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Chings Notes > 2021 > Flashcards

2021 Flashcards

1
Q

progressive gait unsteadiness
electric shock in the cervical spine
has fibromyalgia and have shoulder and neck pain
Upper muscle extremity muscle strength is decreased
What is the cause?

A

Demyelinating polyneuropathy

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2
Q

Lhermitte’s sign or the barber chair is often associated with

A

Multiple Sclerosis

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3
Q

Most useful investigation for detecting gallstones and dilatation of common bile duct

A

Ultrasound

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4
Q

helping in finding out cause of obstructive jaundice

A

ERCP

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5
Q

PCOS trying from last 2 years not conceiving with high BMI took metformin, no USG finding given, asked next treatment?

A

Clomiphene

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6
Q

Women came with very foul smelling discharge from vagina

A

Garnerella

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7
Q

Swelling is irreducible, above the ligament

A

Indirect Inguinal hernia

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8
Q

Visual loss on the Left eye
left eye ischemia, pupillae edema
inv?

A

Carotid Ultrasound

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9
Q

3 wk history of intermittent pain to the hip
o/e shows limitation of movement
Diagnosis?

A

Slipped Femoral capital Epiphysis

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10
Q

multiple, small infarcts in the Right Parietal and temporal lobes and mass in the left atrium

A

Intracardiac Tumor

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11
Q

fever, weight loss, arthralgias and Raynaud Phenomenon

A

Atrial Myxoma

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12
Q

abdominal or flank pain, low back pain, hematuria, Urinary tract infection, hypertension

A

Polycystic Kidney Disease

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13
Q

cobblestone appearance

A

Intranasal decongestant

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14
Q

bloody diarrhea, recurrent attacks of loose stools

A

Ulcerative Colitis

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15
Q

Colicky abdominal pain

A

Crohn Disease

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16
Q

34 wks gestation of severe RUQ pain
BMKI 38 kg/m2
Total Bilirubin 4.8 mg/dl

A

Acute Cholangitis

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17
Q

She feels a lot of guilt
also fears being arrested by the police

A

Acute Stress Disorder

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18
Q

insomnia following the birth of her son
decreased appetite and no interest seeing friends, appears restless and tearful
Diagnosis?

A

Postpartum Depression

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19
Q

Man has burns 40% of her body, developed high gastric residual volumes and progressive abdominal distention. What is the next step?

A

Plain Xray Abdomen

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20
Q

6 day old boy, breastfed and is gaining weight approximately born at 40 weeks gestation at primigravida, medial deviation of the forefoot what is the next step?

A

Karyotype analysis

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21
Q

photophobia, history of flue like symptoms recently, On examination T 39, neck rigidity, Ct scan is normal, CSF reports glucose normal and cell count predominantly lymphocytes
What is the most appropriate management?

A

IV fluids and Observation

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22
Q

tense bulging fontanelles
head enlargement

A

Hydrocephalus

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23
Q

fecal leakage and hematocheiza
conjunctival pallor is present
Colonoscopy - reveals pallor with areas of mucosal hemorrhages and telangiectasia, symptom?

A

Radiation induced Proctitis

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24
Q
A

Contact wit5h her previous doctor about prescription

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25
Q

Aboriginal child came to you with greenish discharge from nostrils and from ear. What is the most suspected sequel?

A

Hearing loss

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26
Q

A 15 yo boy with h/o sudden outburst of anger who is currently in a special school is now at verge of expulsion WHat would be the drug of choice?

A

Risperidone

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27
Q

Sigmoid Volvulus scenario
Which will lead to definitive diagnosis?

A

CT scan

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28
Q

female complaining RUQ pain, took 10 tab of paracetamol 12 hrs ago when you examined her there is tenderness, showed increase LFT + fever. What is the cause?

A

Cholangitis

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29
Q

25 yo female brought to the ER by the police, for verbal abuse and aggression at shopping center. She is barefoot wearing multi-colored scarf and her speech was classic example of word salad with pressured speech
Diagnosis?

A

Illicit drugs

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30
Q

Child presents with multiple small and large bruises on abdomen and limbs with fine small petechiae as well. What will you do to investigate to confirm the diagnosis?

A

FBC

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31
Q

15 year old woman goes to your clinic worried about last night after drinking
had sex with an unknown man
She took the morning pill and now asking advice.
What is the most appropriate next step?

A

Reassure

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32
Q

A man with SOC, ph. 7.29, oxygen 60 mmHg and carbon dioxide 50 mmHg. Bicarbonate high.

A

Partially compensated respiratory acidosis

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33
Q

Patient on meds with RA causes tiredness - Which med is this

A

Ibupofren

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34
Q

Man complained of Allergic Rhinitis which interferes with his sleep. Pale turbinates and nasal congestion at night. What is the treatment?

A

Inhale Fluticasone Daily
- intranasal steroids are the treatment of choice for persistent moderate to severe allergic rhinitis.

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35
Q

Man MMSE 25 before trial. He live with his son (caregiver). During trial his MMSE was 15. You think it is due to drug from trial. Who do you ask to remove him from trial?

A

Patient himself

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36
Q

Patient with lump FNAC shows breast cancer estrogen reuptake negative progesterone reuptake negative BRCA positive. What is the most appro?

A

Mastectomy with Axilliary Clearance

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37
Q

if the lump is 3-4 cm

A

Breast Conversation Surgery

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38
Q

crackles on the base of the chest

A

Pulmonary Embolism

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39
Q

High grade fever
Foul smelling sputum is present

A

Aspiration Pneumonia

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40
Q

Patient with Hereditary Spherocytosis,lethargic anemic HB and decrease platelet what to do next?

A

RBC transfusion (because HB very low)

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41
Q

Tetanus dirty wound vaccinated before but booster dose given 7 years back
What is the next step?

A

ADT

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42
Q

Pic of a child that look like he has an impetigo

A

Topical Mupirocin

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43
Q

Patient presents with obsession. he counts 20 then repeats again had trauma 2 months ago now pressured speech and sleep more what is the diagnosis?

A

Adjustment Disorder

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44
Q

Female patient with LSIL what is your most approp step?

A

Repeat test after 12 months

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45
Q

A man with past psychiatric h/o is presented to court his lawyer comes to you as his GP for his Medical reports. What is the next step?

A

Consent of patient

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46
Q

Patient had catheter passed in Subclavian vein now after 2 days flushing of face unable to move hand what inv should you do next?

47
Q

75 yo taking shower slips fell on floor with outstretched hand radius fracture Vit D 55Hb10.5 PLT 80 Xray shows osteoporosis in regard to fracture stabilization what will you add to treat>?

A

Alendronate

48
Q

Patient with Schizophrenia on Risperidone came for checkup when sits on chair he’s crossing legs then relaxing then crossing what condition best explains?

A

Akathisia (motor restlesness, unable to sit, has to keep moving legs add propanol)

49
Q

irregular and diagnosed with atrial fibrillation, creatinine ratio increased GFR less than 30/min
What to add in the therapy?

A

Warfarin (CHADVASC 2 or more)

50
Q

8 yo comes with mother his teacher say he doesnt obey command he is aggressive hyperactive poor school performance IQ ok language slurred most likely diagnosis?

51
Q

Aggressive, hyperactive, poor school performance IQ, ok language slurred most likely diagnosis?

52
Q

Impaired non verbal communication

53
Q

Motor and vocal tics present

54
Q

Syncope and Angio Done, carotid stenosis < 30% next approp step of management?

55
Q

Most common side effect of Risperidone

A

Gynecomastia

56
Q

mentally dead inside and withdrawn not sleeping for 2 wks, anxious.

A

Acute stress Reaction

57
Q

Type 1 Diabetes 9yo grl mother monitors 8-9 mmol/L in hospital. 2 reason of difference

A

Expired Strips

58
Q

Patient with hematemesis and repeated vomiting what to do next?

59
Q

45yo farmer with soiled lacerated wound had simple scratch wound 5 days ago for which he received a DPT. No other h/o vaccination what is the most appro after debridement

A

TT and TIG

60
Q

10month child brought to a routine well-child visit. The mother discloses that the child is clingy, fussier, and cries when picked up by others.

A

Normal development (separation anxiety)
- can start from the child’s first bday and can last until they turn 4 years old.

61
Q

48F, comes in with urine leakage problem. She voids frequently day and night. Has intense urge to urinate bust passes only a small amount. Next step?

A

Urine Microscopy

62
Q

achy joint pain in the lower back, shoulders hips and knees
excessive sweating, polyuria and erectile dysfunction
has an enlarged tongue and hand reveals widening of the joint spaces, low testosterone and hyperglycemia
Diagnosis?

A

Acromegaly

63
Q

2 occurrences of green
dry mucous membrane and mildly sunken anterior fontanelle

A

Plain Xray abdomen - to look for double bubble sign in volvulus or duodenal atresia

64
Q

Unstable affect, mood swings, marked impulsivity, unstable relationships, suicidal behaviours, chronic feelings of emptiness of boredom

A

Borderline Personality Disorder

65
Q

pregnant woman with painful goitre
TSH low T3 and T4 normal. Which of the following confirms the diagnosis?

A

Iodine Scan

66
Q

gallstone due to pancreatits , CBD 10 cm

67
Q

What vaccine is contraindicated in a child with nephrotic syndrome currently on corticosteroid therapy?

68
Q

What vaccines are contraindicated in immunosuppressed children

A

BCG, MMR, MMRM

69
Q

28wks pregnant. Contact with child having chicken pox. Known history of chicken pox at childhood. What is the next step?

70
Q

Patients taking metformin, Verapamil, Revostigmine, perindropil. Now came with 3 degree heartblock. Which drug should be ceased?

71
Q

Patient has claudication on walking and relieved on rest
Patient femoral pulses are diminished and dorsal pedis not felt. ABI one leg 0.8 and another 1.3
Most appro?

A

CT angiography

72
Q

Boy fell down from the ladder and complain of severe headache and vomiting ever since arrived

A

Do series of skull Xray

73
Q

5th metacarpal fracture and treatment

A

Below elbow cast

74
Q

Patients dad was diagnosed with prostate cancer at age 85
he is healthy

A

do PSA every 2 years

75
Q

Gross hematuria and proteinuria
USG is normal
Next inv?

A

Urine microscopy

76
Q

60yo man difficulty in climbing stairs and not able to comb hair, difficulty in abduction
diagnosis?

A

Polymyalgia Rheumatica

77
Q

pain in the proximal muscles + increased ESR

A

Polymyalgia Rheumatica

78
Q

ocular (ptosis) facial weakness + limb weakness +

A

Myasthenia gravis

79
Q

UMN type of lesion + optic neuritis

80
Q

both UMN and LMN type of symptoms

81
Q

Girl collapsed and lost a pulse had to do CPR and had to revive her
\sent to the hospital in ambulance
appro management?

A

Admit her under cardiac area

82
Q

patient has anemia, macrocytic, thrombocytopenia, abnormal granulocytes. What is the inv of choice to confirm?

83
Q

Macrocytic anemia is due to

A
  1. Vitamin B12 def
  2. Folate deficiency
84
Q

Patient attained menopause having hot flush
Want to start HRT
Which is the right management?

A

continuous oestrogen and cyclical progesterone?

85
Q

long term management of PCOS

A

Weight loss

86
Q

Patient having primary amenorrhea
no improvement with progesterone challenge
next inv?

A

USG and Abdomen

87
Q

PAtient is known case of RA on methotrexate and hydroxycloroquine
Want to get pregnant
what’s next

A

Stop methotrexate and continue hydroxychloroquine

88
Q

Patient has history of hematemesis following Ibupofren took for arthritis. It was treated with omeprazole and has gastric ulcer. Management?

A

Clopidogrel

89
Q

Exercise induced asthma What to do?

A

Inhaled salbutamol

90
Q

Patient with resting tremors

91
Q

Resting tremors

A

Parkinsons disease

92
Q

Postural tremor

A

Hyperthyroidism, anxiety, BET, physiological

93
Q

cerebellar disease

A

Intention tremor

94
Q

Young woman pain post-coitus, examination normal except left cervical motion tenderness?

A

Endocervical swab

95
Q

low back pain for several months
no comorbidities present
no history of IV drug abuse
next step?

A

Xray Lumbo Sacral Spine

96
Q

10 years use of OCP causes what carcinoma

97
Q

5 or more years of OCP used are at increased risk of developing

A

Cervical Cancer

98
Q

COPCPS provide some protection against

A

Endometrial and Ovarian Cancer

99
Q

65Yo M, presents with heart burn and he is on PPI, endoscopy shows low grade dysplasia
What is the msot approp step regarding surveillance

A

Repeat every 6 months

100
Q

14yo female, pregnated by the uncle is 20wk pregnant. What should you do?

A

Call the police

101
Q

15yo female patient was homeless for 3 years and she comes with 10 wk pregnancy with ehr 17 yo boyfriend and wishes to terminate the pregnancy
What should you do?

A

Accept her request

102
Q

complain of infertility for 24 months and has hx of 6 wk abortion of a previous pregnancy when she was 16. Was treated for PID 1 year ago. Which of the ff contributed to infertility?

103
Q

Painless lip swelling and face (angioedema) every week and so does her mother and brother. What do you do next?

A

C1 esterase inhibitor assay

104
Q

Female patient tonic clonic seizure 1st episode xray CT blood test normal she takes only people community transfer one place to another what is your advice

A

Cant drive for 6 months

105
Q

Patient booked an appointment ask if possible to meet outside

A

Say not possible

106
Q

75yo man comes with periodic substernal chest pressure
significant for hyperlipidemia
Smokes a pack of cigarettes daily
he is prescribed with sublingual nitroglycerin to take as needed when anginal pain occurs and daily medication to help prevent anginal episodes
Medication functions through?

A

Coronary Artery vasodilation

107
Q

62F, involved in a motor vehicle collision.
Weakness of hand grip bilaterally and the triceps reflex is decreased on both sides
Decreased pinprick sensation is present on the fingers
What is the cause?

A

Brachial plexus injury (uncommon)

108
Q

becomes irritable and sleeps poorly
reacts negatively and always seem on the edge and worries about almost everything
feels tired and has difficulty concentrating
diagnosis?

A

Generalized Anxiety disorders

109
Q

nulliparous woman complains of lower abdominal discomfort and chronic constipation
cramping with menses
enlarged uterus and irregular and mobile with prominent posterior mass
best nxt step?

A

Pelvic USG
Pssible dx- Leiomyoma

110
Q

Sunburst appearance

A

Osteosarcoma

111
Q

Auscultation of the lungs show decreased air antry into the left lower base
next step?

A

Chest Xray

112
Q

multiple drug for multiple morbidity
lab finding increased NA k =6.5 and creatinine =1.7 anaemia
What is the next most approp step?

A

IV glucose with insulin

Chings Notes (39 decks)

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