April Part I 2017

1.mitochondiral inheritance pic

2.left parietal lobe infarct what visual defect

3.12 hours after headache, and neck stiff ct negative what to do next i used
lumbar puncture

4. volume pressure curve in heart failure didnt understand it

5.figure out drug after giving phenotolamine i used adrenaline and

betablocker

6. high grade fever, cough, green sputum, dull percusion, increase vocal
fermitus i used pleural effusion another option was pneumonia

2 questions about urinary incontinence

Uti allregic to pencillin choice ciprofloxacin
7 weeks after sorthroat odema and proteinuria choice minimal changes
Femal hypertension develop gout with thiazid choice one of acei i think was
losertan may be
Abdominal pain 6 hour dx choice amylase or x ray?

1. skin pigmentation , jaundice , liver failure features , DM ,,,,

heamchromatosis
2. ciclosporin toxicity , hurtsm , tremor
3. CI , SE , SD … increase sample ? ,,what happen to them ?
4. dacitlitis , knee , ankle … psoriasis
5. cervical LD , biopsy showed (….) …. hodgkin lymphoma , CLL , ALL , T cell
lymphoma
6. anterior spinal , posterior spinal infarct
7. folicular thyoid CA , Rx
8. thyroid cancer , lymphadenopathy , father and 2 bro cited at age 40’s
and 50;s ..type ? anapaestic
9. post mortom ,SAH , images of autopsy histology … etiology ..berry
aneurysm , vascular malformation
10. loud S1 , causes except i choose mitral vale stenosis , which is wrong
11. lady with pain even with touching any aspect of the hand , hx of trauma
to the hand , car door shuts , one month case .. i choose compression of the
intracarpel structure ,, median nerve
12. mitochondrial inheritance , diagrams , affected male , optic neuropathy
(Leber's Hereditary Optic Neuropathy (LHON))
13. dentist , 30 , painful ulcers in the hands with epitrochlear lymph nodes
ddx , i choose Herpes
14. visual field defect optometry picture , affected temporal lope , where is
the lesion in the diagrams , i used PITS mnemonic for this temporal —>
superior

15. post transplant colitis → intracytoblasmic lesion → CMV colitis

16. wife wants immunization , husband stage 4 Hodgkin lymphoma
o polio
o influenza
o penomocccal
17. US in two patient , one young and one old lady , both RUQ pain ,
gallstones , younger have positive predictive value ,means what?
o Sensitivity
o Specifity
o Pre-test probability
o Post test
o Accuracy
18. LFT options , jaundice post flue like illness , after resolution of
symptoms he developed jaundice , choose one LFT pattern
19. Hypercalcemia + mobits type 2 block , CXR normal
o I choose familia hypercalcemic hypocaluria
o Parathyroid –hyper
o Sarcoidosis
20. Hypersensity types , watch → I choose type 4 delayed
21. Another hypersensitivity types question ?
22. Agranucytosis , hyperthyroidism , treated then he developed fever and
labs lecopenia
23. Schizophrenia stared meds with Haldol , developed fever → NMS (drug
induced – Haldol )
24. UTI sepsis , hypotensive , treat with IV
o Steroids I choose this
o Antibiotic
25. Hypernatremia
o I choose IV fluids
26. SMALL CELL CA , HYPONATREMIA
o FLUID RESTRICTION
27. Contrast nephropathy , post angio ,MO injry
o I choose direct cytotoxic injury
28. Metalozone MOA
o I choose loop of henle
o Answer is distal convoluted tubule
29. Celiac Dx
o I choose tissue glatuminase
o Other anti gliaden , anti edomysal
o Biopsy 2nd part of dedenum
o Biopsy terminal ilium
30. Drug y , then draw of bloos pressure , (higher systolic , lower diastolic
o Added phenyl
o Then drug x
o Anwers praosozin , prapnalol , adrenaline , isoprenaline
o 5.figure out drug after giving phenotolamine i used adrenaline and
betablocker

31. Warfren anticoagulation

o Minitor with
o APPT
o Prothrombin
o No INR mentioned
32. AKI with hyperkalemia , bp soft , congested
o Option
• HD ,,, I choose this
• Bicarb
• IV fluids
•
33. Uremia , pericaial rub
o Uremic pericarditis , ECG picture
34. Egg shill calcification → silicosis
35. SOB , dry cough , in his late 50’s,bibsal crack → ask hx → I choose
occupation
36. DI feaure , drink a lot of water → I choose water deprivation test
37. Admitted MI , later developed low platelets
o I choose HIT
38. ADMITTED MI , DEVELOPED PULMONARY EDEMA
o I CHOOSE PAPILLARY MUSCLE DYSFUCNTION
39. Alcoholic , given nasgastric suction + other management
o Detrorated
• I choose aspiration , bacterial infection
40. Sigmiodectomy , rectal stump , developed black material , dropped hgb
o EGD – I choose this
o Surgery again
41. Pancreatitis , hypotensive
o I choose fluid sequisterisation 3rd space
42. MI , raised JVP
o Frank starling drawing
o Cardiac out put , venous pressure
43. CF . lack of what
o I choose sweat chloride , actually increase
o Sperm count
44. paget disease one option
45. pernicious anaemia ,with pt having autoimune thyroiditis
46. 12 hours after headache, and neck stiff ct negative what to do next i
used lumbar puncture
47. high grade fever, cough, green sputum, dull percusion, increase vocal
fermitus i used pleural effusion another option was pneumonia
48. 7 weeks after sorthroat odema and proteinuria
 o choice minimal changes
o post infection GN

1. One xray of neck:ankyslosis

2.another xray--spondylethesis
3.MRSA resistance
4.non caseating granuloma...toxoplasmosis?
5.pseudomemobranus colitis-oral metronidazole
6.pneumothorax

UTI CASE WITH PENICILLIN GIVEN AND HAD DRUG ALLERGY

WHICH DRUG NOT TO BE GIVEN
CEFUROXIME
TRIMETHOPRIM
CIPRO

Yah temporal lobe------superior quadrantonopia

Penicilin allergy--cefuroxime cant be given??

HIV PT with low CD4 what to give....cotrimoxazole

ABG ......METABOLIC ALKALOSIS

ANOTHER ABG MIXED METABOLIC ACIDOSIS +RESPI ALKALOSIS,,,,,,,,,,,,,,,ASPIRIN

OVER DOSE

A PATIENT WITH SMALL CELL LUNG CANCER HAD HYPONATREMIA 125 AND
CONFUSION , WHAT IS THE TREATMENT
- NaCL 0.9%
-NaCL 1.8%
- TOLVAPTAN
- DEMCLOCYYCLINE
I think NACL .9 SALINE
If small cell ca then SIADH?so most definite treatment fluid restriction or
demococyline?
 January Part I 2017

Sudden loss of vision unilateral in patient with DM and HTN..i answered RD,
.vitrous hemmorhage.
Stable angina ECG changes- normal, t wave invertion, st depression etc
First question.. RTA with fracture skull, now detrioration , antibiotics
given..? Inc dose of Abx, i answered HIV as he is IV drug abuser, ?CT scan
A wave on JVP, ?pulm HTN,
MI . Papilary rupture,
Pt with CCF which drug for good prognsis? Aspirin?? Spironolactone,
bendroflumethazide, digoxin etc
HIV with sigmoidoscopy showing while lesion ? I answered crispordiasis? Hpv?
Anal fissure etc
Asthmatic now on inhalers, some test were done no change, i answered add
steroid inhaler..other options longacting salmeterol, oral pred etc, inc dose
of salbutamol etc
A difficult question of pt with metabolic acidosis, pco2 and ph mentioned?
Repeat ABG in patient who was on oxygen pco2 9 and po2 20, i asked to
repeat ABG in 30min and reduce oxygen 20-30%
Foot drop i answerd perneal nerve with fibular head compresion? Other
options deep peronial, sural nerve etc
CXR given i answered silocosis, other option klebsella, steptococal
pneumonia, pneumoconiosis, there was bilateral basal hazzines, i thought
silicon is heavy causing lower area of lung disease
MEN1 pic give with herpcalcemia, etc
Epistaxix with renal issues, i aswered wegeners
Hypertension with hypokalemia i answered barters, other option ligol's
syndetc
VT hypotension tachy i gave synchronised DC shock, other options unsync dc
shock, iv acces and aireays etc
Hypercalcemia i gave iv fluids first
Hypercalcemia i gave bisphosphonates
BM of 70 , i gave iv insulin, other option s/c insulin
Bee sting pt with angioedema i gave 1/1000 adrenalin ?im, not sure iv
Unilateral exomphthalmos ?ct scan
Pt with fixed unilateral dilated pupil recent after mi which was
thrombolyed, i answed hemorrhage? Uncal herniation??
Back pain and conjuctivitis i associated with sacroilitis
Another similar question was genetic and inflammatory association
Polysystic kidney or some other disease inheritiance from both parent
carrier?, mother carrier?
Pt femal declined surgery for pancreatic cancer, i answered need further
medical councelling? Other option inform children to convince her and
capacity assessment?
Pt with rash on hand and nail pitting, i answered psoriasis
Pt with af and CRF i answered warfarin or aspirin?
Pt with raised creatinin ? Ambulatory hemodialisis, other options perotonial
dialyssis, home dialysis etc
Pt with ph of 7.1 etc i gave bicarb,
Pt with recent mi now heamatamesis , i asked icu and endoscopy.
Pt with hematemsis i asked for stenkeston tube insertion, other options
traslipression adh
Female girl with spider nevi 18 yrs old, i said cirhosis
Question re budchiari and primary biliary cirrhosis?
Penile ulcer treponema pallidum
Muscular pain, orange urine i asked to do creatinine kinase, ?muscle biopsy
Pt with pelvic pain, i asked for pelvic xray, ?hypercalcemia! Electrophoresis
etc
Epsilateral hemanopia ?temporal lobe or parital lobe
Painless nodule, difuse enlaged thyroid, i answer normal test
Skin pegmentation i answer addisons as hyperkalemia?
Immunology question Polyp in nose I ANSWERED IGM, OTHER iga, igg etc
Young patient Pain on bending backward? Disc prolapse? Other
oteporosis/fracture etc
Pt applied sun block now with rash, solar burns, i said allergic reaction then
corrected to hydralazine exposure sun reaction?
Ear lesion shown pic ? Basal cell carcinoma, other squamus cc, edges are
rolled margins and irregular with central bleeding, cant be keratocanthoma
etc
Pt with chest problems, i asswered occupational
Sleep apnae question i asked for polysmonography
Pt with hearing problem in noisy envoroment i aswered choclear problem, ?
Nerve lesion, brain lesion, middle/external ear problem
Early diastolic murmur? Aortic regurgitation forget this question ( somebody
help)
Xray abdomen shown of patient with prev ruptured appendicits, i aswered
appendicular mass obstruction as small bowel enlarged , other option
adhesion, parlytic illeus?
Rheumatoid arthritis?jevenila as pt had knee crepitis,other option
chondrocalcinsis, ostemalacia. This pt also suffered morning stiffness.
Pt had headaches lumbar puncture wcc raised and protein normal..? Cannlt
recall what were they asking
Pt with haemetemesis? Cirrhosis, portal htn? Cannot recall exactly
 September 2016

Patient pregnancy, Na low - hyperosmolar

On 25mcg methotrexate for RA, ans methotrxate pneumonitis, rh.nodule,
steptococall infection, pneumocystis carni?
Pt on warfarin what will be test interpretation - PROLONGED PT, WITH NORMAL VIII
FACTOR.
x-ray knee - patella subluxation, OA, OPenia
Thyroid scan - hashimotos, toxic nodule, cancer papillary etc
CT brain shows old infarct, pt was confused ? Thrombosis, sinus cavernus, etc
Bloody diarhoea recently with femoral bypass surgery - i answer dudenal fitula
Blood transfusion now febrile after TURP , i thought catheterization, other options
ABO Incop, resus incomp, etc
Rash, recent streptococcal infection ? GNEPHRITIS, MINIMAL CHANGE, SLE, ETC
photophobia neck stiffness, investigation LP,
LOW HB, DYSNOEA, W.T LOSS OCCULT STOOL NEGATIVE TX ORAL IRON,
SVT - adenosine
DM now swollen leg - clindamycin additional antibiotic to prevent fascitis
Raised CK 12000, rhabdomylosis /myositis etc
Pt with dysphagia relieves when lift up arm - somthing ring in esophagus,
Elderly with osteoporosis GFR low ?alendronate (wrong)
Osteosclerosis, Low bony density. .pagets,osteomalsia, osteoporosis
Pt with collapse after laughing in pub ?sleep apnoea/catplexy
Halitosis, dysphagia ,achalsia,Ans-manometry, ph monitering
Spiking temprature graph given ?mediterian fever-hogkins lymphoma,
Rubbery bilateral LN -hogkins lymphoma,
Pt on vegetable 8yrs Vit B defficiency
Nodule on hands .?dubutryns contracture, Rh nodules?
On ramipril - cough cause- bradykinins,?angiotensin
Chest pain radiates to back , HTN - aortic disection
Quincy , swollen and left moved tonsils unable to swalllow
Bitemporal hemanopia, opthalmoplegia !? Cavernous sinus thrombosis , pitutary
apoplexy
Low sodium -secondary to lung cancer ?sq cell ca, small cell ca
Pt with menigits iv fluids given -best further tx abx
Pt with adissonian crisis give iv fluids and dexamethasone
Young pt with gcs 8/15 large intracranial bleed shown on CT VENTRICULOPLASTY /
intubation, dexamethasone
Pt with copd ph 7.2 , retaining co2 worsening -intubate , lower co2?
Ethical question inform after asking question from dad about his cancer
Warfarin 5% means how many pt prevention in 5 years-10,15,20...
Metabolic or mixed met/resp alkalosis hco3 36
Pt with blood pic shown ANS- CML
Pt with low platelets tx splenectomy, platelets transfusion etc
Rash /exzema on elbow and wrist tx oral diphedramine? Topical sterois etc
JVP a wave, ?pulm HTN, ASD etc
Diarhoea, hot flushes , HTN .? Cause investigation colonoscopy, uss abdomen, renal
angiogram???
Urinary catecholamines - pt with hot flushes, pitutary tumor?
FEV 1 etc given, chronic smoker ?emphysema, copd, asthma
Weaknes in lower limbs, neck pain while sleep ?spinal compression
Loss of anal sensation, pudendal nerve? Iliohumeral/femoral nerve
Tirdness and pain on walking in the morning and at night - Planter fascitis
On strict carrots etc now yellow tinge in eyes keratonemia/ vit A toxicity
Pt with newly DM, family hx oF DM .? Association autoimmune etc
Mouth ulcer, chest problems? Heridatry talengiectasia etc? Mixed connective tissue,
MS, UC
small testes, recent mumps infection, shave in 2/52, red. Libido ? Klienfilter,
mumps induced, kallman not as smell intact
Amenhorea, bloods normal ,inv bhcg
Hirsutism, amenorrhoea etc polycystic ovarian disease
High reduced from 160 cm to 157, back pain etc reduced bone density?calcium ,
dexa scan, xray , ct scan, mri scan
Pain radiating into buttock , investigation MRI SCAN
SIEZURE , ?abscence.lamotrigine/carbmazepine, pheytoin, na.valproate
Htn, tachy, af ,?thyrotoxicosis,
Hypoparathyroidism as pt with low calcium, other option hyperparathyroidism,
pitutary, renal failure,
Renal condition dietary cholecalciferol, vit d, calcium oral? Correct answer
Otitis media recurrent - chlesteatoma, otits media or mastoiditis
Split heart sound ?ASD

Metabolic Alkalosis or compensation as well ?

PH 7.56
PCo 2 6
HCo3 high

just metabolic acidosis

Unresponsive patient
NO vocal response
No eye opening
Withdrawal to pain
Ans Intubation

Weight loss
Dysphasia
Halitosis
62 year old
Investigation of choic
? OGD
.manometry
I choose OGD

I did manometery weight loss was 2kg over two years

Halitosis question also mentioned about regurging food- thot it was pharyngeal
pouch that they were referring to so chose barium meal?

Dexamethasone suppression test ?

For bed sores

Change in posture every two hrs
For ethics
Ask patient wish to discuss results

for the bedsore question, the patient had a femoral fracture, is it feasible to be
turning every 2hours?

Recalls:
Insulin and C-peptide relationship (?factitious disorder)
recurrent ear discharge (?otitis media/cholesteatoma)
Lung CA that goes with Hyponatremia
18yr lady, proteinuria, but asymptomatic. urinary ACR fluctuates. (?thin membrane
disease)
Changes in ABG during anaemia

will write more as i remember them

Polyurea
Polydypsia
On Prednisolone
Forgot rest ? Myeloma
Hyper alchemical or hyperglycaemia

X-ray of knee osteoarthritis

Does somebody remembers the stem where, a pt waiting for renal transplant with
GFR and creatinine of 260.
Option
A renal transplant
B haemodialysis in hospital
C Perotoneal dialysis
D 24 hr ambulatory dialysis
E dialysis at home

What was the answer

 May 2016

1. Renal stone : RTA type-I

2. Head Trauma : SIADH
3. ATN: Urinary Fractional excretion of sodium
4. MEN: Parathyroid hormone inc.
5. Hypercalcemia: Inc. Osteoclastic activity
6. Cord compression: MRI spine
7. LQTS: fainting episodes: VT
8. LQTS: Which drug?
9. Hypertrichosis : ciclosporon
10. Ac. Gout with renal failure: colchicine vs allopurinol
11. Post op: Thromboemboli
12. Hypogonadotrophic hypogonadism, anosmia: Kallman's synd.
13. Histology : sq/basal/actinic?
14. Histology : vitiligo: absent melanocyte/ absent melanin.Both are
present, I opt absent melanocyte
15. heriditary angioedema , presents with 6 hours of severe tongue
swelling: Rx?
16. gallstone obstruction level?
17. Most common cause for cholecystitis : E-coli, enterocoocus,
pseudomonas
18.BPV
19. COPD: dec, Fio2 24-28%
20. Ac, asthma: IV hydrocortisone
21. Post transplant pt on infliximab: TB
22. SAH: Non-contrast CT scan
23. 3rd N palsy: ?Absent right consensual reflex
24. gonococcal septicemia
25. Chlamydia trachomatis Inf.
26. R.A.S. : Inc. Renin and Inc aldosterone
27. DKA: add Dextrose
28: ++++ proteinuria , after a viral illness: MCD vs Viral cardiac myopathy?
29. Pain and stiffness in shoulders and hips: ? Amytrophic lateral sclerosis/
polymyositis?
30. RA factor negative :Anti-CCP
31. Morphine : clostomy and bowel filled with fecal matter: Enema?
32. On morphine: Continue same dose with addition of stool softner
33. Weekly headache: propranolo/ CBT/ neurology consult/ CT scan
34. VV syncope : do nothing
35. Bleeding after tooth extraction : thrombocytopenia: ITP
36. Dermatology pic: Hemangioma?/ basal cell?
37. Alcohol : Thiamine def.
38: Alcoholic hepatitis
39: Hepatitis C
40. CHADS score 1 : Aspirin
41. ABGs : Ch. Resp. alkalosis?
42. Rt Lacunar stroke
43. NSCLC : thoracotomy/mediastinoscopy?
44. Status epilepticus : IV phenytoin
45. traumatic brain injury: antiepileptics upto 2 years
46. common peroneal n. palsy
47. sciatic n.palsy vs non organic cause?
48. Median nerve : splint / decompression?
49.CSF neutophills: cefotaxime
50. Neutropenia : cotrimoxazole
51. IgG and IgM dec. : complemnt activation?
52. hemochromatosis
53. creatinine inc : stop metformin
54. TB patint with post. hypo: addison's
55. GERD: oesophageal manometery ?
56. esophageal rupture : esophagogram / CT chest?
57. UTI with abdominal mass: Colon Ca,?
58. Abdominal xray: Ileocecal crohns?
59. pneumothorax xray
60. gilberts synd.
61. Ankylosing spond.
62. wegeners? : c-ANCA
63. Complete heart block
64. DM / HTN: perindopril
65. Endocarditis : strep. viridans
66. COPD: LTOT
67. Aspirin: inhbition of thromboxane A2
68. Lung functions with dec transfer factor: Sarcoidosis
69. Nocturnal cough : PEFR 150: GERD/ microaspiration of gastric contents
?
70. External/internal Intercostals/ diaphragm weakness:??
71. HIV diarhhoea : cryptosporidium
72. URTI with stridor : Influenza
73. LTBI : INH
74. HIV confirmation: Viral load / p24 antigen?
75. Tense bullae: histology: subepidedrmal
76. Mass in neck and stridor : tracheostomy/laryngectomy/laryngeal mask?
77. hidradenitis suppurativa in Diabetic: Rx:Tight glycemic control
78. Pnumaturia : cause?
79. AF with abdominal pain: mesenteric ischemia
80. Admitted pt, nurses observed decreased appetite : nutrition? : oral ?
81. Graph: shaded area? : true/false/positives/negatives?
82. graph glucose: X, Y ?
83. Data : true RRR?
84. ds-DNA : SLE?
Anisocytosis on Blood film
Abdominal xray with mass
AF ? Mesentric ischemia
AF ? Stroke prevention , Anticoagulation
Question with Renin Aldesterone , unsure about answer
Aspirin mech of action?
Positive predictive value ?
Cholecystitis common organism ?
Ph 7.24 /high ketone ? DKA
DKA on treatment BM decreased to 8.9
Add 5% dextrose
Bilious vomiting ? Level of obstruction
AST 150 ALT 100 cause of liver enzyme ? Alcohol
Pneumaturia ? Cause

Chest xray about pneuothorax

Long Qt --> VT
Long Qt---> drug
Renal impariement --->stop metformine
H/O SAH ---> non contrast CT
Pt recived N/S and dextrose ---> thiamine def
Constipation in pt on morphrine
3rd n plasy

Graph regarding Half life

?4 Hr

I quite agree most of your answeer but disagree with the following:
Common organism:Entercocus
Increase KCO with GN: CSS bcause Gn in sarcodsis is rare
PMR not polymyosities
Cardiomyopathy
Oral anticoagulation bcoz CHAD2VASC2 score>2
recuurent VVS: avoiding the situation and aware

agree with u but about morphine continue wit stool softener

Even I answered Enterococcus for common pathogen but had a look on one
research paper which says E. coli is common
I think GN question had neuropathy as well, so I went for CSS ? For neuritis
Nurse with syncopal episodes had urinary incotinence as well, I went for EEG
and imaging

next appropiate Mx of Status epilepticus:

lorazepum or I/v phenytoin?
i did select i/v phenytoin but not sure?
Level of obstruction:cystic duct.
polymyositis is weakness and/or loss of muscle mass in the proximal
musculature, as well as flexion of the neck and torso.[1] These symptoms can
be associated with marked pain in these areas as well.

hi there all, i think we should start discussion on all questions one by one, esp
the ones on disputes.. what u think?>

@DRATTARI u did great effort, thanks...

i agree with most of ur answers but on few disagree and few i wrote down

8. LQTS: Which drug? i choose CITALOPRAM

13. Histology : sq/basal/actinic? i choose BASAL
4. Histology : vitiligo --- i choose absent melanocytes
15. heriditary angioedema , presents with 6 hours of severe tongue swelling:
Rx? it was difficult.. was it C1 concentrate or adrenaline 1:1000 IM.. i choose
adrenaline.. i thought this time patient has allergic reaction sign... may be i m
wrong
16. gallstone obstruction level? in this question as patient was having
conjugated high and he did billious vomiting, it means his bile was coming down
and he has obstruction...so thinking this i choose ?Duodenum...
19. COPD: there was a question on COPD, i don't know is it the same or
different, his PH was fine and also patient don't have any secondary causes to
start LTOT. i choose medical treatment...?
and another COPD q i choose Non invasive
26. R.A.S. : dec. Renin and Inc aldosterone ..prim hyperaldosteronism con's
29. Pain and stiffness in shoulders and hips: ? Amytrophic lateral sclerosis/
polymyositis? i agree with polymyositis
28: ++++ proteinuria , after a viral illness: MCD vs Viral cardiac myopathy? i
agree with MCD
33. Weekly headache: propranolo/ CBT/ neurology consult/ CT scan ;;;; i think
its migraine as per diagnostic criteria for migraine, unilateral headache, sever
intensity, nausea & vomiting,,, i choose Propranolol as prophylaxis
34. VV syncope : do nothing -----i agree with EEG AND BRAIN IMAGING
36. Dermatology pic: Hemangioma?/ basal cell? BASAL CELL i choose
Oral anticoagulation bcoz CHAD2VASC2 score>2
48. Median nerve : splint / decompression==== i choose splint?
56. esophageal rupture : esophagogram / CT chest? i choose water soluble
contrast..if negative then we go esophagogram..if negative then ct chest---my
opinion
43. NSCLC : thoracotomy/mediastinoscopy? i went for mediastinoscopy
44. Status epilepticus : IV bengodiazepines i choose as 1st option
70. External/internal Intercostals/ diaphragm weakness:?? i choose diaphragm
weakness--?
68. Lung functions with dec transfer factor: Sarcoidosis not sure of this question
but i think either asthma was there..

74. HIV confirmation: p24 antigen

76. Mass in neck and stridor : tracheostomy
80. Admitted pt, nurses observed decreased appetite : nutrition? : oral ? i went
for oral. as patient stable..

Thanks softin . a little discussion :

8. LQTS: Which drug? i choose CITALOPRAM .I also chose this but i am not sure
does it cause or not
13. Histology : sq/basal/actinic? i choose BASAL . I opt squamous as there were
mitotic cells, spindle cells and increased keratinocytes.
4. Histology : vitiligo --- i choose absent melanocytes , I agree, I looked in text ,
actually absent melanocytes and dec.melanin are both present but absent
melanocytes is the major pathology that I opted
15. heriditary angioedema , presents with 6 hours of severe tongue swelling:
Rx? it was difficult.. was it C1 concentrate or adrenaline 1:1000 IM.. i choose
adrenaline.. i thought this time patient has allergic reaction sign... may be i m
wrong : i opted as same.
16. gallstone obstruction level? in this question as patient was having
conjugated high and he did billious vomiting, it means his bile was coming down
and he has obstruction...so thinking this i choose ?Duodenum.: There was
Positive murphys sign , looks like CBD , not sure
19. COPD: there was a question on COPD, i don't know is it the same or
different, his PH was fine and also patient don't have any secondary causes to
start LTOT. i choose medical treatment...? :The criteria for chooosing LTOT was
there , plethoric, chronic type II resp failure etc , so I went for LTOT:

and another COPD q i choose Non invasive : for this first thing in the
management steps is to decrease Fio2 to 24-28% , if it does not help then the
next step is NIV.

26. R.A.S. : dec. Renin and Inc aldosterone ..prim hyperaldosteronism con's :
The pateint with peripheral vascular dis, and renal bruits making RAS likely. In
this situation dec blood flow to Renal artries causes Inc Renin secretion which
then leads to Inc aldosterone production, so its not Conns , as in Conns there in
Inc aldosterone that negative feedbacks to reduce renin.
28: ++++ proteinuria , after a viral illness: MCD vs Viral cardiac myopathy? i
agree with MCD. I did not opt MCD as his renal functions were normal , so i
went for viral.
34. VV syncope : do nothing -----i agree with EEG AND BRAIN IMAGING , The
answer is to avoid and aware that i looked in text. my answer is wrong.
36. Dermatology pic: Hemangioma?/ basal cell? BASAL CELL i choose : It was
tough but I opted hemangioma.
Oral anticoagulation bcoz CHAD2VASC2 score>2: The patient age was less than
75 years , not in CCf , non diabetic , no hx of TIA or strokes, was only
hypertensive making the score 1 , so i went for aspirin.
48. Median nerve : splint / decompression==== i choose splint? :difficult again
as splint and decompression are both treatments written in text , i was
confused so i opted decompression, but I think splinnts at night time looks more
appropriate.
56. esophageal rupture : esophagogram / CT chest? i choose water soluble
contrast..if negative then we go esophagogram..if negative then ct chest---my
opinion : yes its contrast first
43. NSCLC : thoracotomy/mediastinoscopy? i went for mediastinoscopy :
agreed
44. Status epilepticus : IV bengodiazepines i choose as 1st option: In the
guidelines and what our neurologist in my hospital recomends id IV phenytoin ,
so i went for it
70. External/internal Intercostals/ diaphragm weakness:?? i choose diaphragm
weakness--? : I opted same. but why ? no explanation
68. Lung functions with dec transfer factor: Sarcoidosis not sure of this question
but i think either asthma was there.Actually no asthma history given making it
tough to decide , thats why i chose sarcoidosis , but maybe they deliberately
did not give this hx.
74. HIV confirmation: p24 antigen: In books i studied , both P24 antigen and
viral load is written for confirmation , so i was not sure what is best between
these two. I chose viral load.
76. Mass in neck and stridor : tracheostomy : next most appropriate step ? i
went for laryngeal mask : I dont know exact answer as i never dealt with such a
case .
80. Admitted pt, nurses observed decreased appetite : nutrition? : oral ? i went
for oral. as patient stable.. agreed .

For one of questions I answered selenium deficiency. don't remember the

question.
There was a slide of plasma cells : MM

for multiple myeloma -- i m not sure it was plasma cells or osteoclasts???

there was a question with???? angular stomatitis i guess was zinc deficiency..im
not sure really. but i think think there was history of small bowl removed... so
zinc def..

there was a question of mixed resp alkalosis n metabolic acidosis

now i guess i am mixing up things...

I think -MM is best choice

VVS-this is simple vasovagal

Incase of obstruction-if its in CBD causes Jaundicand dilated biliary channel on

USG?
Status Epilepticus:i also choose phenytoin but guideline immmediate next
I/VBDZ

this is zinc becuse selenium mainly cause cartilage & Cardiomyopathy

19. COPD: there was a question on COPD, i don't know is it the same or
different, his PH was fine and also patient don't have any secondary causes to
start LTOT. i choose medical treatment...? :The criteria for chooosing LTOT was
there , plethoric, chronic type II resp failure etc , so I went for LTOT:

I went for medical RX optimization

they mentioned pt is on bronchodilator / nothing else mentioned regarding
medical RX, ICS
?

VVS-this is simple vasovagal

I think there was urinary incontinence in that scenario as well

http://utlitslaekning.is/wp-content/gallery/kirsuberjaaedaaexli-cherry-angioma/cherry-
angioma-vi.jpg
?cherry haemangioma

I think haemagioma

There was a question on erthrasma... I choose check bloog sugar. As its

common in diabetics

I agree with erythramsma n diabetes

there was a question on lumber radiculopathy.. femoral reflex was normal... no

common peroneal nerve damage hx..

there was a question for NSTEMI and treatment was ----Aspirin

also there was a question with hyperkalaemia

hyponatraemia
hypoglycaemia
metabolic acidosis

and answer---- adrenal insufficiency

question on anal fissure...

was it there or my mind is making itself now

a question on avascular necrosis

high creatinine, tacrolimus vs metformin

management of gout in ckd patient..... colchicines

there was a question on haemochromatosis with all its complications of

cardiomyopathy tanned skin arthritits
also another question on HIV associated loose motion, no blood in
stool=====cryptosporidium diarrhoea

a question on reactive arthritis gonococcal

 January 2016
1. TIA TERRITORY -> VERTEBROBASILAR ARTERY
2. HOCM
3. MSA
4. PARKINSONS-> LEVODOPA
5. RAS-> ARTERIOGRAPHY
6. SVCO
7. NIACIN DEFF.
8. RIBOFLAVIN DEFF.
9. B12 DEFF.
10. PANCREATIC INSUFFICIENCY
11. INTRACRANIAL HTN -> LP
12. HYPOVOLEMIC HYPONATEMIA-> INCREASED ALDOSTERONE LEVELS
13. ADRENAL CRISES WITH AC. APPENDICITIS
14. CONS SYND.
15. CHURG STRAUSS SYND.
16. ENDOSCOPY-> CANDIDIASIS
17. SQ. CELL CARCINOMA
18. CLL-> OBSERVATION
19. INO-> LESION IS IN MLF
20. EVENING DIPLOPIA-> MYATHENIA GRAVIS-> NORMAL PERIMETERY
21. SERONEGATIVE RHEUMATOID ARTHRITIS
22. AFP IN HCC
23. HEPATITIS A
24. HIV-> SEROCONVERSION
25. C.DIFF-> TOXIN LEVELS TO CHECK
26. GENTAMICIN-> HAIR CELLS LOSS CAUSING DEAFNESS
27. DIGOXIN TOXICITY
28. SUCRALFATE WILL RELIVE SYMPTOMS WITHOUT ACID SUPPRESSION
29. ETHAMBUTOL CAUSING COLOUR BLINDNESS
30. GONOCOCCAL SEPTICEMIA
31. KNEE JOINT INJURY-> STAPH
32. IGA NEPHOPATHY
33. PULMONARY EDEMA-> DIMORPHINE
34. COPD-> TYPE II RESP. FAILURE-> CONFUSED -> INTUBATE
35. DWARFISM-> DECREASED IGF BINDING PROTIENS
36. GASTROPARESIS-> METOCLOPRAMIDE
37. PYLORIC STENOSIS-> HYPOCHLOREMIC HYPOKALEMIC METABOLIC ALKALOSIS
38. MODY-> AUTOIMMUNITY AGAINST ISLET CELLS
39. RAISED GATRIN LEVELS-> ACHLORIDRIA
40. WEGENERS -> C-ANCA
41. VASCULAR DEMENTIA
42. PREGNANT LADY, HIV POSITIVE, INFLUENZA VACCINE GIVEN, NEXT> Hib
43. HERPES SIMPLEX PIC. -> ACICLOVIR
44. HTN-> ADD CALCIUM CHANNEL BLOCKER
45. ALCOHOLIC , UNCONCIUOS-> GIVE IV THIAMINE FIRST
46. SVT, CARDIOVERSION FAILED, NEXT-> AMIODARONE
47. POLYUREA, POLYDIPSEA, 15MMOL BLOOD SUGAR-> START TREATMENT.
48. CVID
49. CA BREAST -> METS-> MRI SPINE
50. PERICARDITIS
51. CKD PT WITH SOB-> HEMODIALYSIS
52. POST OP PATIENT.-> GIVE IV FLUIDS
53. LACTIC ACIDOSIS/KETOACIDOSIS/ASPIRIN POISONING/ DKA
54. INTERSTITIAL NEPHRITIS
55. BIAS?
56. ADRENALINE/NORARENALINE GRAPH
57. MENINGIOMA/GLIOBLASTOMA
58. GUNSHOT-> FISTULA?
59. LUNG ABCESS-> ENDOBRONCHIAL ISTULA
60. HALO NEVUS-> REASSURE.
61. ITP-> STEROIDS NO RESPONSE-> GIVE IVIG
62. TETRACYCLINE-> DON’T GIVE WITH ANTACIDS.
63. GRAM STAIN SLIDE COCCI->?
64. P VALUE->?
65. FACIAL RASH-> STREPT VIRIDANS
66. TB-> CONFIRM BY SPUTUM INDUCTION AND CULTURE.
67. YOUNG MAN WITH GLOMERULONEPHRITIS , FATHER IS ON HEMODIALYSIS->
FSGS? /MEMBRANOPROLIFERATIVE GN.
68. COPD -> GIVE CONTROLLED OXYGEN?/ NIV?
69. GALACTOREA WITH AMENORROHEA> ALNGWITH CHECKING PROLACTIN
LEVELS, WHAT ELSE TO CHECK> ESTRADIOL/TESTOSTERONE/TSH?
70. THORACIC CORD LEVEL INJURY OR LUMBOSACRAL PLEXUS INJURY?
71. ABO INCOMPATIBILITY> HOST Ab REACT WITH NTIGENS ON DONOR RBCs
72. HYPERCALCEMIA> HYDRATION FIRST.
73. AF> CHADS SCORING> WARFARIN
74. PATIENT IN STATUS EPILEPTICUS, UNCONCIOUS, RR 8/MIN> INTUBATE/
PHENYTOIN?
75. CH. PANCREATITIS> DEFFICIENCY OF FAT SOLUBLE VITAMINS
76. XRAYS> TB/CARCINOMA/FUNGAL?
77. ASCITIC FLUID TAP?

There were questions on

CVID
Chrug Strauss syndrome
Interstitial nephritis
Zollinger Elison
Conn syndrome
CEA in HCC
SLE
Pulmonary edema Rx
HOCM
I will post more themes as I will remember
 Increased AFP levels may indicate the presence of cancer, most commonly liver
cancer,

Brain Tumor? Glio Blastoma Multi

Yes glioblastoma multi.

What was the X Ray chest, cancer or abcess?

dont remember x ray

but it was lactic acidosis in hypotension

Lactic acidosis is ok . I mean X Ray chest with RT upper lobe with clubbing??
Cancer/to/ abcess? What was it?

The one in which they were asking that what will be in the sputum. the answer
was hyphe

I don't remember the question you are referring to .

one was l-dopa for the treatment of parkinson disease.

What was the pharmacodynamics? Noradrenalin one

Blood film? Megaloblasric anaemia

Face infection photo? Staph
Squamous cell carcinoma ( skin lesion)

One question was MSA

Another was pulmonary Vascular resistance
One was amiodarone
One was ? Fistula formation after gun shot months ago

I thought the blood film was iron deficiency was kinda whitish rbcs.
One was B12 deficiency
Another was riboflavin deficiency
Another was niacin deficiency

Another was ace inhibitor

Another was decreased preloaded increased contractility and decreased
after load
Another was distended neck veins and svc obstruction as I remember
Another was ? gonococcal sepsis

Another was sucralfate doesn't affect gastric acid production

I think it was not pul vascular resistance as mechanism of hemoptysis is left

atrial dilatation which led to pulmonary viens congestion
one was warrfarin?

iga nephropathy
one was i think wegeners vd skin lesions and proteinuria..i dont remmbr
exactly
hyphae on sputum

I believe pulmonary Vascular congestion will lead to increased pulmonary

Vascular resistance

Don't know ! One was halo nevus and reassure

Another I remeber ??herpes simplex skin lesion and there was knee pain ??

Which question was the warfarin? dont remember

pt had atrial fibrillation and othr conditions like hypertension diabetes and
treatment was asked

one was benign intracranial hypertension?

i guess next investigation was asked which was lumber pumcture

Yup warfarin high chads.vasc

Agree lp

whats CVID?

Cvid=common variable immunodeficiency

Warfarin for high Chad vasc
Not wegnar but invx( ANCA).
Can u remind me with this arthritis with herps cause she was female with
polyarthropathy and ?? Pericarditis pain which increase with leaning or setting
so I choked SLE!

There is one lower third murmur plus arthritis??? What it was it?
Any body know the pass mark, I heard it is 50% ?

yes tht pericaditis female had SLE

ckd with sob thy asked wht is the treatment for sob.i marked frusemide but i
think it was hemodialysis....
thr was anothr post op pt i guess in which answer was normal saline i/v ..
anothr was appendicitis with adrenal crisis

thr was anothr with back pain and h/o some malignancy ,female
pt..investigation was asked..MRI spine?
anothr was calcium and phosphate given..i marked primary hyper
parathyroidism..but i dont know the ans

Psychic patient on lithium developed flat affect had hypercalcemia... I think it

is lithium toxicity ... U can found lithium as a cause of hypercalcemia with or
without hyper parathyroid in medscape( warning box)
-the pt with lot subclavian LN HAD HX OF breast cancer had back main the Q
was what is the invx which could reveles the diagnosis... I choked LN biopsy as
MRI will not say what is the problem? What do u say

anothr was calcium and phosphate given..i marked primary hyper

parathyroidism..but i dont know the ans

yeah the lithium was different question..and one in which cal n phosphate and
parathyroid level were given was different
and the pt vd breast cancer her main complain was backache as far as i
remmbr..the first thing shd b to rule out metastasis

thr ws another in which pt had temporary loss of vision i guess two to three
episodes and had smthing vd carotids..i dont remmbr complete but i guess
answer was problm in carotids??

no, it was vertebral arteries

 Septemper 2015

1. Iv thiamine for wernicke encapth

2. Cf brain was showing calcification...so it was av malformation
3. Compound Naveus of Nail vs Nail bed hematoma
4. A question about chlamydia infec. Dysuria with no discharges...not
gonorrhea
5. blood loss >2000 for blood pressure low to 80 n pulse 142
6. ECG /? hypokalemia
7. Multinodular goiter vs Graves Image
8. images one from osephageal crcimnoa
9. osteomalcia vs hyperparathyroidism....raised alkaline phosphatase ---Vit
D levels check
10. Pulmonary embolism after operation
11. another question on Pulmonary embolism also
12. VSD cxray showing biventricular enlargement
13. bronchial asthma needing icu admission
14. giant V wave--? Liver pulsating?? dont know other options
15. question on pulse more than 150 n SBP 80... afib?v tach?
16. Familial hyperlipidemia
17. internal carotid artery ulcer//insufficiency
18. IBS Rx----tricyclics, fibrates, diet regulation
19. question on Incarcinated Hernia on xray findings
20. breast ca with metastasis n back pain---tt radiotherapy plus
bisphosphonates
21. perianal abscess - organisms group A streptococci
22. leg cellulitis---staphylococcus Aur
23. food poisoning one hour after eating egg cheese with vomiting and
abdominal cramps----- relieved after 10 hours------- Staph poisoning
24. C1 inh deficiency -lip swelling hereditary angioedema
25. started on ACE reported hereditary angioedema
26. slow down of Diabetic nephropathy--rampril
27. weakly positive birefregrent molecules (gout) treatment already on
allopurinol-- continue allopurinoal with colchicine
28. MI treatment----- aspirin plus clopidogrel
29. Rheumatism with splenic enlargementand neutropenia-- felty syndrome
30. images ---- venous ulcer
31. intrinsic factor deficiency and B12 deficiecy
32. RPGN-Goodpastures ?????? not sure
33. renal biopsy – membranous, minimal change, mesangioproliferative
34. hyponatremia-- carbamazepine ????????????? not sure
35. high blood sugar with strong family history in a young male pt....what to
 give...sulphonyl urea (i thought of MODY)
36. Case of MS
37. Hypocalcemia case with calvium chloride to give
38. Case of autoimmune polyendocrinopahthy type 1===pt had featires of
addisons n hypoparathy
39. Cervical myelopathy case
40. Cervical dytonia for unilateral sternocleidomastoid muscle enlargment.
41. Speceficity question
42. Another weired statistics question.
43. Diphtheria question
44. question on stopping naproxen
45. image of blood picture showing stellate cells --ask the pt to avoid sulpha
drugs ??????????not sure
46. Lithiasis question for pain in flank n no fever...hematuria was there
also
47. another lithiasis question
48. bladder ca with painless hematuria
49. A question on syringomyelia
50. gilberts syndrome??????vs other?? not sure
51. protein electrophoresis in multiple myeloma (Image) ???
52. colonoscopy question
53. gord question---PPI (H K ATPase inhibitors
54. basal cell carcinoma on chin lesion
55. avascular necrosis of femur--- steriod use -- increased pain
56. optic chiasm defect—bitemporal hemi anopia was given
57. a case of 5 days old CVA and had urinary incontinence after trying to
control for somtime. All signs of hemicord or brown seq were negative like
perianal sensation and anal tone... they asked where was lesion.....
cerebral coretex ( other options were brownsequard and hemicord and
lesion at L1)
58. a case of lateral rectus palsy.... 6th cranial nerve
59. protection of aspiration pneumonia case with absent gag reflex-----
jejunostomy tube insertion (to avoid emesis)
60. a questions on urticaria with itching and rash all over body
61. a case of wt loss pt n also had chronic cough 6 months—also had some
biochemical problems----thought of paraneoplastic syndrome----- lung ca
62. gout pt on allopurinol already---continue allopurinol and start
colchicine
63. gout case of knee swollen but gram stain negative------ intra articular
steroid inj
64. conns syndrome patient---- do CT ABDOMEN
65. pulsus bispheriens--- mixed aortic valve disease case
66. Thromboangitis obilitrans (bergers Diseas) treatment-- Symphytectomy ?

i think subarachnoid hmg

why not staph.?

staph. Severe vomiting

Short incubation period

Isn't is Bacillus cereus?

IP for B.c is 1-6hrs but for Staph it is 2-7hrs. Both can cause abd. cramp, diarrhoea, nausea and
vomiting. B.c is mostly from chinese rice/fried rice or meat.
Staph from dairy/meat products.

My guess is Bacillus....

regarding that young man with positive family his. of DM , he was asymptomatic
and ias i remember his fbs was not too much high ( 8 mmol i think) my answer
was diet

diphtheria Q was asking about vaccination

Myeloma: the image with 2 spikes

optic chiasm defect—bitemporal hemi anopia was given : decussating fibres

female pt with 2 sisters having SCA , pt was in desert complaining of loin pain
.she was dehydrated : sickle cell trait

there were 2 options in this question one is decussating fibres another un

crossed fibres
one question in endocrinology about acne, hirsutism-- answers were anorexia
ner/cushings synd
psoriasis-- due to keratinocyte division/germinal layer division
polymyalgia rheumatica was one of the answers for this q

there was a question on miller fischer syndrome (desending weakness with

opthalmoplegia)

a question in which pt was putting out grey sputum, x ray shows fibrosis -- what
is the next inv -- ct chest/ bronchoscopy

Which q of sub arachanoid hmg??

Yes it was staph poisoning

Dm question was pt having polyuria n polydipsia n he had to wake up in night at

least twice for urination.. blood sugar was more or like 6.9 i guess. Im not sure
about blood sugar but it was high..n he had strong family hx..

Diphgheria q was abou vaccination...yes

Myeloma q with spikes.. Q 67

Optic chiasm with decussating fibres

Pt with SCA...wasnt retics Normal????

Hirsuitism...i choose cushings

Psoriasis q 68.

PMR??? Do u remember stem in detail??

69.. q on melinoma..take open biopsy

70.. q on protein more than 30

Patient of sub arach hmg n av malformation. Same??

71. Miler Fischer syndrome

72. Q on sputum with nifght sweats, x ray showing patchy infiltrates bilaterallyi
.... Sputum analysis, ct chest, bronchoscopy

Whats ans?? Sputum or ct?? Tb? Or pul frib? Hx wasnt too long

Q70) protein more than 30 was CSF , the findings were in favour of Herpetic
meningitis -- i put Aciclovir IV

a question on epilepsy pt became unconscious then investigations show raised

ldh, ck, answers were ---Rhabdomylysis/ DIC

another q on epilepsy , tonic clonic what is the next thing u do-- airway
maintenance/ IV diazepam/

question on Jerky double impulse pulse-- one of the answer was HOCM

which of the following is a greater risk factor for MI/CAD---- Smoking/weight/

HTN/Cholesterol

there was aquestion on Coorctation of Aorta-- answers i dont remember

Question on protein more than or equal to 30 was in pleural fluid..

However. This q is also new to our recalls

72. High protein in csf..but i remember it were neutrophils in csf not

lymphocytes.. options were iv ampicillin.iv acyclovoir.steroids
73. Q on Rhabdomyelysis...i dont know what i choose

74. Q on pt having epileptic fits in emergency department...give iv diazepam

75. Q on risk factors of cad/mi..... Smoking

76. Q on coarctation of aorta?????also dont remeber this in detail..

77. Q on pt with recurrent chest pain.. PCI done..showed 30stenosis in lad n

40stenosis in lt circumflex.whats the cause of chest pain...options were.
Coronary spasms
Atherosclerotic plaques
Owsophageal spasm
Gord etc

Whats answer?

the answer was coronary spasm , because cardiac markers were normal,
manometry normal, ph normal , in short everything normal so are left with
conoray spasm option

Iv thiamine for wernicke encapth

question on STD unsafe sex heterosexual. Answers were Syphillis, Gonorrhoea,

LGv
another q was ; answer Tumor lysis syndrome - may be question was about
lymphoma treatment
Dumping syndrome
images one from osephageal crcimnoa
haematoma nail bed
toxic nodular giotre
ECG /? hypokalemia/hypocalcemia
alk phosphatase raised - Hyperparathyrodism/

A pt to neurology vd incresing headache and hx of 3 epidodes of amaurosis

fugax fr last 1wk...rest exam normal.options...acute cerebral
infarction...subdural haematoma...cerebral haemorrhage..av
mslformation....anyone knw da ans

One q on polymyositis

Cf brain was showing calcification...so it was av malformation

I tthink it was not hematoma on nail bed
I think its compound Navus

A question about chlamydia infec. Dysuria with no discharges...not gonorrhea

Also a question on blood loss >2000 for blood pressure low to 80 n pulse 142

ECG was hypokalemia

N raised alkaline phosphatase quest was vit d levels check for osteomalacia..

Pulmonary embolism after operation

Myocarditis
VSD
Severe bronchial asthma
Severe TR causing liver congestion

pheochromocytoma / familial hyperlipidemia

one more stem was Carotid artery insufficiency

a question on IBS treatment - Tricyclic Anti Dep

treated incarcerated hernia
upeerGIT borgaymi with multiple fluid levels - gall bladder ileus
breast cancer metastasis- Rx tamoxifen/laminectomy/radiation
perianal abscess - organisms are Bacteriodes fragilis/Steptococcus aureus
food poisoning one hour after eating egg cheese with vomiting and abdominal
cramps-- /salmonella/steptococcal/

C1 inh deficiency -lip swelling hereditary angioedema

started on ACE reported hereditary angioedema
slow down of Diabetic nephropathy--rampril
weakly positive birefregrent molecules (gout) treatment -- start allupurinol/
steriods/allopurinoal with colchicine
STEMI MI -treatment is Aspirin with clopidigrel/thrombolysis/heparin
Rheumatism with splenic enlargementand neutropenia-- felty syndrome

in the images was it venous ulcer/ diabetic ulcer

intrinsic factor deficiency and B12 deficiecy
RPGN-Goodpastures ---
renal biopsy -- Bergers disease/IgA nephropathy
hyponatremia-- carbamazepine/
pts Hba1c 8/fbs 11mmol what rx- he is making insulin shown by c- peptide
levels just below normal- metformin/ basal and bolus insulin/short acting
insulin preprandial
Question of carotid artery was internal carotid artery ulcerative..something like
that.

Incarcinated hernia

Back pain with breast ca... Radio plus bisphosphonates.

Gout...allopurinol with colchicine

Gout with gram stain negative...intra articularvsteroid injec

Food poisoning of staph aureus with spontaneous relieve after 10 hrs

C1 def

Venous ulcer

Feltys syndrome

How about question of young male with strong hx of diabetes in familty n

hadbpolyuria n polydipsia with fasting blood sugar was high.... Wasbit sulphonyl
urea as answer due to MODY as diagnosis

Group A strep for peianal swellung

And staphylococcus for leg cellulitis.

Case of MS

Hypocalcemia case with calvium chloride to give

MI initial treat they asked... I think aspirin plus clopidogrel

Case of autoimmune polyendocrinopahthy type 1===pt had featires of addisons

n hypoparathy

Cervical myelopathy case

Cervical dytonia for unilateral sternocleidomastoid muscle enlargment.

.
Speceficity question

Another weired statistics question.

PE in 2 questions

Diphtheria question
Ace inhibitors in 2 questions for limiting proteinuria

question on stopping naproxen

papillary necrosis-- analgesic nephropathy/ Diabetic Np

image of blood picture showing stellate cells --ask the pt to avoid sulpha drugs

A quest about naproxen to stop...

A qjestion on image of Howel jolly bodies..patient had accident and laparotomy

was done..what to offer. .. Pneumococcal vaccine

Lithiasis question... 2 questionz were there regarding them

Bladder ca question...patient had painless hematuria.

A question on syringomyelia.....

Bronchial asthma patient....treat in ICU

Gilberts syndrome was one of the stems in a question , the other options were
crigger najjar syndrome, both were not correct b,cause question shows
conjugated bilirubin. i marked from the other 3 stems

a question on protein electrophoresis in multiple myeloma (Image)

a question on Gangrene, at first the level of demarcation was low after few
hours the level has risen upto high , pt diabetic . what was the organisms
responsible-- answers were Cl perfringes/ stap aureus/

qestion on a lady with history of constipation and some more findings, mother
of this lady had colon malignancy - what is the best investigation . answers
were Colonscopy/ TSH/

another question asking about rx by showing signs of GORD- answers were H2

antagonists/ other bits dont remember

small ulcerated lesion on the chin - squamous cell carcinoma/ basal cell
carcinoma/melanoma/

avascular necrosis of femur--- steriod use -- increased pain

Thromboangitis obilitrans (bergers Diseas) treatment—Symphytectomy

Avascular necrosis question i remember...

Question of thrombophelebitis i dont remeber..what were other options n do u
remember details of question

April 2015

leprosy -cell mediated immunity

,lever falior , telengectasia -estrogen defficency ,
2 question related to MEN syndrome ,
bicep tendonitis

?G6PD. Sulphaonamide ------Diagram of mitochondrial inn....photo for air rod Ac

myelo----to be cont if iwlll remember.

G6pd - sulfa drugs, primary hyper parathyroidism , vitamin c deficiency,

recurrent tia treatment, median nerve compression, myositis ossificans, Paget's
disease, granulomatosis with polyangitis, pleural effusion , pneumotharax,
cardiac tamponade, infective endocarditis, subclavean steal syndrome, rotator
cuff tendinitis, rheumatoid arthritis, recurrent uti, rhabdomyolysis,
myoglobinuria, optic atrophy, arsenic poisoning, partial seizures with secondary
generalisation, rectal ulcers secondary to viral infections, angiodysplasia...

goiter with brui& pt taking lot of tea,radiolabeled Iodine

scanning,pheochromocytoma, genital vesicular lesion with inguinal L.N
enlargement,pericarditis,MI,polycythemia...... will sahre more as I remember
the other questions.