Intestinal obstruction
6. 7- An old women presents with the history of purulent brownish green vaginal
discharge.She only has sexual relationship with his husband.P/S examination confirms
the discharge.Her pap smear previous were normal.What is the most likely cause of her
discharge?
a.chlamydia trachomatis YES
b.Endometrial Ca
c.Cervial Ca
7. 16 y/o girl with a BMI of 30, who has recently become sexually active, what to screen
for?
BP
Chlamydia
DM
Young female after sex with new partner got sorness in vagina, dysuria n also
8
discharge mild few days,spontaneously resolved in a week and now asymptomatic
came to u, cause?
Chlamydia ,
Gonorrhea ,
Hsv,
Candida its a typical case of candida and new partner is for mislead us
3.
11. 37 yrs. old woman with secondary amenorrhea, normal BMI, FSH: 55,
LH: 54, oestradiol: 77, Prolactin: normal, in USG of ovaries: 3-4 cyst, do not
want to conceive, what is the best treatment?
a. POP
b. menopause hormone therapy
c. clomiphene
d. OCP
e. Metformin
POF tx:
If dont want to conceive: hormone replacement therapy (HRT) until the
age of 50 to relieve the symptoms of oestrogen deficiency and prevent long
term complications
If want to conceive: egg donation (Some women try IVF or drugs to
stimulate egg production but these have a low chance of success)
12. male with sperm count 19 million, 40 motility and 65% abnormal sperm.
Spontaneous pregnancy is unlikely.
No chances for pregnancy.
Hormone therapy to male cane help
13. 28yr old lady lst childbirth 3yrs back, regular cycles, trying for the second one,
intercourse timed aroud ovulation .. no tubal pathologies- confirmed, whats the reason for
difficulty to conceive ?
A antibodies to semen
B. male infertility- abnormality of semen
c shortened luteal phase
D inappropriate timing
10
e)stop both
The serotonin syndrome
This is a dangerous adverse reaction related to the use of the SSRis and is most likely to
occur with the combined
use of MAO I drugs and other agents. The diagnosis is based on three criteria:
Symptoms must coincide with the introduction or dose increase of a serotonergic agent.
Other causes, such as infection, substance abuse or withdrawal, must be excluded.
At least three of the symptoms or signs:
- mental status j behaviour changes (e.g. agitation,confusion, hypomania, seizures)
- altered muscle tone (e.g. tremor, shivering, myoclonus, hyper-reflexia)
- autonomic instability (e.g. hypertension or hypotension, tachycardia, fever, diarrhoea)
stop offending agents immediately + supportive therapy
U r an intern. Asked to witness a patients will. Patient is disoriented. what will u do?
a. Don't witness.
b. witness
c. talk to Medicolegal advisory committee report.
d. speak to his lawyer and witness the will
Amc Guidance :Intern Can not take Consents...BUT can Witness Will
Again a Doctor MUST work towards patient's best interest...RIGHT (as per GOOD
MEDICAL PRACTICE)
That dictates that a douche bag lawyer is in hurry n be done with thsi boring job so want U
to witness will so that he can go home...BUT U being doctor know YOUR PATIENT is not in
his Mental Capacity to do so...SO to protect Your patient...YOU JUST PLAINLY DENY.
You go to medico-legal advisory comity IF lawyer is messing with ur patient.
Lawyer has no power on U unless mentioned in advance directives. So plainly deny.
When it comes to Witnessing Wills...It is between U patient n Lawyer...so If U messed
up...it will be ur neck n not health departments or hospital
16. an elderly male who had a fall and fractured his leg. you give narcotic analgesic and he
becomes drowsy.a few month before this,when she was competent she made an advanced
directives and mentioned that if I become VERY SICK, dont do any treatment, what will you
do?/
transfer him immediately to emergency.
11
do nothing
give non narcotic analgesic
family meeting
Send her for palliative care
a legally competent person has a right to chose what occurs with respect to his or her own
person
Legal authority suggests that a medical practitioner should not provide treatment or
perform a procedure in an emergency where there is an unequivocal written direction by
the patient that such treatment is not to be provided in any circumstances. Should a patient
give such a written direction, a medical practitioner should take reasonable steps to
ascertain the true scope of the patients refusal to consent and whether the patient had the
capacity to decide at the time the direction was signed. In such a case, if the medical
practitioner establishes that the patients refusal was invalid or if the patient lacked the
capacity to give the direction, the medical practitioner can treat the patient in accordance
with his or her professional judgment of the patients best interests.
Advance Care Directives may not contain instructions for illegal activities, such as
euthanasia
4. Nerve pinch below inguinal ligament after operation, What muscle will be affected?
Ext Hall Longus
Flexor Hall longus
Fle Hall Bravis
Hamsrings
20. A medical condition is present in 8 out of 100 smokers. A new drug is under
investigation & desired to decrease the condition by 25%. How many patients are needed
for the study?
200
100
50
25
ARR=25% x 8/100=2/100
NNT=1/ARR=1/.02=50
25. 7 yo girl who start to act strange last months. Complain on headache, vomit, stomach
12
ache. Don't want to leave parents car when they drove her to school. If she attends kids
party she is never stays for night. Dx?
separation anxiety disorder
Common symptoms of separation anxiety disorder
worries and fears
Fear that something terrible will happen to a loved one. For example, the child may
constantly worry about a parent becoming sick or getting hurt.
Worry that an unpredicted event will lead to permanent separation. For example, they may
worry about being kidnapped or getting lost.
Nightmares about separation.
refusals and sickness
Refuse to go to school and almost anything to stay home.
Display reluctance to go to sleep and may make these children insomniacs
Complain of physical sickness like a headache or stomachache at the time of separation,
or before it
shadow you around the house or cling to your arm or leg if you attempt to step out
http://www.helpguide.org/articles/anxiety/separation-anxiety-in-children.htm
26. pic of an infant with cleft lip . mother drinks just a glass of wine with hwe dinner every
night . she is on carbamezapine for epilepsy . what could be the reason for it ?
a) genetic
b) carbamazepine
c) alcohol
ETIOLOGY:
Genes
Medications: Antiseizure agents (phenytoin , sodium valproate , and topiramate) and
methotrexate but not carbamezapine
Cigarette smoking
Alcohol (more than 70 g of alcohol per week or binge drinking one or two times per week)
Folate deficiency
13
the risk of alcohol related birth defects (ARBDs) was observed only after heavy prenatal
alcohol exposure (defined as consuming more than 70 g of alcohol per week or binge
drinking one or two times per week) in the first trimester [ 60 ]. There was no association
between ARBDs and moderate or low prenatal exposure.
5. yong woman with hx of 3 attacks of drowsiness last month, last episode occur
when she was in shop in the time of attck she feel detached from everthing but can
remember the event.what will lead u do dx?
1.ct head
2.eeg .Temporal Lobe Epilepsy
3.ask witnessno need when she can remember
4.LP
5.MRI
27. Truck driver having on and off abdominal pain and bloating for the last 3 months,
sometimes he has a foul smelling diarrhoea. He had colonoscopy and it was normal, what
is the best next management?
a. repeat colonoscopy
b. stool culture ............. giardiasis can be the mos likely diagnosis
c. abdominal ultrasound
d. sigmoidoscopy
e. CBC
HB 2.043:The most common symptoms of giardiasis are diarrhoea, stomach cramps,
bloating, nausea, loose and pale greasy stools, fatigue, and weight loss. The first signs of
the illness will appear between 3-25 days (average 7 days)
28. three days after parathioroid sx for parathyroid adenoma, develop finger and perioral
numbness
ca level was low wt to give
1.ca carbonate IV
2.ca carbonate and vit d3
3.calcitrolManagement of hypocalcemia after thyroid surgery day 2-4
Ca <7.5 mg/dL and symptomatic: IV calcium gluconate + oral Calcitriol + oral calcium
carbonate
Ca <7.5 mg/dL and asymptomatic: oral Calcitriol + oral calcium carbonate
29.
14
31. Mother brought her 16 year old ballet dancer girl..breast bud stage 2, tsh fsh and prl
was NL...amenorrhea present, next?
-USG
-reffer to adolescence unit or something like that
-reassure
-pop smear
I choosed sono
32. Scenario of anorexia nervosa,asking about wof will help you to reach the diagnosis?
Brady cardia
Downy hair I choosed it, but its better to check it out
Dont remember others
33
*
RACGP - Assisted reproductive technology - Whats new and whats important?
While definitions of infertility and estimations of its prevalence vary widely, there is
abundant agreement that the consequences of unresolved infertility on individuals, their
families, and the community are profound. Although there has been no recent dramatic
change in the proportion of couples w
racgp.org.au
54 mins
These are some of my recalls: Sept. 15th. Singapore. I apologise for the crude format
but I have not brought my laptop here so I had to type them on the phone. I'll post a
better version with more questions asap. This is for those of you going for exams in the
15
next few days. Good luck. May the fates be ever in your favour. wink emoticon
1)Photo of red macular skin lesion, but not erythema myltiformme or margimatum? With
a history of migrant, blood stained sputum with cough, weight loss, malaise
(Looked like a TB history to me)
1.bronchgenic ca
2.pulmonary TB
2)handbook question 3.042
3)old recall with the old man saying he can see waves crashing over ceiling. Asked to
identify where the lesion is
6. A patient presented with abdominal pain and vomiting.45 years ago he had
operation for uncomplicated appendicitis.xray looked like SBO, very similar to this
pic:
16
-reassure
-pop smear
I choosed sono
8. An 18 months boy is presented with inspiratory stridor and subcostal recession and
cyanosis, T:37,6 puffs sulbutamol given, but didnt get better, O2 sat is 95%. Which
one of the following is the best way to manage his current problem?
A)IV hydrocortisone
B)nebulised salbutamol
C)inh bromocriptin
D)nebulised adrenaline
E)IV penicillin
***there wasnt any option for repeat sulbutamol(eg, 12 puff), I go for nebulised
adrenalin
9. pt do excess 2000 situp daily ,regular 4 hourly gym exercise bmi 19,checks in
mirror several times etc ,dx
anorexia nervosa,bdd,hypomania,ocd
10. An old man with congestive heart failure and hypothyroidism. On levothyroxine, digoxin, and
other medications came with light headedness and palpitations. His HR was 140 regular. The
ECG was sinus tachycardia as I've noticed. Wt should you do:
1. cease thyroxine
2 . stop digoxin
3. Decrease digoxin
4 . add metoprolol
Sinus tachycardia = Exogenous hyperthyroidism
The symptoms and signs in patients who take excessive doses of thyroid hormone: weight loss, heat
intolerance, tremor, palpitations, anxiety, increased frequency of bowel movements, and shortness of
breath
Discontinuation or reduction in the dose of thyroid hormone is usually the only
17
treatment needed IN LONG TERM,,,,. Beta-blockers will relieve many of the symptoms
of hyperthyroidism promptly
11.A young pt with repeated dizziness and fall when standing only. Head tilt test lowers
BP to 70/50
What advise will you give?
fludrocortisone
increase salt and water intake
initial intervention is to increase intravascular fluid volume by large daily salt intake,
either added to food or as salt tablets:
Continue with this until weight has increased by 1.3-2.3 kg; then can consider giving
fludrocortisone, if necessary, to increase sodium retention.
Can precipitate heart failure but peripheral oedema alone should not cause
cessation of treatment.
12.malingerer ask for certificate cause she did exam and she was not good in exam ,
certificate will help her
refer her to university medical section
give her certificate
18
Combining Amiodarone +frusemide can increase the risk of an irregular heart rhythm.
may need regular monitoring of your electrolyte (magnesium, potassium) levels. You
should seek immediate medical attention if you develop sudden dizziness,
lightheadedness, fainting, or fast or pounding heartbeats during treatment with
amiodarone. In addition, you should let your doctor know if you experience signs of
electrolyte disturbance such as weakness, tiredness, drowsiness, confusion, muscle
pain, cramps, dizziness, nausea, or vomiting
http://www.drugs.com/interactions-check.php?drug_list=167-0,1146-0
17.A 24year man came with SVT,Has complained of 4hours lightheadedness &
palpitations. HR 200 and PR 20/MIN Whats next step of management?
A.Oral Digoxin
B.B.B
C.IV adenosine
D.IV sotalol
Paroxysmal supraventricular tachycardia (PSVT) occurs in less than 10 percent of
patients after an acute MI, MxCABDC)
1- Carotid sinus massage or a valsalva maneuver
2- Intravenous adenosine or verapamil
3- Intravenous beta blockade with metoprolol or esmolol or amiodarone
4- Intravenous digoxin
5- If the arrhythmia persists Cardioversion
18.A very clear ecg of second degree / type 1, heart block, pt on poly pharmacy, acei,
frusimide, digoxin, what to do next. No option for temp pace,
Stop dig
Stop acei
Stop frusimde
Permanent pace maker
a progressively increasing PR interval until a P wave is not conducted
19
19. normal phosphate and high calcium >4 while the normal about 2.5 may be with confusion
agitation and constipation asking diagnosis while calcium in urine was in normal range and the
condition started since 4 months,dx?
primary hyperparathyroidism - malignant osteolytic dis -familial hypocalcuric hypercalcemia
20. mother her son with 48 hours rhinorrhea and lots of abscence among his classmates dt influenzaLIKE illnesses asking best to de?
check influenza
7 days off school
wear a face mask
oseltamivir
No viral investigations are needed.
Recommend patients stay at home until symptoms have resolved.
Most patients do not require oseltamivir.
>>oseltamivir is given with 48 hours if patient has risk factors for more serious disease.
Recommend oseltamivir (prophylaxis) for family members (via LMO) if they have risk factors for
more serious disease, or
attend/work in 'vulnerable settings'.
-----------------------------------------------------------Risk factors for more serious disease
Indigenous people
Chronic illness:
pulmonary (including persistent asthma),
cardiovascular,
renal,
hepatic,
hematological (including sickle cell disease),
neurologic,
neuromuscular,
metabolic disorders (including diabetes mellitus)
Immunosuppression, including that caused by medications, asplenia
Long-term aspirin therapy
21.Cardio vascular risk assessment for a 45 y women with bp 142/66 non-smoker, nondiabetic, standard chart was given
10-15 %
22.Sever Ear pain in the presence of a firm submandibular mass; o/e ear and Tempan
membrane was compeletely NL, what help to diagnose ?
See his tongue
23.40 yrs pt with mass in left posterior angle of neck from 3 months ago, painless,
firm, mobile + some neurological symptoms such as dribbling from same side, what
best next inv?
a. Ct neck
20
b. Ct chest
c. FNA biopsy
d. x-ray
e. Ct abdomen
24. football player suddenly feel acute moderate pain in his right knee while playing, after
hours the pain bubsided but effusion expanded,after some days when the pain and swelling
were setteled, some times he feels his leg is giving away and some other times his knee is
locked DX?
A)antcruiciatelig injury
b)med menscial lig if effusion develops within 24 hours
c)medmenscial +ligamentous lesion effusion develops immediately and the pain would be more
severe
d)fracture patella
25.A 35 year old man came with severe back pain over years that is worse when he
wakes up in the morning , the pain and stiffness makes him stays in the bed for at
least 30 min, and getting better by walking along the day , it is getting worse now ,
after tried naproxen, what will u give next? ? this Xray was given:
a. azathioprine
b. adalimumab bamboo spine in ankylosing spondylitis
c. Aspirin
d. Prednisolon
e. Methotrexate
in patients with severe ankylosing spondylitis unresponsive to NSAIDs and physical
therapy: infliximab, etanercept, and golimumab
26.25 year female with unilateral mild painful loss of vision for the past 12 hours.no
headache,no redness, normal fundus examination.visual acuity is 6/60 LT and RT its
6/6. What investigation to do next?
A: CT
B: LP
21
C:temporal artery biopsy
D:Visual evoked potential
there is no MRI in option
unilateral painful loss of vision in a young pt Optic neuritis => Multiple sclerosis
27.Young man after a quarrel had a fracture of floor of eye what is the more consistent
symptom with that
A- conjunctival hge
B-can't open the mouth completely
C- loss of sensation in the skin around
D- reduce the visual acuity
uptodate
Orbital floor fracture (Blowout)
entrapment of the inferior rectus muscle and/or orbital fat
Enophthalmos (the eye is receded into the orbit)
Orbital dystopia (the eye on the affected side is lower in the horizontal plane
than the other)
Injury to the infraorbital nerve (resulting in decreased sensation along the
cheek, upper lip, or upper gingiva)
patient was hit in the left eye with a baseball
limitation of left upward gaze due to entrapment of the inferior rectus muscle.
Medscape
decreased visual acuity
blepharoptosis
binocular vertical or oblique diplopia (especially in upgaze)
ipsilateral hypesthesia, dysesthesia, or hyperalgesia in the distribution of the
infraorbital nerve
28.developmental q 4 year old child whats considered delayment
-2 weeled bicycle3y jm 845
- cant draw a man
- cant put on clothes.5 y
- cant stand one one foot for 20 sec
29.An 11 months old child comes, who is premature (32 weeks not 34), with history of
admission in NICU, low birth weight, normal Apgar, cannot sit without support, and
low weight,but other than everything is normal what is dx?
Normal because of 8 weeks prematurity sit without support 8 mo + 8 w prematurity
= 10 month
22
Douchen syndrome
Cerebral palsy
Polymiosits
Hypothyroidism
30.old pt with known bilateral chronic osteoarthritis, develop parasthesia and
numbness in the lateral side of leg below knee condition worse at night and
improve after walking for 10 min, wt is the important thing to examin in this pt
1.SLR sign positive
2.Any tenderness in lateral condyle
3.Any loss of sensation in the lateral side of leg
Packed cell
23
colonoscopy
Parental iron
Fobt
Small bowel biopsy
***there was no option for oral Fe
This pt is premenopausal but remember that All adult men and postmenopausal
women with iron deficiency anemia should be screened for gastrointestinal malignanc
http://www.aafp.org/afp/2013/0115/p98.html
33. boy hit to coffee table while playing, presents with epistaxis, lip nd mcosal bleeds, thigh
with bruises, no petachie, no hepatomegaly
a. ITP
B. Vwd
c. factor 8
ITP (Immune Thrombocytopenic Purpura)
isolated thrombocytopenia without anaemia, leucopenia or blood film changes
No pallor, hepatosplenomegaly or lymphadenopathy
Most children present with bruising and petechiae alone.
In some instances there is oral bleeding, epistaxis, rectal bleeding or haematuria.
24
Morbidity in ITP is usually minimal and parents need to be reassured of this.
Dx: FBE (including blood film)
bone marrow aspirate only if diagnosis is uncertain
34. mother present with her boy complaining persistant bleeding after tripping with a coffee
table..what is the treatmnet of this condition?
a)steroid
b)IgG
C)platelate
ITP Tx
http://www.rch.org.au/clinicalguide/guideline_index/Immune_Thrombocytopenic_Purpura/
http://www.rch.org.au/clinicalguide/guideline_index/Von_Willebrand_Disease_vWD/
35.borderline personality for management ?
a.CBT
b.Dialectical therapy
c.Exposure therapy
Unipolar major depression with psychotic features
DEPRESSION= interpersonal therapy
social anxiety = role playing
adjustment = problem solving
schizophrenia, bipolar disorder, anorexia nervosa, alcohol dependency, and childhoodand adolescent-onset psychiatric disorders=family therapy
borderline personality disorder= DBT
36.pt with MS usually confused with which disease?
conversion syndrome.
Conversion disorder Symptoms or deficits of voluntary motor or sensory function
that suggest a neurologic or general medical condition and are associated with
psychologic factors ( table 5 ). Typically, there is a sudden onset of a dramatic, but
physiologically impossible condition like paralysis, aphonia, blindness, deafness, or
nonepileptic seizures. Unlike somatization disorder, patients with conversion disorder
focus upon only one symptom.
37.malingerer ask for certificate cause she did exam and she was not good in exam ,
certificate will help her
refer her to university medical section
give her certificate
25
38.teenager with suspiscious scenario of anorexia nervosa,wof lead to dx?
What do you think about yourself
39.pt who didnt make an appointment and didnt pay previous bills, what will you do?
Refer him to the nearest hospital
40. mammography picture given, typical scenario of fat necrosis what is nex investigation?
FNA
core biopsy
excision
26
43.A 12 week pregnant lady came, with standard alcoholic drink every day, use
cocaine, use marijuana, smoke, sometimes use amphetamine which one is more
teratogen for her baby?
Alcohol
Cocaine
marijuana
Nicotine
Amphetamine
We recommend abstinence from alcohol for women planning pregnancy, at conception, and during
pregnancy because a safe level of prenatal alcohol consumption has not been determined
44.scv obstruction senario with face flushing,arm swelling ,wt s the ix to do?
a.cxr
b.mri of cervical spine
d.ct with contrast
SVC syndrome
signs and symptoms of central venous obstruction:
Dyspnea is the most common symptom
facial swelling or head fullness, which may be exacerbated by bending forward or lying
down.
Other symptoms: arm swelling, cough, chest pain, or dysphagia
Patients with cerebral edema may have headaches, confusion, or possibly coma.
On physical examination, the most common findings are facial edema and venous
distension in the neck and on the chest wall
In most cases, symptoms are gradually progressive over several weeks and then get
better over time, due to the development of venous collaterals
Dx:
identification of the underlying cause of venous obstruction chest CT with
contrast
Gold standard for identification of SVC obstruction and the extent of associated
thrombus formation Venography ( Bilateral upper extremity venography )
It is superior to CT for defining the site and extent of SVC obstruction and for
visualizing collateral pathways. However, it does not identify the cause of SVC
obstruction unless thrombosis is the sole etiology
45.an 11 years old girl with intermittent abdominal pain, WBC 20 in U/A and in urine
culture: 100.000 E.coli/ml, what next?
a. Oral ciprofloxacin
27
b. IM penicillin
c. Oral nitrofurantoin
d. No treatment needed
e. IV gentamycin
100.000 E.coli/ml + 20 WBC abseloutely needs treatment, and I go for oral
nitrofurantoin, but please check it out yourself too
HB 3.297
Normal U/A
colonization < 10*8/L or 10*5/mL
WBC < 5/microlitre or per high power field
100.000 E.coli per litre without any symptom + up to 2 WBC/microlitre,should be
considered as an asymptomatic
bacteriuria and We do not recommend antibiotic treatment of asymptomatic bacteria
in children
guys these are all I remembered but let me reassure you that my other questions were also from
recent recalls, exept for about 20 questions which probably were pilot Qs!
I would like to thank every single member of Amedex, specially our angel Danijela
stojovski, my dear friend farzin yaghoubi and shah navvena, as well as all of you
Fortunately I had a good exam and as your little brother just can say 3-4 month recall
is enough, but find reasonable and conficent answer for them and repeat them
Wish you luck
All the best
Kind regards K1 Fallah
===========
46.A 30 yr old computer softwer programmer with hx of 3y outdoor work, with no FH of melanoma came for m
.wats the risk factor ?
A. melanoma in cousin
b. sunburn in child
c. BCC in family
d,hx of outdoor working
47.Pt. had child 3 months ago now she is very stressed & thinking that she may hurt the baby or may be falls
she lift hem , dx?
A) overvalued idea
B) obsessions
C)postpartum depression
D)postpartum psychosis
Obsessional thoughts and compulsive behaviors in OCD during pregnancy or postpartum often concern the ba
contaminating or harming the baby are a common theme. Harmful behaviors are relatively rare but warrant c
intervention as needed to ensure safety
Mild: CBT
Mod-severe: serotonergic antidepressant
28
father comes with her child, her teacher has mentioned some inappropriate sexual behavior in school -> child abuse
Lewy body dementia asked for diagnosis - learn the clinical features
agitated pt -> Im halo
vit D study in Australia I choosed cross sectional
40 y old man comes with all lower motor manifestations eg. weakness, fasciculations asked for diagnosis, lacunar infarct/ lower motor disease
I chose the second one,
cuz in lacunar infarct should see ataxia, Parkinson signs and some sensory deficit
that famous case of DVT redness on thigh! answer was definitely unfractionated heparin
5 year old boy with recurrent AOM, had tympanostomy tube and now has discharge and many things more asked what is the best step for management I chose discharg
slapped chick cuz -> b19
vaginal redness with white plaque what is the next step in diagnosis -> look for clue cells, look for hyphae I chose the 2nd
29
hiatal hernia ct scan (pt comes with SOB and abd pain)
hyperkalemia ECG asked for treatment
1.40 years old lady came to you because of 8 weeks ago her marriage was broken, 1 year ago she was referred for
(Shouting at colleagues) . After finishing her work she cant able to relax at home. What is the diagnosis?
A) Bipolar-II with depression
B) Cyclothymic disorder
C) GAD
D) Major depression
E) Borderline personality disorder
2. 37 yrs. old woman with secondary amenorrhea, normal BMI, FSH: 55, LH: 54, oestradiol: 77, Prolactin: normal,
cyst, want to conceive, what is the best treatment?
a. POP( I selected this no option for clomiphene)
b. menopause hormone therapy
c. OCP
d.. Metformin
3.Most teratogenic for fetus in pregnant lady :
I slected amphetamines no option of alcohol, cocaine or nicotine , others were diazepam and marijuana
4.Pregnant lady after post partaum ,, 6 weeks came with cervical erosion: 2 years back pap smear was negative:
a. repeat pap
b. punch biopsy
c.hpv vaccine
d.pcr
I selected pap smear.dnt knw it was right or not
5.female 35 yrs obese,,,husband 40 yrs of age , she has nrml regular cycle ( 5 days cyle ) no other disease,, can n
two yrs trying:previously had two children, whats initial :
a. semen analysis
b. us abdomen
c. check bmi
6. endometriosis is detected by : LAPROSCOPY
7. mother present 7 yr old girl,, well , no physical finding,, histry told that school friend lived here at home for three
a. give cefotexime to child 500mg iv
30
b. give cefotexime 500 mg to family
c. councell mother that its not spread thru this contact only
d. say mother to bring when symptoms develop
8. Pt with long standing back pain, no Rx at all, xray show bamboo spine, patient already took paractemol and code
A. Mtx
B. Indomethacin
C. Chloroquine
D. Infliximab
E. I dont remember
9. Pts unable to move his rt hand to abduct with loss of sensation in lateral aspect of arm. Lesion involved
a) C6 b) C5 c) C7 d) T1
10. screening of prostate cancer in pt whose father has prostatic cancer at same age 55 ,, DRE was done already
a. now do psa after 2 weeks.. it looks relevant , no other
11.Picture of para umblical hernia in 5 yrs child ,, no symptoms
a. surgical repair
b. reassure
c.rest were irrelevant
12. Picture of scabies.. treatment was asked
13. 55y old man after return from Bali after short holiday of 5 days with his wife presents with Fever, chill, abdomin
jaundice. All of liver function tests show impairment (AST, ALT, ALK). Dx? (August Recall 2015)
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Cholangitis
e. Malaria
14. pregnant at 10 weeks, she has done IVF after several years of infertilty , she is concerned about Down syndrom
had a baby with Down Syndrome
a- Nuchal Transclucency
b- amniocentesis
c- CVS
15. Most common cause of macroscopic hematuria.. bladder ca
16. Csf :
there is RBCs
Glucose low
31
after long thinking I did Predinsole as it was generalized .. may be im wrong but there my mind said that not ganc
18. You are visiting home nursing for elderly and the nurse told you that there is 85 years old man and 74 old wom
this irritate the residents. Nuse asked you to change the medicine for them
Take to them
Take to each one alone
Take to their families
Do not change the medicine and say doctor has authority to decide and its final
19. one scenario of stone in upper calyx of kidney in young age no symptoms in urine..
I did ,, review xray after 6 weeks
rest of options were surgical
20.other renal stone at distal site with urinary problems size was 4mm=== ESWL was in option
21.man from veitnam 6 weeks before, now 5 dayss back developed constipation and then blood in stool what frst t
a. dre
b.us abdomen
c. ct scan
d. protoscopy
22. Old lady with Hx of prolapse, now has urgency but no stress incontinency.IX ?
A) Urodynamic studies
B) UMC
C) Anticholinergics
23. guy with hemothorax, trachea shfted to same side.. had stap wound to chest,, reduce air entry ,, no previous d
purcussion
a.. under seal drain
24. two PE scenario ask about inv CTPA,, one was having travelling histry nd d dimer was done
32
32. same type of scenario, this time was old in right side and non.transillumination I did also us here initially
33. grand mal seixure . Driver in local bus, no finding on any blood or physical investigation.. no eeg option.. advi
months and check ilicit drug in urine.. I did this one
34. a child with bacterial meningitis being treated with ceftriaxone n half daily requirement had a seizure >5min s/
s/Na=118mmol what is the cause of seizure?
Inappropriate ADH secretion
Dehydration
Antibiotic reaction
35. a young guy with symptoms of heart failure and generalized edema and bibasilar crackles, the urine showed pro
think on x ray normal cardiac sillohet and bilateral lung infiltrates
antiGBM
36. acute OM scenario ,, same old recall. Amoxicillin
37. One qs typical of ca pancreas asked what INITIAL invst u do.old with painless jaundice
Usg abdomen
CT abdomen
Cxr
38. clear USG pic of mets in liver. And the scenario was Sheep farmer with RUQ pain with H/O chole
hemicolectomy for carcinoma colon 2 yers ago.usg pic given.but I cant recognize the pic.
Next inv
1.Hydatid serology
2.Triphasic CT
39, old patient on morphinecomes with wife and drowsy next
33
I did ,,, hydrate first
40.
41. cellulitis scenario in diabetic with temp 38.2. asked investigation
Blood culture
Doppler
42. old recallmother wana knw abt hx of child she was 14 yrs old ..
option was come with daughter next visit..
43.one recall was about copd,, she hospitalized with agitation and dyspnea.. what next
a. abgs
b. ct scan
c. cxr
d.antibiotics change . Already taking and I went for abgs, as she was hospitalized
44. one more was 84 yrs old lady taking asspirin, bb, and oral , has type 2 dm and hypertension..... she hass recu
asked ? everythng was nrml , ecg was told as nrml ,, i did hypoglycemia
45.MgSO4 toxicity in eclampsi women first sign == Hypotension
46. i remeber one,, tongue lateral border has lesion white one, do not cuaterize and not removed on that ,, what di
cell carcinoma
57. one scenario of cystic fibrosis , same hb qs in child problem blah blahinvestigation asked
58.
60. 10 days boy becomes blue when he cries or on exertion. At birth all examinations were normal. APGAR score w
murmur found on cardiac exam.
a TOF
b ASD
a C. VSD
b D. TGA
61. 50 years male, MI case after angioplasty he feels a mass in inguinal area, pulsatile and expanding in nature. W
treatment?
a. Pressure on the area by hand
b. Urgent repair of femoral artery.
c. CT
d. nothing to do
34
=====
2. 55 yrs she got mennapause and now she is 62 yrs oldwho is sexual lyrics active with her husband with va
discharge, her all pap smear had been normal.what is the most likely diagnosis
A.candidiasis
B cervical cancer
C.cervical ectopic
D.chlamydia
e. endometrial ca
for most likely I chose Chlamydia only
3
4. 8 weeks of amenorrhea now present with vaginal delivery what will help to confirm pregnancy is norm
like that
a. bhcg levels
b. tvs
I choose b
5.pic ofcleft palate of a child and again asking the most common reason.. with carbamazipine and smoking h
6.
7.qs of some surgery and on 4th post op day pt presented with pain on left side and dyspnea want to know
to confirm the diagnosis
Keeping pe in mind but no ctpa and no v/q and I choose pulmonary angiogram
Other were d dimer and cxr and ecg
9.colles fracture scenario and with x ray and ask for when to reviw
I answered 2 weeks and same qs ask for the treatment also
10. Which of the following is least likely to be relieved on HRT
a.depression
b.insomnia
35
c.hot flushes
d.vaginal dryness
e.urinary frequency
answer is depression
11. pic of sialedinitis asked for the diagnosis
12. Asbestos exposed man came for advice. During work workers do not use mask, but they are exp
renovation. He is worried about asbestos related cancer, what advice:
Refer to respiratory specialist
Xray now and then 5 years later=YES
Inform government to take some legislation
Do nothing
Inform asbestos has very low risk for cancer
Answer is xray now and then 5 yrs later mentioned by frazin so m with it too
The same scenario
14. Child 4yr with 2 day prodromal then cough fever 39 nasal flaring, tracheal tug,inter
o2 sat 92% treatment
a)nebulized salbutamol,
b)nebulized bedosinuoed
c),im adrenaline croup
d), iv benzyl penicillin
e)iv fluxaacillin
ans as fever is pointing to pneumonia so I choose d
36
16. old pt with known bilateral chronic osteoarthritis, develop parasthesia and numbne
side of leg below knee condition worse at night and improve after walking for 10 min,
thing to examin in this pt
a- SLR sighn positive
b- Any tenderness in lateral condyle
- Any loss of sensation in the lateral side of leg
answer ic c
I choose c too
17. 55 yr anemic wt loss angular stomatitis , howell jolly bodies no hx of diarrhea or GI symptoms ix
- endoscop
- electrophoresis
- small bowel bx
ns is celiac ds so c
19. A chest x-ray given showing half of the left side lung field opaque. Asked for preferred investig
Ct chest
Bronchoscopy
Lung biopsy
Answer is choose was a
20.2 similar scenarios of capsular endoscopy only some choices they changed but qs is totally ide
21.again the scenario of primi gravid with her mother h/o diabetes mellitus during pregnancy. And
this girl now
a.fbs at 28 weeks
b.ogct at 26 to 28 weeks
c. ogtt at 26 to 28 weeks
d. ogtt at 20 weeks
e. blood insulin levels now
I choose d
22. Patint presented with wt loss for last 3 months and fever.on urine RE-pus cell,RBC b
growth of organism in culture.What is your DX
1.Renal TB
2.RCC
3.AIN
Answer I choose is 1.
37
23. 19 years Unmarried women presented with slight lower abdominal pain.On USG 6
beside uterus.whats your DX
1.Teratoma
2.Mucynous cystadenoma
3.Corpus luteal cyst
I choose 1 only
24.women with 2 days h/o vison problem on left eye and pain behind the eye rt eye
with 6/12 and rt with totally normal visionnormal papillary reflex and normal movem
particularly mentioned
1. ct head
2. visual evoked potential
3.lp
I choose ct keeping periorbital cellulitis in my mind
25. After removal of central venous line a lady developed facial swelling and swelling a
is the most appropriate inv
1.CT chest with contrast
2.CT head,neck
3.CXR
Answer is 1
28. Obstructive sleep apnea scenario obese with waist n neck circumstances
1.wt important mx in long term...?
A.wt loss
B.metformin
Answer is a wt loss for me
29. An old female patient on peritoneal dialysis for many months and well controlled o
suddenly refuses to be .Which of the following is the reason
A. depressed mood
B. disorientation
C. blunted affect
Answer is a
38
39. and scenario of varicose vein and mi and on clopidegral started 7 days before.pt is on stent and clopideg
a. refer surgery after 12 months and stop clopidegral 10 days before surgery
b. do surgery now
c.give platelets not and do surgery
I choose a
40. Old age female had a will not to admit her when she is terminally ill , today she fall
she became very drowsy after morhine inj. , what to do now ?
A)Operate her Fracture
39
41. man comes to ED with open wound at chest on examination, vital signs are stable
at the left lower lobe of chest & reduce breath sound in the left side. What to do?
a. strap the wound with pressure
b. intubation
c. underwater-sealed drainage
d.needle thoracotomy
I choose c only
42.
44.same scenario of premature child and now presenting late signs of development
I guess that is because they born immature
45. sign of familial hypercholesterolaemia
a. tendon xanthelesma
i choose it
40
52. 9month old boy with complain of fever 39, cough, tracheal tug, intercoastal recessions and lethargy ca
fluids and oxygen.
A) pneumococal pneumonia
B) croup
C) bronchiolitis
D) anemia
Answer is a
=========
18 July Sydney
1. patient was oliguric after knee surgery : kidney angio
2. jaundice in baby in first 24 hrs after birth.indirect bill rised:
haemoly
3.
4. A university student ask for certificate cause she did exam and she wa
exam, certificate will help her..
A. refer her to university medical section
B. give her certificate
C. refuse to give her certificate
5. .mother come with 10 month old infant with increase head size from 25
birth to 75 percentile now and on examination child hypotonic with ope
fontanelle what will you do next??
a. CT SACN head
b. check CMV infection
c. TSH
d. head ultrasound
41
e. rubella test
Cystoscopy
Ct
7. Guy with ankle joint close trauma after MVA. Skin on feet is pale and co
detect pulse there. Asking next management
A/B
Debridement
Reduction of joint in ER
Tetanus prophylaxis
8. Worried mother of little son about MMR vaccination for her child who is
What to advise her
1- MMR is contraindicated in this case
2- MMR can be given safely
9. 2 year old with fever, upper abdominal pain and vomiting for last 2 day
PR 120/min RR 30/min and he looks unwell..xray done and it showed
lobe opacitytreatment PNUMONIA
A: amox/clav
b: IV pencilin
c: roxithromycin
d: IV flucloxacilin
10.
11.
42
12.
13.
14.
young male with h/o asthma presented with c/o dysphygia on and
mentioned that with particular foods its worsened .diagnosis asked : e
esophagitis
15.
Another scenario of eosinophilic esophagitis, he was given PPI but
fluticasone
16.
17.
scenario of pontine infarct with typical features of sensory loss on
other on oppiste sidediagnosis was asked
18.
old lady with weakness, low back pain, cbc found to have low hb ,h
diagnosis was asked..myeloma
19.
20.
21.
22.
man went to police saying some people are trying to kill him and
him to u what next..collateral history
23.
Young women 25 years old with rash on face and hands with swell
43
24.
25.
The question about the lady with DM and amputation of her foot
with all high BP, lipids and glucose tighter glycemic control
26.
27.
The question with CSF typical for TB young lady malaise for a
some PMN but mostly lymphocytes, protein high , glucose low
28.
Patient presented with wt loss for last 3 months and fever.on urine
RBC but there is no growth of organism in culture. What is your DX
1. Renal TB
2. RCC
3. AIN
29.
30.
Woman last period was 3 months ago, complains of hot flashes an
unpredictable bleeding cyclic HRT
31.
The old lady with redness in front of the tragus but clearly given p
44
lying in bed with IV lines and nasal prongs - I marked poor oral hygien
32.
33.
An adolescent boy with episode of sudden fall in the playground re
consciousness with 5 mins and started playing within 30 mins . diagno
a. postural hypotension
b. arythmias
c. vasovagal syncope
34.
35.
Cohort
Cross sectional
Case control
Randomized control
36.
An obese 32 years old lady whose mother developed gestational d
later developed Diabetes, presented at 8 weeks of gestation what you
A fasting sugar now
B ogtt at 20th week
C ogtt at 28-34 week
37.
38.
Old lady patient of anxiety disorder, breast ca, mets in the bones,
requests u not to tell his mother about it . What shall u do? old recall w
option
1. Call a family meeting without mother
2.tell the son to book another appointment
3.come with his mother in next vis
45
==============
Ist important thing.dont only rely on recalls..use them for topics..coz I got very few recalls with change options.and almost
1.Easiest question of my exam..Common site of endometriosis
2.16yrs girls with BMI 30 just started her sexual life..what will u screen for her
Chalymdia
PCOS
Obesity
4.
5
46
Laprotomy
24.Old recall of renal TB
25.
26.
27.10 yrs girls fall from tree came to you she has protein +1..after three days urine test normal
IGA nephropathy
Underlying UTI
Resolving PSGN
Response of body to injury
28.
29.old recall of pt with 4th post op day.minor tear during delievery which was not stitched.fever and foul smelling discharge..w
Endometritis
UTI
Wound infection
30.Trichotillomania..Boy with loss of hair and eye brow in irregular [pattern..and aome other mood changes..ask for treatmen
Cognitive therapy(I opted this)
Family therapy
Antipsychotic
31.young girl with BMI(falling in obesity)all family members are obese.
Reduce exercise
Increase soft drinks
Strict dieting plan
Family counselling for obesity(I opted this)
32.Bilumia nervosa snerio..A girl with binge eating and laxative use..what is imp rizk factor for this conditionDont remem
history of sexual abuse in childhood(acc to HB all eating distorders shud b looked for sexual abuse history thats y I went for
33.Borderline personality disoreder..asked for Dx
34.Bipolar disorder snerio..asked for treatment
35.ADHD snerioasked for treatment
36.asperger child..asked for Dx
37.Obsessive compulsive disorder snerioasked for treatment
38.
39.old recall of lady in shopping mall..dont touch anything in fear of hepatitis and blab la..asked for treatment
40.Pt has snoring and reduce sleep..some time irritable and lonnggg snerio..what is best inv
Sleep study(I did this)
ECt
Ct
41
42.old recall of pt with recurrent falls and in shopping mall loss of consciousness but she remembers the event..what is initial
Witness
ECT
MRI
44.Drug interactions atleast 5..do drugs of CVS and HTN
45.Diabettes 1 and 2.2 snerios..dont remember
46.15 snerios of resp systemAsthma ..pneumonia..bronchiolitis..bronchitis..all with different stems ..so do it properly
47.Macular degeneration snerio..optic disc findings
47
48.Aboriogal child with ASOMtreatmentoral amoxy
49.Old recall aborigional mother with child ..no eye contact
Cultural issues
50.marjuana abusedont remember the stem
51.alcohlic pt with disorientation in emergency..IM halo
52.
53.
54.A
55.old recall of swelling infront of parotid ..what is initial best
CT(as everybody said on amadex)
FNAC
Biopsy
USG
56.PT with history of trauma to breats..Mamography was given.it was fat nacrosis..what is next
Excisional biopsy
58
======================
19th Sept 2015 - Melbourne
Swetha Iyer
1) Questions of Com med same as recalls got 3: rship of MI &Htn; melanoma n naevus; salmonella 3
exactly same as recalls so please just know the ans well so time not wasted much in these simple o
3) Another ecg of pt with 3rd drgree HB asking mxpacemaker, stop BB and add verapamil.stop digo
4) Effect of dothiepen arrhythmia
11) old lady with loss of vision in one eye for 2days, she has no other symptoms lf eye vision is 6/20 an
next to do
a. do carotid angiography
b. no options of vEP or MRI others irrelevant
13
14) pt with varicose veins and is on clopidogrel what to do:
a. do surgery now
b. give ffp and do surgery
c. delay surgery for 12months and stop clopidogrel a week before and do surgery
48
15)
16)Meningitis scenario with mononuclear cells very high some few neutrophils and rbcs given asking orga
strep pnuemother options of bac
17) 38 year old obese lady primigravida presents to u at 10weeks. Her mother diagnosed with DM at 52yrs
for it. What is the most appropriate management for the her?
a. Ogtt 26-28wks
b. Ogtt 20wks
c. Fbs 1yr
d. Ogtt 6-12 weeks postpartum
23.) abroriginal child comes with lf side green purulent ear discharge and nasal discharge both green and
dull retracted TM what is most app:
a) amoxcilin
b)ear toilet
c)prednisolone
d)reassure
24)
25)
26)man with loin pain and hematuria what in the options needs surgery:
a. severe pain for 48hrs
b.fever
c. vomiting nausea
27) again same scenario but ct done 1cm stone in renal pelvis what to do:
a. eswl
b. surgery
c. percutaneous nephrostomy
d. observe and hydrate
28)16 y/o girl with a BMI of 30, who has recently become sexually active, what to screen for?
BP
Chlamydia
DM
29)
30) 28yr old lady lst childbirth 3yrs back, regular cycles, trying for the second one, intercourse timed arou
pathologies- confirmed, whats the reason for difficulty to conceive ?
A antibodies to semen
B. male infertility- abnormality of semen
c shortened luteal phase
D inappropriate timing
31)mmr vaccine quest egg allergic child what to tell the mother
32)
32) abd xray of pt with LBO asking dx: sigmoid volvulus
a. psudoobs
b.sigmoid volvulus
49
c.ca cecum
33)pregnant lady with MVA comes with complaints of abd pain on examination tender uterus and bleeding
whats the most app next:
a. IV fluids
b.ultrasound
c.amniotomy
d.urgent cs
34
35) Pt. had child 3 months ago now she is very stressed & thinking that she may hurt the baby or may be f
when she lift hem , dx?
A) overvalued idea
B) obsessions
C)postpartum depression
D)postpartum psychosis
37) colles fracture xray give exactly dinner fork deformity and asking when to review pt after cast
a. 2wks
b. 1wk
c. 3months
d. no need
39)
40) An old recall of old man on morhine ,drowsy and dehydrated wife concerned that his medication is cau
a. decrease the dose of morphine
b. hydrate the patient
Thats all guys, I am saturated remembering the questions, will try and remember more and post more.
My exam was okay but I am not sure how i answered? I did get recalls but the options and words differ a lo
whole scenario but they r a must for everyone going for the exam please be active on the group and ans a
helps u remember in the exam. Just read JM, Hb and recalls thats what I did and also Medscape and few r
Finally my thanks to evey single person who helped me in amedex you guys are all amzing . sp
50
-US bladder
-CT
-IVP
53.scenario of multiple mypeloma with anemia and esr 104 ask for d diagnosis
I went for bone marrow examination
54.that old scenario of football player got down and than stand up in few minutes and start playing after 30
I choose vasovagal attack
56.pt with gout attack and got renal failure and asked for the treatment and i choose steroids
57. pt on opioid become drowsy, dehydrated wife think opioid harming him, next
Reduce opioid, continue same dose, hydrate
I went for hydrate the patient first
58.2 qs about nocturnal dusuria in a 4 years old child and one with option urni and cs and no option of nothi
with the option of nothing to do now
So i choose urine cs in one and nothing to do in other
60.dvt two or 3 scenarios almost similar so nothing to worry its from repeated qs only
61.scenario of schock and asked for what to do next.. easy qs to start ns
62.scenario of rhabdomylysis and ask for Mx
Ns with desired 2ml/hr urine output
Ns with desired 1ml/hr uo
I went for 2ml / hr.. old qs
63. CT scan of a sheep farmer.. ct was not so clear but as dimensions were given I could have see cysts so I
cyst only
a. serology for hydatid cyst
b. aspiration of the cyst and cytology of its fluid
ANSWER IS A
64.same recall of svc syndrome and what to do next
51
Ct chest
65.that 19million sperm/ml qs
And m sure its not only 19million its 19million/ml
And answer is pregnancy is possible
66. two qs about smoking cessation with one in pregnant female
Non nicotine chew gums
Nicotine therapy
I went with chew gums
67. in other smoking cessation I guess normal lady want to stop smoking and ask for help.. what to do first
1. nrt
2. chew gums
3. first decide the plan for smoking cessation with her
I choose 3
68
69.old recall of pregnancy with 2 fetus 12weeks pregnant
Folic acid and iron
70. lady with 3 fall history in market which she remembers and feels like detached and i think its an old scen
1. eeg with vediometry
2. ask the witness
3. lp
I chose 1
72. A patient is confused and agitated, lawyer comes to you and asks you to witness his will. What will you
A- Witness will
B- Refuse to witness will
Answer is b
73.that scenario where mother dont want to immunise her child
Answer is respect her wish
74.scenario of iga nephropathy with h/o recurrent hematuria
75.scenario of engineer the old recall where we do endoscopy as all other conditions are normal
76. A 60 y.o. man develops lightheadedness and palpitations. He has hx of thyroid disease and we
failure. He is on thyroxine, ACEI, diuretic. ECG is given clearly showed AFib. What is the next ste
a. Cease thyroxine
b. Start digoxine
c. Start b-blocker
d. Start verapami
Answer is c
52
========
2 questions on skin with picture scc, bcc asking for diagnosis and management
Fracture of tibia and fibula, open communited #, what is the most important step in management?
a. Removal of dead and devitalized tissue with antibiotic cover
b. Urgent blood transfusion and oxygen.
A young 24 year old presents with explosive diarrhoea irritable bowel syndrome/ inflammatory bowel disease
Atypical pneumonia asking for management (choice of antibiotics given in the options)
These are all the questions i could remember, i apologise for some being incomplete. I had a lot of new questions
Study abdomen thoroughly, i got many questions in that field. Be sure to read topics thoroughly (especially comp
questions surprisingly nor did i get any CT scans. I really really hope i Pass!!!! Good luck to us all, thanks gold sta
bless.
=================
53
1-
3- 5yrs old child with vomiting and headache since 6 wks temp: 37.8. Exam: non tend
node in posterior triangle of neck best next inv?
A. Blood culture. B. Ct head. C. Urine culture
4
5- a picture of melanoma on face
===========
54
====================
read
55
1--
baby 2 months age . live in family house ask about vaccines to protect her baby
nza vaccine
3--5 years old boy with cough from 12 months before, was on salbutamole n also tkn oral prednisolone..he has an eczema history, both parents are smo
which one is the best medication for prevention which is used in INHALATION MODE?
a. l monte
b. Chromoglycate
c. Salbutamol
d. Fluticasone
e. budesonide
4-- worst interaction for renal disese
1.gentamicin+cloxacilin
2.gentamicin+cholramphneicol
3.gentamicin + cephalothin
4.interaction with penicillin
5--A young lady with H/O rhinorrhea,low grade feve,photophobia with some neck stiffness.
LPprotein,glucose both are normal,
rbc-100,
lymphocyte-3oo,
neutrophil -20
whats your management
1.iv ceftriaxone
2.iv acyclovir
3.analgesia and observation
6--question about man 64 yr old prostate cancer ..gleason score 4 ..small focus of adenocarcinom
Radical prostatectomy
External beam radiation
56
Orchidectomy
7--question about man 44 yr old prostate cancer discovered ..gleason score 7 .. t3 n0m0
Radical prostatectomy
External beam radiation
Orchidectomy
9--child 6 yr old with asthma mother gave 6 puff of salbutamol .NO improvement speak in words
Give another 12 puff of salbutamol
Give ipratropium
10--13 yofemale , change behavior in school , u had pemission to interview mother , what to check
-history of family mental dis.
-her mood and appetite
-her relation with parents
-change of her school grades..
10--old recall with pregnant with genital herpes, wot to diagnose latencyPcr
, igm now,
biopsy from ulcer( I marked pcr)
Send for Serology now
11--.a young woman present with sevre chest pain aggrevated by inspiration.on exam ahe has a c
sound (I clearly remember ) in left sterna border,she has H/o pulmonary embolism before.whatinv
1.antinuclear antibodies
2.ctpa
3.V/q scan
12-- 80 yr old woman fall from a low high chair and intramedullary nail is given for her femoral frac
advice during discharge??
1.alendronate
57
14--moderate croup scenario with 02 saturation 93% asking next initial appropriate?
.
1.supplemental o2
2.oralprednisole
3.iv methylprednisolone
15--salmonella case in your gp practice in the last week.what study will you do to find out the caus
1.Case control
16--.a man present with left hand and leg weakness.he is on aspirin.she has bilateral carotid arter
h/0 coronary angioplasty 5 years back.what to do?
1.add warfarin
2.addclopidogrel
3.carotidendarterctomy
58
17-- old lay taking carbamazepine and drink alcohol 1sd per day .pic of cleft lip.cause picture was
1.genetic
2.carbamazepine
3.alcoho
18-- a 3 month old child vomit out of milk for 3 days.he was gaining wight previously bt no wt gain l
electrolytes value was normal and urine tset also normal.dx
1.gerd
2.pyloric stenosis
19--uti young guy comes and says he cant sleep so has started on marijuana . he is a good studen
term relationship with his present gal , family v supportive , has come along . tells u to give him pill
so that he can get better as he is sure its sleep thats a problem . no suicide ideation .ur mx ?
1.zolpidem
2.sleep hygiene and routine
3.tell him to stop marijuana
venlafaxine
20--obstructive apnea in a fat man long term Mx
a-CPAP at night
b-Surgery
c-Wt reduction
21--iron deficiency anemia, endoscopy normal, colonoscopy normal but could not go beyond hepa
symptom of GI. Next?
Capsule endoscopy
CT colonography
22--orbital floor fracture.which will u find..dey asked similar one we discussed most consistent one
1.instable TMJ
2.subconjunctivalhemorrhage
3.loss of visual acquity
59
24--A mother complaining that her 10 months old child cant sit supported, he was born 35 weeks,
of the delay
1.Normal delay
2.Due to prematurity
3.Cerebral palsy
25--scenaro of hyperkalemiapt present with confusion,K was 6.5,urea and CR also very high.next
1.urgenthemodialysis
2.rectal calcium resonium
3-5%dextrose with insulin 10 unit
26--old recall with cxr, not typical for sarcoidosis but hilar nodes prominent in one lobe and patient
intermittent abd pain with hematuria.what next investigation?
1.Ace level
2.Mt test
3.ct chest
4.ctabd
27-- patient presents with symptoms of dysuria and hematuria.She has a history of weight lossfrom
malaise.On U/E Rbcs and pus cells present.Your diagnosis?
a)Renal cell carcinoma
b)Renal tuberculosis
c)Bladder carcinoma
28--.xray of collesfracture.asking for follow up after
60
1.1 day
2.1 week
3- 2 wks
29--young guy taking about 20 or25 tablets of paracetamol for suicide his family bringed him to h
A-activated charcoal
B-paracetamol levels
C-N acetyl cysteine
30--a young 25 yr women with rash on face and hands with sewlling of joints .what is the consistan
Ana is 1/640,speculated
Dna 25
Ra factor 14
1.chondrocalcinosi
2.punched out lesion
3.periarticular osteopenia
4.periarticular erosion
31--a man on antidepressant rx for 2 years for 1st episode depression and now recover cmpltly an
rx.best advice
a.continue for another 3 years
b.decrase dose over 2wk interval and discntinue then
c.decrese dose every alternate day and then discntinue
61
3.CT
34--.Young patient presents withankle dislocation,loss of pulse and some paleness at ankle at ER.what will y
1.Reduction in ER
2.Send him to OT
3.Immobilize with plaster
4.surgery
35--.a middle aged man with long history of diabetes present with pain and redness in leg,temparure was rai
venous dicsolration around ankle.next inv.- previous H/O dvt and pt is on warfarin (mitu)
1.duplex usg of leg
2.blood culture
Angiography
36--9 mont old child present with fever 39,cough,dyspnoea,tracheal tug present but chest was clear.,whats u
1.rsv bronchiolitis
2.sterpto pneumonia
37--65 yr old lady with H/O DM,ischaemic heart disease was on antidabetic,anti htn drug.her routine inv sh
HbA1c-normal
RBS-normal
Cholesterol-4.4
She is on strict dietary control and do regular exercise for a long time.which is your next mx
1.start statin
62
63
>> Hypoxia 20 %
>> Hypoxia 10%
43--cardiovascular risk in 5 years for 54 yrs male non smoker diabetic bl.p 149/89 chart give
44-- cardiovascular risk in 5 years 34 yrs old male smoker non diabetic bi.p 125/35 chart given
1.
====
Read only high lighted
Read thz wdout high lighted
64
65
66
67
====
elderly pt came with swelling in rt jaw angle hx of dry eyes and polyarthralgia. For 5 y
done was nl next mx?
A. Sialography. B. Ct... C. Biopsy of sialo duct. D. Us
- 65 yrs old man after knee surgery developed abd distrntion and vomiting ( pain wasn
cause ? There was a ct wasn't realy diagnostic
68
A. Colon cancer
B. Psuedobstruction
C. Volvolus
D. Fecal impaction
18- A Q anout B12 deficiency sign and symp don't remember exactly just had segmen
neutrophil low HB MCV 118
A. B12 deficiency
B. Iron deficiency
C. Folic asid deficiency
19- a COPD pt with shortness of breath on 8L/min O2 then got worse next mx?
A. Intubate him
B. Change to lower O2
28- 48 yrs man sever depression refused to eat and drink and medication and refused
next?
A.take consent from his son to perform ECT
B.consent from mental health tribunal
C. Consent from higher authority
D. EcT without consent under the provision of duty of care
E. Give nasogastric feeding and antidepresant
==================
28) 2 scenarios of schizophrenia. One asking about lack of insight. Other asking for first drug in treatment of psychosis
29) case of achalasia
30) case of sigmoid volvulous..x ray shown
24) case of Q fever
25) case of congestive heart failure.
26) in case of acute stress what hormones increase.
a) increase TSH increase cortisol
17) case of enlarging parotid swelling with facial nerve involvement.What is your next investigation.
a) CT head and neck.
69
70
Cardiovascular risk estimation I picked:
There was no option exercise or dietry plan
I think one was treatment of HTN
A photo of a smoker with finger amputation and history of discoloration in the cold weather
Burger(tromboangitis obliterans)
A long question about hyponatremia
A question of ecg hyperkalemia .asked rx?
Recall of child that can not communicate in school .. interest in matemathic .. no eye contact .. mild language delay?
Aspergaer was one of options
============
20. CTG q/s: meconium aspiration
==============
osteoporosis in a 61 year old man with BMI 18 -> I choosed BMD
6 hours after birth the child develops jaundice most common cuz -> ABO
postpartum psychosis / depression in the past now the lady is worry in her current pregnancy. I choosed delay SSRI to after pr
no signs of anything! risk of recurrence is 30-50 in post-postpartum psychosis and it is highly strongly recommended to start a
other diagnosis were awkward to be frank! the other one was conduct.
==========================
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=============
. one man was frm village side,, drinking 14 drinks per weekned , family hx of cvd, heart disease, he
he is smoker too.. advice for hypertension
a. 24 hr bp monitoring ,
b. homebp check regularly
c. advice stop alcohol
d.admit
==================
8.scenario of pseudoobstruction with x ray given as pt with h/o of some surgery 25 years back not present
and x ray suggestive of toxic megacolon .. age is about 55 I guess..
Treatment
I choose gastrogaffin enema
COLLES # RX
18. lady going to be grandmother ask abt which vaccine necessary to her to protect baby
- infuenaza
- dpt
- Typhoid
answer is b i.i tp or dtp whichever in choices
32. 16 yrs old gal bmi 30 , is starting her sexual life and has come to u for advice on
will screen her for ?
a) chlamydia
b) pcos
answer is b for me
43.old scenario of marijuana pt taking it for pain relieved and now started hypnogog
1. refer to psychiatrist
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================
59.Young lady irritable and uneasy with periods..she has regular periods and no other complains..some symptoms of MMS..w
NO option for relaxation therapy..so I opted for evening primrose oil daily as no complaint of periods
child with sweeling and purulent discharge from ear..tenderness on back bone of ear(like that)what next inv
Culture of discharge
Blood culture
pt presented with oliguria in emergency..he has fracture of tibia 4 days back..what is initial inv
Usg
CT
Ranal angiogram
Urine culture
19.PT presents with 24 hrs history of vomiting and abd pain..tenderness in lower abdomen..Xray shows dilated small intestina
levels ..Dx
Pancreatitis
Cholangitis
Cholelithiasis
Crohns Ileitus(I pted for this)..dont know rt or wrong
pic of ant shoulder dislocation.wat u do istreduction in ER
fracture of clavicle Xray..management aske ..initial
73
Old recall..pregnant with family history of diabetes at 10weeks.wat will u do
Ogtt at 24-8wks
Ogtt at 20wks
FBS now
.some ctg was given.with no acc and deleration and gr 140..
Hypoxia 5% chance so monitor it regularly
Fetal demise
And some weird options.i went for A
=============
scenario of type2 dM in patient had amputated lf leg few yrs ago and now comes with long lab inv HBA1c i
HTN, inc lipids what to do to prevent other leg amputation:
a. meticulous foot care
b.tight glycemic control
c. lifestyle modification
d. cant remember
36) 26. pic of an infant with cleft lip . mother drinks just a glass of wine with hwe dinner every night . she is
epilepsy . what could be the reason for it ?
a) genetic
b) carbamazepine
c) alcohol
59.and another case with ct done for something else revealed 0.5cm stone at upper calyx.. no uti h/o is speci
to do now
a. eswl
b. nephrectomy
c. review after 6 months
no choice of doing nothing
i choose review in 6 months as it it is 5mm with no symptoms so v ll prefer spontaneous it ll come out
=======
12. Other q/s with hypercalcemia and clinical features: asking investigation, so hypercalcemia is not be missed.
13. Questions from renal system with long stem.and lab...which i think is new
26- a 22 years lady newly started sexual activity came with first pop results that was C
A. Pop after 6 mon
B. Colposcopy
C. LEETZ
No option for pop 1 yr later
20yr n young= cin 1=repat papa in 1 yr
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Cxr latral and ap ( I didnt found any thing )..history of intermittent respiratory symptoms and crackle in the left lower chest..n
hemoptysis
I picket chronic bronchitis
2. cause in child: 4 years with grunting and fever, resp distress: Pneumonia, croup, bronchiolitis
24) A lady with OA of left knee for 10 years presents with pain over the lateral aspect of the leg. What do you expect on exam
1. Positive straight leg raise test
2.Antalgic gait
3. Loss of sensation over lateral aspect of leg
1)Photo of red macular skin lesion, but not erythema myltiformme or margimatum? With a history of migrant, blood stained s
loss, malaise
(Looked like a TB history to me)
1.bronchgenic ca
2.pulmonary TB
75
44 vaginal soreness
45PMS..mgt
38 GERD in baby
33 Diabetic with amputation...
34 SLE joint findings
35 Preseptal cellulitis mgt ...HB Q 2.081
36 Colles # ...F/U
37 CT gastric outlet obstruction
29knee sx...oliguria...inv
30 Antipsychotic drugs causing weight gain ...inv
Hyperkalemia with renal failure mgt
15. Phobia ...mgt
16. Renal stone mgt read very well.
17 meningitis Viral..mgt
18 Meningitis TB
19 Renal TB
20. Glomerulonephritis
13 wat will u do to find out the association btw melanoma and nevus?
a- cohort
b- Rct
c- case control
76
d- case series
25. Scenario for female not pregnant and had mania ask about management i choosed lithium. No olanzapine.
26. Two Q asked with same Scenario of premature ovarion failure ask about diagnosis and another Q ask about ho
is not sexually active now and not like to be pregnant. I choosed HRT.
29. No statistics or ctg.
30. Old recall about grand mother vaccination before delivery of her daughter.
77
==========
20. Scenario of acute limb ischemia most important next mangment . I choosed iv heparin.
21. Old recall about brachial plexus injury.
22. Pic for molluscum ask about school isolation.
23. Scenario about alzehimer and IHD ask about management . I answered
Memantin.
24. Old recall about 10 cm psedopancreatic cyst behind stomach ask about managment.
27.i got many questions from ethics I cannt remember the scenarios as dey were new for me..but if you are perfect with wat to
should inform and all..u can answer dem same with psychiatryI had manyjust read d topics..questions were twisted for m
question in recalls..please read d topics
26.anterior dislocation of shoulder- treatment-closed reduction
23.case of effusion of knee,wat to do next-aspirate
.x ray of sbo given,asked for d cause-adhesions-patient had a h/o appendicitis surgery
study of number of diabetis patient in your area-cross sectional,which group to select for vitamin d-general practice patients
diabetis patient with ulcer on medial malleolus-venous ulcer
ECG OF AF-treatment asked-beta blocker
18.picture of amputated finger of foot-patient is diabetic-cause was asked
78
.ECG OF AF+LBBB+RVH
.CT OF OLD brain infarct..plz check it.it appears like a hmg but old infarct has hypodense area surroundin it
.HYPERKALEMIA 5.6,ECG not given,treatment-ca resonium
14.L4/L5 dis prolapse and a question on spinal canal stenosis..read how to differentiate these two a very long scenarios were g
12.22 yrs old boy comes with mild abdominal pain and painless hematuria,family h/o uncle died of cerebral hmg-wat is d diag
OPTIONS WERE renal contusion and AIN.
BMI 25,PCOD wants to conceive-chlomopine citrate
10.old lady menopause uterus removed comes with hot flushes.wat is d treatment-ostrogen only patch
. 2 scienarios on scrotal swelling asking for next line of investigation-u/s
.old lady after menopause comes with ovarian cyst-investigation asked-tumour markers
7.asthma in 5 yrs old with nocturnal cough and after excerise.wats d treatment-na cromogy
.old recall of ctg given which is normal..but 39 wks pregn lady not feeling the movements of baby.what to do next
question in which features of parkinsonism were given and diagnosis asked
.which feature differentiate alziemers from lewys dementiaParkinsonism features
=======
48. narcissim
49.dialysis pt now refusing-disorientation
mass infront of tragus,dripping of saliva ct
2.13 year old girl with history of unwanted sex-child protection authority
79
1.Teratoma
2.Mucynous cystadenoma
3.Corpus luteal cyst
3. Women brings in her child and tell that she is worried about him. He is sometimes very mischevious and gets very naughty , s
have to even beat him and lock him sometime. What would you do first?
a. Call child protection authority
b. Get the collateral history from the father
c. Talk to the boy
4. scenario of varicose vein and mi and on clopidegral started 7 days before.pt is on stent and clopidegral..
a. refer surgery after 12 months and stop clopidegral 10 days before surgery
b. do surgery now
c.give platelets and do surgery
5. old pt with known bilateral chronic osteoarthritis, develop parasthesia and numbness in the lateral side of leg below knee condition worse
walking for 10 min, wt is the important thing to examin in this pt
a- SLR sighn positive
b- Any tenderness in lateral condyle
c- Any loss of sensation in the lateral side of leg
Months old child of fever 39, cough, tracheal tug, intercoastal recessions and lethargy came to ED. You gave Iv fluids and oxygen.
A) pneumococal pneumonia
B) croup
C) bronchiolitis
D) anemia
80
1. After removal of central venous line a lady developed facial swelling and swelling around neck.what is the most appropriate
6. Old age female had a will not to admit her when she is terminally ill , today she fall & had # femur , she became very drowsy a
now ?
A)Operate her Fracture
B)arrange family meeting
C) admit her
D) Refer to Emergency department
E) Refer to Palliative care unit
7. pt on many medications , indapamide, verapamil, prendopril , aspirin.. present wth light headedness and exactly similar to a
a- valsalva manover
b- cease verapamil
c- temporary pace maker
D- cease indapamide
8. patient with history of mi last month comes with cholecystitis pain not responsive to iv antibiotics what is next
a)change antibiotic
b)percutaneous cholecystostomy
c)ercp and extraction
d)surgery
===============
81
tophus on a finger in a pt on allopurinol, he has come for surgery I chose surgery other choices
were not relevant.
post-op Fever on day 3 with umbilical redness and severe pneumonia asked for source of
infection I chose umbilical source
osteoporosis in a 61 year old man with BMI 18 -> I choosed BMD
ctg base was on 120 two accelerations asked for the next step.
I have forgotten the choices
6 hours after birth the child develops jaundice most common cuz -> ABO
father comes with her child, her teacher has mentioned some inappropriate sexual behavior in
school -> child abuse
Lewy body dementia asked for diagnosis - learn the clinical features
another question asked for the difference of Lewy body with dementia - answer all about the
prognosis / not the clinical features
82
that famous case of DVT redness on thigh! answer was definitely unfractionated heparin
5 year old boy with recurrent AOM, had tympanostomy tube and now has discharge and many
things more asked what is the best step for management I chose discharge culture and
microscopy
slapped chick cuz -> b19
parvovirus infection was CONFIRMED in a pregnant woman -> next USS for 12 weeks
vaginal redness with white plaque what is the next step in diagnosis -> look for clue cells, look
for hyphae I chose the 2nd
primary amenorrhea -> what helps you to diagnosis: asking more questions about the pubarc! I
choosed this one cuz the step was leading me toward this :D I thought this would be the correct
one cuz the most common cuz of primary amenorrhea is constitutional growth delay
postpartum psychosis / depression in the past now the lady is worry in her current pregnancy. I
choosed delay SSRI to after pregnancy cuz here there was no signs of anything! risk of
recurrence is 30-50 in post-postpartum psychosis and it is highly strongly recommended to start
antipsychotics after delivery.
acute mania case ->Risperidone
another one -> lithium
11 year old girl with staying away from school ->I chose truancy
another case was a child who goes to school but does not speaks in class, enjoys breaks, and
fights with other classmates ->mutism?!
other diagnosis were awkward to be frank! the other one was conduct.
hiatal hernia ct scan (pt comes with SOB and abd pain)
same child what to do after confirmation of recurrent UTI ->cystoureterogram (PUV assessmen
BANGKOK 18 th September Recalls
PARDEEP OMANI
10.screening of prostate cancer in pt whose father has prostatic cancer at
same age 55 ,, DRE was done already
a. now do psa after 2 weeks.. it looks relevant , no other
11.Picture of para umblical hernia in 5 yrs child ,, no symptoms
a. surgical repair
b. reassure
c.rest were irrelevant
83
12. Picture of scabies..treatment was asked
13. 55y old man after return from Bali after short holiday of 5 days with his
wife presents with Fever, chill, abdominal pain, malaise and jaundice. All of
liver function tests show impairment (AST, ALT, ALK). Dx? (August Recall
2015)
a. Hepatitis A
b. Hepatitis B
c. Hepatitis C
d. Cholangitis
e. Malaria
14.pregnant at 10 weeks, she has done IVF after several years of infertilty ,
she is concerned about Down syndrome because her cousin had a baby with
Down Syndrome
a- Nuchal Transclucency
b- amniocentesis
c- CVS
15. Most common cause of macroscopic hematuria.. bladderca
16. Csf :
there is RBCs
Glucose low
Leukocytes were also there
a- zeilneilson stain
b- viral
c- bacterial culture
8.Pt with long standing back pain, no Rx at all, xray show bamboo spine,
patient already took paractemol and codeineRx?
A. Mtx
B. Indomethacin
C. Chloroquine
D. Infliximab
E. I dont remember
18. You are visiting home nursing for elderly and the nurse told you that
there is 85 years old man and 74 old woman both in realtion and this irritate
the residents. Nuse asked you to change the medicine for them
Take to them
Take to each one alone
Take to their families
Do not change the medicine and say doctor has authority to decide and its
final
20.other renal stone at distal site with urinary problems size was 4mm===
84
ESWL was in opti
19. one scenario of stone in upper calyx of kidney in young age no symptoms
in urine..
I did ,, review xray after 6 weeks
rest of options were surgical
22. Old lady with Hx of prolapse, now has urgency but no stress
incontinency.IX ?
A) Urodynamic studies
B) UMC
C) Anticholinergics
23.guy with hemothorax, trachea shfted to same side.. hadstap wound to
chest,, reduce air entry ,, no previous disease there,, dull on purcussion
a.. under seal drain
24.two PE scenario ask about invCTPA,, one was having travelling histrynd d
dimer was done
25. Picture of perianal abscess with pain in perieal region
26.that old recall of golden watch frm patient I selected ignore it
27. Vit c study in community
28. vitamin D study in two groups of university
29. Abgs..clear diagnosis was there for metabolic acidosis
30. ct scan for pancreatic pseudocyst
31. young age patient having scrotal swelling on left side, not retracted on
lying ,, cord is palpable,, what intial do we do.. I marked us , no option for
tumourmarkr
32. same type of scenario, this time was old in right side and
non.transillumination I did also us here initially
34. a child with bacterial meningitis being treated with ceftriaxone n half
daily requirement had a seizure >5min s/electrolytes show s/Na=118mmol
what is the cause of seizure?
Inappropriate ADH secretion
Dehydration
Antibiotic reaction
35. a young guy with symptoms of heart failure and generalized edema and
bibasilar crackles, the urine showed protien 3+ and blood 4+ i think on x ray
normal cardiac sillohet and bilateral lung infiltrates
85
antiGBM
36. acute OM scenario ,, same old recall. Amoxicillin
38. clear USG pic of mets in liver. And the scenario was Sheep farmer with
RUQ pain with H/O cholecystectomy and hemicolectomy for carcinoma colon
2 yersago.usg pic given.but I cant recognize the pic.
Next inv
1.Hydatid serology
2.Triphasic CT
39, old patient on morphinecomes with wife and drowsy next
I did ,,, hydrate fir
41.cellulitis scenario in diabetic with temp 38.2. asked investigation
Blood culture
Doppler
42. old recallmother wanaknwabthx of child she was 14 yrs old ..
option was come with daughter next visit..
43.one recall was about copd,, she hospitalized with agitation and dyspnea..
what next
a. abgs
b. ct scan
c. cxr
d.antibiotics change . Already taking and I went for abgs, as she was
hospitalized
44. one more was 84 yrs old lady taking asspirin, bb, and oral , has type 2
dm and hypertension..... shehass recurrent falls.. causes asked ? everythng
was nrml , ecg was told as nrml ,, i did hypoglycemia
45.MgSO4 toxicity in eclampsi women first sign == Hypotension
46.iremeber one,, tongue lateral border has lesion white one, do not
cuaterize and not removed on that ,, what diagnose,, i did squamous cell
carcinoma
48.one was confirmation of rhumatoid arthritis...
a. rh factor
b.antinuclear factor
c.intra articular effusion
86
49. one other wass ,, weight of baby wass 97 percentalie and height was 50
percentalie, he hass awkward gait.. hip , nrml, knee has some issue , dntknw
the word , it loooked new there for me :P ... options were , do refer to ortho
surgeon ,, second iremeber was reasuure , age was 3 yrs and it was
termadneverythngnrml with growth only gait issue and weight was high..
no advice was there to maintain strick diet , one other option was review
after 8 ... i weeks , i went for ortho surgeon
57.one scenario of cystic fibrosis , same hbqs in child problem blah blah
investigation asked
61. 50 years male, MI case after angioplastyhe feels a mass in inguinal area,
pulsatile and expanding in nature. What is the best treatment?
a. Pressure on the area by hand
b. Urgent repair of femoral artery.
c. CT
d. nothing to do
60. 10 days boy becomes blue when he cries or on exertion. At birth all
examinations were normal. APGAR score was normal. Now systolic murmur
found on cardiac exam.
c TOF
d ASD
c C. VSD
d D. TGA
====================
A 55-year-old man comes to your clinic concerned about his family history. His
father was
diagnosed with prostate cancer at the age of 85. His neighbour was recently
diagnosed with
metastatic prostate cancer and he says that there is screening to detect early
disease. On DRE
prostate was smooth, and median sulcus felt. No other symptoms. What is the next
step in
management?
1-PSA within 2 weeks
2-Reassure
3- Transrectal USG
4- DRE annually
According to RACGP guidelines, screening for prostate cancer is not recommended
unless the patient specifically asks for it, and after fully counseled about risks,
benefits, and uncertainties, both DRE and PSA should be done.
87
A farmer has experienced an acute upper quadrant pain for six hours then it's all
gone. He feels alright now. What is the possible diagnosis a bit the same picture
1 . hematoma
2. Simple hepatic cyst
3. Cholecystitis.
4. Hepatic abscess
88
89
90
Hydatid cyst(Parasitic
abscess)
91
d. Duodenal atresia
http://emedicine.medscape.com/article/930313-clinical
29)epiglottis scenario in 10 month old child and did not go fine with cefoxtamine,,fever does not
decrease,,,best managemet
Treatment of acute epiglottitis centers on maintenance of the airway and
administration of appropriate antimicrobial agents
Airway
Patients with epiglottitis and severe respiratory distress (eg, "sniffing" or "tripod"
posture, stridor, drooling, cyanosis) should undergo prompt placement of an
artificial airway. In those with impending or complete obstruction, endotracheal
intubation should be performed immediately in the emergency department.
92
Additional indications for urgent placement of an artificial airway may include
epiglottic abscess, comorbid diabetes mellitus (in adults), and immune deficiency.
93
31)in which sleep pattern ,child can not remebr the dream & is
unarousable,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,sleep walking
deep non-REM sleep........JM(5th)771
33)which on can be endometrisis locn?#IMP
appendix,,,,,,no common places in options
second most common site of endometritis
a)ovary
b)brad ligament of uterus .. if there wasnt anterior and posterior cul-de-sac
c)abdominal cavity
d)round ligment
The most common sites of endometriosis, in decreasing order of frequency:
1-ovaries
2-anterior and posterior cul-de-sac
3-posterior broad ligaments
4-uterosacral ligaments
5-uterus
6-fallopian tubes
7-sigmoid colon and appendix
9-round ligaments
94
visual assessment The first step in this process involves ruling out other possible
causes of the difficulties being experienced, such as a sensory problem (e.g., visual
or hearing impairment)
ENTevaluation
assess family dynamics
refer to psychiatrist
While individuals experiencing learning problems can be identified by observing
their behaviour and achievement, actual diagnosis of a specific learning disability
requires formal assessment conducted by a psychologist using standardised
psychological tests. These tests compare the person's level of ability to that which is
considered normal development for someone of that age and intelligence.
>>>>>>>>>>>>>The first step in this process involves ruling out other possible
causes of the difficulties being experienced, such as a sensory problem (e.g., visual
or hearing impairment), emotional disturbance (e.g., depression), environmental
factors (e.g., cultural or economic disadvantage or a lack of access to adequate
teaching) and intellectual disability. All of these can also have an effect on learning
95
6. Pregnant women in early pregnancy complains of nocturia but no other signs of UTI, UA
shows only nitrates and leucocytes. Cultures are sent. Whats the best action?
A. Cephalexin
B. Reassure
C. Tell her to call as soon as she feels dysuria
D. Wait for culture results
The dipstick test is most accurate for predicting UTI when positive for either leukocyte esterase
or nitrite
Dipstick findings of urinary leucocytes or nitrite are suggestive of UTI and may be
an indication for empirical treatment if asymptomatic.....JM228 page
96
9. Mother came with 5 yr old child with nocturnal enuresis, he was dry before so she was angry
at him, and demanding for symptomatic treatment without further examinations..etc
You noticed some bruises on the child's leg and back which she attributed to his playing and
falling, what do u do ?
A. Prescribe Rx
B. Investigations
C. Report child abuse
D. Reassure
11. Newborn with bad apgar scores, not improving on Oxygen, o/e cyanosis,hr 140 only systolic
murmur, xray (not given) normal heart size with only mild lung plethora, likely Dx !
A. TGV
B. PDA. no cyanosis
C. TOF. Cyanosis in childhood not infancy
D. VSD. no cyanosis
13. Pt with 24 hr onset of lt. ear pain, salivation on same side, pic showing only ptosis of left
eyelid , Rx?
A. Acyclovir
B. Prednisone probably bells
C. AB
16. Two questions on ectopic preg., one scenario asking about best dx ?
A. TVUS showing empty uterine cavity
B. TVUS showing tubal mass
C. Serial hCGs
18. Lump in the neck , what feature is most significant clinical sign for malignancy
A. Rapidly growing
B. Hoarseness
C. Retrosternal extension
D. Causing face fussiness when pt. elevates his arm !!
19. A 54y woman presented with a month of dark discharge from her left nipple. Dx:
a. Benign duct papilloma
b. Intraductal carcinoma in situ
c. Mammary duct ectasia
d. Paget disease
20. Young lady presents with toothpaste like discharge and mild nipple inversion,
probably Dx?
And to make things worse, both Qs have the same answer options (as far as I
remember )
A. DCIS
B. Duct ectasia
C. Breast papiloma
97
D. Invasive CA
E. Some benign lesion
MCQ 3.127
Nipple discharge from multiple ducts of a thick and viscous discharge of toothpastelike material of greenish-yellow colour or bloodstained with duct dilatation: classical
mammary duct ectasia
Tx: excision of the main ducts below the nipple
22. Scenario of a gallstone ileus ..AXR of bowel obstruction with hx of recurrent GB
disease
A pregnant lady with multiple gallstones came to a GP. He advised her
cholecystectomy after delivery. Why?
a. risk of Ca gallbladder
b. increased risk of CHOLESTATIC jaundice in next pregnancy
c. increased risk of Ca pancreas
d. increased risk for primary biliary cirrhosis
23. Case of post cholecystectomy pt. 6 hrs presents with signs of shock, what to do
first
A. Return to OR
B. N.s.
24. Post c.s. Patient goes to the bathroom and feels dizzy near unconscious, o/e BP
difference sitting/ lying... Cause?
A. Vasovagal
B. Hypovolemia
C. Hypoglycemia
D. Other gyn problem
27. Old recall of most teratogenic substance among:
A. Cocaine
B. Marijuana
C. Alcohol
D. Others
28. You are giving a lecture in a primary school regarding skin cancer awareness,
What thing you wanna focus on most?
A. Using sunscreen in the morning
B. Lessen sun exposure from 10 am to 4 pm
C. Anual screening
D. Excision of skin lesions
29. young pt. come to you to check on his 2 chest normal looking nevuses, he's
computer programmer or something, his brother had mal. Melanoma that
metastasized to the bones..what to do?
A. Reassure
B. Do bone scan
C. Excise theses nevuses
D. Refer to dermatology
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E. Regular skin exam - i think annual
30. Pt present with painful swollen ankle and wrist joints, after being treated for
chlamydial infection with doxidar .Whats best Rx now
A. Azithromycin
B. Prednisolone
C. Other antibiotics
Reactive arthritis is a painful form of inflammatory arthritis (joint disease due to
inflammation). It occurs in reaction to an infection by certain bacteria. Most often,
these bacteria are in the genitals (Chlamydia trachomatis) or the bowel
(Campylobacter, Salmonella, Shigella and Yersinia). - The early stage of reactive
arthritis is considered acute (early). Acute inflammation can be treated with NSAIDs.
These drugs suppress swelling and pain. They include naproxen (Aleve), diclofenac
(Voltaren), indomethacin (Indocin) or celecoxib (Celebrex).
32. 50s old Pt present with symptoms of OA, no Rx before, whats the best intial Rx?
A. Paracetol
B. Aspirin
C. Ibuprofen
D others i don't remember
33. ULcerative colitis pt., bp 90/60, hr 110, diarrhea with blood and abd. Distended, Axray
show dialated bowels, how do u treat him now?
A. Admit and monitor
B. Decompression
C. Colectomy
D. ABs
34. Old patient with iloischial abscess, has this problem recurrent many times, what s the cause?
A. Anal fistula
B. Diverticular disease
C. Crohns bcz of reccurance
D. Diabetic
E. Immunodeficiency disorder
35. Another case of immunodeficiency syndrome with recurrent infections with staph. Whats the
most likely
A. Neutrophils
B. Lymphocytes
C. Complements something
D. Other weird options
36. 6 day baby with erythema around umbilical cord, which is still attached and dry, he has mild
diarrhea..Whats the best Rx (options all all antibiotics)?
A. Cephalex
B. Penicillin
C. Flucloxacillin
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D. Erythromycin i think
39. Case of calf pain relieved by resting , best Dx Ix?
A. Doppler
B. Venous venography
C. CT angio
D. MRI angio
40. Case of hypercalcemia with increased PTH, asking about further investigation for the cause?
A. Thyroid u/s
B. Parathyroid something scan
C. Ct scan
D. Bone scan
this cud be primary or tertiary hyperPTH.. next shud be ALP, PO4, renal function tests to exclude
tertiary.. bt if that choice isnt given, prarthyroid schintography brfore surgery to locate
adenoma...
41. Most common causative microorganism on infected gallbladder :
a. E.coli
b. fecalis
c. Bacteroides
d. some other normal flora bacterium
43. Your colleague witness a strong accident in the workplace, you notice that since she became
more hesitant and less confident in her work, u suspect alcohol abuse . What is the best thing to
do
A. Report her to you senior
B. Arrange a meeting with her
C. Tell her to take a vacation !
44. 16 yr old lady fought with her parents I dont know why and now living in the streets and
with her friends ,left school
Whats the best advice you can give when she comes to you
A. About alcohol abuse
B. About drugs dangerousness
C. About STDs and sexual matters
1.pt with longstanding ureteric stricture and history of recurrent UTI underwent
bladder dilation suddenly became pale, sweating, and BP 80/50.whats the cause?
AMI
PE
Bacterial infection
gram -ve sepsis causes sudden nd severe shock without signs of infection like
fever/raised wbc..pts r usually warm
100
2. female pt came for medical check-up for Airhostess job urine examination
done shows Haematuria and her blood frame shows Atypical nuclide. Next invest
Abd CT
Renal Biopsy
USG
Cystoscopy
In patients with asymptomatic microscopic hematuria who do not have risk factors
for transitional cell carcinoma, urinary cytology or cystoscopy may be used. If
cytology is chosen and malignant or atypical/suspicious cells are identified,
cystoscopy is required
3. Pregnant pt C/O frontal headache and flushes. BP 160/100 urine no proteinuria,
next invest
Serum electrolytes
USG .r/o IUGR
4. 5yrs pt c/o mild fever, jaundice , splenomegaly, blood exam: anaemia with
microsporocyte
I just remember H. Spherocytosis
5. Old lady c/o fatigue, malaise ,weight loss a long invest report with ESR 120 (I
just rem. This)
Multiple Melanoma
7
8.pt with history of valvular heart disease preparing to undergo tonsillectomy.what
he need for prophylysis
Amoxicillin
Azithromycin
Panicillin
Ceftriaxone
9. pt is admitted for ECT a day before get agitated, aggressive and refuse for
ECT.what to do next
Do nothing
Do ECT as she needed it
Do after her husband constant
Take consent from Mental Health Tribunal
HB 2.146 states that a person whose mental state preludes his ability to consent or
refuse treatment should be detained involuntarily in hospital and application made
to mental health review tribunal, if necessary, to immediately commence ECT.
Additionally the family must be informed but they are not legally able to consent
and refuse treatment
101
19. Asthma pt under solumedrol and steroid c/o exertion dyspnoea. What will you
give
Cromoglycate
LABA
Oral Steroid
21. 16yrs boy for routine check up ..no complain at present and all examination
normal blablaseems like asking about opportunistic examination..
BP
BSf
Testis
R.Ks Recalls:15-08-15
40 yo female , history of migraine , polycystic kidney ,sudden occipital headache ,
no neck stiffeness nor photophopia , ct normal and 2 LP unsuccessful , next
appropriate inv. ?
-repeat ct
-MRI
-cerebral angio
-Repeat LP
ct>>>>lp>>>ct angio
Elderly female patient lives in her own home is brought to GP clinic by her son due
to progressive gradual loss of personal care n forgetfulness so GP advised to
commence Donepzil. She insists that she is coping well without medication.Her son
refuses to start medicine n says that we dont care about her n family dont want to
start her on medication; what to do
a) respect sons wish
b) Tell him to take her medication when she out of her home
c)explain that she must take Medication if she wants to live in her own home(alone)
55 yrs male find it hard to perform his duties heavy smoker for 15 yrs ankle edema,
massive hepatomegaly splenomegaly and ascites high jvp and rises with inspiration
and drop with expiration dx?
A. Tamponade
B. Bud chiari synd.
C. Superior venacava obstruction
D. Constrictive pericarditis due to tuberculosis
E. Cirrhosis
Primigravida in labour presents with 2 cm cervical dilatation n fetal head above
ischial spine on PV examination. You do PV after 4hrs, which of the following feature
on this PV exam will lead u to do C-section?
a)everything unchanged of the previous exam
b)4 cm dilatation but same fetal position
102
c)4 cm n +1 station fetal head
d)2 cm +1 fetal head position
An academic presents to u severely distressed after his pubkication paper rejected
despite his previous good record. He thinks they are jealous of her n want to apply
against them in court. She has previously written complaint about her disrespect in
her academics performance. Diagnosis?
a.shizopherenia
b.Narcissistic
c.borderline
old 70s lady pap ve never positive before so what to advise further-no further
screening with pap required
26 a stat Q about prevalence of obesity, BMI>30 in a population of 200 in 2009
were 30 increased to 40 in 2010 assuming it remained static in the next year what
is prevalence in 2011?
40/200X100=20%
30.Meningitis 2 Q one with Mononuclear cells high(in thousands) in otherwise
Normal CSF findings-TB
32.Rx of U/L renal artery stenosis-Perindropril ACEis are choice
33.a lady withfamily History of obesity n CAD presents with
Hypercholeserolemia-5.5mmol n HTNMx?
Perindropril
34 a lady with persistently high BP on previous readings for 3 months range b/w
130/70-180/105, Rx?
initially life style modifications if not controlled thn ace inhibitors(Perindropril)
41pt 45 year old with H/o childhood DVT undergoing nissen fundoplication received
IPC for DVT prophylaxis would require? Heparin 10 days post op
Modified Caprini risk assessment model for VTE in general surgical patients:
1+3+2=6 => high risk
For high risk general and abdominal-pelvic surgery (Caprini score 5 or more) we
recommend the use of prophylactic anticoagulation over other methods
Reasonable choices include LMW heparin , low dose unfractionated heparin three
times daily, or fondaparinux
44 a lady with night sweats wt loss n axilliay Lymphadenopathy with Lymphocyte v
high platelets 70000 hw will u treat
A prednisolone
B radiotherapy
C platelets transfusion
D acyclovir
Most probably is Lymphoma
103
Treatment options include chemotherapy, radiotherapy and monoclonal antibodies
But if CLL: graft or cytotoxics
47.Ca head of pancreas initial investigation?
CT USGabdXRay
51 a man with attempted suicide discharged after Rx, now presents with loss of
interest in job n lack of concentration but sleep n eat well Diag??
A recurrent depression
B factitious disorder
C conversion
70 newonsetschizopherenia Rx-olanzapine
81 an elderly lady with constipation n s/electrolytes revealed mild-moderate
hypercalcemia with all other normal values which investigation to reach diagnosis?
Thyroid scan Abd CT Bone scan
PTH is the right answer but they don't give us what we know is right. I would go for
CT abdomen on this looking for paraneoplastic source for PTHrP in GI or pancreas
104
My recalls 15-8'
--ct brain with minute hge and infarction asking next appropriate cease warfarin or
vit k or plasma
105
If serious or life-threatening bleeding is present, or if rapid reversal of
anticoagulation is required (eg, in preparation for emergency surgery), warfarin
should be stopped then vitamin K IV + FFP should be given
--haemolytic uremic syndrome easy diagnosed but asking invex? FBE u/a alb
Raised white cell count and low platelet count are early indicators of development
of HUS,, but hematuria and protinurea also occur early in HUS, so urinalysis must be
sent
--rash in a child with flu after ampicillin what to do invex? lymphocytes in FBE
it can be inf. Mononucleosis rash app after antibiotic or drug reaction => atypical
lymphocytes in FBE
--coach calling you asking for prescription of a boy with asthma you are his gp but
he couldn't reach parents what to do?
try to call parents or give him or ask him to bring the boy to you but it depends
to the full stem
1.
A pic very similar to this (the closest I cud find) and Long scenario of PAD asking
management? anioplasty
2. A 14 yr old ADHD boy refuses to take medication during lunch at school. His parents are
concerned and ask you for alternative. What will you advice?
a. Ask the parents to forcefully give the medicine
b. Ask the techer to force him to have the medicine
106
c. Ask for an appointment to meet the boy and talk to him regarding the situation
d. Prescribe him medicine to take in the night.
3. A 58yr old man returned from Thailand after 2 weeks holiday with his wife. Now presents
with fever, malaise, pain in the right upper quadrant. His lab findings were given with a
big list of all the FBE, LFTs, etc. Almost all his LFTs raised. GGT was very high. Whats the
diagnosis?
a. Hepatitis A
b. Cholangitis
c. Liver abscess
d. Acute pancreatitis
e. Cholecystitis
The incubation period averages 30 days (range 15 to 49 days), after which the illness begins
with the abrupt onset of prodromal symptoms including, fatigue, malaise, nausea, vomiting,
anorexia, fever, and right upper quadrant pain. Within a few days to one week, patients note
dark urine, acholic stool (light-colored stools lacking bilirubin pigment), jaundice, and
pruritus. The prodromal symptoms usually diminish when jaundice appears. The most
common physical findings are jaundice and hepatomegaly
Laboratory abnormalities may include marked elevations of serum aminotransferases
(usually >1000 IU/dL), serum total and direct bilirubin, and alkaline phosphatase
4. A young lady comes to your practice after 6 months of the death of her father. Her BMI is
23. She was on a strict diet and has lost 10kgs and is concerned about gaining weight.
On talking to her u find out she is not suicidal or majorly depressed. She also later
reveals having taken laxatives but reasons that its because she doesnot want any
constipation issues. She now dreads the idea of gaining weight and cannot trust herself
around food and wants you to prescribe some weight losing drugs. What is ur diagnosis
of her?
a. Depression
b. Anorexia nervosa
c. Abnormal grief disorder
d. Bulimia nervosa
5. An old patient with multiple drug history for various conditions posted for hip
replacement surgery. Whatsur management post op?
a. Warfarin for 1 month
107
b. Warfarin for 3 months
c. Dont give anything
d. LMWH for 1 week
For patients undergoing total hip replacement or hip fracture surgery, we recommend that
thromboprophylaxis be extended beyond 10 days and up to 35 days after surgery:
low molecular weight heparin
fondaparinux
rivaroxaban
dabigatran etexilate
6. Another similar question of a patient with both extra pulmonary and intrapulmonary
findings with photophobia, neck stiffness, headache, long stem on h/o symptoms there
was a mention on patient coughing rusty sputum and also something about a NNT
findings was given(honestly dont remember the exact value) CSF findings has protein
1.5 and Glucose 0.4. What is the causative organism?
a. Escherichia coli
b. Mycobacterium tuberculin
c. Mycobacterium pneumonia
d. Strep. Pneumonia
8. A patient with BMI >43 underwent Gastric Bypass surgery. Now presents to u after 2
months with c/o dumping syndrome 30 min after having breakfast of especially cereals
milk and toast. How will u manage?
a. Diet counselling
b. Post for a review of surgery
c. Vit. B12
d. Esomeprazole
108
9. A ct of closed skull fracture asking to identify.
right temporal fracture with subgaleal haetoma, subdural haemorrhage and subaracnoid
haemorrhage.
10. A pt. bought to ED after Motor vehicle accident with fracture of tibia. Paramedics already
did closed reduction in the ambulance on the way to the hospital. Whatwill be ur next
appropriate management?
a. Wound debridement
b. External fixation
c. Internal fixation
d. Suture wound
11. A middle aged female with h/o migraine 2 unsuccessful LP, normal CT, what will be ur
next appropriate management?
a. Repeat ct
b. Do another LP
c. MRI
d. Cerebral angio
12. A patient comes to you with burning sensation on the right side of his face and upper
and lower limb weakness of the left side. Abnormal gait. Diagnosis?
109
a. GBS
b. MS
13. 38 year old obese lady primigravida presents to u at 24weeks.Her fbs and 2hr ogtt in
early pregnancy was 5 and 7. Her mother diagnosed with DM at 52yrs is under
medication for it. What is the most appropriate management for the her?
e. Ogtt 26-28wks
f.
Ogtt now
g. Fbs 1yr
h. Ogtt 6-12 weeks postpartum
15. 4yr old child with cough, wheeze and inter costal recession. He uses his accessory
muscle while breathing. He has fever 39. O/E chest clear, he is treated with IV fluid and
O2. Which organism is responsible for his condition?
a. RSV
b. Strep pneumonia
c. Staphylococcus aureus
d. H. influenza
16. An old lady drowsy from morphine given after she fell and now brought to you for further
management. She has advancedirectives to not put her on any life support if she
becomes seriously ill. What is your management?
a. Admit her for further evaluation
b. Call for a family meeting
c. Sent her to a nearby physiotherapy centre
d. Respect her wishes
e. Do nothing
17. Mother brings her son who has measles rash now since 6 days. She wants to know if the
110
child needs to be excluded from school, as the teacher informed him that all the kids in
school are immunized. What advice will u give the mother?
a. No need to exclude.. 5 days exclusion from the onset of rash
b. Exclude for 4 days
c. Immunize immediately
20. A group of guys returned from camping in the forrest. After a week they were admitted to
the ED with bruises on the skin, renal bleeding and shock. What is the most likely cause?
A.Giardia lamblia
B.Escherichia coli .. Hemolytic uremic syndrome
C.Disseminated intravascular coagulation
D.Staphylococcus aureus...
E.Ross River fever
A liver biopsy
B serum ferritin &transferrin
C hfe genotype
D uss
1- transferrin saturation and serum ferritin).
2- HFE gene testing or referral to gastroenterologist if: transferrin >45%, ferritin
>250g (pre-menopausal female) or >300g (post-menopausal female/male).
22. 5th POD lady presents with watery vaginal discharge slightly blood stained. Patient had
undergone hysterectomy before. What is the diagnosis?
111
a. Vesicovaginal fistula
b. Vaginal cuff dehiscence
c. Vaginal abscess
d. Vaginal vault granulation
e. Vaginal vault prolapse
f we use absorbable string as chromicfor closing vaginal cuf. chromic cut gut string is
absorbed between 3-7day post operation
23. Middle aged man who is hypertensive and just treated for his helicobacter pylori with
triple therapy. Now comes with urine protein and haematuria with 3-4renal cysts seen on
USG. Diagnosis?
a. PKD
b. IgA Nephropathy
c. Nephrotic syndrome
d. Acute Interstitial Nephritis
24. A young boy with symptoms of heart failure and generalised oedema and bilateral
basilar crackles, urine shoed protein 3+ and haematuria 4+. X ray normal cardiac
silhouette but bilateral lung infiltrates. Diagnosis?
a. IgA Nephropathy
b. Anti GBM
c.
16. female sore after sex with new partner dysuria n also discharge mild few days
now asymptomatic came to u.nothing more in hx for sure something in the scenario
"soreness coming down" Chlamydia ,Gonorrhea ,Hsv, candida
22)scenaria of tubercular meningitis asked about the organisms? Mycobacterium
tuberculosis
alcoholic with agitation or confusion 24 hours post operative what investigation
blood alcohol
blood glucose
The single most important laboratory test in a patient who appears intoxicated with
ethanol is a serum glucose level
112
Pulmonary atelectasis is the most common cause of early postoperative fever and
tachycardia after all classes of surgery
clear USG pic of mets in liver. And the scenario was Sheep farmer with RUQ pain
with H/O cholecystectomy and hemicolectomy for carcinoma colon 2 yers ago.usg
pic given.but I cant recognize the pic.
Next inv
1.Hydatid serology
2.Triphasic CT
32)54. scenaro of hyperkalemia pt present with confusion,K was 6.5,urea and CR
also very high.next 1.urgent hemodialysis 2.rectal calcium resonium 3.5%dextrose
with insulin 10 unit
36. patient with recurrant ischirectal abscess. Asked cause
Anal fistula
Chrons
Diverticulitis
37. acute gout scenario asked what to prescribe initial
Naproxen
Cochicine
Allopurinol
A patient presents with acute gout but has a low serum uric acid. Which of the
following drugs can be
responsible for a low serum uric acid?
a) Colchicine
b) Prednisolone
c) Indomethacin
d) Naproxyn
e) Salicylates
43. Mother of twins. Does not want contraception other than breastfeed. What will
indicate thatr she needs OCP?
-She has her period
-One twin doesnt eat
-Twins only breastfed at night
44. scenario of acute angle closure glaucoma with acute painful and hazy cornea.
asked treatment
Oral acetazolamide
Topical pilocarpine
Topical timolol.
45. alcoholic man, was OK, had a vehicle accident, after it was OK. Now confused,
slurred speech, weakness. ? cause (same/similar as blue book mcq)
113
- Subdural haematoma
-alcohol withdrawl
Mcq 2.059 A 70-year-Old woman presents with a blood-stained vaginal discharge.
Both the ectocervix and the vagina look atrophiC on speculum examination.
Cervical cytology shows no evidence of malignant cells, although no endocervical
cells were seen. Which one or the following is the most appropriate next step in
managment?
A. Vaginal swab far microscopy and culture.
B. Colposcopy.
C. Ultrasound assessment of endometrial thickness.
D. Hysteroscopy and dilatation and curettage (D&C) .
E. Laparoscopy.
would define the presence of an endometrial lesion and would faCilitate histologic
examination of any endometrium
which is present.
malignancy is less likely if the endometrial Ihickness is less Ihan 4mm, Ihe risk is not
excluded by such a finding
48. Mx of obese 9 y/o with obese family.
-Strict exercise
-Exercise + diet to maintain weight
-Obesity will disappear during puberty
- prescribe diet regimen
-replace soft drinks with fruit juice
50. You are asked to solve a dispute btw a nurse and a patient. The patient is
arguing that she want a vip room in the hospital and that she is a private patient .
when you reach the patient says you are a doctor you would understand what I
want .. I bet you are also on a private panel unlike these nurses. What is it?
Paranoid
histrionic
narcissism,,,
shizoaffective
18. Xray of sarcoidosis. Typical bilateral perihilar lymphnodes can be seen. Patient
had cough since long time(cant remember the duration exactly but I am sure it was
too long). And now presented with hematuria. Asked next investigation?
CT abdomen
Urine culture
If sarcoidosis..ACE level
If Anti gbm.first u/a then renal biopsy
114
Pulmonary reticular opacities
Skin, joint, and/or eye lesions
In approximately one-half of cases, the disease is detected incidentally by
radiographic abnormalities (eg, bilateral hilar adenopathy, reticular opacities) on a
routine chest radiograph prior to the development of symptoms.
most common presenting symptoms include cough, dyspnea, and chest pain.
Common extrapulmonary abnormalities on presentation include eye and skin
lesions.
Other features of sarcoidosis include fatigue, malaise, fever, and weight loss.
Systemic inflammation may contribute to muscle weakness and exercise
intolerance. Patients over the age of 70 years appear to be more likely to present
with systemic symptoms, including fatigue and anorexia; however, dyspnea and
cough are generally present at the same time.
on chest examination wheezing may be present.
Bilateral enlarged hilar lymph nodes as well as right paratracheal and aortopulmonary lymph
nodes are visible. Fine linear and reticular opacities are present in the perihilar lung parenchyma.
115
Left: The chest radiograph shows interstitial disease (multiple small nodules in the mid-to-upper zones) with
shrinking hilar nodes (Stage III)
The chest radiograph shows interstitial opacities with upper zone predominance, volume loss, and advanced fibrosis
(Stage IV)
116
Intravenous fluid.
CTG
Ultrasound
Induction of labour
Immediate CS
2 A --24 years old, primigravida, pregnant 37 weeks, initial examination revealed fundal level 36
cm ,fetal heart sound audibale, CTG baseline 140/min with good variability, vaginal examination
cervix post, long internal os 1cm vertex presentation, head 3 cm above ischial spine, after 4
hours, vaginal examination revealed cervix full effaced, os 3 cm, vertex 2 cm above ischial spine,
membrane intact.
Obstructed labour
Continue CTG
Induce labour
Normal Labour
Oxytocin derip
4- A-38 years old, having 3 children, taking oral combined pills and she is hypertensive on ttt,
and she is using ?cream, Pt c/o from milky discharge from both breast.
Stop ttt for hypertension
Local cream is the cause
Ask for serum prolactin
117
Others, I forget.
6-56 years old woman live alone in her own home, was diagnosed as Al-zihymer dementia
She came with her son to your clinic. The woman is convinced that she is not suffering and
disorders and refused to take the medicine. Her son discloses that the family do not care about
her and she is ok without medicine and he do not want to give her the medicine.
What you will do?
Agree for their decision and do not give the medicine
Inform them that if she will stay alone in her own home, she have to take the medicine.
Arrange nurse to visit and give the medicine.......
8- 22 years old aboriginal man in the waiting list for the renal dialysis. He told you that he did
not want to continue the dialysis.What you will do?
Arrange for a donor for him.
Discus with him his decision to be sure he understand what is the sequences of his
decision
Other options can not remember
12-58 years old woman, is not happy from the primary school next to her home, some
halucinations that the owner of the school will extend his business to her home
Depression
Alcohol withdrawal less than 4 years
She do not have children
15- 12 years old boy came with his parent to your clinic, the boy is depressed and have decided
to be out of his father when he saw him teased by two men came inside his fathers home
Depression
Post traumatic depression
Panic
16- Child 12 month have missed his vaccination , came today with his mom. What is the
contraindication for vaccination for him now?
Temp. more than 38.5
Have allergy to egg and his due for MMR today
Some others.
17- A-36 years old day, 6 week postpartum is coming for check up. She c/o from lethargy,
fatigue, hair loss.What is the investigation
TSH
Haemoglobin & iron
Thyroxin
19- A 22 years old woman with 1ry infertility, her investigation is going with the diagnosis of
PCO.What question you can ask
She notice facial hair growth
She notice Deeping of her voice
Others
20-You are going to give lecture at primary school about healt.What is the important issue you
can discuss
Health food
Obesity
118
Increase physical activity
Diabetes
http://www.racgp.org.au/your-practice/guidelines/redbook/preventive-activities-in-children-and-young-people/
21-You are going to give a lecture about obesity and BMI.What is the important information to
give
BMI is the best way of estimation of obesity alone.
BMI will give false estimate in elderly people because of fatty abdomen.
Waist circumference is the best wayto estimate
Waist circumference with BMI is the best for estimation of obesity
22 year old pregnant lady has come to you with headache, and visual disturbance. On
examination her BP was 150/80 mm of Hg. On investigations , in the urine the protein was +
+.what is the next most important investigation
A. USG
B. LFT
C.PLATELET COUNT
22-One of your colleague told you that he haveapatient who have delivered her 3 children and he
helped her to settle a problem between her and her partner. He told you that he had met her in the
city and both want their relation to be intimate. He asked your advise
Donot see her any more as a patient and ask some body else to see her
See her as a doctor and continue your sexual relation after 3 months
See her as a doctor and continue your sexual relation after 6 months.
Do not mix your sexual relation with your patient and cease her as a patient.
http://www.racgp.org.au/afp/2013/september/managing-professional-boundaries/
23- Junior doctor is hepatitis B +ve, the medical manager advised him not to do any aggressive
surgical manoeuvre and to keep this issue secret. Senior registrar told him that he is busy with a
major operation and asked him to do management for a deep lacerated wound, What he has to do
?
Do the surgical management and put two gloves
Inform the senior registrar that you have hepatitis B
Inform the senior registrar that you will not be able to do this job.
25- Picture for a baby with macrosomia and asking what investigation should be done to his
mum during her pregnancy
TSH
OGTT
Urin A/CS
27-54 years old man with history of depression and suicidal ideation, came today and asked you
for the best way to end his life
Advise him to go to other colleague who can help him
Discuss with him different ways to finish his life
Take with him about your principles of ethics
30 -6 month old boy after bath, his mom felt a hard mass in left hypochondria, non tender
119
Wilm's tumor
Neuroblastoma
Polycystic kidney disease
wilms 2-5 years.
Wilms even echogenic haloes
Wilms intrarenal mass
Wilms doesnt cross midline
Calcification wilms uncommon
calcifications.
Wilms Is well circumscribed
Wilms extends to renal vein
asymptomatic abd distension
thrombocytopenia (neuroblastoma)
In children both neuroblastoma (skull metastases are not infrequently the first sign
of disease) and Ewing sarcoma are encountered.
nuroblastoma
wilms
A 4 year old child has abdominal pain and nausea for the last few months. O/E he
has mass on the right side in the midline. He is not complaining of any other
symptoms. What is the cause?
a. Wilm, s tumor b. hepatoblastoma c. Neuoroblastoma#IMP
A
The age and not passing the midline
120
General anaesthesia and compression
US
Surgical repair
33-Symptoms of lower cancer rectum
Melenia, constipation and lower colicky pain
Diarrhea, bloody stool and abdominal pain
Constipation
External haemorrhoids
36-CT for a girl after fall from a horse with #IMP
Haematoma of the liver
Rupture spleen
39-42 yeears old with history of valve replacement, is going for teeth extraction.
What antibiotics for prophylaxis
Amoxi.
Gentamycin
Ceftriaxone
http://www.tg.org.au/etg_demo/desktop/tgc/abg/16628.htm
http://www.aapd.org/media/policies_guidelines/g_antibioticprophylaxis.pdf
http://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis
43-33 year sold woman came for check up , speculum examination done revealed cervical
erosion, her pap smear two years back and was normal.
Refer her for colposcopy.
Treat her with local cream
Cauterization
Pap smear
44-29 years old lady came for check-up,for sexual health what investigation you have to take
with her
TSH, LH
Prolactin
Blood sugar
Pap smear
45- 37 years old woman with irritability, anxious, can not do her job, irregular menses for the last
few months.Investigations FSH 41
Prolactin 245
LH 4
Diagnosis
Hyperprolactinoma (Pitutary Tumour)
Premature ovarian failure
PCO
121
See him in the presence of other health staff.
47-58 years old woman, cannot control her urination, as she will pass droplet of urine on
coughing or sneezing
Urinary incontinence (Stress)
Urgueincontence
Detrusor instability
UTI
48- 59 years old woman with wet bed at night. She is drinking 4 standard glass of peer every day
and coffee as well. Urodynamic study done and revealed detrusor instability. She had mild
descent of her uterus.Management
Surgical repair of cystocele
Bladder training
Urine analysis
49- 38 years old aboriginal complaining from painless blood in the urine, next?
Cystoscopy
CT scan
Urine analysis and culture.
50- 4 years old boy with blood in the urine and dysuria. Urine C/S revealed mixed growth.
Amox.
Nitrofuranton
Take a suprapubic sample and repeat the culture
51-33 years old man with endoscopy revealed gastritis and ulcer.Management
Prednisolon
Trial therapy for H Pylori
Gavicson
Antacid
52-X ray for the pelvis of 83 years old man, C/O from hip pain and inability to move to his
garden. He received paracetamol but no effect
Prednisolon
Indomethacin
Bone scan
53-X ray of large bowel obstruction, H/O constipation, enema tube was fixed but ineffective
Management
Surgrey
CT scan
MRI
Enema tube for 3 hours
54-52 years old man with H/O DVT and on warfarin, INR is 4
IV vitamin K
Oral tablet Vit K
Stop warfarin
122
5658-7 years old boy with history of cough,auscultation revealed bilateral crackels on both sides
and wheeze
Investigation
X ray
CT abdomen
CT chest
MRI
60-A 73- years old man came to ER by his neighouer who informed that he live alone and since
3 weeks did not appear No body from his family leave near by..He c/o from shortness of breath
and anxiety.
Inform his family to take care
After his treatment and before discharge from the hospital, arrange a house for him to be near
from any of his relative.. Involve social worker or other stuff on this, the doctor can't take
care of this.
Other options
62- Man with haemophilia, but his wife does not have, Incidence in the children? zero
x-linked,wife normal.so zero,but daughters will be carriers
65- A 56 years old woman with sleep disturbance and depression, She came today with an
application for pension because she can not go for work and unable to do anything for education.
She is not taking your medication as she is using her herbal medicine .
What you will do
Inform the social security organisation
Refuse to sign the application
Refer her to another doctor who believes in herbal medicine
66- A somalian man 45 years old now became refuggie, C/O from bleeding with the stool.
What investigation
Do rectal examination
Occult test
CT abdomen
MRI
67- A 42 years old man with no risk factors of family history of cancer colon. His occult blood
test came positive.
Colonoscopy
Repeat occult blood test after 3 months
MRI
CT
68- A 64 years old man with incontinence of the urine after a long trip. He have to strain
strongly in order to evacuate his bladder.You did rectal examination, you felt enlargered irregular
prostate.
123
Prostate specific antigen
CT prostate
MRI
US
Cystoscopy
71-51 years old woman, menopause since 5 years, during checkup an ovarian cyst 4 cm in
diameter(simple, unilocular cyst)
What you will do?
Hysterectomy
Tumor markers
CT
MRI
Reassure and repeat us after 3 months
because ovarian Simple cyst (unilocular,without any vegetation or septum)in menopause
women ,under 5 cm in diameter >>reevaluate if growing occurred then tumor marker.but if it
was greater than 5cm or was complex cyst (multilocular ,septa the,with internal echo )then check
tumor markers
73- A 20 years old woman came to your clinic, preg. 16 weeks with history of abortion twice at
20 weeks.
What you will do?
USG .. usg at 14-24 weeks helps in dxing cervical incompetency!
Reassure her
To attend at 20 weeks for admission
OGTT
Suture her cervix
http://3centres.com.au/library/uploads/guideline/Cervical_shortening_9th_Aug_2011.pdf
75-An old man 85 years old attend to your clinic with history of shortness of breath and
hypertension and both well controlled. He came for renewal of his driving license.
What investigations or test you should do for him?
Check visual acuity
Mini-mental check test
Blood sugar
Cholesterol and LFT
78-patient with open chest wound. What to do first ?
Mouth to mouth
Chest drain
124
Close the wound with gauze.
79- A 22 years old girl fall down in the gym and shifted to ER, the trainer who accompanied her
mentioned that she is always doing vigorous exercise and trying to induce vomiting, What
character in this girl?
Depression
Schizophrenia
OCD
Worry about the shape of her face and her weight.
80- A 45 years old man came to ER after accident with gauze around his scalp and soaked with
blood, dyspnea, conscious, long senarion
What is the immediate action, ?
Ensure airway clear
O2
IV fluid
Care of the wound at the scalp
US
83- A 57 years old man with H/O tremors on resting, if you will observe him it will increase.
Scenario of Parkinsonism
Treatment
85- A medical student after she had finished her gastroenterology and surgery course, have a
phobia that she had cancer colon. No family history of cancer colon or even risk factors. She had
been seen by two surgeons but still not happy. She c/o from diarrhea, abdominal pain and
distension since long time
Depression
Irritable colon
In persons who fulfill symptom-based criteria of IBS, the absence of alarm features (e.g., rectal
bleeding; weight loss; iron deficiency anemia; nocturnal symptoms; family history of colorectal
cancer, inflammatory bowel disease, or celiac disease) should confirm an IBS diagnosis.
86-Patient had inf mi two days back. Today in hospital has bradycardia ,pulse 35/min
Adenosine
Atropine
Adrenaline
89- A 53 years old woman came to your clinic several times in a week, each time she is
complaining from something. Her BP 13/80, pulse 73, no risk factors.Last time she complained
from spotting.What you will do?
Ask her to go to another GP
Refuse to see her.
125
Just investigate her last complaint.
91- A mother bring her 7 month son with history of sudden bending of his trunk and flextion of
upper limbs. Treatment?#IMP
Risperidone
Steroids
Lithium
Nitrazepam
It is infantile spams - most effective treatment is IM injection of ACTH but mostly used is
corticosteroids
92- An old man 72 years old came to ER with chest pain and shortness of breath. ECG and
angiography done which revealed stenosis of Rt. Coronary 70% and left Coronary 30%.
Treatment
Pace maker
Digoxin
Angioplasty for both coronaries
Angioplasty for Rt.coronary
Angioplasty for Lt.coronary
***************Sumbla Khalid******************
MCQ 2.076
A 25 year old plimigravid patient a t 40 weeks of gestation presented because she
had not felt any fetal movements for 24 hours. The fetat heart beats were clearly
audible on auscultation at a rate of 140/min. and the cardiotocograph (CTG) was
normal and reactive. Her cervix was 2cm dilated and fully effaced. You therefore
reassured her and sent her home. She telephones you 24 hours later and tells you
that she has still not felt any fetal movements. now for 48 hours. Which one of the
following is the most appropriate next step in management?#IMP
A. Admit for induction of labour.
B. Immediate Caesarean section.
C. Urgent oxytocin challenge tesl.
D. Urgent ultrasound scan of the fetus.
E. Amniotic fluid volume assessment.
Where the fetal movements are still not being felt 24 hours after a normal CTG.
induction of labour should be performed. especially if the pregnancy is at or near
term and the cervix is favourable
Ultrasound examination of the fetus may show it was small, but is not necessary
at this time as delivery should be expedited anyway.
21)female 34 anxious about breast ca bcz read in magazine some celebrity got ca
at 32.no positive sign and symptoms.no family hx
A)mammo
B)usg
126
C)MRI
D)reassure that no more inv is needed at this time
E) put her on breast screening program(but didnt said by now or from 50 years of
age)
22)male old age with sudden fracture.esr raised around 104.low hb ,low
plt.wbcnormal.whsr next
A)bone marrow
B)pSA
C)cea
Rest dnt remember
23)female with painful periods on COC 30.want to conceive
A)mirena
b)NSAID n condoms
C)depot
35)female pregnant 32 weeks after Mva in emergency fundal height 36 .fetal heart
sound audible.but was raised.mother vitals borderline, What next?
A)cross match 4 unit
B)usg
C)amniotomy
D)c/section
E)2L NS in 2hr
35)old women with t score -1.2 I think next? calcium and vitamin D daily
........Osteopenia #IMP
Osteoporosis
Normal T-score: 1.0 or higher
Osteopenia: between 1.0 and 2.5
Osteoporosis: less than 2.5 (meaning a bone density that is two and a half standard deviations
below the mean of a thirty-year-old man/woman)
127
http://www.racgp.org.au/afp/2012/march/osteoporosis-pharmacological-preventionand-management/
A lady fear of going outside specially in large crowded spaces, loves to stay at home
and sometimes her friends visit her at her house. Diagnosis?
A agoraphobia
B social phobia
Agoraphobia is defined as anxiety and/or avoidance associated with situations
where help may not be available or where leaving the situation may be difficult or
embarrassing in the event of panic symptoms or a full blown panic attack.
Commonly feared situations include crowds, shopping malls, driving, public
transportation, and being away from home
The anxiety or phobic avoidance should not be related to another mental disorder
such as:
social phobia (eg, avoidance limited to social situations because of fear of
embarrassment),
specific phobia (eg, avoidance limited to a single situation like elevators),
obsessive-compulsive disorder (eg, avoidance of dirt in someone with an
obsession about contamination),
posttraumatic stress disorder (eg, avoidance of stimuli associated with a severe
stressor),
separation anxiety disorder (eg, avoidance of leaving home or relatives).
Tx:
SSRI or CBT), or a combination of the two
K1 recalls 15th Sep 2015-09-15
Every body, let me give you some relieve before read these recalls: by the greate teamwork of Amedixans, my MCQ
exam was one of the easiest exam in all of my medical exams
1. A youn guy has noticed with a massin his right testis, sono given, what is the most important next step in
management?
Fine needle aspiration
Alfa fetoprotein.
Inguinal excision
Sclerotherapy
128
- epididymo-orchitis
- swollen testis with trivial injury
- gynaecomastia (teratoma)
2. a lady fear of going outside specially in large crowded spaces, loves to stay at home and sometimes her friends
visit her at her house. Diagnosis?
A agoraphobia
B social phobia
C.OCD
Agoraphobia is defined as anxiety and/or avoidance associated with situations where help may not be available or
where leaving the situation may be difficult or embarrassing in the event of panic symptoms or a full blown panic
attack. Commonly feared situations include crowds, shopping malls, driving, public transportation, and being away
from home
The anxiety or phobic avoidance should not be related to another mental disorder such as:
social phobia (eg, avoidance limited to social situations because of fear of embarrassment),
specific phobia (eg, avoidance limited to a single situation like elevators),
obsessive-compulsive disorder (eg, avoidance of dirt in someone with an obsession about contamination),
posttraumatic stress disorder (eg, avoidance of stimuli associated with a severe stressor)
separation anxiety disorder (eg, avoidance of leaving home or relatives).
3. female 34 anxious about breast cabcz read in magazine some celebrity got ca at 32.no positive sign and
symptoms.no family hx
A)mammo
B)usg
C)MRI
D)reassure that no more inv is needed at this time
E) put her on breast screening program(but didnt said by now or from 50 years of age)
It is recommended that women aged 5069 years attend the BreastScreen Australia Program every 2 years for
screening mammograms
129
130
131
49. Csf protein and glu was normal, but lymp was 290*10 to
power 6, and normal values were mentioned below 2 I think, and
neutrophil was high too. Next
a.obsever and supportive
b.acyclovir
c.iv ceftriaxone
answer is a m sure
50. patient with history of mi last month comes with cholecystitis pain not
responsive to iv antibiotics what is next
a)change antibiotic
b)percutaneous cholecystostomy
c)ercp and extraction
d)surgery
answer i choose b
51. 3 days oliguria , after knee surgery , appropriate next :
-US bladder
-CT
-IVP
After an explanation by dani i choose 1
52. 9month old boy with complain of fever 39, cough, tracheal tug, intercoastal
recessions and lethargy came to ED. You gave Iv fluids and oxygen.
A) pneumococal pneumonia
B) croup
C) bronchiolitis
D) anemia
Answer is a
53.scenario of multiple mypeloma with anemia and esr 104 ask for d diagnosis
I went for bone marrow examination
54.that old scenario of football player got down and than stand up in few minutes
and start playing after 30 minutes
I choose vasovagal attack
55.a child with scenario of meningitis and presents with seizures... rest
investigations were normal but na was 120.. asked what u ll do next.. i got puzzled
in 2 options
a. ns with 3% na
b. i/v hydracortisone
and i choose 1 as an answer i hope m right
132
133
134
1.normal due to prematurity
2.CP
3.Duchenne muscular dystrophy
4.spinal muscular atrophy
19 september recalls
1) eye picture with history of back pain asking for diagnosis- uveitis
2) Growth chart asking kid is obese/ overweight
3) Rash on trunk looks like crusted,bled,painful ,blistered- Tx- famcicyclovir
4) Pic of burger disease asked dx
5) Pic of red testis swollen asking causative organism- ecoli, chlamydia,gonorrhoea
6) Pic of varicocele asking investigation- ct/ venogram
7) Pic of deputreyenes contracture asking ix- us
8) Pic of swelling of neck in posterior traingle with pain asking dx- cervical lymph node
abscess
9)
10)
11) Ecg of pulmonary embolism with scenario of flight journey asked for dx
12)
13)
14) X-ray of chest with h/o fever,malaise,abdominal pain,vomiting,dry cough- dxatypical pneumonia
15) X-ray of anterior shoulder dislocation- asking mx- reduction/ sling cuff
16) Ct brain with infarct -dx
17) Ct tumour in kid with ataxic gait- astrocytoma/ medulloblastoma
18) Screening for diabetes,bp,pap smear,colonoscopy- read all I've got 5 questions
19)Obese,bp-135/90, waist-103 cm,h/o family HTN - asked Mx- start anti
hypertensive,check 24 hour
ambulatory bp/check no at home
20)
21) Abi< 0.25, pulse less,parasthesie- asking mx- ct angio/ Doppler ultrasound
22) PVD scenario asking investigations- Doppler ultrasound
23) Rheumatic scenario- Tx- penicillin
24) Sle scenario asked Tx- anti platelet&
immunosuppressive,anticoagulant&immunosuppressive
26) Depressed with hypercalcemia next investigation - PTH
27) hyponatreamia cases 5asking dx,Ix,mx
28) Hypothyroid features - Ix- tsh assay
135
29)
30) Lmn lesion in arm and leg,sensations of touch.proprioception lost on dorsum
hand,urinary incontinence- asking dx- c7/
cauda equina
31) Pckd with cerebral aneurysm scenario- ix- cerebral angio/ ct
32) Kawasaki disease scenario- Tx
33)
2---a 32 weeks pregnant with motor vehicle accident came with bp 90/56,pulse
110,fundal height 36wk,next managmnt
1.cross match 4 bag blood
2.iv dextrose 2l over 6 hours
3.usg
4.cs
5.amniotomy
nza vaccin
13--What study will you do to find out association of naevus and occurrence
of melanoma in your community
1.Case control
2.Cohort.
136
15--salmonella case in your gp practice in the last week.what study will you
do to find out the cause of this outbreak?
1.Case control
18-- a 3 month old child vomit out of milk for 3 days.he was gaining wight
previously bt no wt gain last week.all electrolytes value was normal and
urine tset also normal.dx
1.gerd
2.pyloric stenosis
20--obstructive apnea in a fat man long term Mx
a-CPAP at night
b-Surgery
c-Wt reduction
137
case of anal fissure and urine retention , after bladder catheter to relief retention wt
to give next
1. GTN cream.
39--pt wth mass infront tragus with saliva dribbling next
1.ct head and neck
2.fnac3.us
d- intraoral xray
2.DRE
3.proctoscopy
138
43--cardiovascular risk in 5 years for 54 yrs male non smoker diabetic bl.p
149/89 chart give
44-- cardiovascular risk in 5 years 34 yrs old male smoker non diabetic
bi.p 125/35 chart given
1
9. After removal of central venous line a lady developed facial swelling and swelling around
neck.what is the most appropriate inv
1.CT chest with contrast
2.CT head,neck
3.CX-Ray
4. USG Doppler
10. a child with scenario of meningitis and presents with seizures... rest investigations were normal
ivheprain,
antbtc,
enoxaparin
13. Women brings in her child and tell that she is worried about him. He is sometimes very
mischevious and gets very naughty , sometimes hard to control so have to even beat him and
lock him sometime. What would you do first?
a. Call child protection authority
b. Get the collateral history from the father
c. Talk to the boy
14. 19 years Unmarried women presented with slight lower abdominal pain.On USG 6 cm SOLID
lt. eye with 6/12 and rt with totally normal visionnormal papillary reflex and normal movements
of eye particularly mentioned
139
1. ct head
2. visual evoked potential
3.lp
32.a young patient with history of sickle cell anemia, after along history of flight, came with calf pain,
all well wth respiratory part, which one of the following is the most appropriate next step in Rx?
O2 therapy
IVIG
enoxaparine
steroids
.anelgesics
38.girl with bmi 30 started sexual activity what to screen for-chlamydia
40.
41.:/
42.13 year old girl with history of unwanted sex-child protection authority
48. narcissim
49.dialysis pt now refusing-disorientation
140
thses are my recalls friends!
my friendly advise would be just concentrate on HB and recalls!
Last 4-5 months recalls should be enough!
I dont know how was my exam! Need ur prayers!
Thank you
141
20) case of osteopenia t score -1.5 asking management.
a) ca and vit d..
23) 24) case of Q fever
25) case of congestive heart failure.
26) in case of acute stress what hormones increase.
a) increase TSH increase cortisol
27).
28
29) case of achalasia
30) case of sigmoid volvulous..x ray shown.
15- a picture of melanoma on face
67
8- 65 yrs old man after knee surgery developed abd distrntion and vomiting ( pain wasnt
there)
cause ? There was a ct wasn't realy diagnostic
A. Colon cancer
B. Psuedobstruction
C. Volvolus
D. Fecal impaction
22- 2yrs old child with genital wart her mother had wart 4 yrs ago cause
A. Sexual abuse
B. From mother during labour
24- a student who works in a resturant got gastroenteritis mx?
A. Put on gloves when is in restaurants
B. Whash his hands frequently
C. Exclusion of school until full recovery
D. Give him sick leave for resturant
25
2627- pt on lithium and resperidone came with acne and obesity cause
A. Resperidone C. Drug interaction due to combination of lithium and resperidone
B. Lithium
2. Pic of erythema nodosum and patitent complaining from hemoptysis old recall ,TB.
142
3. Ct brain ask about diagnosis intra cerebral hge.
4. Ulta sound liver looks metastasis for me.
5. Old recall about least effect for hormonal replacement therapy.depression.
6. Old recall htn and mi . Cohort study
10. Senario about pulmonar embolism after surgery how to diagnose . Ct angio
11. Senario of post partum convuloin . What is the most immediate management . I
choosed, air way clearnace.
12. Senario of anaphylaxis what is management . Im adrenalin.
13. Ecg inf STEMI ask diagnosis.
14. Same question os STEMI ask management, coronary angio.
14. Old recall about chlamydia is asymptomatic...
18. Old recall about allergey to egg and MMR vaccine.
19. Patient with old mi and cholesterol 6,5 what to add to management, i choosed statin.
18. Ecg not clear looks LBBB ask about management, i didn't understand the Q .
21. Scenario of acute limb ischemia most important next mangment . I choosed iv
heparin.
22. Old recall about brachial plexus injury.
23. Pic for molluscum ask about school isolation.
24. Scenario about alzehimer and IHD ask about management . I answered
Memantin.
143
26. Scenario for female not pregnant and had mania ask about management i choosed
lithium. No olanzapine.
27. Two Q asked with same Scenario of premature ovarion failure (fsh menopausal
range=3- 250)ask about diagnosis and another Q ask about how to manage if the
patient is not sexually active now and not like to be pregnant. I choosed HRT.
144
(cyclical gv........continous gvn in late menopause)
28. Xray for ankylosing spond. Ask management.
29. Old recall of old patient with intestinal obstruction ask diagnosis. Xray given not
clear.
30. No statistics or ctg.
31. Old recall about grand mother vaccination before delivery of her daughter.
Recall of child that can not communicate in school ..interest in matemathic .. no eye contact ..
mild language delay?
Aspergaer was one of options
A photo of a smoker with finger amputation and history of discoloration in the cold weather
Burger(tromboangitisobliterans)
.
Lady mother diabetic, father hypertention has bp :160/80 BMI : 31 first management ?
Cardiovascular risk estimationI picked:
There was no option exercise or dietry plan
I think one was treatment of HTN
Lady drinksalchohol before pregnancy ..wt do u advise her?
Decrease amount
2 day week without alchohol
Immediately stop it
4 or 5 case about post operation complications!!!
Chillean woman with perianal problem and fissure in examination I dont remember anymore
I choosed intestinal shistozomiasis
Pregnant lady in 3 trimester lost 200 cc blood ..now with bad condition .. bp :
Bp: 90/50..pr : 130.. garding and tenderness.. firsinv ?
Resuscitation
145
146
6)which study u do to assess range and variance of vit D in Australia
A)cohort
B)cross sectional survey
C)case report
D)randomised control trial
7)4yr old with enuresis nocturnal 4-5 times a week.daytime dry next what
A)urine dipstick
B)renal ultrasound
C)urine culture
D)urea,creat and electrolyte
No option of reassurance
Pregnant women ( I think at 39 w) presents with no fetal movement for 2 days,CTG
Pic normal (10 min showing 2 UC and 3 accelerations with good rate and variability),
whats next
A. Repeat ctg after 24 hrs
B. Admit and monitor
C. Continue till next appointment
D. arrange to see her after 24 hrs n reassure.