Mid Rotation EMQ

Question 1

Select the most appropriate next investigation:

45 year old carpenter presents with a 2 month history of pain and tenderness over the lateral aspect of his L elbow, with no precipitating acute injury.

Answer 1

2/3 chance or correct

U/S of shoulder

Question 2

Select the most appropriate next investigation:

58 year old woman presents with a 4 month history of pain and paraesthesia in the lateral half of her R hand, worse at night

Answer 2

2/3 chance or correct

Nerve conduction study

Question 3

Select the most appropriate next investigation:

68 year old woman presents with 1 week history of constant, severe pain in the lateral aspect of her L shoulder and upper arm with no precipitating acute injury. There are signs of C5 sensory nerve dysfunction on initial examination

Answer 3

2/3 chance or correct

Plain x-ray and CT of cervical spine

Question 4

Select the most appropriate therapy for a patient presenting with contraception needs in general practice

Anna has just given birth 2 months back and is breast feeding. She plans to continue breast feeding for the next 6 months. What method of contraception would you advise?

Answer 4

Progesterone only pill (Minipill)

Question 5

Select the most appropriate therapy for a patient presenting with contraception needs in general practice

Liza is a 24 year old lady, who has recently got into a relationship. She does not know much details of her partners past. She comes to you for advice as she does not want to get pregnant.

Answer 5

Barrier methods - condom

Question 6

Select the most appropriate therapy for a patient presenting with contraception needs in general practice

Aishah is 40 years old and has 3 children. For the past 6 months she has been experiencing menorrhagia with intermenstrual bleeding. Pap smears has been normal for the past 3 years and the hysteroscopy (plus D and C) done was normal. What would you recommend as the treating Doctor?

Answer 6

Mirena - IUD with progesterone

Question 7

Select the most appropriate therapy for a patient presenting with contraception needs in general practice

Alice comes to your practice worried as the condom that her partner had used ruptured. She comes to see you after 10 hours of the incident and is worried that she may get pregnant. What would be the best contraceptive advice for her?

Answer 7

High dose Levonogesterol (1.5g)

Question 8

Select the most appropriate therapy for a patient presenting with contraception needs in general practice

Nina who is 28 years old has mild intellectual disability. She has just got into a relationship. She manages to go about her daily activities with no problems. However she has problems in memory and is rather forgetful. Her Mother is worried and has come for advice from you, on the best option for her.

Answer 8

Depo-provera injections

Question 9

Choose the most appropriate diagnosis for a patient presenting with these symptoms in general practice

Angela is 5 years old who attends pre school. Her mother is worried as her daughter has been having low grade fever past 2 days with ulcers in the oral cavity. She has maculo papular rash over both the hands and feet.

Answer 9

4/5 chance of being correct

Hand, foot and mouth disease

Question 10

Choose the most appropriate diagnosis for a patient presenting with these symptoms in general practice

Jane 16 years old presented with 3 days of flu like symptoms. Then she noted rash presenting in crops, first on the upper limbs, body and then the lower limbs. This is associated with itchiness

Answer 10

4/5 chance of being correct

Varicella zoster

Question 11

Choose the most appropriate diagnosis for a patient presenting with these symptoms in general practice

Ali presented with moderate grade fever of 38C for two days. This was asociated with headache and retro orbital pain. He also gave history generalised myalgia and severe bodyache. Once the fever subsided, he started developing a rash all over the body.

Answer 11

4/5 chance of being correct

Dengue

Question 12

Choose the most appropriate diagnosis for a patient presenting with these symptoms in general practice

Sarah 48 years old, an ex intravenous drug user (IVDU). She presents with history of jaundice, abdominal pain, nausea & vomiting. She has been advised on further investigations on Viral load and a liver biopsy

Answer 12

4/5 chance of being correct

Hepatitis C

Question 13

Choose the most appropriate diagnosis for a patient presenting with these symptoms in general practice

John is 8 years old presented with pain over cheeks, earache & drooling of saliva. He also complains pain on taking sour food. His temperature is around 38C

Answer 13

4/5 chance of being correct

Infectious mononucleosis

Question 14

Choose the appropriate diagnosis:

John is a 3 year old boy who presents with fever and sore throat for a day and rapidly deteriorates when his mother brings him to the emergency department. He is toxic looking with drooling of saliva and stridor. His neck is hyperextended. Neck Xray done shows a “thumb sign”.

Answer 14

3/5 chance of being right

Epiglottitis

Question 15

Choose the appropriate diagnosis:

Jane , 20 years old presents with severe sore throat. Her voice is rather muffled. She has trismus and drooling of saliva. On examination of the oral cavity a bulge is noted above the Right tonsil and uvula is pushed to the left. There are enlarged cervical lymph nodes.

Answer 15

3/5 chance of being right

Pharyngeal abscess

Question 16

Choose the appropriate diagnosis:

A two year old boy was seen eating candy while playing. There was sudden onset of choking and wheezing. He had a weak cough, weak cry and appeared to drool. He has no history of any respiratory problem prior to this. On examination of oral caity no foreign body was noted. Examination of lungs showed decrease air entry on right side.

Answer 16

3/5 chance of being right

Airway obstruction (foreign body)

Question 17

Choose the appropriate diagnosis:

Jonathan is a 5 year old boy who presented with history of fever and flu like symptoms for 3 days. Today his cough is getting worse and his mother describes it as a “barking” like cough. He has developed stridor. On examination there is chest retraction and decreased breath sound with wheeze.

Answer 17

3/5 chance of being right

Croup

Question 18

Choose the appropriate diagnosis:

Ahmed works in a farm. He had injured himself while harvesting and sustained a laceration wound over the right upper limb about 7 days back. He had treated the wound himself with some antiseptic. His family brings him to the hospital as he has been having headaches, neck stiffness, muscle spasms, excessive sweating and drooling. He also has dysphagia and is very irritable. He is febrile.

Answer 18

3/5 chance of being right

Meningitis

Question 19

Choose the most appropriate management:

Nina presented with one week history of pain over her the left lower 1st molar. Today she presented with neck swelling, trismus, odynophagia and drooling. On examination, her dental hygiene is poor and the floor of the mouth is raised. There is some trismus and the first lower left molar is decayed with surrounding gingivial infection. There is no stridor at present. What would be your management?

Answer 19

1

Question 20

Choose the most appropriate management:

Mary had developed sudden shortness of breath and wheals all over her body after being bitten by a wasp half an hour back. She also presents with stridor and has bilateral periorbital oedema. How would you treat her?

Answer 20

1

Question 21

Choose the most appropriate management:

Ali gives history of mild dysuria & uretheral discharge after having casual unprotected intercourse 3 days back. What would be the best choice for him?

Answer 21

1

Question 22

Choose the most appropriate management:

Jason 8 years old was accidentally bitten by his pet dog over the hand while playing. The dog has all the scheduled vaccinations and stays at home. On examination there is a small superficial laceration wound with no active bleed over the dosrsum of the left hand. What would be your advice?

Answer 22

1