JAN

Question 1

Pedia + sever dehydration + fluid type?

Answer 1

RL

High electrolye

Question 2

Fever >5d+ conjunctivitis + lymphadenopathy + strawberry tongue + dx?

Answer 2

Kawasaki

Question 3

Sx of meningitis + low glucose + high protein + polymorph cell + type of infection?

Answer 3

Bacterial

Question 4

1st line tx of anal fissure:

Answer 4

Conservative (sitz bath, diet, topical analgesia & vasodilator, stool softner) —> >8wks —> rule out ibd & start surgical

Question 5

Pregnant + SLE + IUGR + expected amniotic fluid status?

Answer 5

Oligohydraminos

Question 6

65 yr + smoker + screening test?

Answer 6

AAA.

Screening between 65-74

Question 7

34 wks pregnant + mild placenta abruption + bleeding stopped + nxt?

Answer 7

Discharge home and f/u as high risk pregnancy w/US.

“34-36+6 you have two option, if severe then admit to the hospital & consider delivery, if mild then go expectant”

Question 8

K/c of primary hyperparathyroidism + did surgery to remove glands + then came w/signs of hyperparathyroidism again, cause?

Answer 8

Missed adenoma.

“<6m this is missed, >6m is a new adrnoma”

Question 9

34wk + PPROM + no contractions/cervical dilation, nxt?

Answer 9

Antibiotics.

She’s already 34 & lung has matured, no need for steroids. Instead give heR GBS prophylaxis

Question 10

Breastfeeding + hot, tender, <5cm mass in breast, mx?

Answer 10

Choose between aspiration or incision and drainage.

• aspiration: small and intact overlying skin
• i&d: large w/nectotic skin.

Breast abscess is a complication of mastitis, so you consider AB therapy.

Question 11

Vaccine:

• steroid <2wks:
• steroid >2wks:
• chemotherapy:
• biologics:
• PRBC:
• FFP:

Answer 11

• all vaccine
• live defer 1m
• live 3m
• live 6m
• live 6m
• live 7m.

Question 12

HIV + toxoplasmosis, mx?

Answer 12

Pyrimethamine & Sulfadiazine

“Toxoplasmosis is caused by cat, she says purrrr - the cat in tweety is sylvester”

Question 13

Baby laugh + stranger anxiety, age?

Answer 13

Baby start laughing at 4m, but develop stranger anxiety at 6m. Baby is 6m old

Question 14

High LH+FSH + inability to conceive + amenorrhea for 6m

Answer 14

Premature ovarian failure

Question 15

Differentiate between sirs, sepsis, severe sepsis, and septic shock:

Answer 15

• SIRS: 2 of 4 criteria
• Sepsis: 2 of 4 + suspected infection
• sever: 2 of 4 + organ dysfunction
• shock: sepsis + hypotension + vasopressor need to keep MAP>65 + lactate>2 despite fluid.

Criteria:

Temperature: > 38°C or < 36°C
Heart rate: > 90/min
Respiratory rate: > 20/min or PaCO2 < 32 mm Hg
White blood cell count: > 12,000/mm3, < 4000/mm3, and/or > 10% band cells

Question 16

Warm extremity in shock is a sign of

Answer 16

Disterbutive shock (anaphylactic, septic, neurogenic)

Question 17

Male + gynecomastia tanner 5 + nxt?

Answer 17

Endocrine& thyroid test

Question 18

3rd degree burn +1% gentalia, nxt?

Answer 18

Admit to burn unit.

Major burn: areas (face, genetala, feet, hand) - 10% full thickness - 25% partial

Question 19

1st Investigation for midline swelling in the neck

Answer 19

TSH

Question 20

Pedunculate leison in colonscopy + 1.3cm tubular adenoma, screening?

Answer 20

After 3 years.

This is advanced adenoma (> or eq to10)

Question 21

Vitamin b12 absorbed where?

Answer 21

Terminal ileum along with bile salt

Question 22

Vascular leison in pedia cheeks l

Answer 22

Hemangioma

Question 23

Pt with asthma + Test after which FEV1 reduced by >20, diagnostic test?

Answer 23

Methacoline challenge test.

If spirometry is in the choices go for it

Question 24

Most significant RF for breast Ca

Answer 24

Non modifiable risk factors like gender (female) & age

Question 25

Pedia + non billous + projuctile vomitting + olive pylorus + No diarrhea, mx

Answer 25

Initial is electrolyte repletion, treatment of choice is pylomyotomy

Question 26

Pedia + bilateral inguinal hernia, MX

Answer 26

Lap herniotomy

Question 27

Arm in adduction, and internal rotation, dx?

Answer 27

Posterior shoulder dislocation

Question 28

Dysphagia to solid & liquid + diagnosed w/achalasia. Mx?

Answer 28

Balloon inflation followed by heller myotomy

Question 29

Mc common complication after petussis infection is

Answer 29

Pneumonia