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1904001.You have been sent to a school to give sex education. What else would
you give advices about?

A. Regular cancer screening

B. Prevention of acne

C. Chlamydial infection

D. PAP Smear.

1904002. A man presents with inflammatory joint pain in multiple areas. He also has
renal failure. Which of the following is contraindicated in this man?

a. Methotrexate

b. Hydroxychloroquine

c. Sulfasalazine

d. Azathioprine

e. Etanercept

1904003. A man with inflammatory joint pain in multiple

areas. Renal failure present. Which drug is ok?
a. Methotrexate
b. Hydroxychloroquine
c. Sulfasalazine
d. Azathioprine
e. Etanercept

1904004. 21 yr old male, Stable, Height:170 cm Wt: 60 Kg, took 14 or 16(not sure)
PCM tablets of 500 mg, present at your place after 10 hours, what is your most
appropriate next step?
a) PCM level
b) N-Acetyl Cystine
c) Charcoal
d) Reassure

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IV acetylcysteine is indicated if ingested >200mg/kg body wt. here 133 mg/kg thats why reassure. if pt
comes within 4-8 hrs thn blood level sd b done n if nomogram
indicates than IV acetylcysteine.

1904005. Woman with subtotal thyroidectomy, in post

op room, 12 hrs may b , got difficulty breathing ,stridor,
drain tube collection is few, what to immediately?
a. Removes deep muscle suture
b. Remove skin staples
c. Intubation
d. Oxygen via mask

1904006. And for 6 to 10-year students parent teacher meeting u called for health
education, option was
a. growth,
b. BMI,
c. weight reduction program

1904007. You have been sent to a school to give sex education. What else would
you give advices about?
A. Regular cancer screening
B. Prevention of acne
C. Chlamydia infection
D. Pap Smear.

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1904008. GP to give a education in school for 13 yrs old girl, sex education has
covered, which one to give next?
a. Sunscreen
b. Pap smear
c. Skin cancer
d. Bullying

1904009You are to give a lecture for 13 yr old girls at school, sex education has
been covered before, what is the best to talk about:'
a. alcohol
b. Sun screen.
c. Pap smear.
d. Bullying.

1904010. 65 yr old man present with three weeks history

of headache & vomiting. He has history of melanoma and
surgery 3 years ago. (Clark stage is not mentioned). On
examination, temperature 37.3 & no other abnormal
findings. CT given. What is the most likely diagnosis?
Exact scenario

a. Brain abscess
b. Melanoma metastasis
c. Glioma
d. Cerebral infarct
e. Tuberculous meningitis

1904011. Hepatitis c positive mother. You will advise all of the following except
A. Advise proper diet and management
B No foetal scalp ph monitoring with blades n clips
C There is risk of transmission during the delivery
D infected neonate will have to be monitored regularly

1904011. Probability of schizo in dizygotic twin:

a. nil
b. 10%
c. 20%
d. 40%

1904012. ankylosing spondylitis first line treatment no previous meds.

a. indomethacin
b. Methotrexate
c. Sulphasalazine
d. Azathioprine

1904013. ankylosing spondylitis. not responding to paracetamol and codeine. next

treatment.
a. indomethacin
b. Methotrexate
c. Sulphasalazine
d. Azathioprine

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1904014. Man with scenario of claudication in left calf. On exam, all peripheral
pulses palpable on right side. Left side all pulses palpable but dorsalis pedis weak
and hardly palpable. Bilateral weakness of ankle reflex and loss of sensation in foot.
Side. ABI on right side 1, left 0.75. Appropriate investigation?
A. Conventional angiogram
B. CT angiogram
C. CT spine best HB 3.073
D. EMG
E. Arterial Doppler-next

1904015. A 25-year-old man came after MVA with hoarseness of voice, loss of aortic
knuckle, and widening of mediastinum, BP stable.
a) Echo
b) CXR
c) CT angiogram—
d) MRI
e) Fast USG

1904016. `pt with 3 month ulcer ,pulses not palpable ,X-ray done erosion showing
,what ll do for next for management :
a. Ulcer swab
b. MRI (ulcer > 6 weeks-MRI)??????????
c. Leg ultrasound for arteries( ulcer <6 weeks)

1904017. Picture of cherry red spot on fundoscopy given. But scenario said vision
loss in right eye improved after some time. Cause?
a. CRAO
b. Carotid Disease
c. Retinal detachment

1904018. Female with recurrent candidiasis. Clotrimazole vaginal cream failed

controlling the symptoms. What is the most appropriate next step?
A) Oral Nystatin
B) Oral Grisofulvin
C) Oral Ketoconazole
D) Oral Fluconazole
E) Vaginal Nystatin

1904019. Pregnant dx with genital herpes, mgt?

A) Topical acyclovir
B) oral acyclovir
C) IV acyclovir

1904021. What is the most appropriate management? Exact picture

A. Local excision
B. Excision with a 2 cm margin.
C. Fluorouracil cream
D. Review in 12 months

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1904022.Patient with h/o melanoma in the past, now presents with frontal headache
for
3 weeks, Temperature 37.8 F, CT scan given
A. Brain abscess
B. Gliom
C. Mets

1904023. Weakness of the right side of the body for 10 min

A. Hypoglycemia
B. Hyperglycemia
C. Carotid stenosis
D. Vertebra- basilar ischemia
E. Lacunar ischemia

1904024. 6 yo child presents with asthma attack. Mom has given 6 puffs of
salbutamol for him. He improved, but now is worse again. He talks in words. Next
management?
a. Give steroids orally
b. Give ipratropium puffer
c. Give inhaled steroids
d. Give another 12 puffs of salbutamol
e. Admission & O2 shan

1904025. Scenario a mother who brings her 15 years old, she worries
about skin cancer. Asked the risk factor of cancer?
a) Sunburn more than tan
b) Positive FH in melanoma
c) Exposure to Uv at childhood
d) Persistent Atypical nevus

1904025. 6 years old boy presented to the ER due to asthma

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attack. He had 6 puffs of salbutamol and not improved

wheezing
a. add salmeterol
b. salbutamol in 20 mins interval
c. Ipratropium nebulization
d. oral prednisolone
e. hydrocortisone iv

1904026. 6 years old boy presented to the ER due to asthma attack. He had 6 puffs
of salbutamol and he improved but still has wheezing and speaks in words
a. add salmeterol
b. more 12 puffs of salbutamol
c. ipratropium nebulization
d. Oral prednisolone
e. hydrocortisone iv

1904027. 78-year-old lady complains of fatigue and weight loss 5 kgs in the past
couple of months. She also has occasional loose bowel movement. Bp normal heart,
rate 58. Rest of the labs normal. What could be the cause of her presentation?
A. Occult malignancy
B. Hyperthyroidism
C. Iron deficiency anemia
D. Hypothyroidism

1904028. Elongated mass from xiphisternum to umbilicus, patient says mass

prominent on coughing and straining and on examination mass prominent when
patient raises head. What is the most appropriate management?
Mesh herniorrhaphy
Abdominoplasty
Physiotherapy
Reassure

3) Woman with pain in her wrist fingers and other small joints. Has a history of scaly
rash on her elbows previously treated. What initial investigation?
Ana
CCP
Xray
Mri
4) Rheumatoid arthritis patient on methotrexate and ibuprofen with all liver enzymes
elevated. What is the cause?
Mtx
Ibuprofen
Viral hepatitis
Idiopathic
5) lady due to have a grandchild asking what vaccine to take before child is born?
Dpt
Tetanus
Inflenza
MMR
6) Patient treated for pneumonia now develops high fever 39 cause asked?

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Iv canula bacteremia
Empyema
Hospital acquired pneumonia
7) post op patient x ray given day 2 looked like atelectasis agitated, asking
management.
Droperidol
Diazepam
Pulse oximeter
Iv fluids
Antibiotics
😎 pneumonia patient developed high fever. Xray shows well defined circular lesion
with air fluid level. Appropriate management. Antibiotics given
Lobectomy
Bronchoscopy
Transpleural drainage
Ct chest

9) Elderly man around 65 presents with severe chest pain radiating to the back. Ecg
normal. Pain not relieved with nitrates. Bp was high i think. Rest all normal. What is
the next appropriate investigation?
Transesophageal echo( hb 3.070)
Transthoracic echo
Ct angiogram
Troponin(if no xray given for widening of mediastinum bcz 1st rule out MI)
Ecg repeat

10) Newborn with hr dropped to 40 cyanosed.

Same options. I selected intubation.
Ans should be bag and mask

11) RA with chronic pyelonephritis and anemia. Erythropoietin stimulating agent

question.

12) viral pneumonitis with xray and asia travel history.

13) rcc ct scan with dvt risk. Man with the ct above what increases risk of dvt post
op. Question doesn't say anything about man's bmi. It was a one liner with ct.
Bmi 35
Smoking
Varicose veins

14) first degree heart block ecg with potassium 5.5 ( normal level was upto 4.9) in
the question.
Calcium carbonate
Resonium
Insulin glucose
Stop ramipril
Pacemaker

15) recurrent perianal fistula what is the cause? No other history of bowel
disturbance etc

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Inflammatory bowel disease

Perianal abscess
Diverticulitis

16) amiodarone warfarin drug interaction question.

Sorry about the delay in posting

woman with subtotal thyroidectomy ,in post op room , 12 hrs may b , got difficulty
beathing ,stridor, drain tube collection is few, what to immediately?
a.remove deep muscle suture
b.remove skin staples
c.intubation
d.oxygen via mask

6 years old boy presented to the ER due to asthma

attack. He had 6 puffs of salbutamol and not improved
wheezing
a. add salmeterol
b. salbutamol in 20 mins interval
c. ipratropium nebulization
d. oral prednisolone
e. hydrocortisone iv

1.You have been sent to a school to give sex education. What else would you give
advices about?
A.Regular cancer screening
B.Prevention of acne
C.Chalmydial infection
D.Pap Smear.

2. gp to give a education in school for 13 yrs old girl,sex education has

covered,which one to give next?
a.sunscreen
b.pap smear
c.skin cancer
d.bullying

3.you are to give a lecture for 13 yr old girls at school, sex education has been
covered before, what is the best to talk about:'
a. alcohol
b. Sun screen.non melanoma skin ca
c. pap smear.
d.bullying.

27 yr obese with acne and hirsutism asking for ocps, she has regular migraine
headaches with scotoma at times. What to prescribe her for contraception?
Ethinyl estradiol and drosperinone
Erhinyl estradiol and cyproterone
3 monthly dmpa
Barrier methods(hb 3.226)
Ethinyl estradiol and norgestrel

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24 weeks pregnant with c/o, watery vaginal discharge, uterus lax, no contractions,
fetal heart 140, what is the next most. Important step in management
Refer to tertiary care
Admit and observe
Tocolytics
Dexamethasone
Per speculum exam(initial to dx pprom)

26 weeks pregnant with draining liquor, no uterine contracrions, fetal heart positive,
os closed. After examination what is the next most appropriate step?
Refer to tertiary care
Refer to secondary care
Admit and observe
Discharge with oral antibiotics
Tocolytics

28 weeks pregnant with draining liquor, apparent contractions, fetal heart positive, os
closed after dexamethasone next step
Tocolytics
Antibiotics
Refer
Steroid then antibiotic then tocolytic(if contraction present) then refer

Pt post colectomy day 5 with wound oozing of fecal materiat and fever, long scenario
Asking antibiotic to add
Flucoxacillin
Metronidazole
Vancomycin

60 yr old women Post colectomy day 5 on 60ml ns and 30mcg potassium drip
Labs
Na 110
K 2.6
Glucose 33mmol
Urea 9
Asking nexr management step
Give hypertonic saline
Give calcium chloride
Increase saline infusion
Change to hartman solution

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9 weeke pregnant with uti, symptomatic

Culture shows ecoli
Resistant to amoxycillin
Cephalosporins
What to give?
Trimethoprim
Augmentin
Gentamicin
Metronidazole
Ciprofloxacin

12 weeks pregnant 18yr old. Normal pregnancy, mild spotting yesterday then
stopped, no complains now, asking abortion, you refused to proceed and advice her
to
1. Refer to ethics committee
2. Refer to another dr with same view
3 Follow up after 4 weeks and review
No option to accept or refer to another dr.. or refer to hospital

Another same scenario pt asking for abortion, you refused but whats next
1 refer to another dr
2 inform parents
https://images.app.goo.gl/CbqucLHSK8YKxtSH8
Like this
, pt with nail injury 6 weeks ago, asking mangent

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Excision biospy
1cm margin excision
Debridement
Dx paronychia
Like this, pt with nail injury 6 weeks ago, asking mangent
Excision biospy
1cm margin excision
Debridement

Pt with insomnia, weight loss, anhedonia, hallucinations. Past hx of treatment for

depression
What to give
Quetiapine
Mirtazapine
Duloxetine
Altrazolam

Pt with hx of admission for 3 mnths in psych ward fot depression, present after 1
mnth with c/o loss of memory of last yr trip, cause
Hx of ect in last admsiion
Delirium

68 yr Women brought by son with inc falls and ataxia, vitals normal. No loss of
memory mentioned
Urinary incontinence present
Ct with dilated ventricles, minimal cortical atrophy
Dx
Normal pressure hydroceph
Alzheimer
Lwy body

68 yr Women brought by son with inc falls and ataxia, vitals normal. No loss of
memory mentioned
Urinary incontinence present
Ct with dilated ventricles, minimal cortical atrophy
Dx
Normal pressure hydroceph
Alzheimer
Lwy body

60 y/0 man with hematuria and left loin pain,

Next step in mx
Ive pyelogrma
Cystoscopy
Ultrasound abdomen pelvi(best ct)

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Another scenario with dribling of urine, frequency throughout the day, incomplete
urination
Wakes up Twice in the night
Best inv
Ascending pylogram
Ct abdomen
Cystoscopy
No option for urine analysis

Another scenario with dribling of urine, frequency throughout the day, incomplete
urination
Wakes up Twice in the night
Best inv
Ascending pylogram
Ct abdomen
Cystoscopy
No option for urine analysis

9 yr boy with painful knee, on exam knee normal, hip joint tender, limited movt, temp
38, synovial fluid effusion 8mm Next step

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Aspiration of hip.
Iv antibiotics
Immobilization
Physiotherapy

child with croup mx

Copd
Coal mine worker, what will u find in respirstory function
Mycoplasma pneumonia
Left pleueal effusion xray
25 yr old lady has dizygotic twins with schizophrenia, what is her chance of having
schizophrenia
1
10
20
50
100

Pt came. With 3 weeks hx of hoarsness of voice and 1 week hx of dysphagia. Past

hx of surgical treatment for achalasia. Dx?
Ca of esophagus
Ca of lung
Ca of larynx
Ca of pharynx

Neck lump, supraclavicular fossa,in old. Lady, mets of which ca

Lung(if said right side another one is breast)
Esophagus
Nasopharyngeal
Larynx
If said left side then git mass
Pt with sudden loss of hearing in left ear, otoscopy. Revealed wax in both external
auditory canal, further exam non tender firm irregular mass in submandibular region
What will u examine further to reqch to dx

Examine tongue
Examine larynx
Rhinoscopy
Maxillary sinus ct
Repeat otoscopy

Acute migraine attack tx

Sumitriptan(1st paracetamol and antiemitic)
Propanolol
Ergotamine

70 yr old lady, post mi admitted in ward, receiving tx, suddenly becomes agitated,
shouts, nurses assist her to avoid falls, what is she at greatest risk of?
Falls
Repeat mi
Stroke

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One photo of amputated 1st toe, with ulcer bed with redness and yellow granulation
tissue, pt diabetic, .dorsalis pedis artery palpable. Asking dx
Thromboangitis(if said smoker)
Small vessel obstruction
Femoral artery thrombosis
Popliteal artery thrombosis

Loss of calculation, speak, few other functions like that, pt right handed,
Unable to write
Lesion?
Left temporal
Left parietal

Visit to thailand 1mnth back, there the pt had diarhea and resolved
Now presented with mild epigastric pain, vitals normal, fever 37.8, ct scan revealed
Amoebic abscess
Hydatid cyst
Hepatocellular ca

Needle prick to nurse. Pt is admitted with thoracic herpes zoster, he is hiv antibody
positive, hbsag neg, hbsab positive, hbsab positive, she bled the wound and washed
with water, whats next
Give her hep b immunoglobulin
Lamivudine
Zidovudine (JM 1454)
Acyclovir
Antibiotics

One photo of amputated 1st toe, with ulcer bed with redness and yellow granulation
tissue, pt diabetic, .dorsalis pedis artery palpable. Asking dx
Thromboangitis
Small vessel obstruction
Femoral artery thrombosis
Popliteal artery thrombosis

3 yr old baby with renal scarring, how to investigate

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DMSA
Dtpa

Pt post colectomy day 5 with wound oozing of faecal material and fever, long
scenario. Asking antibiotic to add?
Flucloxacillin
Metronidazole
Vancomycin

60-year-old women post-colectomy day 5 on 60ml

ns and 30mcg potassium drip
Labs
Na 110
K 2.6
Glucose 33mmol
Urea 9
Asking next management step?
1. Give hypertonic saline
2. Give calcium chloride
3. Increase saline infusion
4. Change to Hartman solution

9 weeke pregnant with uti, symptomatic

Culture shows ecoli
Resistant to amoxycillin
Cephalosporins
What to give?
Trimethoprim
Augmentin
Gentamicin
Metronidazole
Ciprofloxacin

12 weeks pregnant 18yr old. Normal pregnancy, mild spotting yesterday then
stopped, no complains now, asking abortion, you refused to proceed and advise her
to:
1. Refer to ethics committee
2. Refer to another dr with same view
3 Follow up after 4 weeks and review
No option to accept or refer to another dr.
Another same scenario pt asking for abortion, you refused but what’s next
1 refer to another dr
2 inform parents

Like this, pt. with nail injury 6 weeks ago, asking managent
Excision biospy
1cm margin excision

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Debridement

Drugs, sertraline 3,4 questions about side effects of sertraline ans management

Pt with insomnia, weight loss, anhedonia, hallucinations. Past hx of treatment for

depression
What to give
Quetiapine
Mirtazapine
Duloxetine
Altrazolam

Pt with hx of admission for 3 mnths in psych ward fot depression, present after 1
mnth with c/o loss of memory of last yr trip, cause
Hx of ect in last admsiion
Delirium

68 yr Women brought by son with inc falls and ataxia, vitals normal. No loss of
memory mentioned
Urinary incontinence present
Ct with dilated ventricles, minimal cortical atrophy
Dx
Normal pressure hydroceph
Alzheimer
Lwy body

60 y/0 man with hematuria and left loin pain,

Next step in mx
Ive pyelogrma
Cystoscopy
Ultrasound abdomen pelvis

Another scenario with dribling of urine, frequency throughout the day, incomplete
urination
Wakes up Twice in the night
Best inv
Ascending pylogram
Ct abdomen
Cystoscopy
No option for urine analysis

9 yr boy with painful knee, on exam knee normal, hip joint tender, limited movt, temp
38, synovial fluid effusion 8mm Next step
Aspiration of hip.
Iv antibiotics
Immobilization
Physiotherapy

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From pulmonology, child with croup mx

Copd

Coal mine worker, what will u find in respirstory function

Mycoplasma pneumonia

Left pleueal effusion xray

Pt came. With 3 weeks hx of hoarsness of voice and 1 week hx of dysphagia. Past

hx of surgical treatment for achalasia. Dx?
Ca of esophagus
Ca of lung
Ca of larynx
Ca of pharynx

Neck lump, supraclavicular fossa,in old. Lady, mets of which ca

Lung
Oesophagus
Nasopharyngeal
Larynx

Pt with sudden loss of hearing in left ear, otoscopy. Revealed wax in both external
auditory canal, further exam non tender firm irregular mass in left submandibular
region?
What will u examine further to reach to DX.
Examine tongue
Examine larynx
Rhinoscopy
Maxillary sinus CT
Repeat otoscopy

Acute migraine attack tx

Sumitriptan
Propanolol
Ergotamine

70 yr old lady, post mi admitted in ward, receiving tx, suddenly becomes agitated,
She was receiving asprin metoprolol and perindopril, shouts, nurses assist her to
avoid falls, what is she at greatest risk of?
Falls
Repeat mi
Stroke

One photo of amputated 1st toe, with ulcer bed with redness and yellow granulation
tissue, pt. diabetic, dorsalis pedis artery palpable. Asking dx
Thromboangitis
Small vessel obstruction
Femoral artery thrombosis
Popliteal artery thrombosis

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Loss of calculation, speak, few other functions like that, pt right handed,
Unable to write
Lesion?
Left temporal
Left parietal

Visit to thailand 1mnth back, there the pt had diarhea and resolved
Now presented with mild epigastric pain, vitals normal, fever 37.8, ct scan revealed
Amoebic abscess
Hydatid cyst
Hepatocellular ca

60 yr old women Post colectomy day 5 on 60ml ns and 30mcg potassium drip
Labs
Na 110
K 2.6
Glucose 33mmol
Urea 9
Asking nexr management step
Give hypertonic saline
Give calcium chloride
Increase saline infusion
Change to hartman solution

Tocolytics are associated with:

A ability to administer the full course of steroids for prevention of RDS.
B reduction of perinatal mortality.
C reduction of preterm delivery prior to 34 weeks.
D reduction of perinatal morbidity.
E All of the above

3 With respect to preterm birth:

A Bed rest reduces the risk of preterm birth.
B Intensive antenatal surveillance reduces the risk of preterm birth.
C Periodontal treatment in pregnancy reduces the risk of preterm birth.
D Smoking cessation reduces the risk of preterm birth.
E Ovarian cystectomy increases the risk of preterm birth.

2 year old child presenting, mother concerned as he still doent walk. On neuro exam
he had exaggerate reflex of lower extremity. He was born gestation age 26 weeks.
At delivery he was given gentamycin and dexamethasone for respiratory. Cause of
his current symptoms?
- Gentamycin toxicity
- Antenatal infection
- Preterm delivery
- Antenatal hypoxia
- Something else

Pt with insomnia, weight loss, anhedonia, hallucinations. Past hx of treatment for

depression
What to give

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Quetiapine
Mirtazapine
Duloxetine
Altrazolam

2 questions about salmonella typhi,

16 yr old working student got diarhea and salmonella dx, there is an endemic these
days and many students are affected, what is the most imp in the history of the boy?
Regular hand washing
His part time job
His school names
Est fruits and vegetables

25 y/o old works in a restaurant and got diarrheal, salmonella diagnosed. What is the
most imp to advise?
Inform restaurant about salmonella
Don’t go to job until diarrheal settles

salmonella food poisoning outbreak 2 days girl with negative stool culture what to do
next?
a.serology.
b.urine culture
c.stool culture
d.blood culture

6)Rural doctor wants to make study about the relation between admission to hospital
with rota virus infection and birth weight , what’s appropriate ?
a. RCT
b. Case control
c. Cross sectional
d. Cohort
e. Case series

X Ray with something in mediastinum but it was evident only when u see the
contours and there was supra clavicular lymph nodes FNAC for lymph node was
negative how will u proceed ...
a. Ct neck
b. ct chest
c. Bmi bx

There was another q about a man coming for his testing and now test results after
one week are Elisa neg Western blot negative He was having partner with hiv but
once he comes back for receiving results then he was having diffuse pharyngitis rash
no lymphadenopathy and splenomegaly what will u test now
a. Hiv
b. ebv
c. Influenza

4 years child asking milestone taht should be attended in order to reassure the
mother
a. Riding two wheel bicycle

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b. Managing toilet at night

c. Wearing clothes by himself
d. Draw figure

Nurse got stick from hive positive pt now immediet safety protocols followed with
washing and squeezing and taking bloods samples whats next
a. Immediet anti retroviral therapy
b. Do give after results available
c. Do give immunoglobulins and antiviral

Ct of infarction with intrainfarct haemorrhage cause asked

But importantly three months hx of symptoms bcz the ct dose seems like tumor there
were clear infarcted area black with central white lesion I choose infarction rest
options were
Infarction
haemorrhage
Gliobalatoma
Abscess

There was one head ct with there was a lesion with margin enehanced on non
contrast ct ... that was tumour

Post colectomy Hartman pouch recall but age was very old 85 year and get confused
on 3rd day no respiratory distress Cause electrolytes Urine culture Pulse oximetry I
mark urine culture bcz of the age its first in the list ...

Another q was a lesion of 4 years child with no other abnormality mother apploed
antiseptic and it was red lesion isolated one and rest no signs of inflammation ...
Asking cause
a. Herpes zoster (But not dermatomal distribution)
b. Herpes simplex
c. Staph aureus

Your nephew comes to you complains that his exams are near and he is suffering
insomnia and fatigue asks you to write him a prescription of temaxepam what will
you do
a. Prescription of the drug
b. Tell him relaxation techniques and excercise
c. Tell him to get checked by another doctor
d. Refer for neurophsychiatric evaluation

Fluxocilline induced hepatitis

Doc pt realtonship q many options where there transver the pt to other doc and stop
socialise with pt B u agree with them C privately talk about it

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One q about a guy of 25 yrs old had a pneumonia 3 years back now presented with hx of description of
Raynaud phenomenon .... rest of the exam was plum normal no crepitation etc mentioned nothing
abnormal cause asked
Scleroderma
Primary Raynaud
Sle
Cryoglobolonemia

A 10-month-old girl presents to ED with a two week history of coryza symptoms, and her mother has
become worried as she seems to be struggling for breath and wheezy. On examination, the infant looks
well but there are some intercostal and subcostal recessions, a respiratory rate of 35 and a widespread
expiratory wheeze on auscultation. You suspect she has bronchiolitis. Which of these management
options would not be considered appropriate infants with bronchiolitis?
a) Bronchodilators
b) Palivizumab
c) Oxygen
d) Nasogastric feeds
e) Nebulised adrenaline

I got the question of that picture, fingers with raynauds, asking dx, it was scleroderma

The boy with bronchiolitis, initial step oxygen

One meningitis scenario in 8 yr old boy asking about organism. There were csf findings of positive
proteins and leucytes, options were
a. Mycobacterium tuberculosis
b. Ecoli
c. Herpes simolex
d
Rsv

6 weeks amenorrhea now spotting and the home based beta hcg positive and no pain and us shows 12
mm thickness of the endometrium and corpus luteum visible rest no fluid in cul de sac asking cause
A-Ectopic
B-False positive beta hcg
C-Rest options were not correct
d. aborte

Beta hog serum never false positives, urine can be false

There was baby of 12 months now lethargic and vomiting milk neck stiffness and there was rash too
purpuric what’s the most appropriate next step
a. Refer to hospital
b. I’m penicillin
c. Iv cannula
d. Blood cs
e. Ct scan

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1) you noticed a nurse in your practice came in with smell of alcohol and slurred of
speech in the morning. You confront the nurse but she strongly denies it. Whats your
next step?
A) terminate her employment
B) document her behavior
C) the nurse’s practitioner
D) inform the nursing board

2) 9y/o girl has been skipping school to play game at arcade. When seen show low
mood and tearfulness. Whats the likely diagnosis?
A) Depression
B) conduct disorder
C) ADHD
D) social phobia

3) a woman came to refill her cocp. On further questioning, she occasionally has
headache ass with photophobia. Whats the next appropriate management?
A) continue prescribe cocp
b) tell the patient to come in for review if the headcahe present again
C) tell patient cocp is contraindicated in her condition

4) 20y/o came to terminate her pregnancy of 12weeks. The pregnancy is normal and
no abnormality found. You are strong believer tht termination should be reserved if
medically indicated. Whats next approprite management?
A) refer her to another gp who shared similar value for second opinion
b) refer to local ethic comittee
C) refuse her in view of your value
D) refer to tertiary centre for further care and assesment

1) A wife complained that her husband has become forgetful. He doesnt enjoy his
past hobbies anymore due to minor stroke 2 years ago. Currently her husband
having difficulty to manage their financial. Whats the likely diagnosis?
A) Vascular dementia
b) Alzheimer
C) Fronto temporal dementia
D) Lewy body dementia

2) 18 y/o girl experienced recurrent abdominal pain for the past past few weeks.
Occasionally has tongue or lip swelling. Whats the investigation to confirm
diagnosis?
A) Skin allergy test
B) c1 esterase antibody
C) Serum immunoglobulin assay

3) 3o y/o woman 32 weeks pregnant presented with fever, RUQ abdominal pain,
jaundice. she just came back from Kenya 2 weeks ago. Whats the complication to
her fetus in view of her condition?
A) hydrop fetalis
B ) hepatosplenomegaly
C) stillbirth
D) low birth weight

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////
HB 3.066

////

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1)olanzapine
2)narsisistic
3)pop
4)pop
5)ct head dx mastoiditis

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6)speculum examination
7)cholangitis
8)ascending urothrogram
9)due to enzyme deficiency (21 hydroxylase)(

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10)complete abortion
11)indapamide
12)electrolyte

We have been compiling stuff for our upcoming course and free sessions. Making lists of
topics to be covered and MCQ’s for further practicing. In order to help those who are already
in the system. Down below is list of topic you need to learn by heart. This list is just from
April 2019 recalls. Recalls are to be used as a guide for which topic to prepare. Don’t make
yourself suffer with a tunnel vision. Trying our best to help IMG’s. Let us if you need to
know the reference book for these topics. —> Medicine/Surgery :
1) Abdominal pain ( choleliathasis , post cholecystectomy , acute cholangitis )
2) Osteoporosis ,
3) pulmonary hypertension , arrhythmia a fib , ACS and MI , DM , Peripheral vascular ( dvt
) diseases , murmurs , cardiovascular risk assessment
. 4) RA and connective tissues disorders ( SLE , wegener’s granulomatosis )
5) alcohol withdrawal , cannabis overdose

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6) facial weakness Bell’s palsy ,

7) vision problem and driving homonymous heminopia ,
8 ) OSA ,
9 ) melanoma ,
10) dysphagia , barium swallow , esophagitis , , ct scan divertulitis ,
11) tetanus prophylaxis ,
12)BPH incontinence
13) tonsillitis mass , nasopharyngeal ca , primary scc ,
14) brachial plexus ,
15) neck swellings and investigations,
16) allergic reactions to antibiotics
17) splenic injury ,
18) pneumothorax. —->
mental health 1) ( delusions overvalued idea ) ,
2) OCD ( management )
3) chronic schizophrenia and antipsychotics compliance ,
—-> child and adolescent health 1) ( milestones ) ,
2) limping dx and ix ,
3) epilepsy and status epilepticus ,
4) growth charts ,
5) common skin infections and varicella ,
6) orbital cellulitis ,
7) vulvovaginitis ,
8 ) vaginal discharge , cystic fibrosis
—-> women health 1) LSCS indication ,
2) ctg , 3) malpresentation and transverse lie
, 4) perinatal infection hep B ,
5) post coital bleeding in young and pap smear cervical screening test ,
6) Bishop score ,
7) Candidiasis ,
8 ) recurrent miscarriage causes ,
——> Ethics 1) sexual abuse 2) doctor - doctor relationship
——> general population 1) standa

Hyperkalemia ecg mx asked

Hcv transmission prevention
Ct pelvis asking ? Caecal ca
Ct brain – SAD
X-ray pneumonia
Ifant torsion testis pic ?
Impetigo pic ? Skin tag ? Herpes simplex
PPROM mx Many obs complication related q

30 yr female come from prison having shingles what is the next management ?
A look for partner screening B check for immune status

Ethics Vietnam travel pt not wiling for others except yellow fever vaccine what to do
A report to immi dept
B document it medical report
C don’t treat the pt

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Stab injury to chest drop in sat

q Psm
q- vit c efficacy best studied =rct
what is the best method to collect data in hcv prevalence
data on new case
data of treating case
data from 5yrs healthdepartment

Doc pt realtonship q many options where there transver the pt to other doc and stop socialise
with pt
B u agree with them
C privately talk ab

he left upper limb, weakness of interosseous muscles and right plantar response is equivocal,
left is increased; reflexes are normal. What investigation will you do to reach diagnosis?
a MRI cervical spine
b Ach receptor antibodies c EMG
d CT brain e. Respiratory function test?

Haematology q asked about the diagnisis of b thalassemia

Ethics Patient came with sweating pain in abdomen and light bleeding 6 week of pregnancy
she didn’t allow her abdominal exam because it was tender you call the surgical resident and
he scolds you about not doing the Abdominal exam and tells you to call Gynecological
registerar patient has BP of 100/90 or 90/60 I can’t remember exactly all other vitals are
normal what will you do next
A call gyne registerar
Give IV fluids
Call your surgical resident again
Can’t remem

ith both parents come in to ask about the girl being pallor. Upon examination, her
hemoglobin count is 92 (105-115). You diagnosis it as B-thalassemia minor. The parents ask
what is the chances of their second child having this trait?
A. 0.0
B. 0.25
C. 0.33
D. 0.5

27-year-old pregnant female visited you in her first trimester for routine antenatal care.On
investigations,you came to know that her hepatitis c status is positive. She is concerned about
vertical transmission of hepatitis c virus to her baby. Which of following regarding hepatitis
C transmission during pregnancy is most appropriate?
a. Do an elective caesearean section to prevent transmission
b. Foetal scalp blood sampling should be avoided
c. Breastfeeding is contraindicated for hepatitis c positive mother
d. Baby should be screened between 12 and 18 years of age to determine whether they have
been infected
. e. Coexistance of HIV has no effect on HCV transmiss

Your nephew comes to you complains that his exams are near and he is suffering insomnia
and fatigue asks you to write him a prescription of temaxepam what will you do

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Prescription of the drug

Tell him relaxation techniques and excercise
Tell him to get checked by another doctor
Refer for neurophsychi

A couple came to you for pre pregnancy advice. Man has rheumatoid arthritis and pain is
now controlled with methotrexate and hydroxychloquine. Asks you advice regarding dug
continuation
. a. Stop both
b. Continue hydroxy and stop methotrexate
c. Stop hydroxychl and continue methotrexate
d. Continue

nother q was a lesion of 4 years child with no other abnormality mother apploed antiseptic
and it was red lesion isolated one and rest no signs of
inflammation ... Asking cause
Herpes zoster (But not dermatomal distribution )
Herpes simplex
Staph aureus (impetigo)

Q about receptive and expressive language disorder

Post colectomy hartman pouch recall but age was
very old 85 year and get confused on 3rd day no
respiratory disetress Cause electrolyte urine culture pulse oximetry
There was one head ct with there was a lesion with margin enehanced on non contrast ct ...
that was tumour
Gynae q was there where 6 weeks amenorrhea now spotting and the home based beta hcg
positive and no pain and us shows 12 mm thickness of the endometrium and corpus luteum
visible rest no fluid in cul de sac asking cause
Ectopic
False positive beta hcg
Rest option
ct infarction with intrainfarct haemorrhage cause asked But importantly three months hx of
symptoms bcz the ct dose seems like tumor there were clear infarcted area black with central
white lesion I choose infarction rest options were
Infarction
haemorrhage
Gliobalatom
nurse got needle stick from hive positive pt now immediet safety protocols followed with
washing and squeezing and taking bloods samples whats next\
Immediet anti retroviral therapy
Do give after results available
Do give immunoglobulin and antiviral

Another q was a lesion of 4 years child with no other abnormality mother apploed antiseptic
and it was red lesion isolated one and rest no signs of inflammation ...
Asking cause
Herpes zoster
(But not dermatomal distribution )
Herpes simplex
Staph aureus

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Q about receptive and expressive language disorder

Post colectomy hartman pouch recall but age was very old 85 year and get confused on 3rd
day no respiratory disetress
Cause electrolytes
Urine culture
Pulse oximetry
I mark urine culture bcz of the age its first in the list ...
There was one head ct with there was a lesion with margin enehanced on non contrast ct ...
that was tumour

Gynae q was there where 6 weeks amenorrhea now spotting and the home based beta hcg
positive and no pain and us shows 12 mm thickness of the endometrium and corpus luteum
visible rest no fluid in cul de sac asking cause
Ectopic
False positive beta hcg
Rest options were not correct
Ct of infarction with intrainfarct haemorrhage cause asked
But importantly three months hx of symptoms bcz the ct dose seems like tumor there were
clear infarcted area black with central white lesion
I choose infarction rest options were
Infarction
haemorrhage
Gliobalatoma
Abscess
Nurse got needle stick from hive positive pt now immediet safety protocols followed with
washing and squeezing and taking bloods samples whats next
Immediet anti retroviral therapy
Do give after results available
Do give immunoglobulins and antiviral

There was another q about a man coming for his testing and now test results after one week
are
Elisa neg, Western blot negative
He was having partner with hiv but once he comes back for receiving results then he was
having diffuse pharyngitis rash no lympahdenopathy and splenomegaly what will u test now
Hiv
ebv
Influenza
X Ray with something in mediastinum but it was evident only when u see the contours and
there was supra clavicular lymph nodes FNAC for lymph node was negative how will u
proceed ...
Ct neck
ct chest
Bmi bx
Xray of wide mediastinum..dx
diaphragm rupture
aortic rupture
haemthorax
a guy of 25 yrs old had a pneumonia 3 years back now presented with hx of description of
Raynaud phenomenon .... rest of the exam was plum normal no crepitation etc mentioned
nothing abnormal cause asked

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Scleroderma
Primary Raynaud
Sle
Cryoglobolonemia

I marked primary
I got the question of that picture, fingers with raynauds, asking dx, it was scleroderma

The boy with bronchiolitis, initial step oxygen

One meningitis scenario in 8 yr old boy asking about organism. There were csf findings of
positive proteins and leucytes, options were
Mycobacterium tuberculosis
Ecoli
Herpes simolex
Rsv
#pediatrics A 10-month-old girl presents to ED with a two week history of coryza symptoms,
and her mother has become worried as she seems to be struggling for breath and wheezy. On
examination, the infant looks well but there are some intercostal and subcostal recessions, a
respiratory rate of 35 and a widespread expiratory wheeze on auscultation. You suspect she
has bronchiolitis.
Which of these management options would not be considered appropriate infants with
bronchiolitis?
a) Bronchodilators
b) Palivizumab
c) Oxygen
d) Nasogastric feeds
e) Nebulised adrenaline

One q about a guy of 25 yrs old had a pneumonia 3 years back now presented with hx of
description of Raynaud phenomenon .... rest of the exam was plum normal no crepitation etc
mentioned nothing abnormal cause asked
Scleroderma
Primary Raynaud
Sle
Cryoglobolonemia

I marked primary
There was a scenario of meningitis and CSF values were given options were herpes influenza
mycobacterium so just read the and onset was in 3 days
Meningioma and glioma ct
8:08 PM
#April2019
1) you noticed a nurse in your practice came in with smell of alcohol and slurred

2) of speech in the morning. You confront the nurse but she strongly denies it. Whats
your next step?

A)terminate her employment

B)document her behavior

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C)the nurse’s practitioner

D)inform the nursing board

2) 9y/o girl has been skipping school to play game at arcade. When seen show low mood and
tearfulness. Whats the likely diagnosis?
A)depression
B)conduct disorder
C)ADHD
D)social phobia
Key Symptoms. Bullying, fighting, cruelty to people or animals, and rape, vandalism, fire- setting, theft,
robbery, running away, school truancy

3) a woman came to refill her cocp. On further questioning, she occasionally has headache
ass with photophobia. Whats the next appropriate management?
A) continue prescribe cocp
b) tell the patient to come in for review if the headcahe present again
C) tell patient cocp is contraindicated in her condition

4) 20y/o came to terminate her pregnancy of 12weeks. The pregnancy is normal and no
abnormality found. You are strong believer tht termination should be reserved if medically
indicated. Whats next approprite management?
A) refer her to another gp who shared similar value for second opinion
b) refer to local ethic comittee
C) refuse her in view of your value
D) refer to tertiary centre for further care and assesment
#APRIL2019
X Ray with something in mediastinum but it was evident only when u see the contours and
there was supra clavicular lymph nodes FNAC for lymph node was negative how will u
proceed ...
A-Ct neck
B-ct chest
C-Bmi
D-bx
#APRIL2019
a man coming for his testing and now test results after one week are Elisa neg Western blot
negative He was having partner with hiv but once he comes back for receiving results then he
was having diffuse pharyngitis rash no lympahdenopathy and splenomegaly what will u test
now
a-HIV
b- EBV
c-Influenza

1) A wife complained that her husband has become forgetful. He doesnt enjoy his past
hobbies anymore due to minor stroke 2 years ago. Currently her husband having difficulty to
manage their financial. Whats the likely diagnosis?
A) vascular dementia
b) Alzheimer
C) fronto temporal dementia
D) lewy body dementia
2) 18 y/o girl experienced recurrent abdominal pain for the past past few weeks. Occasionaly
has tongue or lip swelling. Whats the investigation to confirm diagnosis?
A) skin allergy test

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B ) c1 esterase antibody
C) serum imunoglobulin assay

3) 3o y/o woman 32 weeks pregnant presented with fever, RUQ abdominal pain, jaundice.
she just came back from Kenya 2 weeks ago. Whats the complication to her fetus in view of
her condition?
A) hydrop fetalis
B ) hepatosplenomegaly
C) stillbirth
d)low birth wt
#GIT A women with colectomy 12 hours earlier, now symptoms of small bowel obstruction ,
one groin has tender swelling without cough impulses next?
Observe
Explore surgery
Gut rest
4years child asking milestone taht should be attended in order to reassure the mother
Riding two wheel bicycle
Managing toilet at night
Wearing clothes by himself
Riding two vehicle bicycle
Draw figure
Diabetic amputation of big toe with intact pulses cause asked
A--Aortic obstruction
B--Femoral obstruction
C—Popliteo-femoral obstruction
D--Thromboangitis obliterans (if smoking)
E--Small vessel 9 if not smoking)
There was another q in which 9 or 10 months child started vomiting for the Last 3 months
and mother Ames and worried about growth of child rest was normal an head circumference
given on graph that wa sincreasing fro. 20 to 50 percentiles in last couple of moths asking
what will u do.
... Us abdomen
Ct head
Cxr
Bm exam
Note on chart there was no growth or body bmi etc just head circumference Here I mark ct to
rule out some obstructive pathology causeing hydrocephalus Bcz th esutures a

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Monoclonal gammopathy of undetermined significance scenerio Corrreect option was serial yearly
review of protein electrophoresis ...

30y/o, 26 weeks pregnant, pprom confirmed by speculum, VE: os 3cm, effaced Contraction 1 every 10
minute. Whats the next step?
A)IV Salbutamol
B ) oral bethamesone
C) IV syntocinon
D)IV antibiotics

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2) A man brought in to Ed by police on a shopping cart. He yelled that he knows this is prison. Claimed
that sees the painting into the wall. Whats the likely diagnosis? A) delusional disorder B ) delirium C)
schizophrenia

3) ECG of AF- 20 y/o male presented with feel a little faint. No chest pain. No sob. Whats the appropriate
next step?
A) Amiadarone
b ) digoxin
C) vasovagal manoeuvre
D) dc cardioversion

Post colectomy for ca colon come after one year and cea done what will
you do now
Ct
Us
Sigmoidoscopy
Colonoscopy
Marked colonoscopy

42 year old pt ,post colectomy day 5 with wound oozing of yellowish foul
smelling discharge and fever,T-38 , what antibiotic to choose ?
IV Augmentin
Vancomycin
Ceftrixone+Genta
Metronidazole

27 year old female who had abortion at 8 weekend , did D&C and come
back with highe grade fever and lower abd pain … what will u give ?
IV Ceftriaxone
Oral Azithromycin
Oral Augmentin
Oral Doxy plus Oral Metronidazole

Uterine prolapse ... which ligment weakness

Broad ligament (fix uterine)
Round ligment (weak in prolaps0
Uterosacral ligament

33 year of woman who had done TAH and BSO, t score femur -2.5 and ,
what to give---
1. Oestrogen therapy
2. Oestrogen and progesterone

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3. Vit. D and Ca
4. Alendronat

48 year old came with infertility who had 2 children ( 9 years of age and
6 years of age ) from her previous relationship and he is with her new
relationship who is 52 year old , he never had children before , what is
the reason for infertility ?
1. Female over 40
2. Male Over 50
3. Oligospermia
Don’t remember others ( not related options)

Dupuntry contracture pic was given, 46 year old alcoholic pts came with
the picture above … what investigation will be most appropriate

USG
MRI
X-ray of hand
Electromyelogram

One university contact u to do a research about vit c efficacy in the

population

case control
Cohort
Double blinded
Randomization

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27 year old female came with history of DVT and migraine headache but not having attack over 1 year
had ectopic pregnancy 6 months ago came for contraceptive advice , what to give ?
OCP-no
POP-C/I in previous ectopic
Depo ?-no
3 monthly Condom
Ethenylestradiol+ ( something don’t remember )

12 years old female who lives with her grandmother (didn’t mention
why she was with her grandmother ) was brought to your clinic with
lack of concentration , wt loss and falling grade at school ( used to
be good ) What else in the hx will help for dx ?
a. Suicidal ideation
b. Feeling of inferiority
c. Her eating pattern
d. Drug abuse
e. Missing parents

5 years old was brought by parents stating that their child looks
different than others , he likes to play by himself , watch his fav
TV show everyday on time but no language or developmental delay
, less facial expression on examination
What is the most likely dx ?
A.Autism
B. Asperger Syndrome
C. ADHD
D. ? impairement something

52 year old male came to your office worrying about Ca Prostate

because his friend was diagnosed with Ca prostate but he doens't
have any urinary symptoms .What will you do ?

a. Take the blood for PSA

b. Tell him to come back if any symptoms develop
c. Tell hiim there is no screening test for prostate
d. Do DRE
e. Transrectal USG

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A 46 y/o man suffered his first MI. Recovery was uneventful,two days

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after admission to hospital, thr patient FBS : 5.8 mmol/l. (upper limits of
nl 6.2 mmol/l); a BS2HPP was 8.3 mmol/l. 4 weeks later an OGTT was
performed with thw following results- FBS: 6.5 mmol/l. 1 hr: 9 mmol, 2hr
:7.2 mmol. Blood glucose values in this patient indicate:
a.definite DM
b. Possible DM
c. Nl tolerance
d.reactive hypoglycaemia
e.functional hyperinsulinism

Laproscopy done, umbilical area rash fever, asking what might have caused?
Cannula
Nosocomial
Umbilicus
Vagina

Parvo virus igm igg came positive, pregnant women asking for next

Usg
Recheck after 2 weeks
1

Papua new Guinea travel after 3 weeks develeops dirrahoea

Salmonella
Travellers diarrhoea

Old couple travelled to western australia. Pt confused, gcs very low, High temp, Had few mosquito
bites while there.. asking cause?
Australian ...?
Malaria
Dengue
river

Murray valley encephalitis

HB p.141 blue book for infection disease

Ptnt on venlafaxine for a while started tramadol for shoulder pain. Now sweating, agitated, what to do
next
Stop venlafaxine
Stop tramadol

A man with history of limb claudication on 100 meters relieved by rest, on examinations there was absent
left femoral pulse and absent dorsalispedis pulse, ABI was done and it was 0.25. What is the most
appropriate test leading you to the diagnosis?
a. Arteriography

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b. Ct angiography
c. compression Doppler ultrasound
d. MR angiogram
e. X-ray

24 yrs of age on salbutamol recently was taking budesonide 400mg, 2

times daily. Had allergy but avoiding all allergic factors, now what to give

Inhale ipratopium
Oral montelukast

Hoarseness one month then 2 weeks of dysphagia. Operation for

achalasia 7 yrs ago. Asking cause?

Larynx ca
Oesophagus ca

Diabetic pt with 3 month ulcer ,pulses not palpable ,X-ray done erosion
showing ,what ll do for next for management :
Ulcer swab
MRI
Leg ultrasound for arteries

2 yrs old child suddenly enters his parents room at night , they found him
confused so they rush to the ED … by exam all is nomal … what to do
next ?? very weird Qs
- EEG
- CT brain
- Drug screen
- Glucose tolerance test
1
Elongated mass from xiphisternum to umbilicus, patient says mass
prominent on coughing and straining and on examination mass
prominent when patient raises head. What is the most appropriate
management?
Mesh herniorrhaphy
Abdominoplasty
Physiotherapy
Reassure

1. Patient of vwd,,,, some surgery advised ,,,, what to give before

surgery

A. Factor 8

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B. Desmopressin spray

16. Swelling angle of mandible ,,, pain with swallowing ,,, h/o dry eyes
for 5 years ,, fnac done ,,, non specific results ,,,, next

A usg
B ct
C biopsy of salivary gland
D sialogram

18. Acne + wt gain

A lithium
B risperidone
C lithium + resperidone

20. Post partum woman asking husband to keep watching her so that she don’t throw the baby
A overvalued idea
B delusion

22 child presents with vertigo

A eeg
B audiogram and refer to ent
C ct

There was one q I get about hx of gastric by pAss now comes with
postprandial signs and symptoms of hypoglycaemia given
Ans was damping
Dumping syndrome
1

4 yr old child . Developmental mile stones that should b achieve at this

age
Stand on one leg for 5 sec
2 wheeled cycle
Toilet trained at night
1
Mass lump that moves with swallowing up and down asked for investigation: a- FNAC b-ultrasound c-x-
ray d.MRI e.CT

One qs patient is not eating taken velafaxine already

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Now
Ect

Famous Recall of Mother of 8 month old boy gives him juice when he wake up at midnight.what
condition this boy will develop in future -Fe def anaemia -dental carries -obesity
B

16. Swelling angle of mandible ,,, pain with swallowing ,,, h/o dry eyes
for 5 years ,, fnac done ,,, non specific results ,,,, next
A usg
B ct
C biopsy of salivary gland
D sialogram

15. Thyroid swelling pic ,,, moves up and down with swAllowing next
A fnac
B ct
C usg
D tfts

TFT>USG>?CT>FNAC

14. Pregant , 6-7 weeks ,, minor spotting ,,, empty cul de sac,, uterus
empty ,,, endometrial thickening > 12 mm

A complete abortion
B missed abortion
C ectopic pregnancy
D incomplete abortion

9. Post op lady ,,, Hartman procedure done ,,, on 2 day ,,, is agitated but
no fever and no resp distress

A pulse oximetery
B urine culture
C electrolytes

Warfarin patient with intestinal obstruction...what to do

-----proceed abd fo surgery while on warfarin,
stop and operate,
give vit k and operate,

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give ffp and operate,

do opreation after warfarin reversal

APRIL 12 RECALLS

exam was very tough for me. Most of the Qs was unfamiliar to me. I felt that I have read
most of the Qs questions somewhere someday, but options were very different. And most of
the questions which were recalls was very very old recalls that I’m not even able to recall
now. I remember of of the questions from recent recalls and I have tried to collect these Qs
here.
1.Ethics: Consultant asked JUNIOR to perform knee aspiration but junior
doctor had never seen this procedure before. What will be your advice here?
A- Tell patient that the junior doctor who is going to perform procedure has
never done this before
B- Tell junior doctor that it’s his responsibility and he has to do it
C- Defer procedure until he is trained to do so
d- ask him to proceed under supervision
e- ask hum to refuse to perfom since he is not trained

2. ONE office working lady getting treated by you with elbow fracture. Her
office supervisor called you to get her treatment related information. What will
be your response?
A- GIVE all the information about her to supervisor
B-DON’T Give any info wither her consent
C- Ask supervisor to get appointment along with her

3. 28 years old lady has bleeding disorder and bruises oh her body. Her father
and brother had same proble,. What could be the cause of this disorder in her?
A- Difficiecy of factor VII
B- haemophilia
c- vwd

4. an old women was brough to hospital by her daughter with bowel obstruction
and incarcerated hernia. What will be your next step?
A- Proceed with surgery
B- Ask if there is any advance directives

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C- Proceed with operation if two surgeons agree

D- get order from court (something like that)

5. .You have been sent to a school to give lecture for 6-10 years old kids. What
else would you give advices about?
A. Regular skin cancer screening anually
B. promote physical ectivities
C. low cholesterol intake
D. alcohol consumption

6. Pt post colectomy day 5 with wound oozing of fecal materiat and fever, long
scenario
A--Asking antibiotic to add
B--Flucoxacillin
C--Metronidazole
D—Vancomycin

7. 9 Yr boy with painful knee, on exam knee normal, hip joint tender, limited
movt, temp 38, synovial fluid effusion 8mm. Next step
A-- Aspiration of hip.
B-- IV antibiotics
C-- Immobilization
D-- Physiotherapy

8. what study will you conduct to see the efficacy of paracetamol on head?
a- case control
b- case series
c- cross sectional
d- cohort
e- RCT

9. child , bite by black snake on his finger, what is initial management:

a- crepe bandage from finger to axilla
b- antivenom acc to body wt
c- immediate transfer to hospital

10. lady came for morning missed pill. What will be YOUR most important to
her?
a- When was your last day of LMP
don’t remember other options

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11. (2015)Pt. admitted with a crush injury to his lower abdomen and pelvis. On
examination he has fresh blood at the external ureathal meatus.
A- Pass a catherter
B- Excretion urethrogram
C- Arrange urethroscopy
D- Urethrograph
e- ssuprapubic cather

12. (2015)-primigravid ,in labour,cervix fully effacement,cephalic position ,5cm

dilation after 4 hours again in this situation but fetus is ok and there is no sign of
distress again no progress but fetus is ok and no progress
a-normal labour
b-obstructive labour
c-require ctg
d. require CS

13. lady came to you with his 18 months old child. She has upper respitaory
tract infection. During examination u noticed some bruises on her arm and
abdomen. She is quite and depressed. What will be your next appropriate
action?
A- tell her that it might be because of domestic violence
b- call her husband and talk to him
c- inform police
d- explore more about the cause of these bruises talking to her
e- inform child protection and physical assault authority

14. 52 years old man came to your clinic. He was found to have FOBT positive
but he is asymptomatic. There is no family history of any cancer. What will be
your next step?
A- CAE
B-Colonoscopy
c- advice advice regarding diet plan
D- CT
E- DRE

15. Ethics Vietnam travel pt not wiling for others except yellow fever vaccine
what to do (COUNTRY’S name was different)
A report to immi dept
B document it medical report
C don’t treat the pt

16. Stem was given and diagnosis of stress incontinence was asked

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17. pic of parotid tumor was given with stem and diagnosis was asked.

18. A man after bee sting,collapsed & breathless with inspiratory stridor &
expiratory wheezes. 1st step in mx ??
a. IV adrenline
b. IM adrenaline
c. SC adrenaline

19. Pt has to get morphine , but after 2 days still have severe pain.u checked and
saw nurse gave only paracetamol. what will u do next.?
a. formal complaint to head nurse.
B talk to nurse
c. nurse supervisor
d. Write down the incident

1Inguinal hernia( pic)

2Varicoceal symptoms were given have to diagnose

3Dacrocystitis treatment (pic)

Interactions

4Serotinin syndrome

5Lithium sideeffect (acne)

6Sertaline and nefidepine

7pcos (labs were given have to diagnose

8parkinsons symptoms were given ... see triad..

Rigidity tremers were there
Asking about bradykinesia
BRITish gentleman remember this
lobes q..

9man complain about seeing sea wave coming towards him, where is
the lesion
a)Parietal lobe
b) Medial temporal lobe
c) OCCIPITAL lobe
d)Frontal lobe

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10. A 68 y old man develop right-left confusion, He cannot write and

add or subtract. Where would be the likely lesion
A. Rt parietal glioblastoma
B. Left parietal glioblastoma
C. Right temporal
D. left temporal
E. Internal capsule

11Female with 5 months old baby with bronchiolitis, after treating the
baby u found out that his immunisation book isn't checked for any
immunisation. U have a short conversation with her and she tells that
she doesn't want to immunise him. What to do?
A. Reinforce her wish
B. Try to persuade her
C. Call child protective authority
D. Respect her wish
E. Call police

12#psychiatry 41 year old man had headache and is accusing

neighbours as they use insecticide excessively.He mentioned that he
had frequent trouble with them as they are very noisy.He moved twice
before as he was unlucky with neighbours.He thinks that they hate him
and want to harm him.Diagnosis?
Delusion
Depression
Schizophrenia
Paranoid personality disorder

13builder 48 yr,weekness in left side of body for few minutes.past same

episode for 5 times.advice after giving aspirin and discharge with follow
up by local doctor
A)add antiplatelet
B)Can’t drive 6months
C)Can’t go to work without local doctor’s permission
D)No strenous work

1413 y/o school student ,,, sex education is given ,,, what else to advice
A, alcohol
B. Non malanoma skin cancer
C. Pap test
D, chlamydia

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15Young male 25yrs presented with pain in scrotum from last 2days. On
exam testes is swollen, red & tender thick spermatic cord. What’s
organism responsible for it
Pic was also there

16Female comes at 5 th postpartum day with fresh bright red bleeding

and having fever she had lochia before and she us breastfeeding
What treatment wil u give.

17Mentally retarded girl with menorrhagia and noncompliance

to OCP
Implanon
IUD
Mirena
Endometrial abl
depo provera
Warfarin patient with intestinal obstruction...what to do
-----proceed abd fo surgery while on warfarin,
stop and operate,
give vit k and operate,
give ffp and operate,
do opreation after warfarin reversal
There was a question on treatment od optioc neuritis-
immunoglobulin or
iv methylpred or
cyclophosphomide or
azio

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A 25 year old woman, arrested once for shoplifting, now says 'i am
forever depressed' my friebds let me down, she also has self harm
behaviour. What management to give: drama therapy, aversive
behaviour therapy, diathec therapy, exposure response

A gal 14 years pulling hair says she ferls dustress and relief after pooling
hair: ocd, impulsive bahaviour etc
Trcichilomania.. an example of ocd
had this question - choices refer for psychological consult )

8. Child lived in different foster cares ,,, now come to gp clinic and hugs
doctor and then he got injury in clinic and then hugs parents and then hit
them and repeat hitting and hugging ,,, diagnosis

1. Reactive ...... something forgot ,??

2 adhd
3 autism
There was a question on treatment od optioc neuritis- immunoglobulin or iv methylpred or
cyclophosphomide or azio

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Question on 4 months old exclusiveky breast fed baby waking up

frequentky at night crying, askin for what to do: start solid feeds, start
bottle feef at night when awake, consol baby, use persifire?

A 25 year old woman, arrested once for shoplifting, now says 'i am forever
depressed' my friebds let me down, she also has self harm behaviour. What
management to give: drama therapy, aversive behaviour therapy, diathec
therapy, exposure response

There was xray fracture scaphoid asking diagmosis

Another xray very dilated loops i tbink it was paralytic ileus do i chose
nasogastric decompressions and ivf

The famous question for a lady going to different gps severallt and all say she is
ok now saying she is tired and wants ent referal, she was tearful. Choices
same: give referal , get collateral hx, and also new option give antidepressants i
chose give antidepressants

Baby waking up a lot at night but tbis time baby 6 moths . What to do i
chose introduce solid feeds-rice cereals

Ebdoscopy photo of oesophagus..metaplasia. pt on 20mg omeorazole. What to

do. Chose increase omprazole dose

Jasmin why liked by women- chose because of wright lose-doesn’t increase

waight

Warfarin patient with intestinal obstruction...what to do proceed abd fo

surgery while on warfarin, stop and operate, give vit k and operate, give ffp
and operate, do opreation after warfarin reversal

Neuro questions got ne mixed up. One looked like polymyositis, another like
spinal compression

A barium wuth obstruction was given symptoms had been for 3 month's i
guess to show that it was not emergency...so i chose do after reversal. Which
means after inr is normal

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A gal 14 years pulling hair says she ferls dustress and relief after pooling hair:
ocd, impulsive bahaviour etc

A man back from jarkatra where he was for golf with his wife for 3 days, now
oresents wirh 3 days of rash, fever, fatigue, back ache. What investigation to
do:
flavivirus pcr,
malaria,
Japanese encephalitis antibody,
hiv

A 19 yrs old gal had traveled to thailand she had several episodes of sore
throat while there . On presenting with fatigue malaise. On examination
mascular pains no other abnormalities. Diagnosis: infective mononucleosis
, post viral fatigue syndrome

1. Man with dry eyes with parotid gland dry ( Basically Referring to
Sjogren Syndrome )

A. MRI
B. Biopsy of Submandibular gland
C. CT
D. CXR

Its Pembertons sign

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( Pembertons sign - Picture resembles the same on the exam , only difference is
man was facing the right and poor quality picture )

2. Picture and history of dyspnoea of facial and arm swelling. Asking for investigation which
leads you to diagnosis.
A.Chest xray
B.ct angiography
C.duplex doppler study
D.contrast venography

( CT scan was not there )

3. Presents to ED with swelling below and lateral to the pubic tubercle . Swelling is non
reducible , no cough reflex. What is the diagnosis ?
A. Inguinal Hernia
B. Epigastric Hernia
C. Femoral Hernia

4. Parents brought 5 years old son with spinning around with no loss of consciousness and
lasting for 1-2minutes every month for last 3 months and subside spontaneously. No h/o
headache or vomiting. Ear examination normal. What will you do?
A.EEG and CT scan head
B.Audiology and ENT referral
C.Reassure due to BPPV that it will resolve later

5. Ankle swelling, afebrile, stiffness for an hour relieved by walk ,Xray show periarticular
osteopenia and narriw space, other foot joint is normal. What is the diagnosis?
A-osteoarthritis

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B-Rheumatoid arthritis
C-sle
D-septic arthritis

6. Patient on Prosthetic heart valve on warfarin, with acute abdominal symptoms.

Gastrograffin xray shows apple-core lesion,INR is 4.5 ( Exact ) what to do next?
A.Stop warfarin, proceed with surgery
B. Give FFP, proceed with surgery
C. Give Vitamin K, proceed with surgery NOT SURE HERE ( IF B OR C )
D. Give antiplatelet then do Elective surgery

7. Girl ( Scenario having sex with boyfriend, was screened for chlamydia screening.what
would be the most important reason to screen for chlamydia in this girl?
A Chlamydia assymtomatic carriers
B chlamydia causes infertility in untreated cases
C chlamydia is most common in Australia
D. His partner might have chlamydia

8. Man brought to the ED after he sustained accident, Labs shows multiple rib fractures.
Most appropriate management to the patient?
A. Endotracheal Intubation
B. Chest tube Insertion
C. Elevation of the head
D. Tracheostomy

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9. Patient had sudden right upper pain that resolve after a few hours ( 8 or 12 hours? )
Patient PE unremarkable. What is the diagnosis?

A. Simple Cyst
B. Hepatic Abscess
C. Hydatid Cyst
D. Hemangioma

10. Old man from nursing home transferred to ED with increasing constipation for one month.
Use laxatives for several years He now presents with abdominal distension and pain in 3
days, he has not passed stool for days ( forgot the specific days ). What is the diagnosis?
a) Sigmoid volvulus
b) Ca colon
c) Adhesion obstruction
d) Pseudo-obstruction

11. Women 34 yr old had paternal aunt with ovarian and breast cancer brca postive what
would u advise her.
A. No testing reassure her
B. Refer to genetic clinic for assesment
C. Mamoography
D. Ask for assesment father

12. During influenza epidemic, Women presented to with right sided abnominal pain and
fever. What is the Diagnosis?
a. Acalculous cholecystitis
b. Abscess
c. Hepatitis
d. Subphrenic Abscess

13. Caucasian Female had vacation from China with history of sore throat. Came to you with
fatigue and mild lymphadenopathy.
A. Infectious Mononucleosis
B. Mycobacterium Tuberculosis
C. Influenza
D. Hodgkins Lymphoma

14. What is the diagnosis ?

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( Similar scans 2 views on the exam )

A. Middle Lobe Pneumonia
B. Lower Lobe Pneumonia
C. COPF
D. Tuberculosis

( Picture somewhat similar on the exam, erythematous, non edematous, non swelling, ONLY
ERYTHEMA )

cellulitis?

15. A picture of red discoloration on one thigh.(I am sure that it is just red discoloration
without swelling and oedema, not full blown picture of cellulitis or not gas gangrene) A
farmer present got injury to his left thigh with sharp object in farm. Next day, he comes to
you with the following picture. (No others given like fever, pain, etc). What is the causal
organism?
A. Clostridium tetani
B. Clostridium perfringens Not sure between B or C

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C. Staphyllococcus aureus
D. Streptoccus pyogenes
E. Pseudomonas pseudomalle

16. What is the diagnosis ( non painful cyst )

A. Sebacaceous Cyst
B. Epidermoid Cyst
C. Kerathoacanthoma

17. A child with ECG showing WPW syndrome. Child Looks normal. Asking for the
management:
A- Immerse head in cold water
B- Metropolol
C- Adenosine
D.Verapamil

18. Man presented with central chest pain of 4 hrs duration. ECG Given STEMI in V2 – V4.
What is the next appropriate management after giving aspirin?
a. troponin I now and after 8 hrs
b. subcutaneous heparin
c. intravenous heparin
d. coronary angiogram

19. A woman with menstrual cycles ranging from 4 to 6 weeks presents with vaginal
bleeding following an amenorrhea of 6 weeks duration. A urine pregnancy test is
positive. On vaginal exam the OS is closed. An endovaginal ultrasound scan is
performed which reveals, an endometrial thickness of 12mm and an empty uterus.
Adenexa are clear and there is no fluid in the pouch of Douglas. There is a corpus
luteum cyst in the left ovary. Which one of the following would be the most likely
diagnosis?
A. Ectopic pregnancy.
B. False positive pregnancy test result.
C. Complete abortion.
D. Incomplete abortion.
E. Complicated corpus luteal cyst

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20. Lady came with left lower abdominal pain. Her menstrual cycle usually is for 4-6 weeks
,she has the same pain 4 weeks before and she had her last menstruation 9 days ago.
She usually has this pain 1 day before her menstruation starts and continues for 3 days
and pain increase with urination.What is the cause of her pain?
a. Ectopic pregnancy
b. Dysmenorrhea
c. complex corpus luteum cyst
d. Torsion of ovary
( NO Ovulation in the choices )

21. CVS risk chart given, same 62 year male smoker, BP 142/85, smoker, HDL ratio 6.2 ,
lipid ratio of 1. what it ask is – according to Australian CVD chart provided, which of the
following will be patient’s CVS risk?
A.10-15%
B.16-19%
C.25 – 29 %
D. 20-24 %

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16 year old female presents with jaundice, pallor

PERTINENT LABS:
Hgb: low
MCV: normal
Reticulocytes: increased
Unconjugated bilirubin: inc

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A. Rotor Syndrome
B. G6PD
C. Can’t remember (other causes of obstructive jaundice)

I have answered G6PD since it will present with normal MCV anemia with reticulocytosis. Plus.
Unconjugated bilirubin is increased. Other options will have increased conjugated bilirubin (Rotor) and
obstructive jaundice. For all my answers you may verify it correct it if i’m wrong thanks.

. Pregnant woman with anemia. Labs: low MCV

A. IDA
B. Thalassemia

Patient with history of head trauma, labs Hyponatremia other labs impertinent
A. SIADH
B. Other options

5. 6year old boy presenting with throbbing headache with photophobia. Tx?
A. Paracetamol
B. Sumatriptan

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There was a question on how to intubate someone with cervical spine fracture- direct laryngoscope,
tracheal intubation, crycithyredectomy

A question drugs that cause hyperkalaemia

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A question on bloody stool in an old person: diverticulitis

A question on toxic megacolon

Chronic cough in an imigrant with skin lesions on legs: sarcoidosis

A question on chronic cough on a smoker with hyperresonant chest exam..there was an exray: looked like
chronic brinchitis for me

There copd with cor pulmonale

18 year old lower abdminal pain, urine exam, hormonal exams normal . U/s showed a solid/cystic mass:
dermoid cyst, serous cystadenoma forgit the rest

An old man with dm, hypertension had a stroke now, r-l disirientation not able to do simple maths etc. Asking
cause: temperal lobe denentia, frontal lobe dementia, vascular dementia, alzeihmers

Duptyens contracture picture askinng before deciding on management wgat to investigate: lfts, glucose

A case on a child leving home to go to school but teacher reports that he somtimes doesnt reach school,
simetimes late, but to parents he has never shoes signs of not loving school: diagnosis? School refusal,
truancy

A couple nit able to get prwgnant after trying for 6 months. What to check, sperm count, fsh, frequency of sex

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Child with lactulose intolerance what to give: low lactulose milk, soy milk

86 old man living a lone. Presented due to mailaise, fatigue, easy fatigability. Blood picture was iron def
anaemia asking possible cause? Hypothyroidism, occult blood loss

Croup sign of worsening, noisy breathing, tarchcardia, moderate intercostal ressetion

A post partum mum complaining that child is crying much wbile the baby us gaining weight ok. What to
check on her? Mood, past psychiatric disorder etc

Patient had post partum depressin during past pregnancy, baby 4nyears now. She was on ssri till 2 years ago
worried bwants advice for this pregnancy. start after delivery, start during postpartum period, discuss with
husband now, discuss with the two of them later in pregnancy befire delivery

A teenager on marijuana, now having problems with sleeping asking for sleeping pills. Question was to
establish before treatment plan...infirm police, find out if he is using other drugs

18 yr old bartebder, 3 days histry of bilateral headache, fever, shaking, neck stiffness. Initial test? Ct head,
lp, blood culture, mri

Medial maleollus leg ulcer, pigmented pt of dm, had dvt. Likeky cause: chronic arterial insufficiency,
venous ulcer, diabetic ulcer

2 questions on osteoporosis, one reguarding a lady exoeriebcing hot flushes early menopause, another
one old man with bmi of 18. Fir both looked like they needed screening with bone density scan
Questi oon on early complication of pancreatitis: renal failure, abscess, pseudocyst,

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A patient witg end stage renal failure good with nurses in ward but very rude to nurses in dialysis ward:
splitting, reaction formation

Question on venlafaxine and tramadol drug reaction what to do

One Q was regarding pt with Fobt positive and next step asked
Cae, ECT, colonoscopy

Another Q was pelvic Fracture one . Patient wanted to void but couldn’t

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void. There was blood on external part of urethra

Asked about the best way to proceed

Suprapubic cathere
Urethral catheter82 y/o lady, pos-op femur fracture after fall of a chair. She has a great
family support. Today she is ready to be discharged. What is the most important in her
management?
1 - Heparin

2 - Warfarin

3 - Panadeine forte

4 - Alendronate

18 y/o Chinese student, 1st year university. Complains of diarrhoea for the last 3w, 3-4 x/24h. Felt
fine before arriving in Australia. Important University exams next week. PE normal.

1- smooth muscle relaxant

2- metronidazole

3 - Ciprofloxacin

PCOS scenario, (…) lab reveals elevated LH. What else is raised

1 - Testosterone

2 - Progesterone

3 – Prolactin

In her 30’s Obese woman, acanthoses nigrans, amenorrhea, vaginal bleeding after 7 weeks
amenorrhea, pregnancy test (-), cause:

1- PCOS

2- Cushing

3 – Type 2 Diabetes

21 y.o. man (BMI 27), smokes and drinks, first visit to a GP. Screening to offer him today:

1 - Skin cancer (0 y.e.)

2 – Testicular (not recommended)

3 – Lipids profile (35 y.o.)

4 – Blood pressure (not sure if this was an option) 16 y.o.

5 – Diabetes (40 y.o.)

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65 y/o man c/o fatigue and weight loss. Haematuria and dysuria (2 episodes). Urinalysis blood and
pus. Dx?

1- renal tuberculosis

2- bladder ca

3- nephrolithiasis

40 y/o man complains of malaise, retroorbital pain, arthralgias, fever and rash. He returned from a
trip to Cambodia recently. Which test for diagnosis

1 - blood smear for trophozoites

2 – Flavivirus PCR

A young patient will undergo urgent surgery. He refers severe bleeding after a dental procedure.
It’s found out he has Von Willebrand disease. What to do:

1 - Platelets transfusion

2 - Factor VII

3 - Factor VIII

57 y/o man symptoms of urgent incontinence. What 1st attempting to curb the problem

1 - Bladder training

2 - Fluid restriction

3 - Pelvic floor exercises

Old man admitted in the hospital because of pneumonia, but during his stay he fractured his
femur after a fall. Of the bed. The surgery to fix it went well and he is recovering well. However,
he is getting increasingly and argumentative with staff, he blames them for letting he falls.
Management:

1 – Trial with antidepressants

2 – Diazepam

3 - Risperidone

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4 y/o boy fell from gym equipment at school with the head first. Reported brief loss of conscience,
he remembers and describes how it happened. 1 episode of vomiting. Small swelling on scalp. No
neurological finding. Fully alert now.

1- Discharge home

2- 4 hours neurological observation and discharge if no neurological signs present

3- admit to the hospital for neurological assessment

4- CT

8 weeks pregnant with auto limited vaginal bleeding, what warrants urgent surgical referral

1 -crampy abdominal pain

2 - Shoulder tip pain

3-

Photo with a red mass, apparently thrombosed, on the edge of the anus. The scenario was: Young
lady constipated because of the use of Panadeine, she noted slight rectal bleeding and it aches.

1 - Internal prolapsed haemorrhoids

2 - Perianal hematoma

3- pilonidal cyst

4 – Perianal abscess

Scenario of a patient with signs and symptoms of Calculi in the ureter, which was confirmed by CT.
What would Indicate surgical treatment

1 - Several pain for 48h (ureter)

2 - Size 0,5 mm

3 - Haematuria

4 - High fever and tenderness in the flank (nephrotic )

Very fit young man. Painful Lump in the groin after 15km run. On physical examination it’s mild
tender, has no cough impulse.

1 - Inflamed lymph node

2 - Femoral hernia

3 - Inguinal indirect hernia

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Man hurt his leg, few days later it gets inflamed and he has an erythematous plaque in his left
thigh (photo - Around this plaque I noted some petechiae too). He is otherwise healthy. Causative
microorganism

1- S aureus

2- S pyogenes

3- C difficille

4- C perfigerens

5- C tetani or it was c botulinum (I cannot remember, other options were there for sure)

New born (33 weeks gestation) became dyspnoeic, x-rays shows signs hyaline membrane disease.

Placed on head box oxygen 40%, antibiotics and IV fluids. But deterioration occurs in a couple of
hours, now needs 80% oxygen and he has more effort on breathing, SO2 92 (?)

What the reason for he is getting worse:

1- Hyper viscosity syndrome

2- worsen of sepsis

3- Congenital cardiac anomaly

4- Pneumothorax

5-

Man, 55 y/o asymptomatic comes asking for blood test for prostate cancer. Family history is
negative. What should you do next?

1- Explain him the pros and cons of this test

2- US guided prostate Bx

3- DRE+PSA

4- Tell him this test is not recommended for asymptomatic patients to undergo this test

5-

Construction worker comes after being exposed (unprotected) to dust containing asbestos

in a demolition site. What is appropriate to do:

1- nothing to do now

2- X- ray now and in 5 years’ time

3- Tell him that the probability of him evolving with cancer is considerably low. Therefore, he should
not fear it.

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Fundoscopy with red cherry spot (I believe it was CRAO).

Old lady with High blood pressure and DM type 2 presenting with unilateral amaurosis. CT scan
without contrast and carotid doppler were normal. Management

1- Hyperbaric O2

2- acetazolamide( second)

3- timolol

4- massage (first)

Patient presents with cough and

shortness of breath.
Auscultation abolish sounds in
Left base, crackles above this
point. Left lung base dull to
percussion. (X-Ray given shows
image suggestive of pleural
effusion in my opinion). What to
do next

1- CT of thorax

2- Aspirate of pleural effusion

3- Bronchoscopy + BAL

4- thoracotomy

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Elderly patient scenario with symptoms of community acquired pneumonia (As I remember there
were no complications, other than the patient felling ill and mild SOB, X-ray given with infiltrates
in right middle Lobe) Treatment:

1- Ceftriaxone

2- Vancomycin

3- amoxicillin + clavulanic acid

4- doxycycline

Commonest site for endometriosis

1- ovaries

2- round ligament

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3- utero sacral ligaments

4- broad ligament

25 years woman, pregnant, 16 weeks, is concerned about Down Syndrome after talking to

a friend. She has no personal or family history. Pregnancy uneventful so far. First antenatal visit at
8 weeks everything alright. What to do now?

1- PAAP test (1st trimestr)

2- USG

3- Review consultation at 20 weeks

4- Amniocentesis

5- MS-AFP (rare)

Mother brings her 25 y.o. mental handicapped daughter because of heavy menses (itʼs been

like that for a while). The girl is on OCP without satisfactory improvement. Mother mentions it’s
hard to make her take the pills. Management?

1- Hysterectomy

2- Implanon

3- cooper IUD

4- mirena IUD

5- endometrial ablation

Young man, 27 y.o., smokes 15 cigarettes/year, drinks 10g alcohol day, cocaine and marijuana
socially, comes with chest pain, ECG reveal ST elevation on lateral wall. Which one lead to his MI

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A- alcohol

B- Marijuana

C- smoke

D- cocaine

18 y/o girl, no secondary sexual characters, physical examination w/o any abnormalities. What to
do next for diagnosis: (It did not mentioned amenorrhea in the question, it was simple as above)

1- FSH and LH

2- Ultrasound

3- Prolactin

4- TSH

5- Karyotype

Young previously healthy man with palpitations and light-headedness after running a marathon.

What is the most likely presented on ECG?

5 ECG strips were given I believe they were

1- 3rd degree A-V block

2- Ventricular fibrillation

3- Atrial Flutter

4- Atrial fibrillation

5-

85 yo lady, cervical secretion pcr test positive for gonorrhoea. She denies any sexual relationship
for the last ten years. What’s better to her management:

1- repeat pcr test in 3 weeks

2- ignore it because it’s probably a false positive

3- Ceftriaxone 1 dose IM

4- Metronidazole Intravaginal

15 y/o involved with drugs, not going to school, behaving badly. Mother comes in. The options
were:

1 - call the police

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2 - talk to the school

3 - contact child protection service. (All the options were about contacting some sort of authority)

Woman being beaten by husband but adamantly refuses to leave him or contact the police.

On PE bruises and other injuries.

1 - Call the police

2 – Couple advising

3 – Arrange a shelter place for her

4 – Start counselling her about the impact of these aggressions

5 – Respect her wish and do nothing

A man comes after severed his leg while working in his farm. 5 weeks ago, he presented with a
laceration in his arm and received dT vaccine. He can’t remember any previous immunization
other than this one. About tetanus prophylaxis:

1 – dT vaccine in 3 weeks time

2 – dT + TIG

3 – IV Azithromycin

4 – Nothing needs to be done

5-dt now

What I can’t remember:

Medicine:

• Otherwise healthy kid with proteinuria (2 episodes). There was Orthostatic proteinuria in the
options, and I believe that was the correct one.

• Another many questions involving proteinuria in children, young and older adults, options
ranging around IgA nephropathy, membranoproliferative nephropathy, membranous
nephropathy, urinary infection…

• Haematology (anaemias) was a recurrent topic in my exam. Two questions mentioned

Howell jolly bodies. Other questions suggestive of Myeloma, but not sure, maybe they were
tricky…

• Patient c/o SOB on exertion, FEV 50%, FVC 70%, a scenario very suggestive of Asbestosis, x-
ray with pleural plaques. Asked next test to do: CT, Bronchoscopy, transcutaneous Pleural
biopsy.

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• There were at least 5 questions with ECG strips, none of them were obvious. They were
about medicines overdose for self-harm (digoxin, verapamil, opiates…), about pts with
sudden palpitations, bradyarrhythmia and tachyarrhythmias. Wolf-Parkinson White.

• Even a question regarding Acute coronary syndrome was not easy. The ECG given had an
elevation in I, V4, V5 but the elevation in the precordial leads were not that clear, I am not
sure if it was >= 2 mm, or 1 mm only… so Should I consider it a STEMI or a NSTEMI? The
question was about treatment, so it was crucial differentiate the possible Dx.

Mental Health:

• Question to distinguish btw the cluster B personality disorder.

• Many questions regarding schizophrenia, manly the prodromal stages, not when the patient
has already full clinical characteristics.

• Questions regarding mental impairment, but the MMSE were above 25. So what to do? The
options given were all about dementia, Lewy body, Alzheimer, vascular dementia, and then
a more unlikely diagnose, but by exclusion I took them.

• Questions (1 kid and 1 teenager) suggesting autism in the scenario asking the most
important finding on these patients. For example: Watch same episode of Star Wars every
day many times or Construct air planes mini models were among the options.

• 1 question involving truancy

Child Health

• Two question which scenarios about 4-year-old boys with vertigo. 1 of them seemed
uncomplicated and there was benign paroxysmal vertigo among the options. The other one,
the kid had signs of increased intracranial pressure. Both questions asked the most likely
diagnosis.

Population Health

• Salmonella outbreak, best method to find the source

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Surgery

• Scenario highly suggestive of Diastasis of abdomen

How to test it

• No driving recalls, no stats, no osteoporosis, nothing from Extraocular muscles.

Most were very vague stems, cant make out diagnosis with certainty and they
were asking investigations and management.

• Was very aware of time, so made sure to finish 50 questions in each hour, flagged
any question with doubt, got more than half hour for reviewing flagged
questions. Most questions were with short and medium stems, no long
paragraphs so saved me time

• They don’t give normal values in most, and in my center they allowed breaks but
no extra time for break,

1. Wife comes with bruises but doesn’t want to complain to police or anyone
a. Advise to go to shelters
b. Inform police
c. Tell her to inform to police
d. Counsel her about effects and implications of abuse
e. Take photographs
2. Hemochromatosis pt with tense ascites, flapping tremors and fever 39 , what
next
a. Liver biopsy
b. Paracentesis
c. CT scan
d. Blood letting
3. Man smoker 20 per day, worked in electrical plant in china comes with cough x
ray given of pleural effusion, what next
a. Lung biopsy
b. Pleural biopsy
c. CT scan
d. Bronchoscopy
4. 13 years, living alone, come pregnant, due to rape 4 weeks before, what is next;
no option of informing child services
a. refer for abortion

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b. inform parents
c. inform sexual assault services
d. advise on contraception
5. couple go to Jakarta for gold, on return male has fever, ret orbital pain, rashes,
what to test for
a. malaria
b. flaviviirus
c. hep a
d. blood cultre
6. cardiovascular risk chart male non diabetic non smoker, 62 years old bp sys 182,
chl 6.2; hdl 1
7. 3 cases of typhoid, what study will you do to find cause
a. study about cases in your opd
b. study pattern of disease and takeaway fodd
c. some more don’t remember
8. child, fever 39.2, severe resp distress, reduced air entry on right side, no xray tt
a. oral amoxicillin
b. oral axithor
c. iv penicillin
d. iv vancomycin
e. iv ceftriaxone
9. 28 weeks pprom; steroid, ab given swab taken what next; no contractions
a. send to secondary centre
b. send to tertiary centre
c. send home
d. admit for observe
10. metropolitian city hospital; ecg of stemi given, o2 morphine nitrate given what
next
a. admit in icu
b. angioplasty
c. observe
11. man with multiple risk factors, smoking chol 7, bp 150/10, bmi 27 which one is
most risky for cardiobascular disease
a. choleseterol
b. smoking
c. hypertension
d. lack of exercise
12. child born at 34, diagnosed hyaline memernae disease, given ab and put in
oxygen box, after 4 hours saturation not improving with 80% o2, cause
a. more sepsis
b. cyanotic heart disease
13. insect bite few months back, noow have skin lesion, no punctum, small rounded
raised, not inflammatory, pic given
a. melanoma
b. dermatofibroma
c. basal cell ca
14. student missed exam, now say she missed because she had urti and headache
and asking for certificate
a. don’t give as you don’t know if she was really sick
b. don’t give because she didn’t come on day of exam
c. give certificate of back date

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d. give certificate of today explaning reasons for last 3 days

e. give certificate saying that she was not fit for exam
15. chinese student, loose motions, now 3-4/24 hour, was well in her country, exams
coming soon, no abdnormaliity on examination treatment
a. metronidazole
b. ciprofloxacin
c. smooth muscle relaxin
d. antridepressent
16. there was a question about a traveller, returned from Nepal something I forget…
really could not believe.. if they know form which country candidate is
17. young lady had contact with measelses child, no pregnancy mentioned, now
what
a. check Ig
b. give mmr vaccine
c. ask to come if symptoms develop
18. nurse exposed to hep C needles, what next
a. serial hep c testing
b. give hyperimmune ig
c. give antiretroviral
d. check viral load in 24 hours
19. scenario of cholecystitis, high fever, patient deoriating, usg,, obs cystic duct with
tense GB, no bile duct obstruction what next
a. ERCP sphincteretomy
b. Mri
c. Cholecystectomy
d. MRCP
20. Perianal pain after straining wile defecation, pic showing hematoma at anal
verge
a. thrombosed int hemorrhoid
b. perianal hematoma
c. perianal abscess
21. inguoscrota mass that almost completely disappears on lyhing dwon
a. direct inguinal hernia
b. vericocele
c. saphene verix
d. encysted hydrocele
22. testicular mass, 1.5 cm what is the management; really confused as not
mentioned next or best
a. fnac
b. inguinal orchidectomy
c. reassure
d. tumor markers
23. lacerated injury, received tt 5 weeks back, what now, vaccination hx not
mentioned
a. DPT
b. IG
c. dT and Ig
d. clean and antibiotic
24. all cell lines decreased asking cause – remember only thiazide as I chose that
25. old lady 82 y, colostomy, 3rd post op day, agitation, confused,
a. electrolytes

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b. urine routine and cultre

c. CTPA
26. 18 year old lady secondary sexual characters tanner 1, height and weight both
below 1SD of normal, what next
a. fsh and lh
b. usg
c. normal variation
d. karyotyping
e. mri head
27. 15momths Child mild urti missed mmr of 12 months
a. give mmr and next dose after 3 months
b. defrer till urti gets well
c. give mmr and next in 1 month
d. no more vaccines needed
e. start all vaccines again
28. abdominal injury while playing football, was well and played but in evening
came to er, unstable bp 80/50, spo02 90 after iv access and fluids what next
a. echo
b. ct
c. give 02 by mask
d. laparotomy
e. reassure
29. image of crao, came with sudden vision loss after 3 hours
a. eyeball massage
b. aspiration of acqueous
c. oral acetazolamide
d. 100% oxygen
30. headache and sudden loss of vision, hx of shoulder and hip aches, what to do
confirm diagnosis
a. iop measurement
b. esr
c. temporal artery bipsy
d. ct head
e. mri head
31. 45 years old lady, last pap 18 months back comes with post coital bleeding
a. pap smear
b. colposcopy
c. usg
d. utersosalphingography

32. ECG of wfw syndrome.. asked diagnosis

33. hepatic simple cyst – ultrasound image
34. 2 CT brain images – 1 abscess, one tumor
35. PUJ obstruction scenario – chose usg during pain attack
36. Sigmoid vulculus cenario – old lady constipation, now pain abd since 2 days,
tener on palpation, pr – nad asking for diagnosisChild had a fever, harsh cough
and stridor most appropriate management

1.antibiotics
2.nebulise with adrenaline
3.intubation

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(Steroids not in the option)

13 year and 4 months boy not selected for sports c/o he is a shortest in the class for four
years, tanner stage 1 for genitalia and axillary pubic hair growth. Their parent’s height
matched for average mid parental height. His bone age is 11years and 6months.what will
you tell them regarding his condition
1.He has underlying illness
2.he will be short stature in long term
3.This is due to his over involvement in cricket
4.He will achieve his parent’s average height when he became adolescent

Child presented with diarrhea and stool for Rita virus positive and resolved. Mother gave
normal feeds, after 3/4 days again had profuse diarrhea noticed perianal excoriation
What modification u advise
1. Low lactose
2.Soya based milk
Dx- secondary lactose intolerance. due to the previous diarrhea. Normal physiology is Lactose with
the help of lactase enzyme converted in to galactose +glucose.
Due to the villous damage by previous diarrhea lactase enzyme want be there.
So now lactose will change in to lactic acid +co2 by the bowel bacteria.
Co2 cause gaseous distention lactic acid cause peri anal excoriation.
More over the lactose retained with water and cause explosive diarrhea.

Child presented with fever and productive cough all chest examination chest X-ray blood esr
normal. What will you further order for investigation?
1.HRCT
2.Bronchoalveolar lavage
https://www.thoracic.org/professionals/clinical-resources/critical-care/clinical-
education/critical-care-procedures/bronchoalveolar-lavage.php

Patient has undergone carotid endarterectomy 6 days back and now developed difficult to
breath spontaneously came to ED. On admission severely laboured and harsh stridor what is
ur next step?
1. O2
2. Endotracheal incubation
3. Cricothyroidotomy

Girl had recurrent abdominal pain and angioedema of face and lips family history in mother
and brother what investigation you will do
1.Allergy test
2.C1esterase inhibitor level
https://www.rch.org.au/clinicalguide/guideline_index/c1_esterase_inhibitor_deficienc
y/

Scenario of acute angle closure glaucoma what will be ur Mx

1.Oral acetazolamide
2.Topical timolol
https://emedicine.medscape.com/article/798811-treatment
3.Topical pilocarpine

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• Baby born by Lscs found limbic severely cyanosed HR 40 no respiration what

is APGAR score?

• 26weeks of gestation admitted with uterine contractions vaginal n speculum

examination revealed intact membranes what appropriate next step
1.IV antibiotics
2.LSCS
3.Beclomethasone.

4.Rash pic on hand

Description given mother notice red popular circular rash and applied antiseptic it
increases in size over four days what is the organism responsible
1.varicrlla
2.papilloma
3.herpes simplex
4.staphylococcus

• RA patient on prednisolone hydroxy chloroquine and Mtx. Fbc shows WBC

1.9 he 10.2 plt 140000 Mcv 95 or 110not sure. Which drug is responsible?

• 65 yr.pt on multiple drugs metoprolol, aspirin, hydrochlorothiazide present to Ed

with drowsiness ABG shows pH acidic pco2 22 base excess -15..... Hco3 not
given blood glucose high which drug is responsible for this condition
All the drugs above in options

• You are planning to start Paclitaxel and one more chemo agent for a cancer
patient which long term side effect you should discuss with the patient
1.Rash
2.Neuropathy

• Common cause of death in schizophrenia

1. Suicide
2. CVA
3. Ischemic heart disease

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• One of your patient with

comorbidities request for DNR you
assess MMSE is 28, but family members
said should do resuscitation during ICU
stay what you will do
1.arrange family meeting
2.take it to ethical court or jury
3.tell them you will not resuscitate

• You have involved your patient for a

new trial study on antihypertensives for
six months after three months her blood
pressure normal and she want to exit
from the study what will be your action
1.Allow her to terminate from the study
2.Inform relevant pharmaceutical
company who carry out this study

• Woman presented with hemiparesis CT shows infarction and her blood

investigation positive for ana and anti DNAase which drugs combination you
prefer
1.anticoagulat and anti-inflammatory
2.antiplatelet and anti-inflammatory

• Young woman has history of pleurisy in past has arthritis and morning stiffness
resolved over day had recurrent oral ulcers too
Diagnosis
1.RA

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2.Gout
3.SLE

• 10 days baby found to have jaundice noticed it few days after birth full breast
feed growth normal what investigation you order next
TSH
Coombs test
USS abd
Direct and total bilirubin

• Man presented with right side hemiparesis and aphasia symptoms developed
5hours before. CT says infarction what is the management
Aspirin
TPA
Other management options

• Optic neuritis scenario what is the

management for long term improvement or
prognosis I couldn't remember well
1.O. Steroids
2.Immunoglobulins
3. IV methylprednisolone

• 3year child mother admitted following febrile convulsion what advice you will
give regarding her long-term prognosis
1. She will not avoid of developing high temperature
2. This condition will not develop into convulsions
3. Usual course of the disease is resolving after 6 years

• Picture and history of dyspnoea of facial and arm swelling. Asking for
investigation which leads you to diagnosis.
A. Chest x-ray
B. CT angiography
C. Duplex doppler study

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D. Contrast venography

• Promi mother 39weeks poa admitted with contractions vaginal examination

reveal is 5 CM cervix fully effaced and in four hours vaginal examination same
finding with cephalic presentation occipito transverse position what will be
your next step
1.Ventouse delivery
2.Lscs
3.Fetal blood sampling
4. Oxytocin

• Girl came to clinic Cx just one genital ulcer u did syphilis & other screening she
didn’t come to clinic for 2wk now come for test result. Her viral culture is all
negative but RPR test is 1:64 positive how will u do for further Mx???
A. Test for another STD
B. Contact tracing
C. Notify local public health
D. Advise her to use condom
E.HIV testing

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