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Chings Notes > 2022 > Flashcards

2022 Flashcards

1
Q

LOW LEVEL Of PAPP - A

A

Evaluation of Growth Screening

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2
Q

white thicky creamy cheese vaginal discharge
itchy, soreness and redness
colour white curd like discharge

A

Candida Albicans

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3
Q

Yellow green vaginal discharge
strawberry appearance of the vagina

A

Trichomonas

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4
Q

gray watery profuse vaginal discharge
foul smelling
wet mount test positive positive clue cell

A

Bacterial vaginosis

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5
Q

Yellow green
thick mucupurulent
SIGNS of PID

A

Cervicitis

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6
Q

cervical motion tenderness

A

PID

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7
Q

Colles Farcture
How will you apply the cast

A

FUDP
Flexion
Ulnar Deviation
Pronation

or Flexion and below elbow

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8
Q

eye trauma and reduce vision.
dx?

A

Lens dislocation

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9
Q

A 25 yo female
Patient took rubella vaccine 2 weeks ago, 1 week before her period
She missed her periods and now is pregnant . What will you do?

A

Rubella Serology

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10
Q

5.1 cm stone at Uteropelvic junction
What to do?

A

ESWL
Extracorporeal Shock Wave Lithotripsy

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11
Q

Best way to prevent Trachoma in a community?

A

Handwash

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12
Q

Studying a case if food poisoning that happened one week ago in a marriage. Appropriate study?

A

Cohort

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13
Q

Abdominal Plain Xray normal small bowel filled with gas, asked investigations?

A

Colonoscopy

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14
Q

0.2 ABI and patient smokes 40 cigarette a day. What to do next?

A

CT arteriogram

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15
Q

When to intubate?

A

GCS below 8

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16
Q

Rhinorrhea, CSF+ , Periorbital hematoma
What to do next?

A

CT Scan

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17
Q

5yo with asthma attack and was given inhaled Salbutamol and symptoms were relieved/ Now he is discharged. What to give to prevent future attacks?

A

Fluticasone(ICS)

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18
Q

Admitted and discharged shortly
Asthma attacks

A

Oral prednisolone must during discharge

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19
Q

best way to prevent exercise induced asthma

A

SABA

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20
Q

32.-3.6 cm aortic aneurysm increase in 2 years. When do you screen?

A

Every 2 years

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21
Q

Floaters and flashes

A

Retinal Detachment

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22
Q

Hematuria and hemoptysis
What is the inital Diagnosis?

A

Urine Culture

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23
Q

DHematuria and hemoptysis
What is the confirmatory Diagnosis?

A

anti-GBM antibodies

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24
Q

hematuria associated with sensorineural deafness and eye disorders
it progress to renal failure

A

Alport Sydnrome

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25
Q

if patient with asthma doesnt present symptom

A

LABA

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26
Q

Severe asthma:
A. nocturnal asthma more than 1 per week
B. symptoms most day
C. Multiple ED visits

A

SABA prn and
LABA with ICS
add
Ipratropium bromide (Nebuliser)
or
Oral Prednisolone

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27
Q

History of duodenal ulcer
H pylori in biopsy

A

Triple Therapy

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28
Q

MTX and pred long term no remission
Now wants to get pregnant

A

Change to SULFA

DRUGS OF CHOICE FOR RA in pregnancy: CASH
Cyclosporine
Azathioprine
Sulfasalazine
Hydroxychloroquine

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29
Q

develops fever, malaise, sore throat and dry cough, hacking cough
diffuse rales and rhonchi
What is the diagnosis?

A

S. pneumoniae

Atypical pneumionaie

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30
Q

Alcoholics
lungs abscess
organism?

A

Kleibsiella pneumoniae

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31
Q

COPD
organism?

A

Haemophilus influenzae

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32
Q

Recent viral infection
org?

A

Staphylococcus aureus

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33
Q

poor dentition
aspiration
organism?

A

Anaerobes

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34
Q

Young, healthy patients
pneumonia
org?

A

Mycoplasma pneumoniae

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35
Q

haorseness
pneumonia
org?

A

Chlamydia pneumoniae

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36
Q

contaminated water sourdes
air conditioning
ventilation systems
pneumoniae
org?

A

Legionella

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37
Q

Birds
pneumoniae
org?

A

Chlamydia Psitacci

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38
Q

1st year pneumoniae

A

BEL
beta Hemolytic
E coli
Listeria

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39
Q

animals at the time of giving birth
veterinarians
farmers
pneumonia
org?

A

Coxiella burnetii

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40
Q

Right Upper lobe collapse

A
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41
Q

Pancoast tumor history
asking diagnosis
Pemberton Sign
SVC obstruction

A

Horner’s Syndrome

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42
Q

outpouching that occurs at the junction of the lower part of the throat and upper portion of the esophagus
the poucg forms because the muscle that divides the throat from the esophagus the cricopharyngeal CP muscle, fails to relax during swallowing

A

Zenker’s diverticulum

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43
Q

keratin pearls and intercellular bridges
hilar mass arising from bronchgus

A

Squamous cell Carcinoma

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44
Q

Genetic test for cystic fibrosis

A

Sweat Chloride Test

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45
Q

88 yo woman slipped and hit her head on the tub
now confused and only knows her name not the date and where she is at
diagnosis?

A

Subdural hematoma
bridging veins - most commonly affected vessel
next best step and initial diagnosing test ? - CT scan without contrast - classic finding - crescent shaped hematoma
most appropriate therapy - immediate surgical evaluation and hematoma evacuation thourgh either a burr hole or craniotomy

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46
Q

intermittent stream and difficult in voiding, soft DR with moderately enlarge, painless hematuria. What to do next?

A

Urinalysis

if it is painless, always initial is Urinalysis then followed by
if >55 yo, macroscopic - Cystoscopy
if >35 yo. macroscopic - CT abdomen
if >55 yo, microscopic - USG or Cytoscopy
if >30 yo, microscopic - USG or Cytoscopy

if it is painful, initial is still urinalysis then followed by
if >40 yo - Xray to confirm then Spiral CT scan

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47
Q

A premenstrual 47 yo
fatigue, breast tenderness and bloating
pills alleviated PMS symptoms except for depression and emotionals
What is the next step?

A

Fluoxetine 20mg or Sertraline 50 mg in the morning for 14 days before the anticipated period

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48
Q

post menopausal symptoms

A
  1. Hot flush
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49
Q

old man with voiding difficulties,
prostate DRE done
and its normal
what’s next step?

A

Day to day activities

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50
Q

A man with HTN and COPD, cramps in the calf muscles upon walking one block
diminised popliteal and pedal pulses
what medication should be used to avoid ?

A

ACEIs

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51
Q

Choice of antihypertensive in different situations
- with Asthma?

A

CCBs
Diuretics

Beta Blockers, ACEIs - is contraindicated

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52
Q

Choice of antihypertensive in different situations

  • in Pregnancy?
A

if there is emergency - Beta Blockers ( Labetalol BP 150/)

Essential Hypertension ( random visits then increased BP) - Methyldopa

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53
Q

Choice of antihypertensive in different situations
- in Renal Artery Stenosis?

A

Unilateral - ACEIs
or Bilateral - Diuretics (ACEIs is contraindicated)

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54
Q

Choice of antihypertensive in different situations
- Chronic Kidney Disease?

A

ACEIS
ARBs

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55
Q

Choice of antihypertensive in different situations
- Post dialysis ?

A

CCBS
Beta Blockers
ACEIs

Cannot give Diuretics - there is already too much fluid

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56
Q

Choice of antihypertensive in different situations
- Acute Renal Failure

A

in case of congestion - DIURETICS
is stable case - BETA BLOCKERS

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57
Q

Choice of antihypertensive in different situations
- End stage Renal Disease?

A

Transplantation

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58
Q

Man with urinary retention mass above the pubic symphysis
DRE shows enlarged prostate with palpable median sulcus
catheter inserted what is the most appropriate step?

A

Trans Rectal Ultrasound Guided biopsy

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59
Q

woman with cardiac artery stenting, debelops episodes of transient visual loss to her left eye. Vision returns within 30 minutes. 10 of these within the past 3 months. Symptoms?

A

Retinal Vein Thrombosis

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60
Q

40yo male patient with RA, on Methotrexate and Hydroxycholorquine, planning to start family. What is your advice?

A

A. Stop Methotrexate and continue Hydroxychloroquine

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61
Q

a 32 yo woman came with greenish vaginal discharge. She had an implanon 3 years ago. She lives with her female sexual partner. A diagnosis of bacterial vaginosis was made and she was given Metronidazole. What else will you do?

A

Treat her partner

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62
Q

A 5 day infant - mild puruelnt eye discharge
mild cursted yellowish discharge in both eyes without a prominent swelling and inflammation of eyelids
org?

A

Gonorrhea

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63
Q

neonatal eye discharge
first day

A

Chenical Irritation

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64
Q

neonatal eye discharge
1st week

A

Gonorrhea

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65
Q

neonatal eye discharge
1- 2 wks

A

Chlamydia
tx: Azithromycin 20 mg/kg orally for 3 days

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66
Q

female first trimester. trying to stop smoking. How will you help?

A

Nicotine Patch

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67
Q

Man working in garden fell and rubbed his face on grass vision blurring, no pain, no conjunctivitis. What is the next investigation?

A

Fluorescien

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68
Q

28 yo female positive for HPV 16, 18 and negative for 16 and 18

A

Cervical screen 6-12 months

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69
Q

10 cm cyst two months after pancreatic, middle age patient comes with epigastric pain, a cyst is exactly posterior stomach, best managed asled?

A

Endoscopic Gastrostomy

up to 40 % of pseudocyst resolve without intervention

Pseudocysts smaller than 6 cm - usually disappears without intervention

if it is larger than 6 cm with symp, > 6 wks - surgically drained

less than 6cm without symp - careful observation with periodic CT scan

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70
Q

Xray of slipped Capitofemoral joint of a 14 year old boy with BMI 30. What will you do?

A

Pinning of joint

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71
Q

A young patient has got often light headedness
normal CXR
ECG normal
Holter monitor reveals ventricular ectopic

A

Plain echo

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72
Q

45 from Sri Lanka with painless haematuria. probable dx?

A

UTI

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73
Q

Female with gestational diabetes fx,
normal OGTT at 8 wks
What to do?

A

24-28 wks

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74
Q

7 days post op patient with dyspnea and breathlessness
Most appropriate investigation?

A

Since he is post op Patient then answer is CTPA

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75
Q

CTG of primigravida given, FHR at 120 bpm What to do?

A

FHR is normal so continue Fetal heart monitoring

if there is late decelerations then scalp ph sampling then put mother in left lateral position then second give O2 and third if hypo - give synto and do monitor CTG every 4 hrs.

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76
Q

An old age patient with cataract had improve vision after surgery, in post op day 4 he had painful eye and blurred vision. What is the diagnosis?
A. Conjunctivitis
B. Uveitis
C. Suture infection and Abscess
D. Hypopyon
E. Acute Glaucoma

A

C. Suture infection and Abscess

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77
Q

A ball hitting the eye leading to floaters and vision loss asking cause?

A

Retinal Detachment

The five F
Fall of vision
Flashes of light
Floaters in the vitreous
Fundus findings
Field changes

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78
Q

Baby 17 days old with jaundice
Normal weight gain
Stools and urine also normal
What can be the cause?
A. Biliary atresia
B. Breast Milk jaundice
C. ABO incompatibility

A

B. Breast Milk jaundice

ABO incompatibility - is a first day jaundice so within 24 hrs but this baby is 17 days old

While Biliary atresia - will have obstructive features such as dark urine and pale stool.

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79
Q

Covid Positive 6 days symptoms
88% saturation
after oxygen treatment
A. Ceftriaxone
B. Amoxiclav
C. Remdesivir
D. Prednisolone

A

D. Prednisolone

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80
Q

Case of temporal lobe epilepsy in a lady asking about which step will help you to make diagnosis?
A, Video EEG - never the first line
B. History from the witness
C. CT head
D. ECG
E, Carotid message

A

B. History from the witness

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81
Q

What is the first line investigation for seizure?

A

Electrolytes
recurrent time - glucose

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82
Q

patient went to Jakarta but did not visit rural area only city and hotel. Fever, malaise and rash. What is the investigation?

A

Dengue Ns1

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83
Q

What are the complications of Malaria?

A

CHAPLIN
Cerebral Malaria or Coma
Hypoglycemia
Anaemia
Pulmonary edema
Lactic Acidosis
Infections
Necrosis of Renal tubules

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84
Q

Gastrointestinal symptoms, hepatomegaly, neurasthenia, cholangitis. cholecystitis
Dx?

It is a common infection of dogs and other fish -eating carnivores (reservoir final hosts) in China, Korea, Republic of Kora and Vietnam, Cambodia and Taiwan

A

Clonorchiasis

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85
Q

Transmission is tru undercooked fish

bilary tract inflammation - pigmented gallstones associated with cholangiocarcinoma

A

Clonorchis sinensis
Tx: Praziquantel

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86
Q

Short Intubation and Long intubation

A
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87
Q

D

Cambodia

A

Cholangitis
Liver Abscess

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88
Q

India

A

Enteric

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89
Q

patient went to Thailand
fever malaise hepatosplenomegaly
DX

A

HIV

other diseases:

Pneumonia
STD

Chikunguniya
Viral Hepatitis
Measles
Anthrax
Ricketssiae

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90
Q

Old female patient is abusing alcohol
laboratory test to confirm this
A. MCV
B. ALT
C. MCH
D. AST

A

A. MCV

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91
Q

Which of the ff abnormalities not associated with long QT segment?
A. Hypokalaemia
B. Hypocalcaemia
C. Hypomagnesemia
D. Hyponatremia
E. Bradycardia

A

D. Hyponatremia

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92
Q

A boy with ADHD was initially treated with methylprhenidate after 6 month how do you adjust the dose?
A. Assess the level of hyperacitivity
B. Side effects
C. Reduced Symptoms
D. Improve lifestyle
E. Good grades in school

A

A. Assess the level of hyperacitivity

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93
Q

Alcohol withdrawal synmptoms

A

Delirium Tremens
Tx:

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94
Q

Tx for Adjustment disorder

A

Psychodynamic therapy

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95
Q

Tx for OCD

A

Exposure and Response Therapy

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96
Q

Tx for Tourettes Syndrome

A

Habit Reversal therapy

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97
Q

Tx for ASD

A

Behavioural modification program

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98
Q

tx for Persistent depressive disorder

A

Insight Oriented Psycotherapy

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99
Q

Tx for grief

A

Supportive Therapy

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100
Q

Tx for ODD

A

Family therapy

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101
Q

TX for Kleptomania

A

Insight Oriented Therapy

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102
Q

Tx for Separation Anxiety DIsorder

A

CBT and Psychotherapy

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103
Q

TX for ADHD

A

Behavioural Therapy

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104
Q

Tx for Specific Phobia

A

Systematic Desensitization and Exposure therapy

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105
Q

Tx for all dissociative disorders

A

Psychotherapy

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106
Q

tx for Anger management

A

CBT or anger management therapy

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107
Q

Divorded parents
Child lives with father, complains abdominal pain O/e normal. Tx?
A. COgnitive therapy
b. Behavioural therapy
C. Fluoxetine
D. Amitriptylline

A

b. Behavioural therapy

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108
Q

tx for alcoholics + agitated

A

B2

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109
Q

Tx for alcoholic + psychosis

A

Haloperidol

nonalcoholic + agitated
Nonalcoholic + psychosis
TX; Haloperidol

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110
Q

Teen boy falling grades
Plays video games all day
knows that video games is affecting his studies
Wants a career in video games
dx?
A. Normal adolescent behaviour
B. Drug addiction
C. ADHD
D. ODD

A

A. Normal adolescent behaviour

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111
Q

Patient stopped eating for 2 days. Says she has no gut. Patient does not want ECT
A. Give ECT on the ground of patient no care no consent needed
B. mental Health ribunal
C. COnsent of husband

A

B. mental Health ribunal

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112
Q

Patient lawyer wants his medical records as he is going to appear in the court. What do you do?
A. give him the records
B. Tell him need court order
C. Need to do forensic assessment before giving records

A

B. Tell him need court order

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113
Q

All of the following can cause Serotonin Sydnrome except:
A. Haloperidol
B. L tryptophan
C. Clonazepam
D. Meclobemide
E. Dectromorphan

A

C. Clonazepam

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114
Q

Pt hit the eye by a ball
orbital floor fracture
A. Diplopia upward and outward
gaze
B. Diplopia on downward gaze
C. Pain on opening mouth

A

A. Diplopia upward and outward
gaze

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115
Q

Features of Orbital FLoor fracture

A

decreased visual acuity
binocular vertical diplopia
eyelid swelling
ipsilateral hyperaesthesia

Enopthlamos is a late feature that can be seen after edema settles.

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116
Q

horizontal diplopia and chewing

A

Zygomatic Fracture

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117
Q

Specific feature of orbital floor fracture

A

ipsilateral hyperaesthesia

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118
Q

most common feature of orbital floor fracture

A

vertical diplopia

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119
Q

cluster of autonomic, motor and mental status changes resulting from excess 5-HT

A

Serotonin Syndrome
tx: Cyproheptadine

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120
Q

Asymptomatic with 30% pneumothorax

A

Intercostal tube with large bore catheter

<25% collapse with no symptoms - observe
<25% collpase with symptoms - Drain
>25% collapse - usually drain

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121
Q

Symptoms and Management in Serotonin Syndrome

A
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122
Q

mediastinal shifting

A

Tension Pneumothorax
tx: Needle throcostomy

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123
Q

newly diagnosed ankylosing spondylitis treatment asde from physiotherapy?
A. Naproxen
B. TNF inhibitors
C. Paracetamol
D. morphine

A

A. Naproxen

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124
Q

If NSaids Failed what is the second line management for Ankylosing Spondylitis?

A

Etenercept
Adalimumab
Infliximab

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125
Q

What is the accurate method to diagnose Ankylosing spondylitis?
biomarker for AS - HLAB27

A

MRI

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126
Q

Acute Tophous gout treatment?

A

Prednisolone

Prophylaxis of a flare of gout
Cochicine 0.5 mg daily or bid
or Predinisolone 6mg daily
or NSAID eg Diclofemac 25-50 mg up to 200 mg/daily

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127
Q

60 lady joint pain with Heberden’s nodes. How to diagnose?

A

Osteoarthritis
- Xray
- ESR and CRP is not raised. coz it is non-inflammatory

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128
Q

polarized light microscopy
positive birefringence

A

Pseudogout

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129
Q

polarized light microscopy
negative birefringence

A

Gout

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130
Q

Tx of Gout with Renal problem

A

Corticosteroids
if its not in the choice
low dose colchicine

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131
Q

How to treat Seborrheic Keratoses?

A

freezing them with liquid nitrogen or cryotheraphy
, or electrocuatery or laser resurfacing or Ablative laser

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132
Q

4yo child with sudden onset of fever, resp distress, drooling, soft inspiratory stridor. Diagnosis?
A. Croup
B. Epiglottitis
C. Bronchiolitis

A

B. Epiglottitis

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133
Q

81yo 3 month progressive constipation
Pain for 5 days
Xray is given
A. sigmoid Volvulus
B. Colon Cancer

A

A. sigmoid Volvulus

more common in older men and has sudden and severe onset

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134
Q

4months runny nose - low grade fever and family members got infected
wheezing, cough. cause?
A. RSV - bronchiolitis
B. Pertussis
C, Influenza

A

A. RSV**

Bronchiolitis is for less than 1 month old

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135
Q

Initial investigation for bronchiolitis and pertussis?

A

Nasopharyngeal Swab

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136
Q

boggy swelling of knee. Clicking sound. Inv?
A. Xray
B. MRI
C. Arthrocentesis

A

B. MRI
Dx - ACL tear

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137
Q

Croup, what org?

A

Parainfluenza
Adenovirus
Influenza

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138
Q

Old patient, bilateral shoulder and hip pain. Lab given ESR raised, Ck normal
Treatment?
A. Prednisolone
B. Paracetamol

A

A. Prednisolone

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139
Q

myopathy
CK and ESR both elevated

A

Polymyositis

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140
Q

myopathy
ESR and CK both normal

A

Drug induced - steroids - statin

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141
Q

myopathy
ESR is raised and CK is normal

A

Polymyalgia Rheumatica

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142
Q

Long standing angioedema can be associated with what medications?

A

ACEIs

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143
Q

Age > 50
new headache - throbbing, unilateral
diplopia
polymyalgia rheumatica
loss of pulsation of temporal artery
jaw claudication
temporal artery 5cm is diagnostic

A

Temporal Arteritis

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144
Q

fatigue / malaise + headache + jaw claudication

A

Temporal Arteritis

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145
Q

Inv for temporal arteritis

A

ESR is elevated
C-reactie protein elevated
mild anaemia 0r normochromic normocytic

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146
Q

Thyroid operation done
After sometime develop difficulty breathing
management?
A. Intubation
B. Open the sutures

A

B. Open the sutures

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147
Q

Right Homonymous hemianopia
with macular sparing
where is the lesion?

A

Left Occipital cortex

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148
Q

Epigastric hernia on linea alba commonly contains what?

A

Extraperitoneal Fat

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149
Q

Collegue is HIV positive doesnt want to reveal the condition and continues to practice what to do?

A

Report to APHRA

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150
Q

patient that takes medications for RA well controlled
Ibuprofen, Sulfasalazine, prednisolone, cyclosporine suddenly feeling tiredness and elevated platelets and abnormal labs

A

Ibuprofen

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151
Q

Female patient hx of syncope. ECG normal, bp sitting and lying same and normal. What is next?

A

Holter to rule out cardiac arrythmias

dx: Fatigue + dizziness +/- Syncope = Cardiac Arrythmias

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152
Q

Patient gf came to pick up prescription for insulin?

A

Confirm over the phone

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153
Q

Patient suicidal. Involuntarily admitted. Dad lives with him comes later and asks for what happened?
A. Tell father
B. Don’t tell father because of confidentiality

A

B. Don’t tell father because of confidentiality

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154
Q

Foster mother wants to return girl child as she was doing unusual sexual behavior with other kids
A. Inform child protection
B. Arrange another foster home
C. Get psychiatric evaluation
D. Chase collateral information about the family structure
E. Notify hospital admission

A

C. Get psychiatric evaluation

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155
Q

Down’s patient ear pain. Carer says patient has intermenstrual bleeding. She doesn’t want you to allow to examine her and just wants to discuss about the ear pain? What will you do?
A. Examine her under GA
B. Ask her about the knowledge of intermentstrual bleeding
C. Arrange for ultrasound

A

B. Ask her about the knowledge of intermentstrual bleeding

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156
Q

38 wks, amniotomy meconium stained, CTG is normal. What is next?

A

STOP CTG

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157
Q

Child healthy, playful, no bruise anywhere, mild urti. Mother young very sickly, bruise on both hands, lives on uncle’s basement and eats leftover, coffee, beer and cigarettes. What to do?
A. Child protection
B. Child health services
C. Emergency shelter service

A

C. Emergency shelter service

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158
Q

female bruising all over. Says bf abuses. What to do?
A. Photograph
B. Encourage to report
C. Arrange shelter

A

C. Arrange shelter

Protect first

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159
Q

Allopurinol dosage

A

50 - 300 mg

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160
Q

Picture of heberden nodes. Which condition causes this?

A

Celiac Disease

161
Q

Hyperkalemia

A
162
Q

Previous 1 week h/o headache, fever. Now came with h/o dark urine, jaundice, hepatomegaly, splenomegaly. Sexual partner is well. What is the diagnosis?

A

EBV

163
Q

34wks pregnant patient, came with complaints of itching
What is the diagnosis

A

Cholestasis of Pregnancy

164
Q

presents in the last trimester with symptoms of fulminant hepatitis - jaundice, vomitinh, abdominal pain, headache and possibly coma

A

Acute Fatty Liver of pregnancy

165
Q

40 yo male with visible hematuria. Kidneys palpable. No pain symtoms what is the diagnosis?

A

Polycystic Kidney Disease

palpable kidneys

166
Q

Good pasture disease. Investigation to confirm the diagnosis?
A. Antibuclear antibody
B. Anti basement membrane antibody

A

B. Anti basement membrane antibody
Anti-GBM antibody

tx for GBM - plasmapheresis and immunossuppression
the defect is in the alpha 3 subunit of type IV collagen

167
Q

DXT: failure to thrive + chronic cough + loose bowel actions

A

Cystic Fibrosis

dx: Sweat chloride test

168
Q

Picture of prolapsed hemorrhoids. What is the appropriate management?

A

Rubber Band ligation

169
Q

tx for ADHD

A

Methylphenidate

170
Q
A
171
Q

vulva itchiness that doent respond to two course Itraconazole
White lesion on examination
mgt?

A

Lichen Sclerosus

Ans- Bethamethasone (steroid) cream

172
Q

A woman came to you with infertility, she also has hirsutism. What will be your next investigation?

A

PCOS
- FSH/LH (same with infertility cases - always check this one out first)

173
Q

During routine check up, adrenal mass is seen in CT and MRI, but no symptoms and all well. What will you do?
A. CT in 6 months
B. Percutaneous biopsy
C. Tumor resection

A

A. CT in 6 months

174
Q

Middle aged man, comes with lower back pain, radiating to the right thigh, leg pain, hard to walk, difficulty with everyday activities. H/o urine incontinence, O/e verterbal local tenderness. Which one of these condition is more consistent with spinal cord compression?
A, Urine incontinence
B. Leg pain
C. Impaired ankle jerk
D. Vertebral local tenderness
E. Lower back pain

A

D. Vertebral local tenderness

175
Q

Women concerned about ovarian cancer, because her Grandma got one. She is on COCP. What will you do next?
A. Continue COCP
B. Increase the dose
C. Decrease the dose
D. CHange POP
E. Condoms

A

A. Continue COCP

176
Q

A woman came for OCP, mother and sister have recent DVT. What will you advice
A, Thrombophilia Test
B. Low dose COCP
C. High dose estrogen COCP
E. POP

A

E. POP

177
Q

32 yo woman, came with amenorrhea for 12 mos, no sexual activity since 1 yr ago. best inv?

A

Beta-HCG

always exclude pregnancy first

178
Q

mother with car accident, bruises in abdomen by seatbelt, condition is good, fetal heart sound auscultation is good, What is next?

A

Admit and hospitalize

179
Q

5 year old child leg pain during night but well at daytime, normal well development. What is the next step?

A

Reassure

Dx; Growing pains

180
Q

an old lady fell on her shoulder 6 wks ago
sustained no fractures
now returns with the swelling and mottling on her shoulder and proximal area of her arm
complains of hypersthesia and extends from arm to mid-forearm
Normal doppler sonogram
Diagnosis?

A

CRPS
Complex Regional Pain Syndrome

181
Q

Young man after jogging and going up slopes pain in lateral aspect of knee tenderness in 30 degree knee flexion in lateral distal femur what is the diagnosis?
A. Iliotibial band syndrome
B. Lateral meniscus
C. Stress Fracture of Lateral condyle of femur

A

Ilotibial Band Syndrome

182
Q

Young lady with epilepsy for which she was on phenytoin. She wants contraceptive for 2 years. What is best for her?
A. COCP with 30 ug ethinyl estradiol
B. POP
C. Copper IUCD
D. Implanon

A

C. Copper IUCD

183
Q

Symmetrical arthralgia in small joints of both hands.
ANA, ENA (anti roSSA), RF and dsDNA positive
Anti CCP negative
What is the diagnosis?

A

SLE

184
Q

Patient in cardiac care unit for MI 2 days ago
PCI done
Now ECG of 3rd degree heart blocl
What to do?
A. transcutaneous pacemaker
B. Permanent pacemaker

A

B. Permanent pacemaker

185
Q

Patient presenting with diarrhea, generalized arthralgia, rash on lower extremities since 2 days. Treated for sore throat with Amoxiccillin 7 days before. What is tyhe cause?

A

HSP

186
Q

char by tetrad of palpable petechial rash or purpuric rash, arthralgia/ arthritis, abdominal pain and nephritis

A

IgA Vasculitis (HSP_

187
Q

17 yo boy admitted for some leg fracture. Asked nurse to give morphine. Now the boy is complaining of severe pain. Found out nurse decided that he doesnt need morphine so gave him PCM. What will you do?
A. Notify AHPRA
B. Incident report
C. notify the hospital administrator
D. Discuss the issue in nursing head meeting

A

B. Incident report

188
Q

if patient has breath sounds decrease on left upper side of the back and Xray shows opacity in the left upper lobe. What is next?

A

CT chest

189
Q

Assistant of specialist came to you complaining of work overload. Distressed because of that. Specialist is your friend so what will you do?
A. Declare conflict of interest
B. Tell specialist about this
C. Tell her its okay
D. Ask her to find new GP

A

A. Declare conflict of interest

190
Q
A
191
Q
A
192
Q

Z

A
193
Q

equivalent amount of radiation in Xray

A

400

194
Q

55yo has diplopia for 1 day R eye
Glucose is normal
ECG shows occasional ventricular ectopic
Management?

A

Observation

195
Q

A man presents with pansystolic murmur which is radiating to the axilla
What is the diagnosis?

A

MR
MR. Pan napunta sa axilla
Mitral Regurgitation

196
Q
A

B is correct

PVT - cannot stop the heart from poundingA

197
Q
A

B Stop patient’s metoprolol

198
Q

65 yo man digoxin with HF and basal crepitation came with SOB in emergency pedal edema
Management?

A

A. Furosemide

199
Q
A

A. TEE

200
Q
A

A. TEE

201
Q

young, basketball player, swollen arm, edematous, mild discoloration, tender
o/e small lymph nodes are palpable but not tender
cat is unwell
A. Cat scratch disease
B. Cellulitis
C. Axillary vein thrombosis

A

C. Axillary vein thrombosis
(vs catscratch - with fever)

202
Q

Athlete + fever for few days + lymphadenopathy usually painful + animal / cat sick + limb swelling

A

Cat Scatch disease

203
Q

swelling in the arm with pain high in the axilla
seen in people working above their head, such as painters and basketballers.
it is an emergency requiring antithrombotic therapy.

A

Subclavian or Axillary Vein thrombosis

204
Q

68 yo hip fracture, comes for third day with SOB with chest tightness
What is your probable diagnosis?
A. Fat Embolism
B. Pulmonary Embolism
C. MI
D. Cardiac Tamponade

A

A. Fat Embolism

It occurs within 24-48 hrs after trauma but thromboembolism is uncommon before 5 days after immobilization.

205
Q

Hampton’s hump
Wedge opacity

A

Pulmonary Embolism

206
Q

`28yo diagnosed with HOCM and now is worried if her 10 years old child has the same. ECG echo normal what next?
A. Stress Echo
B. ECG echo in 2-3 years
C. repeat Echo

A

B. ECG echo in 2-3 years

207
Q

Melanoma in the eye (on eyelid) treatment
A. send plastic surgeon
B. Observation

A

A. send plastic surgeon

208
Q

What will you do for follow - up with Melanoma
A. Chest CT
B. Mammography
C. LFT
D. Brain CT

A

Chest CT

209
Q

An 28 alcohol male patient agitated brought to the hospital glucose is 4. Qhat is the immediate thing you will do in the ER before definitive treatment?
A. IV glucose
B. IV thiamine

A

A. IV glucose

210
Q

Adult, agitation, woman, alcoholic
A. Blood Glucose
B. Look for Oral Diazepam
C. Haloperidol IM

A

C. Haloperidol IM

211
Q

Four years snakebite (black snake) boy is alert plus conscious. First step at site
A. Immobilize plus pressure
B. Do nothing
C. tourniquet

A

A. Immobilize plus pressure

212
Q

diabetic ketoacidosis in 19 yo , glucose 22 mmol.
A. IV fluids
B. Insulin
C. KCL

A

A. IV fluids

213
Q
A
214
Q

What does the comatose patient needs

A

water
sodium
(3L normal saline)
Potassium (KCL)
Insulin

215
Q

Diaphragmatic rupture
what to diagnose?

A

Abdominal CT scan

216
Q

Diarrhea with HCO3 = 8 (N 24). What will you add to the IV fluid?
A. NaHCO3
B. Fluid restriction

A

A. NaHCO3

217
Q

All of the ff can cause serotonin Sydnrome except?

A

Clonazepam

218
Q
A
219
Q

bloody diaarrhea, and o n Sulfasalazine now came with red rash on leg picture of

A

Erythema Nodosum

220
Q

CT is given - adeno, chronic calcification pancreatitits, woman
3 glasses of wine intake, weight loss
dx?

A

Pancreatic carcinoma

221
Q

colicky abdominal pain and anorexia for 7 days
2 days with diarrhea
tenderness all over the abdomen with guarding
temp 39
diagnosis?

A

Perforated appendicitis

222
Q

Acute tophous gout treatment?

A

Allopurinol

223
Q

Abdominal ultrasound - focal hepatic lesion
abdominal ct scan - enhaving focal mass suring the arteril phase with rapid washout during the portal venous phase
diagnosis?

A

Liver cancer

224
Q
A
225
Q

fever and petechial rash
diagnosis is meningitis
What is the next step in the management?
A. Blood Cultures
B, Intravenous access
C. Lumbar puncture
D. Intravenous ceftriaxone
E. Intravenous Benzoyl Penicillin

A

B, Intravenous access

226
Q

Vietnam travel - What prophytlaxis is required?
A. Doxycycline
B. Ampicillin

A

A. Doxycycline

227
Q

Salmonella travel advice?
A. TRSD Vaccine
B. Doxycycline
C. Avoid street food
D. Drink Bottle water

A

C. Avoid street food

228
Q

boggy swelllling at the knee, clicking sound

A

ACL
dx: MRI

229
Q

Why do you notify Salmonella
A. To research
B. To prevent spread

A

B. To prevent spread

230
Q

Typhoid travel advise
best suggestion
A. Vaccine
B. Personal hygiene

A 
A.  Vaccine
231
Q

70 male, recent travel to asia, now confused, neighbors brought to ED
axillary and lymph node enlargement. What test will you do
A. HIV
B. Syphilis serology

A

A. HIV

231
Q
A
232
Q

Varicella Zoster

A

PCR

233
Q

Cellulitis red swollen hand
antibiotic?

A

IV Fluctox

234
Q

27yof, breast mass 0.5 cm, painless, no swelling, , nontender and firm. aunt had breast ca age 65

A

USG

235
Q

A young woman with pap smear results: LSIL and HPV test was negative for none 16 and 18. Management?

A
236
Q

54 yo, asymptomatic man, comes concerned with colon cancer, father has colon cancer at 67. What can he do for cancer screening?

A

FOBT now

237
Q

patient is in hospital for cholecystectomy
tachycardis + increased BP + chest pain + dyspnea + ECG ST segment depression
management?

A

Cath Lab

238
Q

sputum fever, CXR lower lobe consolidation
Probable cause?

A

Streptococcus Pneumoniae

239
Q

54yo F, with stress incontinence
What is next?

A

Urine analysis

240
Q

A young man with mass in the lft testis separated from the testicle, painless, mass is compressible, nontender and can be felt soft and firm. What is your diagnosis?
A. Varicocele
B. Epididymal cyst
C. Inguinal hernia
D. Non seminomal testis cancer
E. Seminomal testis cancer

A

Inguinal hernia

241
Q

bulge above the umbilical. mass located above the umbilical, painful, does not get smaller by lying down and does not disappear
dx?

A

Epigastric hernia

242
Q

yellowish greenish offensive discharge
thin and foamy + vaginal itching
dx?

A

Trichomonas

243
Q

which indicates severe infectivity with Hepatitis B?

A

HbeAg

244
Q

A young man has come complains of epigastric pain. Pain gets worse after eating, urease test positive. management?

A

D. PPI + Amoxiciillin + Clarithromycin

245
Q

nuchal translucency

A

Oligohydramnios

246
Q

HX of intermittent acute right iliac pain by vomting
no vaginal bleeding
LMP 12 wks ago
dx?

A

Ruptured Ovarian Cyst
inv: TVS
RX: reassurance - sinple cyst ,$cm
why not torsion? - very ill patient, severe cramping
mobile mass in abdomen - laparoscopy

247
Q

amenorrhea + abdominal pain + vaginal bleed
urinary b-hcg test can be negative

A

Ectopic pregnancy

248
Q

most approp treatment for umbilical hernia?

A

Mesh Repair

249
Q

left leg and hip muscle weakness
and weakness of left hand
fasciculation in lower limb and left lower limb hyperreflexia, weakness of ankle joint. what is most likely the site involved?

A

Cervical spine

250
Q

A man concerned of Prostate cancer. PR is done and normal. What is next?

A

PSA after 2 weeks pf performing DRE

PSA every 2 yrs from 50-69 - men at average risk of prostate cancer

251
Q

A man prescribed oxycodone for lumbar pain, recentlu because of severe pain he took heroin what is next?
A. Reduce oxycodone
B. Switch to Tramadol
C. Check Oxycodone level

A

A. Reduce oxycodone
(it is less potent 6 x than heroin)

252
Q

Abdominal pain
elderly
sudden onset

A

Sigmoid Volvulus

253
Q

most common affected site leading to intermittent claudication

A

Superficial femoral Artery

254
Q

pregenancy, 18 wks, TSH - low
palpitations, lethargy, ecg ectopic beats whats next?

A

Free T4
- Primary Hyperthyroidism
-

255
Q

38 male with epigastric discomfort
increased with alcohol and spicy food. No weight loss. What to do next?
A. CT abdomen
B. Upper GI endoscopy
C. Urea breath test
D. fecal occult blood

A

C. Urea breath test

256
Q

39 pt with Warfarin, INR 9 with bleeding
What to do?

A

STOP WARFARIN

Stop the offending drug first

257
Q

15 yo, bilateral, exaggerated reflex, ataxia, joint position all gone

A

Friedrichs Ataxia

258
Q

Back pain what features in the history make you think of doing more investigations?
Reflex
Fever
Pain Radiation
Local tenderness

A

Fever

259
Q

1+ proteinuria on routine health check
No other abnormalities
A. Repeat Urinalysis
B. 245hr Urinary Protein
C. Urine culture

A

A. Repeat Urinalysis

260
Q

Child have psychotic problem started Risperidone what should be suspected in the consequence?

A

RISPERIDONE = WEIGHT GAIN

261
Q

endoscopy shows a narrow ring in esophagus in biopsy
treatment?

A

Budesonide
tx for EoE

262
Q

infertility, female with prolactin level 5500 taken Paracetamol and Esomeprazole. What is the cause?

A

Pituitary Adenoma

> 4000 - Pituitary Tumour
< 4000 - Drugs

263
Q

Lurias test- frontal lobe test, unable to perform dementia symptoms also mentioned, what investiagtion to help the diagnosis?
A. Serum Vitamin B12
B. Blood Alcohol
C. Urine Drug screen
D. No option of CT

A

A. Serum Vitamin B12

264
Q

GBS scenario with CSF - albuminocytological dissociation, most approp test for diagnosis?
A. Nerve conduction studies
B. EMG
C. MRI brain
D. MRI spine

A

A. Nerve conduction studies

265
Q

consequence of RISPERIDONE

A

Gynecomastia or
Weight gain

266
Q

athlete, h/o multiple neck injuries, diarrhea 2 wks ago, difficulty in extending wrist and elbow, numbness in posterior aspect of lower third of arm. Nerve and nerve root asked

A

C6-C7

267
Q

man with h/o criminal records now h/o insomnia, agitated, recently charged with minor assault
A. Oral Olanzapine
b. IM Diazepam
C. IV Phenytoin
D. IV morphine

A

b. IM Diazepam

268
Q

earache and droopy face
episodes of viral illness in the past
difficulty closing his R eye and has a right sided facial droop
Right otoscopy shows crusted eruptions in the External auditory Meatus
What is the cause?
A. Drug induced allergic reaction
B. Fungal infection of external canal
C. Reactivation of herpes zoster virus

A

C. Reactivation of herpes zoster virus

269
Q

Treatment of gout when allopurinol didnt work

A

Febuxostat

270
Q

fixed semi-dilated pupil
tx?

A

Pilocarpine
dx: Acute Angle Closure Glaucoma

271
Q

Persistent diarrhea more than 2-3 days

A

Metronidazole

272
Q

child limping and difficulty in walking
no fever

A

Perthes is in children 4-8 yo

273
Q

Pt with complains of multiple symptoms but no records for that even after search
Diagnosis?

A

Factitious disorder

274
Q

HLAB27 positive with back ache
on methotrexate and hydroxycholoroquine
What to do?

A

Cease Methotrexate

275
Q

rash on abdomen in 18 months old child with previous fever

A

Herpes 6

276
Q

Antibiotic to give post splenectomy

A

Amoxicillin

277
Q

Acute limb ischemia what is the next step?

A

Heparin

278
Q

Rash on abdomen in 18 months old child with previous fever

A

Herpes 6

279
Q

Post splenectomy
tx?

A

Amoxicillin for 2 years

280
Q

Typical drussen

A

Intravitreal Becavizumab

281
Q

Sjogrens
anti ro +
dry eyes
tx?

A

Naproxen

282
Q

Molar Pregnancy

A

Hydatid form

283
Q

Orbital floor fracture

A

Diplopia

284
Q

What is the late feature for the Orbital Floor Fracture

A

Enopthlamos

285
Q

redness and swellling just anterior to the neck
Mgt?

A

Regular Sialogogues

286
Q

Foot deformity with a high arch (pes cavus)
Invrted champagne bottles
Diagnosis?

A

Charcot Marie Tooth Syndrome

287
Q

Clear discharge from urethra and dysuria
mgt?

A

Azithromycin

288
Q

Initial management for hyperemesis gravidarum

A

IV fluids

289
Q

Abdominal distention which electrolyte can cause

A

Calcium

290
Q

History of hoarding what to look?

A

Social Anxiety

291
Q

swelling and redness in scrotal 36-72 hours

A

Testicular Torsion

292
Q

USG of testis showing hypoechoic area
Next step

A

Afp

USG - Beta-HCG- AFP
But afp if theres no other ans

293
Q

swelling i the testicular region
swelling not tense
transilluminate
next step?

A

Defer surgery for 1 yr
Hydrocoele - dx

294
Q

pain in lateral epicondyle
difficulty in flexing the wrist
what is next?

A

Inj Corticosteroids

295
Q

post appendectomy 3 years ago
dyspareunia

A

Pelvic Adhesions

296
Q

Patient stable on Clonzapine BMI 41
What is next

A

Aripiprazole

297
Q

Eosinophilia means

A

New growth for parasites

298
Q

A

Preg 6 wk with intense itching what is advice

A

HCC post partum screen

299
Q

tx for atropic vagina

A

Estrogen Cream

300
Q

Tx for meningcoccal meningitis
antibiotic of choice for 5 yo

A

Ceftriaxone

301
Q

What drug to stop in hyponatremia

A

HCThiazide

302
Q

Upper abdominal pain + worse after eating and at night

A

GERD

303
Q

What is the physical examination finding of Polycythemia vera

A

Splenomegaly

304
Q

What is the most common cause of death in peole with Polycythemia vera

A

Thrombosis

305
Q

Diplopia + arthralgia + hematuria + hemoptysis + HT

A

Good pasture Disease

306
Q

White band ring
floater increasing

A

Vitreous hemorrhage

307
Q

For Asthma,
spo2> 92
What to give?

A

Steroids

308
Q

For Asthma,
if spo2 <92
What to give?

A

Ipratropium then steroids

309
Q

What is the treatment for Lichen Sclerosis

A

Clobetasol

310
Q

bilateral mastalgia and bilateral nipple discharge with greenish yellow staining

A

Mammary duct ectasia

311
Q

pregnancy and itching

A

Cholestasis

312
Q

confused and restless after day 2 abdmonail surgery and hiatus hernial repair

A

Electrolyte imbalance

313
Q

Diabetic foot ulcer treatment

A

toileting the wound

314
Q

protreinuria, hematuria,
2 days of sore throat
(1-4days)

A

IgA Nephropathy

315
Q

protreinuria, hematuria,
2 wks of sore throat
(1-2 wks)

A

PSGN

316
Q

Basilar skull nfracture
Racoon eyes, CSF leaking
What to do next?

A

Oral Gatric tube

317
Q

Fertility

A

Sulfasalazine

318
Q

Body pain
Test are all normal
tx?

A

Amitriptyllline

319
Q

post op day 5
painless distention of abdomen
rectal examination unremarkable
Small bowel distentoon
nxt?

A

NG tube and decompression

320
Q

Joint pain
tenosynovitis
swollen joints
vesicular eruptions in arms

A

Gonococcal athritis

321
Q

erectile dysfunction
enlarged tongue
widening of joint spaces, low testosterone and hyperglycemia
What is the diagnosis?

A

Acromegaly

322
Q

intense photophobia, painful red eye but pupils reacting normally what is the diagnosis
?

A

Keratitis

323
Q

flattened deltoid

A

Ac dislocation

324
Q

2 yo, blood in stools, abdominal pain

A

Meckel’s diverticulum

325
Q

premature ejaculation but no problem with erection

A

SSRI

326
Q

edema and pain in the lower extremity
loss of pulse
diuplex of the leg is negative
what is next?

A

CT angio

327
Q

multiple, dilated loops of small bowel
post cholecystectomy
site of anatomic obstruction?

A

Jejunum

328
Q

HUntington disease chances of offspring to get the disease

A

50%

329
Q

Site of reflux in GERD and location of hiatal hernias
Transposition point between stratified swquamous and columnar

A

Gastroesophageal junction

330
Q

distal portion of the stomach
site of the hypertrophic pyloric stenosis
obstruction leads to the gastric outlet obstruction

A

Gastric antrum / pylorus

331
Q

Site of small bowel obstruction
prior abdominal surgery

A

Duoedenum / jejunum/ ileum

332
Q

Transition between small bowel and large bowl
site of intussusception and gallstone ileus

A

Ileocecal junction

333
Q

Watershed blood supply
Splenic flexure : SMA (artery of Drummond) and IMA (left colic supply)
Rectosigmoid junction: IMA (sigmoid and internal iliac (superior rectal) supply

A

Splenic flexure and Rectosigmoid junction

334
Q

older males
acquired weakness of transversalis fascia
within the hesselbachs triangle (medial to inferior epigastric vessels)

A

Direct Inguinal Hernia

335
Q

young males
incomplete obliteration of processus vaginalis
lateral to inferior epigastric vessels through deep and superficial inguinal ring

A

Indirect Inguinal Hernia

336
Q

Highest risk of incarceration

A

Femoral Hernia

337
Q

AST 500 U/L , ALT 510 U/L
positive smooth muscle antibodies

A

Autoimmune hepatitis

338
Q

elevated alkaline phosphatase
anti-mitochondrial antibody

A

Primary Biliary Cholangitis
(IgM)
- middle aged women

339
Q

p-ANCA antibody
asso with ulcerative colitis “onion-skin

appearance of bile ducts, beads on a string

A

Primary Sclerosing cholangitis

340
Q

RUQ pain, fever, jaundice
gallstone obstructing common bile duct
history of cholelithiasis

A

Acute Cholangitis

341
Q

CAG repeat

A

Huntingtons disease

342
Q

weakness in facial muscle, frontalis having swallowing difficulties coughs when he tries to drink water

A

Bell’s Palsy

343
Q

Postpartum mother with heavy vaginal bleeding

A

Amoxicillin

344
Q

10 month, rep distress, exp and insp wheezing, intercostal recession

A

Nasopharyngeal swab

345
Q

sign of intestinal ischaemia

A

A fib

346
Q

Patient wsith subarachnoid what willl you add for long term management

A

Nimodipine

347
Q

Boy with head trauma playing foot ball fainted for some seconds, became drosy and unconscious

A

CT Scan

348
Q

feels detached from the environment

A

Take collateral history from relatives who have seen her

349
Q

PCOS scenario what to expect in the lab

A

High free androgen index or free testosterone

350
Q

patient had MI and is on aspiring for 10 years and doppler shows 60% stenosis in both sides in the Right and Left carotids
What’s next?

A

Endarterectomy

351
Q

back pain
labs raised ALP 500
cause?

A

Paget’s disease

352
Q

vertigo, nausea, nystagmus and ataxia with no hearing impairment
diagnosis?

A

Vestibular neuritis

353
Q

swelling 2cm in non tender below the inguinal ligament medial to the femoral artery
pain increases upon internal rotation and hyperflexion of the hip.
cause of the pain?

A

Femoral Hernia

354
Q

left sided chest pain, no spine tenderness, no skin changes but pain on upon trunk rotation and numbness over the bilateral lower limbs and ankle reflex loss

A

Anterior Cord compression

355
Q

hypertensive medication that should be avoided in bilateral renal artery stenosis and is useful in diabetic patients

A

ACE inhibitors

356
Q

Hypertensive medication that can treat nephrogenic diabetes insipidus, icreases lithium concentrations
side effects: gout, hypercalcemia, hyponatremia
Inhibits the Na/Cl cotransporter in DCT

A

Thiazide Diuretics

357
Q

Inhinits calcium channels in vascular amooth muscle
helpful in treating Raynaud syndrome
causing orthostasis and lower extremity edema

A

Dihydropyridine calcium Channel blockers

358
Q

blocks AT11 receptor
side effects: hyperkalemia and Acute kidney injury
its avoids the ACEI cough

A

Angiotensin II receptor blockers

359
Q

Man eating in restaurant and has severe allergy involving SOB, resp distress
tx?

A

Adrenaline

360
Q

prebious cs secondary to obstructed labout came with labor pains at term, at 2nd stage loss 1.5 L of blood, abdomen soft and tender

A

Uterine Aton

361
Q

Abdominal pain.irregular pulse
next?

A

Xray followed by CT
- Mesenteric Ischemia

362
Q

slow growing persistent red scaly patch on areas of skin exposed to the sun

A

Bowen disease

363
Q

Patient has dysmenorrhea, no improvement with NSAIDs and COCPS

A

USG then Laparoscopy

364
Q

history of back pain, renal involvement, increased calcium and increased phosphorus
What is the next inv?

A

Serum electrophoresis

365
Q

female with hair loss, alopecia, rash and pancytopenia and thrombosis present, which antibody to order?

A

Anti Cardiolipin

366
Q

enlarged testis, transillumination test is negative
What is the next step?

A

USG of the testis

367
Q

male patient with history of travel comes with a long pain and fever and jauncie. fluid given
stones in the gallbladder and ducts
Next immediate management?

A

Endoscopic decompression of the Bile ducts

368
Q

48 female mother had breast cancer at 60, father had colon cancer at 70, brother is diabetic
what to order?

A

FBS is correct

369
Q

RTA (major) + internal bleeding + INR (INR < 5 patient is quite stable)
+ Vital BP 80’60
+ mgt?

A

Stop Warfarin and give FFP and Do immediate surgery

370
Q

rape victim is irritable and have flashbacks
Dx?

A

PTSD

371
Q
A
372
Q

How would calculi in gallbladder look on USG

A

Single FIlling defect

373
Q

female patient hsuband dies a year ago, she develops insomina, tiredness , weight loss and irritability for the last 3 months
Dx?

A

Pathological Grief

374
Q

Patient is given with sertraline
pain in abdomen, psychotic symptoms improves what to do?

A

Decrease the dose

375
Q

Alcoholic patient third day post op, confused and agitated
What to do

A

Haloperidol IM

376
Q

child 5 months weaned from breast milk to cows milk presents with altered bowel habits
what is the cause?

A

Cow milk protein allergy

377
Q

45yo f, colonoscopy and endoscopy normal, blood transfusion is required 2 units per day to maintain Hb of 9 gm/ dl
What will you do?

A

Capsule Endoscopy

378
Q

Pt accidentally taken Warfarin and now INR - 7 what to do next?

A

Cease Warfarin

379
Q

Molluscum contagiousum
Advice?

A

Avoid taking bath

380
Q

pain, tenderness to palpation to malleoulus
intolerance to weight bearing

A

Xray

381
Q

transillumination test, upper pole discomfort with compressible mass
Dx?

A

Inguinal Hernia

382
Q

PSA > 20, Irregular DRE, bone metastasis and back pain
What is the treatment to be given?

A

Radiotherapy - EBRT

383
Q

A mom has a kid 2 yrs with pertussis and has a 2 wk old baby. they are against vaccination
What you will do?

A

Isolate the baby at home

383
Q

Pt with COPD, had recurrent admission, most impt to reduce the recurrence of hospitalization?

A

Long term use of O2 at home

384
Q

Indication for an operation in a lady with neck swelling that becomes larger and has bleeding from it

A

Dysphagia

385
Q

A lady with swelling looks like parotid swelling. What is the investigation needed?

A

Ultrasound

386
Q

A lady with greenish discharge from the breast
next inv?

A

Breast ultrasound

387
Q

A man with prostate cancer and back pain
Lumbosacral xray shown
What is the best therapy to improve the pain?

A

Androgen Deprivation Therapy

388
Q

cause of pneumonia in a 1 year old

A

RSV

389
Q

starting dose of Allopurinol

A

50mg

390
Q

PCOS scenario
What is the cancer that you need to check?

A

Endometrial cancer

391
Q

claudication pain while sleeping , history of ACS
tips to toes pain

A

Peripheral Artery Disease

392
Q

Fundsocopy given blood clot bigger than 7 figure as in mirror
Central visual loss and straight lines wavy
initial Investigation?

A

Amsler Grid

393
Q

10 mm nodular lesion on the cheek
been present for the past 12 months and now started increasing
Management???

A

Excision

394
Q

3 yo milestone

A

copy circle

395
Q

Diminished breath sound / tracheal deviation
dullness on percussion
What next?

A

Large bore Chest Tube

396
Q
A

Chings Notes (39 decks)

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