Whatsapp Recalls

Question 1

A patient with wegner’s granulomatosis is on Aziothioprine and steroids. He has now productive cough and dyspnoea.Dx?

A) Pneumocystitis Pneumonia
B) Atypical Pneumonia
C) reoccurance of Wegner
D) Lobar pneumia

Answer 1

A) Pneumocystitis Pneumonia is a possible diagnosis in this scenario since the patient with Wegener’s granulomatosis is on Azathioprine and steroids, which are immunosuppressive medications that can increase the patient’s risk of developing an opportunistic infection like pneumocystis pneumonia. The patient’s symptoms of a productive cough and dyspnea also suggest a respiratory tract infection. Therefore, option A is the most likely diagnosis in this case.

Question 2

man comes to the emergency department with chest pain for the last hour that is crushing in quality and does not change with respiration or the position of his body. An EKG shows ST segment depression in leads V2 to V4. Aspirin has been given. What is the most appropriate next step in the management of this patient?
a. Low molecular-weight heparin
b. Thrombolytics
c. Glycoprotein lib/lila inhibitor (abciximab)
d. Nitroglycerin
e. Morphine
f. Angioplasty
g. Metoprolol

Answer 2

The most appropriate next step in the management of this patient would be f. Angioplasty. The patient’s symptoms, EKG findings, and risk factors are highly suggestive of an acute coronary syndrome. Angioplasty is the most effective treatment for an acute coronary syndrome and should be performed as soon as possible to restore blood flow to the affected area of the heart. Low molecular-weight heparin, thrombolytics, and glycoprotein lib/lila inhibitors are also used in the management of acute coronary syndrome, but angioplasty is the most effective treatment. Nitroglycerin and morphine can be used to relieve chest pain but do not treat the underlying cause of the pain. Metoprolol may be used as part of the management of acute coronary syndrome, but it is not the most appropriate next step given the patient’s presentation.

Question 3

5 year old boy had an episode of crampy abdominal pain and large bloody stool self limiting. Cause?
A. Meckels diverticulitis
B. Duodenal ulcer
C. Colon polyp
D.Intessucception

Answer 3

The most likely cause of the episode of crampy abdominal pain and large bloody stool in a 5-year-old boy is D. Intussusception. Intussusception is a condition that occurs when one segment of the intestine slides inside another, causing obstruction of the bowel, crampy abdominal pain, and bloody stool. It is more common in children between the ages of 3 months and 5 years and is typically self-limiting and resolves on its own.

Meckel’s diverticulitis, duodenal ulcer, and colon polyp are less likely to cause these symptoms in a 5-year-old child. Meckel’s diverticulitis is a condition that occurs when a pouch in the wall of the small intestine becomes inflamed and can cause crampy abdominal pain and rectal bleeding. However, it is a rare condition and is typically diagnosed in older children and adults. Duodenal ulcers and colon polyps are also uncommon in young children and are more commonly seen in adults.

Question 4

How will u determine worse prognosis of Laparaoscop8c appendicectomy?
A)By virtue of retrocecal peritonitis
B)By virtue of being Pelvic
C)By virtue of increasedfecolith

Question 5

A 60 yr old man present to your office for followup of prostate biopsy. Gleason score is 8 T3a (extracapsular extension to both sides) and recent PSA is 20 ng/ml. WOF is the most appropriate treatment?
A)Radical prostatectomy plus EBRT and androgen deprivation
B)Partial prostatectomy
C)Both a n b
D)Active surveillance
E)Androgen deprivationtherapy

Answer 5

The most appropriate treatment for a 60-year-old man with Gleason score 8 T3a (extracapsular extension to both sides) and recent PSA of 20 ng/ml would be A) Radical prostatectomy plus EBRT and androgen deprivation.

This is because the high Gleason score and extracapsular extension indicate an aggressive type of prostate cancer with a higher risk of recurrence and progression. The PSA level is also elevated, which further suggests an aggressive cancer that requires prompt treatment.

Radical prostatectomy (complete removal of the prostate gland) along with external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT) is the standard treatment for locally advanced or high-risk prostate cancer. This approach aims to remove the cancerous tissue while also targeting any remaining cancer cells with radiation therapy. ADT is used to lower the level of male hormones (androgens) that can stimulate the growth of prostate cancer cells.

Partial prostatectomy is not appropriate in this case because the cancer has already spread outside of the prostate gland. Active surveillance would also not be suitable as the cancer is high-risk and requires active treatment. Androgen deprivation therapy alone is not sufficient for locally advanced prostate cancer and is often used in combination with other treatments such as surgery and radiation therapy.

Question 6

9 year kid , after running wheeze. Never diagnosed asthma. What to give?
A)Oral montelukast
B)Budesonide
C)Inhaled fluticasone
D)Salbutamol

Answer 6

If a 9-year-old child presents with wheezing after running but has no prior asthma diagnosis, the first-line treatment would be D) Salbutamol (a type of short-acting bronchodilator).

Salbutamol is a type of beta-agonist medication that can help relax the muscles in the airways and alleviate breathing difficulties associated with wheezing. It is typically administered using an inhaler, and the dose will depend on the child’s age, weight, and severity of symptoms.

Oral montelukast (A) and inhaled corticosteroids such as budesonide (B) and fluticasone (C) are not typically used as first-line treatments for acute wheezing. Oral montelukast may be used as an add-on therapy for persistent asthma, but it is not typically used for immediate relief of symptoms. Inhaled corticosteroids are also not typically used as a first-line treatment for acute asthma symptoms but are used for long-term control of asthma and prevention of exacerbations.

It is recommended that the child be evaluated by a healthcare provider to confirm the diagnosis and determine appropriate treatment options beyond the acute wheezing episode.
They’re asking for immediate or maintenance? If immediate then salbutamol inhaler. If maintenance then oralmontelukast

Question 7

Xray showed fracture of C2-C3 . Pt has resp distress .Best management?
A)Endotracheal intubation with collar
B)Tracheostomy
C)Cricothyroidotomy

Answer 7

If a patient has a fracture of C2-C3 with respiratory distress, the best management would be A) Endotracheal intubation with collar.

The fracture of C2-C3 may be associated with spinal cord injury, which can cause paralysis or weakness of the respiratory muscles, leading to respiratory distress. The management goal is to provide immediate stabilization of the cervical spine and to support the patient’s airway and breathing.

Endotracheal intubation is a procedure where a tube is placed in the patient’s trachea to provide a secure airway. It is typically performed in the hospital setting and is performed by trained healthcare professionals. The cervical collar can be left in place, and the intubation can be done under manual inline stabilization to avoid further movement of the cervical spine. Once intubated, the patient can be mechanically ventilated and transported to a facility with appropriate management of the spinal cord injury.

Tracheostomy (B) and cricothyroidotomy (C) are invasive procedures that may be considered if endotracheal intubation is unsuccessful, or there is no access to advanced medical care. The decision to perform a tracheostomy or cricothyroidotomy should be made on a case-by-case basis taking into consideration the patient’s clinical status and available resources.

Question 8

What’s the rectal suction biopsyfor?

Answer 8

A rectal suction biopsy is a medical procedure that involves inserting a small hose into the rectum and using suction to collect a tissue sample from the inner lining of the rectum. The biopsy sample is then examined under a microscope to look for abnormalities in the rectal tissue.

A rectal suction biopsy is most commonly performed to diagnose Hirschsprung’s disease, a condition where the nerves that control the colon do not function correctly. This results in a blockage of the bowel, which can cause constipation, abdominal swelling, and other symptoms.

The procedure may also be used to diagnose other conditions that affect the rectum and colon, such as inflammatory bowel disease, infections, or cancer.

Overall, a rectal suction biopsy is a safe and relatively non-invasive procedure, and it can provide valuable information to help diagnose and treat various medical conditions affecting the rectum, colon, and bowel function.

Question 9

16. Man submitted 4m ago to vasectomy, >20 ejaculations, spermogram with non motile sperm. Conduct?
    A. Repeat after 50 ejaculations
    B. USG for spermatocole
    C. Repeat Next month
    D. Can have sex without worry for pregnancy
    E. Renal USG

Answer 9

D. Can have sex without worry for pregnancy

Question 10

17. Man 34 yo, urinary dribbling, straining and post void micturition. Physical exam normal, include RDE. What’s next?
    A. Urethoscopy
    B. Renal USG
    C. USG Rectal Biopsy

Answer 10

B. Renal USG

Question 11

Elderly man presents with malaria, endocopy and colonoscopy does not reveal any bleeding/ His vitals are stable at the moment, but he requires 2 units of blood daily to maintain a HB at 90. What is the best management?
A. Capsule Endoscopy
B. Catheter angio
C. CT angio
D. 85 tethnectium scan

Answer 11

A. Capsule Endoscopy

Question 12

18. An 18 yo girl comes with father with a 10wk pregnancy, she don’t want you to tell this to her father. She has right arjm fracture and not speaking in front of her father. What in history suggest physical abuse by father?
    A. Fracture of Right Arm
    B. Patient’s mood and affect
    C. The secret pregnancy
    D. History of previous hospitalizations

Answer 12

B. Patient’s mood and affect

Question 13

19. Which valvular disease is most commonly associated with the sudden death in younger patients?
    A. Aortic stenosis
    B. Mitral Stenosis
    C. IHSS Idiopathic Hypertrophic Subaortic Stenosis
    D. Tetralogy of Fallot
    E. Mitral Valve Prolapse

Answer 13

C. IHSS Idiopathic Hypertrophic Subaortic

Question 14

34 lady with amenorrhea, regular menses since age 12. Suction curettage for missed abortion, followed by IUD placement. Initial irregular and heavy bleeding. No menstrual perios in 6 months diagnosis?
A. Intrauterine Adhesions
B. Primary ovarian Insufficiency

Answer 14

A. Intrauterine Adhesions

Question 15

42 male ankylosing spondylosis, fell on the back, severe pain. History of duodenal ulcer. Vital signs normal with mild tachycardia. Midline tenderness over upper lumbar region, restricted spinal range of motion. What is the cause?
A. Disc herniation
B. Vertebral fracture

Answer 15

B. Vertebral fracture

Question 16

26 lady presented with thigh skin lesion appeared 3 weeks ago. No similar lesions in the past. Mild pruritus, no fever, chills or pain. Sexually active.
A. Liquid nitrogen
B. Punch biopsy
C. Topical Acyclovir

Answer 16

B. Punch biopsy

Question 17

. 28 Male with 6 month extreme nervousness, irritability, restlessness, muscle tension, beers on weekends. Reluctant for psychotherapy. What is the medication?

A. Bupropion
B. Venlafaxine

Answer 17

B. Venlafaxine

Question 18

34 female with progressive dyspnea, drowsiness, difficulty swallowing, choking, ciprofloxacin treatment. Reduced work hours, difficulty lifting books, absent Babinski reflex. What is the diagnosis?
A. Foodbourne Botulism
B. Myasthenic crisis
C. Polymyositis

Answer 18

A. Foodbourne Botulism

Question 19

25. 53 yo male with DM, has foot ulcer on sole of the foot and is allergic to Penicillin. What is the best management?
    A. Amoxicillin
    B. Co-amoxiclav
    C. Clindamycin
    C. X-ray
    E. MRI

Answer 19

C. Clindamycin

Question 20

A patient came to your practice because of sore throat. The nurse informed you that she hasn’t paid for the last three consultations. What should you do?
A. Ask the patient to go to the public hospital
B. Leave a prescription for Amoxicillin
C. Book her for the next available appointment
D. See her after she paid the previous bill
E. Refuse to see her

Answer 20

C. Book her for the next available appointment

Question 21

26. Elderly man taking oxycodone/ naloxone, added to amitriptyline he has been using for pain. Now patient presented with cramps of legs. What is the cause?
    A. SS – SS: hyperreflexia mydriasis increase in BS, TX Cyproheptadine
    B. NMS - SS hyporeflexia N pupils, TX IB Benxo, dantrolene Na, bromocriptine
    C. TXA toxicity

Answer 21

A. SS – Serotonin syndrome: This can occur when two drugs that affect the body’s level of serotonin are taken together at the same time. The syndrome can occur when the level of serotonin, a chemical in your brain, becomes too high. Symptoms can range from mild to severe and include high blood pressure, hyperthermia, and muscle rigidity. Amitriptyline and oxycodone can both increase serotonin levels, so their combined use may increase the risk of serotonin syndrome. It’s important to get medical care right away if you think you have symptoms of serotonin syndrome. Treatment often involves discontinuing the medication that caused the symptoms and, in severe cases, administering medication to block the effects of serotonin already circulating in your body.

Question 22

An old age lady came to new nursery house in last month and thinks the nurses put worms in her dish. She had the same problem before and received medication and got better but stopped the medication and now has the same symptoms again, Diagnosis?

A. MDD
B. Delirium
C. Brief psychotic disorder
D. Schizophrenia

Answer 22

C. Brief psychotic disorder

Question 23

A 27 yo woman is about to get discharged from the hospital where she was admitted 2 weeks ago due to a psychological breakdown. When you tell her about the discharge plan, she says, doctor you cannot discharge me. If you do, I will hurt myself and you will be responsible for that. Doctor Barkley knows me very well. Which one of the following best describes the underlying cause to her behaviour?

A. Narcissistic personality Disorder
B. Histrionic personality disorder
C. Borderline Personality Disorder
D. Factitious Disorder
E. Malingering

Answer 23

C. Borderline Personality Disorder

Question 24

67 female come for knee pain. Gradually increasing pain in Left knee worse with prolonged walking in the stairs Brief Morning stifness. Reduced flexion at Left knee. What is next? A. Hyaluronic Acid injection or B. Quadriceps strengthening exercises

Answer 24

B. Quadriceps strengthening exercises

Question 25

38 F wit advanced brest cancer, bone metastases. Routine ff up. Mild vague bone pain relieved by acetaminophen. moist mucous membranes? A. Biphosphonate therapy B. Loop diuretics

Answer 25

A. Bisphosphonate therapy

Question 26

75 gentleman severe back pain x 3 wks, worse past 12 h. Difficulty waking, urinatng. Hx of prostate cancer with radiation therapy. Tenderness over midline spine near T10-T11. Initial?A. Intravenous glucocorticoids B. Radiation to the spine C. Skeletal Survey

Answer 26

C. Skeletal Survey

Question 27

What is the most dangerous risk factor for CAD?A. Smoking B. LDL c. HDL D. Hypertension E. DM

Answer 27

A. Smoking

Question 28

34 m severe diarrhea. light headedness. Diarrhea for 14 days, malaise, fever, hypotension, tachycardia dry mucous membranes. brown stool, negative blood. Organism? A. C parvum or B Cytomegalo

Answer 28

A. Cryptosporidium parvum

Question 29

55 male with wound laparotomy with bowel resection,left nephrectomy/ Post op day 4, fever, tachypnea, SOB, lethargy. Crackles on the lung auscultation, well-healing abdominal wound. What is the tx if this is Pulmonary Embolism? A. Hemodialysis B. IV lactated ringers C. Iv Dopamine

Answer 29

B. IV lactated ringers

Question 30

27 female f/u for fibromyalgia, previously had musculoskeletal pain and fatigue, intermittent dizziness. Worsened lethargy, dry mouth. What is the cause MEds: Amitriptylline, Acetaminophen,Polyethylene glycol..

Answer 30

Amitriptylline

Question 31

27 female f/u for fibromyalgia, previously had musculoskeletal pain and fatigue, intermittent dizziness. Worsened lethargy, dry mouth. MEds: Amitriptylline, Acetaminophen,Polyethylene glycol.. What is the cause? A. Carotid sinus massage or B. orthostatic blood pressure

Answer 31

B. Orthostatic blood pressure

Question 32

Rotterdam criteria

Answer 32

1) Hyperandogenism
2) Insulin resistance
3) Menstrualirregularities

Question 33

26 female with worsening PCOS symptoms, abnormal uterine bleeding, lip/chin hair, pigmented plaques on neck/axilla. Small comedones on forehead. Which among the choices can lead to tumor? A. Body hair pattern B. Changes in voice C. Menstrual bleeding cycle?

Answer 33

B. Changes in voice

Question 34

Patient with hypertension, osteoarthritis. Missed last 2 appointments. Reports low energy, pain in knees/nack/hands. Weight gain, decreased ROM. Difficulty dieting, What is the response? I can understand why your wife is worried about your healtj. or B. It can be difficult to keep up with diet, exercise and medication on a daily basis

Answer 34

B. It can be difficult to keep up with diet, exercise and medication on a daily basis

Question 35

6 day old routine visit after birth. Exclusive breastfeeding adequate voiding / stooling. FUll term, spontaneous vaginal delivery. Normal temp, BP, pulse, resp. clear lungs. 2/6 holosystolic murmur at LLSB. Normal cardiac impulse and pulses.A. Obtain arterial gas or B. Perform ECG

Answer 35

B. Perform ECG

Question 36

Known DM case , previous pregnancy complicated with DM. 18 weeks .What to do next?
A)OGTT 50 g at 26 weeks
B)OGTT 75 g at 26 weeks
C)FBS now
D)FBS at 20 weeks

Answer 36

C) FBS now

Question 37

CT brain with huge left sided hemorrhage pt gradually reducing contagiousness,wife tell he doesn’t want to be bed redden and stop all the treatment ,son want to continue all ,no documented guidelines
tell wife it’s too early to stop management
stop all
get son’s consent for feeding jejunostomy
guardianshipcourt

Question 38

46 yr old lady came to gp for referral to a surgeon as she was diagnosed with cholelithisis and needs surgery. She wants to be referred to this particular surgeon who claims to do laparoscopic cholecystectomy with smaller keyhole incisions and he can do it very fast. But the GP knows that this surgeon’s patients have a high complication rate post surgery. What should GP do?

A. Refer patient to this surgeon as per her wishes
B. Suggest referring to another surgeon

Answer 38

B. Suggest referring to another surgeon

Question 39

36 yr old lady complains of dyspareunia and lower abdominal pain for past 2 years. On examination, there’s retroverted uterus, tenderness on palpating of bilteral adnexa but no mass felt, and a haemorrhagic lesion seen in the posterior fornix of the vagina. What’s the diagnosis?

A. PID
B. Endometriosis
C. Gartner duct cyst

Answer 39

B. Endometriosis

The symptoms presented such as dyspareunia, lower abdominal pain, a retroverted uterus, and presence of a haemorrhagic lesion in the posterior fornix strongly suggest endometriosis. This is a condition where tissue similar to the lining of the uterus grows outside the uterus causing pain, sometimes severe, especially during menstrual cycles. The disease can lead to complications like formation of scar tissue, adhesions and fertility problems if left untreated.

Question 40

Picture of pyogenic granuloma of on finger and occupation as sheep shearer

A. Pyogenic granuloma
B. Orf

Answer 40

B. Orf

Orf, or “ecthyma contagiosum”, is a viral infection caused by a Parapoxvirus. This virus is commonly found in sheep and goats and can infect humans through skin abrasions. Being a sheep shearer, the person may have gotten infected through direct contact with the animals. The infection typically presents with a pustular lesion or granuloma, often on the hands or fingers, which may initially resemble a pyogenic granuloma. The occupational history supports the diagnosis of Orf in this case. Please consult a healthcare professional for an accurate diagnosis.

Question 41

A 20 year old man presents to ED with a 5cm laceration on his thigh and is in a lot of pain. Doctor instructed nurse to give codeine. When Dr reassessed patient a while later, pt complains of pain. The nurse said she didn’t think the patient needed codeine, so she gave PCM instead. What should the doctor do next?

A. Discipline the nurse for her actions
B. Complete an incident report

Answer 41

B. Complete an incident report

Question 42

An old man c./o colicky abd pain which has become generalized now,o/e bowel sounds r
absent,on p/r reddish tinge on finger. MOST LIKELY

A.DIVERTICULOSIS
B.CA RECTUM
C.MESENTERIC ARTERY OCCLUSION

Answer 42

C. Mesenteric Artery Occlusion

Question 43

A person who have hyperkalemia 5.6 and has hyper notremia 148 and has a crotonin about 160 and has a calcium about 3.2. After iv Fluid resuscitation what should we do next?

Resonium
Pamidronate

Answer 43

Resonium

Question 44

26. Elderly man taking oxycodone/ naloxone, added to amitriptyline he has been using for pain. Now patient presented with cramps of legs. What is the cause?
    A. SS – SS: hyperreflexia mydriasis increase in BS, TX Ciproheptidine
    B. NMS - SS hyporeflexia N pupils, TX IB Benxo, dantrolene Na, bromocriptine
    C. TXA toxicity

Answer 44

A. SS – Serotonin syndrome: This can occur when two drugs that affect the body’s level of serotonin are taken together at the same time. The syndrome can occur when the level of serotonin, a chemical in your brain, becomes too high. Symptoms can range from mild to severe and include high blood pressure, hyperthermia, and muscle rigidity. Amitriptyline and oxycodone can both increase serotonin levels, so their combined use may increase the risk of serotonin syndrome. It’s important to get medical care right away if you think you have symptoms of serotonin syndrome. Treatment often involves discontinuing the medication that caused the symptoms and, in severe cases, administering medication to block the effects of serotonin already circulating in your body.

Question 45

A patient came to your practice because of sore throat. The nurse informed you that she hasn’t paid for the last three consultations. What should you do?
A. Ask the patient to go to the public hospital
B. Leave a prescription for Amoxicillin
C. Book her for the next available appointment
D. See her after she paid the previous bill
E. Refuse to see her

Answer 45

C. Book her for the next available appointment

Question 46

25. 53 yo male with DM, has foot ulcer on sole of the foot and is allergic to Penicillin. What is the best management?
    A. Amoxicillin
    B. Co-amoxiclav
    C. Clindamycin
    C. X-ray
    E. MRI

Answer 46

C. Clindamycin

Question 47

34 female with progressive dyspnea, drowsiness, difficulty swallowing, choking, ciprofloxacin treatment. Reduced work hours, difficulty lifting books, absent Bab. What is the diagnosis?
A. Foodbourne Botulism
B. Myasthenic crisis
C. Polymyositis

Answer 47

A. Foodbourne Botulism

Question 48

28 Male with 6 month extreme nervousness, irritability, restlessness, muscle tension, beers on weekends. Reluctant for psychotherapy. What is the medication?

A. Bupropion
B. Venlafaxine

Answer 48

B. Venlafaxine

Question 49

42 male ankylosing spondylosis, fell on the back, severe pain. History of duodenal ulcer. Vital signs normal with mild tachycardia. Midline tenderness over upper lumbar region, restricted spinal range of motion. What is the cause?
A. Disc herniation
B. Vertebral fracture

Answer 49

B. Vertebral fracture

Question 50

34 lady with amenorrhea, regular menses since age 12. Suction curettage for missed abortion, followed by IUD placement. Initial irregular and heavy bleeding. No menstrual perios in 6 months diagnosis?
A. Intrauterine Adhesions
B. Primary ovarian Insufficiency

Answer 50

A. Intrauterine Adhesions

Question 51

Man submitted 4m ago to vasectomy, >20 ejaculations, spermogram with non motile sperm. Conduct?
A. Repeat after 50 ejaculations
B. USG for spermatocole
C. Repeat Next month
D. Can have sex without worry for pregnancy
E. Renal USG

Answer 51

D. Can have sex without worry for pregnancy

Question 52

26 lady presented with thigh skin lesion appeared 3 weeks ago. No similar lesions in the past. Mild pruritus, no fever, chills or pain. Sexually active.
A. Liquid nitrogen
B. Punch biopsy
C. Topical Acyclovir

Answer 52

B. Punch biopsy

Question 53

34 lady with amenorrhea, regular menses since age 12. Suction curettage for missed abortion, followed by IUD placement. Initial irregular and heavy bleeding. No menstrual perios in 6 months diagnosis?
A. Intrauterine Adhesions
B. Primary ovarian Insufficiency

Answer 53

A. Intrauterine Adhesions

Question 54

Pancreatic cancer is associated with a poor prognosis because -
a- It is a rapidly growing tumour
b- It has usually spread beyond the pancreas at the time of presentation.
c- It seldom arises before the age of 70 years
d- It is associated with anorexia and weight loss tendering the patient unfit for surgery
e- the presence of jaundice indicates that the cancer is incurable

Answer 54

b- It has usually spread beyond the pancreas at the time of presentation.

Question 55

Elderly man presents with malaria, endocopy and colonoscopy does not reveal any bleeding/ His vitals are stable at the moment, but he requires 2 units of blood daily to maintain a HB at 90. What is the best management?A. Capsule Endoscopy
B. Catheter angio
C. CT angio
D. 85 tethnectium scan

Answer 55

A. Capsule Endoscopy

Question 56

Man 34 yo, urinary dribbling, straining and post void micturition. Physical exam normal, include RDE. What’s next?
A. Urethoscopy
B. Renal USG
C. USG Rectal Biopsy

Answer 56

B. Renal USG

Question 57

Which valvular disease is most commonly associated with the sudden death in younger patients?
A. Aortic stenosis
B. Mitral Stenosis
C. IHSS Idiopathic Hypertrophic Subaortic Stenosis
D. Tetralogy of Fallot
E. Mitral Valve Prolapse

Answer 57

C. IHSS Idiopathic Hypertrophic Subaortic Stenosis

Question 58

Lady travelled to Kenya, weight loss jaundice. Was taking doxycycline, increased liver enxymes, bilirubin. What is the diagnosis?A. Malaria B. Yellow fever C. Pancreatic cancer D. Ross river fever E. Choledocholithiasis

Answer 58

B. Yellow Fever

Question 59

A patient came to your practice because of sore throat. The nurse informed you that she hasn’t paid for the last three consultations. What should you do? A. Ask patient to go to public hospital B. Leave a prescription for amoxicillin C. Book her for the next available appointment D. See her after she paid the previous all D. Refuse to see her

Answer 59

C. Book her for the next available

Question 60

A 17 years old woman is a heavy drinker. She drinks a lot, about 14 standard drinks per week feeling drowsiness. She came for advice ?
a. stop alcohol completely
b. 2 days free alcohol/week
c. 2 standard/day
d. tell her its illegal to drinkinthisage

Answer 60

a. stop alcohol completely

Question 61

Known DM case , previous pregnancy complicated with DM. 18 weeks .What to do next?
A)OGTT 50 g at 26 weeks
B)OGTT 75 g at 26 weeks
C)FBS now
D)FBSat20weeks

Answer 61

C)FBS now

Question 62

weakness of dorsiflexion lateral rotation impaired inward movement reflexes ankle knee intact
a sciatic nerve
b tibial nerve
c c.p. nerve
d l4 involvement
e l5 involvement

Answer 62

e l5 involvement

Question 63

Dog phobia recall.Already showing pics of dogs and improving.what is the next ??
a.take dog out with boyfriend
b.listen to sound of dogs
c.Keep diary of dog sightings

Answer 63

b.listen to sound of dogs

Question 64

Greenstick fracture child came after 2wks. Imp indicator for healing?
A. Normal xray
B. Wide range of movement at wrist
C. No tenderness at wrist
D. No pain on straining

Answer 64

C. No tenderness at wrist

Question 65

A patient comes with history of stricturoplasty for Crohns disease. Six months ago he was started on warfarin after an episode of pulmonary embolism. Now presents with right iliac fossa tenderness. Rest of the examination is normal. (CT was given of full abdomen-wasn’t able to identify-thought it to be rectus sheath hemat)
What is your diagnosis?
A. Mesenteric adenitis
B. Rectus sheath haematoma I
C. Intestinal obstruction
D. Peritonitis

Answer 65

B. Rectus sheath haematoma

Question 66

What is the treatment?
1-miconozole
2-nystatin
3-chlorhexidine

Answer 66

3-chlorhexidine - 1st line for mouth ulcers

Question 67

Women on paroxetine well controlled on it since 2 yrs now wants to conceive but concerned about post partum depression due to previous pregnancy what advice you will give
A. Cease paroxtine
B. Cease paroxtine replace it with escitalopram
C. Use both paroxtine and escitlopram
D. Use escitlopram
E. No medication

Answer 67

B. Cease paroxtine replace it with escitalopram

Question 68

Arsenic posioning question.Definitive treatment asked-
A-iv charcoal
B-Iv saline
C-Succimer
D-Penicillin

Answer 68

C-Succimer

Question 69

Flecainide overdose.What is your next step in management?
A-adrenaline
B-ecg
c-charcoal
d-dont remember

Answer 69

B-ecg

Question 70

Abrupt discontinuation of amphetamines, especially after prolonged use, can lead to withdrawal symptoms. These symptoms can include fatigue, depression, and _________which is a decreased interest or pleasure in all, or almost all, activities one used to enjoy.

Answer 70

Anhedonia

Question 71

Old lady..schizophrenia diagnosed treated on anti psychotic..she is now in alzheimers old home..son has her power of attorney..she keeps packing hers stuff..she is constantly wants to go out. When asked why. She says I have to scale the fence..what is the most important instruction to give to nursing staff?

A. call son as he has power of attorney..
B. tell them to keep her busy with social activites…
C. keep her stuff back in her room
D. one option was of psychiatric review/change med/ or dose of anti psychotic

Answer 71

D. one option was of psychiatric review/change med/ or dose of anti psychotic

Question 72

Patient with CHF taking B-blocker , furosemide , perindopril , K supplement , Metformin for DM , started Amiodarone due to arrythmic problems , now complain of lightheadedness and palpitation & feeling like syncope. Potassium level was given about 6.5 and other lab values were within normal range

A.Metformin & amiodarone
B.Metformin & K supplement
C.Frusemide & Perindopril
D.Frusemide & Metformin
E. Amiodarone +Perindopril

Answer 72

E. Amiodarone +Perindopril

Amiodarone is an antiarrhythmic medication that can cause side effects such as lightheadedness, palpitations, and syncope
2
. Perindopril is an ACE inhibitor used to treat hypertension and heart failure, which can also cause hyperkalemia as a side effect
1
. Therefore, the combination of amiodarone and perindopril may contribute to the patient’s symptoms and elevated potassium level. It is important for the patient to consult with a healthcare provider or physician to evaluate the symptoms, assess the potential causes, and determine the appropriate management plan. Adjustments to the medication regimen may be necessary to address the symptoms and manage the elevated potassium level.

Question 73

A 68 years old man came for prescription for tamazepam. He says he has to take at least 3 temazepam to sleep. Otherwise she is unable to fall asleep without it. He feels anxious and has tremors during the day if he doesn’t use Temazepam. Whats the management?

a) prescribe tamazepam
b) switch to diazepam and wean
c) prescribe SSRI
d) prescribe mirtazapine

Answer 73

b) switch to diazepam and wean

Question 74

46 years female (premenopausal ) with lower abdominal pain in the past few hours. o/e adnexal mass is palpated. USG shows a uniocular cyst 10cm in diameter in right ovary. What is the diagnosis?

1- mucinous cystadenoma
2- serous cystadenoma
3- corpus leuteal cyst
4-teratoma
5epidermoid cyst

Answer 74

1- mucinous cystadenoma

Question 75

68 yr old female presenting with fatigue jaundice and abdominal pain for past few months. o/e tenderness over right upper quadrant and a mass felt. On usg examination no stone in gallbladder or bile duct. Bile duct 10mm dilated. What is the most appropriate next investigation?

1-ERCP
2- CT scan of abdomen
3-MRCP
4-laprotomy

Answer 75

3-MRCP

jaundice, abdominal pain, tenderness over the right upper quadrant, a palpable mass, and a dilated bile duct on ultrasound, it is highly likely that this is a case of biliary obstruction. Obstruction of the bile duct can be caused by various conditions, including tumors in the pancreas or bile ducts, strictures or narrowing of the ducts, or gallstones lodged in the biliary tract.

Question 76

8 year old male child brought by parents for the complaints of episodes of starring in space with lip smacking and limb movement (focal not generalized) for past few months. Episodes lasts 3-5 minutes and the child appears drowsy after wards. There are around 3 episodes per day for 2-3 days followed by absence of episodes for the next week. No history of trauma to head or vomiting. What is the most appropriate medication for this child?

1- sodium valproate
2- ethosuximide
3- lamotreigene
3- Levetiracetam

Answer 76

1- sodium valproate

Question 77

A man asking to ur clinic asking about travel precaution.He is going to Bali and what will u advice him?
A.Avoid piercing and tattooing
B.Avoid mosquito bite
C.take all the appropriate vaccines

Answer 77

B. Avoid mosquito bite

Question 78

80 year old women at a hospital, taking risperidone. she asked the stuff daily to open the back door coz she wants to measure the yard fence .The stuff have to collect her belongings to prevent her from leaving , her son has power of Attorney. What should you advise to the stuff? Exact scenario

a. Ask the staff to lock the back door ( exact )
b. Inform her son
c. Increase the dose of risperidone
d. Return her belongings
e-distract her with social activities

Answer 78

b. Inform her son

Question 79

30 year old male patient presenting to your GP clinic complained about having to sit next to a talkative patient in the waiting room. The talkative patient happened to be a schizophrenic patient. What will be your response to his complain?

1- acknowledge the patients concern
2- explain him that the talkative patient has schizophrenia and its part of the dis-ease
3- make separating waiting area for psychiatry and patients and other patient
4- bring the schizophrenic patient last at the end of the day so that he won’t dis-turb other patients

Answer 79

1- acknowledge the patients concern

Question 80

old patients with MI and stent 2months ago. Now he is on clopidogrel now falls and has a fracture of neck femur FBC and platelet morphology normal,INR-1.5, but has bruises on the body what should be done?
A. stop clopidogrel immediately and do surgery in 1 week if there is no stent
B .give platelet and do surgery now
c. do surgery now
d.Vitamin K and surgery
(no option for ffp)

Question 81

A 2 years old healthy child complains of frequent cough and wheeze not im-proved by antibiotics and inhalers.
Next investigation?

A. CXR
B. Serum electrolytes
C. Sweat chloride test
D. Skin prick test
E. Spirometry

Answer 81

E. Spirometry

Question 82

Mr. and Mrs. Smith have come to your clinic for pre- conception counseling. Mrs. Smith has a history of rheumatoid arthritis. His RA is well controlled on metho-trexate and hydroxychloroquine. They want to plan a child. Which of the follow-ing advises would be appropriate?

A. Stop both medications
B. Stop methotrexate and continue hydroxychloroquine
C. Stop hydroxychloroquine and continue methotrexate
D. Continue both medications and add folic acid Stop both drugs and start leflunomide

Answer 82

D. Continue both medications and add folic acid Stop both drugs and start leflunomide

Question 83

A child din’t pass meconium for the first 4 days (hirschprung scenarion)
Asking for next investigation.

A-Xray
B-CT
C-Ultrasound
D-Barium swallow

Answer 83

A-Xray

Question 84

In what situation not mandatory requirement to report to authority?

A.woman presenting with neck abrasion who admits of being assaulted by part-ner
B.sewage worker with leptospirosis
C. healthy driver dx epilepsy who needs job to support his family
D.A child crying all the time with bruises on back

Answer 84

C. healthy driver dx epilepsy who needs job to support his family

Question 85

what is the least Effect from lead poisoning

A. neurological abnormalities
B. Abdominal pain
C. Liver abnormalities???
D,,behavior problem

Answer 85

C. Liver abnormalities???

Question 86

A scenario of mesenteric ischemia , what most useful to confirm ur diagnosis beside CT ?

1-abd x ray
2- abd us
3- serum lactate
4-serum lipase

Answer 86

3- serum lactate

Question 87

45 year old soldier from Iraq has dry cough for 2 weeks. O/e his chest is clear. But he has a systolic murmur at the apex. A cxr is given I couldn’t see anything on it. Whats the diagnosis?

A) pTB
B) lung ca
C) sarcoidosis
D) pneumonia

Answer 87

C) sarcoidosis

Question 88

A 29-year old woman, 6 months previously had pleurisy, in the last 2 years mouth ulcers, now develops stiffness and oedema of the wrist and MCP joints; in the morning which disappears afterwards. The most likely cause?

a) Rheumatoid arthritis
b) Crohn’s disease
c) Ulcerative colitis
d) SLE
e) Dermatomyositis

Answer 88

a) Rheumatoid arthritis

Question 89

An 45 year old man with progressive abdominal distension and constipation for 5 days.What is the diagnosis?

1-diverticulosis
2-Cancer colon
3-Sigmoid volvolus
4-Crohn’s
5-ulcerative colitis

Answer 89

3-Sigmoid volvolus

Question 90

A 23-year-old who is 10 weeks pregnant is reviewed by the midwife at the booking visit. This is her first pregnancy and she is well apart from some sickness which is worse in the morning and a generalised pruritus. Bloods tests including the full blood count, hepatitis B, C and HIV serology are normal. A slight yellow tinge of her sclera is noticed and liver function tests are ordered:

Bilirubin 31 μmol/L
ALP-160 U/L
ALT-25 U/L
Albumin 34 g/L

What is the most likely diagnosis?
1-Gilbert’s syndrome
2-Gallstones
3-Acute fatty liver
4-Intrahepatic cholestasis of pregnancy
5-Primary biliary cirrhosis

Answer 90

4-Intrahepatic cholestasis of pregnancy

Question 91

Prisoner reluctant to give history. Non specific upper abdominal pain. Xray given (could not understand). Asking manament
a. Endoscopy
b. Laparotomy
c. Barium enema

Answer 91

a. Endoscopy

Question 92

Woman 30 years old comes to the clinic for screening of colon cancer. Family history of familial non polyposis colorectal cancer.
What to advice regarding screening?

A-Genetic screening
B-colonoscopy every 5 yrs
C-Fobt every 2 years
D-Fobt after 50 years

Answer 92

A-Genetic screening

Question 93

Pic showing mucous membrane of inner lower lip showing pin point lesions. 35 year old man with abdominal pain for 6 hours. (no features of bowel changes such as constipation is given) Associated with

a. Intussusception
b. Adhesive obstruction
c. Volvulus
d. CA caecum

Answer 93

a. Intussusception

Question 94

History of travel, headache , jaundice, RUQ pain, full blood count given
HB ↓
Platelet ↓
Liver Enzyme ↑

What is the diagnosis
a. dengue
b. Hep. A
c. Malaria
d. Other

Answer 94

b. Hep. A

Question 95

1) A 11-week pregnant lady’s CVS karyotyping report became as 46XY, what to do?

a. Reassure
b. Terminate
c. USS
d. Amniocentesis
e. Repeat CVS

Answer 95

d. Amniocentesis

Question 96

2) Neonate, systolic murmur at 3rd Left intercostal, fixed split, no cyanosis. Likely diagnosis?

a) TOF
b) ASD
c) VSD
d) PDA

Answer 96

b) ASD

Question 97

3) 16 years girl living with boyfriend, requesting contraception, said she knew about the contraception through internet?

a) Give OCP
b) Advice to bring the parents.
c) Inform child protection.
d) Decline the request.

Answer 97

a) Give OCP

Question 98

Neonate jaundice after birth, mother O positive. Cause?

a) Rh isoimmunization
b) ABO incompatibility
c) Immature liver
d) Hepatitis
e) Breast milk jaundice

Answer 98

b) ABO incompatibility

Question 99

Irregular cycles, LMP 3 months ago, came with severe vomiting to ED, after initial resuscitation, next step?

a) Antibiotics
b) USS
c) Beta HCG

Answer 99

c) Beta HCG

Question 100

PV spotting, POA 6 weeks, abdominal pain, vomiting, came to ED. What is the feature if present indicating escalation of management?

a) Abdominal tenderness
b) Shoulder tip pain
c) Guarding

Answer 100

b) Shoulder tip pain

Question 101

7) 16 yrs, 4 months duration of recurrent headache, vomiting, mother diagnosed with brain tumor at 60 yrs, uncle had aneurysm rupture, what is the appropriate management?

a) Follow up and observe.
b) MRI brain
c) CT brain
d) Reassure

Answer 101

b) MRI brain

Question 102

8) JMO, had a needle stick injury, patient is an IV drug user, JMO not sure about the vaccination?

a) Check hepatitis serology in 4 weeks.
b) HHIG
c) HHIG + Vaccine
d) Vaccine

Answer 102

c) HHIG + Vaccine

Question 103

Medical student had needle stick injury, vaccinated for Hep B, patient refusing to check status?

a) Apply to medical tribunal to check patient’s status
b) Discuss the benefits and risk of PEP
c) Check the serology later.
d) Give PEP

Answer 103

b) Discuss the benefits and risk of PEP

Question 104

10) History of MI, on aspirin, came for routine check-up, Examination normal, cholesterol 5.5, what is the appropriate action?

a) Start ACE
b) Add Clopidogrel
c) Add Simvastatin

Answer 104

c) Add Simvastatin

Question 105

11) Return from 6 days trip Thailand, fever, abdominal pain, headache. Likely diagnosis?

a) Malaria
b) Dengue
c) Hepatitis

Answer 105

a) Malaria

Question 106

12) Patient with dyspnoea, Hb 6, platelets 80, WCC normal MCV 110 (100) LFT normal, blood film tear drop cells. Which one will give the diagnosis?

a) Direct coombs
b) CT abdomen
c) Serum electrophoresis
d) USS
e) Bone marrow biopsy mylofibrosis

Answer 106

e) Bone marrow biopsy mylofibrosis

Question 107

13) Two Statistics questions, gave data, asked to calculate the prevalence and likelihood.

Answer 107

Prevalence can be calculated by dividing the number of existing cases by the total population.

Likelihood can be calculated using Bayes’ theorem, which involves prior probability, likelihood, and marginal likelihood.

Question 108

14) Motor vehicle accident,6 cm fracture and laceration in the leg, at ED after initial management, next important step?
a) X-ray —–
b) Antibiotics …
c) Wound debridement —
d) Tetanus toxoid—-

Answer 108

d) Tetanus toxoid—-

Question 109

15) Patient with abdominal pain, vomiting, BP normal, PR 102/min, X-ray of SBO features, after some hours of initial management, pain increased, PR 120/min, what next?

a) CT abdomen
b) USS
c) Surgical exploration
d) Nasogastric tube

Answer 109

a) CT abdomen

Question 110

16) Young patient, CVA left side, rashes, arthritis, (features of some autoimmune disease), CT brain infarction. Appropriate management

a) Immunosuppression
b) Anticoagulation lifelong
c) Anticoagulation lifelong + immunosuppression

Answer 110

c) Anticoagulation lifelong + immunosuppression

Question 111

17) 14-year-old, knee pain, difficult to walk, x-ray left slipped epiphysis. Appropriate management ?

a) Bed rest
b) Some kind of stabilization (forgot the name)
c) Pin

Answer 111

in situ screw fixation

Question 112

37 years, Amenorrhea, no other symptoms, Exam normal, had NVD last year, secondary PPH of 900ml due to retain cotyledon and had D&C. Reason for amenorrhea?

a) Pituitary necrosis
b) Intrauterine adhesions
c) Premature menopause

Answer 112

b) Intrauterine adhesions

Question 113

Patient with palpitation, ECG- absent p-wave, narrow QRS, irregular R-R interval.

a) VT
b) AVNRT
c) Atrial flutter with 2:1 block
d) AF

Answer 113

d) AF

Question 114

Term pregnancy, regular contractions, meconium-stained liquor, CTG BHR 110, BV 8, no deceleration, acceleration present, cervical dilatation 3 cm. What next?

a) Augment the labour
b) Em/CS
c) Continue CTG

Answer 114

c) Continue CTG

Question 115

47 years, acute back pain, radiating to legs, no numbness or focal neurological weakness. Apart from analgesics what other management?

a) X-ray
b) Bed rest and immobilization
c) Advise to mobilise

Answer 115

c) Advise to mobilise

Question 116

Middle-aged man brought by wife due to not talking to her or listening her, not eating and poor working and socialization with colleagues, staying alone in the room. What in the history help for diagnosis?

a) Childhood abuse
b) Substance use history
c) Frequently waking up from sleep

Answer 116

a) Childhood abuse

Question 117

After covid vaccine, recurrent global headache which is only partially responding to paracetamol. What investigation?

a) CT brain
b) Anti Platlet-4 antibodies

Answer 117

b) Anti Platlet-4 antibodies

Question 118

Xray of a child who swallowed the coin, coin is in the upper oesophagus, child has minimal symptoms.

a) Observation …. 24 hours,,, RACGP
b) Endoscopy … for batteries
c) Serial x-rays

Answer 118

a) Observation …. 24 hours,

Question 119

Pregnant lady with abdominal pain, breech presentation and placenta previa, CTG normal, vitals normal.

a) Induction of labour
b) Observation
c) Em/CS

Answer 119

b) Observation

Question 120

Patient presented with pain and swelling in the mandibular area, increase after meals. Investigation?

a) USS
b) Intraoral plain x-ray
c) ? some blood Ix

Answer 120

b) Intraoral plain x-ray

Question 121

Patient with pain and swelling in the parotid area, all Examination, vital normal. Mx?

a) Mouth hygiene
b) Incision and drainage
c) Sialagogue
d) Antibiotics

Answer 121

c) Sialagogue

Question 122

Patient tried diet management for one year but no use. BMI 32. No other issues.

a) Refer to dietician.
b) Graduated exercise program
c) Metformin
d) Bariatric surgery

Answer 122

a) Refer to dietician

Question 123

Mother with 12-year-old child requesting screening for familial hypercholesterolemia as her father recently diagnosed to have that and there are many other family members with premature heart diseases. Your action
,
a) Lipid profile
b) Screen the whole family
c) Screen the daughter
d) Say that daughter is not eligible now

Answer 123

a) Lipid profile

Question 124

50 years old found out that she was adopted and her biological mother had Huntington disease and requesting for screening.

a) Tell her disease is unlikely at this age
b) Refer to genetic counselling

Answer 124

b) Refer to genetic counselling

Question 125

Patient with history of alcoholism and smoking, acute abdomen, pain radiate to back, epigastric tenderness. What will likely to give the diagnosis?

a) CT abdomen
b) Serum lipase
c) USS

Answer 125

b) Serum lipase

Question 126

31) Patient with abdominal pain after taking Ibupofren for 4 weeks. Smoker, drink 2 class of wine per day. Fever, abdominal rigidity and guarding, PR 110/min. Diagnosis?

a) Acute pancreatitis
b) Acute cholecystitis
c) Peptic ulcer perforation

Answer 126

c) Peptic ulcer perforation

Question 127

34) Patient with haematuria, proteinuria, cough, haemoptysis, purpuric rashes, and diplopia. Diagnosis?

a) Wegener’s granulomatosis
b) Good pasture syndrome
c) IGA nephropathy
d) Renal cell carcinoma

Answer 127

a) Wegener’s granulomatosis

Question 128

Patient with painful left axillary lump of 1 cm. Recently had covid vaccine and having mild swelling and erythema on left arm. Had a history of breast cancer on right side 10 years ago. (Otherwise, normal findings). What is the diagnosis?

a) Hidradenitis suppurativa
b) Reactive lymphadenitis
c) Metastatic deposit
d) Lymphoma

Question 129

Mother came with child for vaccination, complains she has sleep disturbance due to frequent crying of baby and husband is not supportive at all. Despite this she is able to do work and interact with colleagues as usual.
a) Send a nurse to home for assessment.
b) Refer to marital relationship counsel
c) Sleep hygiene

Answer 129

c) Sleep hygiene

Question 130

Adult patient with features of meningitis, gram stain showed diplococci. What is the organism?

a) Neisseria meningitidis
b) Streptococcal pneumoniae
c) Haemophilus influenza
d) E coli

Answer 130

a) Neisseria meningitidis

Question 131

11A 2-year-old child with fever, rashes, neck stiffness and had an episode of tonic-clonic fit. What is the cause for fit?

a) Meningitis
b) Febrile convulsion
c) Enteroviral encephalitis
d) Brain tumor

Answer 131

a) Meningitis

Question 132

Patient with fever, headache, mild neck stiffness, (clinical findings within the range), LP and CSF findings – pressure – normal, protein normal, glucose normal, red cell +, WCC 100, culture negative. Management?

a) Cefotaxime IV
b) Penicillin IV
c) Gentamycin IV
d) Supportive/symptomatic management

Answer 132

d) Supportive/symptomatic management

Question 133

Patient with pain in the elbow and more when do extend against flexed wrist. Tenderness in the lateral epicondyle. (No comments about occupation). What is the appropriate management?

a) Antibiotics
b) Steroids
c) Immobilization

Answer 133

c) Immobilization

Question 134

A patient with pain and swelling in the calf. Leg is tender, warm, and CVS and RS findings are normal. Investigation?

a) Duplex USS
b) X-ray

Answer 134

a) Duplex USS

Question 135

old lady, menopause, urinary symptoms with LUTS emptying. Physical exam: labia major United Until urethral meatus
A. TOpic Estrogen
B Separate labia major

Answer 135

B Separate labia major

Question 136

Female washed her home today morning with bleaching powder in evening while she go for waking had nasal congestion, wheeze past h/0 adult onset asthma, asking reason for exacerbation? She said she had no symptoms when using bleach?

A. Chlorine
B. URTI
C. Hypersensitivity pneumonia D. Allergic bronchopulmonary aspergillosis E. Asthma

Answer 136

A. Chlorine

Question 137

Patient with haematuria, difficulty in passing urine, DRE normal. Urine analysis- macroscopic haematuria. He is heavy smoker. Investigation?

a) X-ray
b) Cystoscopy
c) CT
d) USS

Answer 137

b) Cystoscopy

Question 138

15 years breathless with drooling, right tonsil with enlarged uvula moved to the left. What is the next step?

A. Isolate in hospital til cough subside
B. Isolate in the hospital til Chest Xray Clears
C. Isolate in the hospital till sputum smear negative
D. Community based direct observation treatment

Answer 138

not sure

Question 139

Aged 42 male , 40 Bmi, HTN, DM, lipid,now knee pain due to osteoarthritis. Posted for Bariatric Surgery, which comorbid condition among these will get better after surgery/

Answer 139

DM

Question 140

Known alcoholic with Schizophrenia, hospitalized now having hallucinations. What is the diagnosis?

A. Exacerbation
B. Alcohol
C. Charles Bonner Syndrome

Answer 140

B. Alcohol

Question 141

4 weeks ago patient has a fall. Now burning sensation from shoulder to mid forearm on examination mild swelling . What is the diagnosis?

A. Brachial Plexus Inj
B. Radial Nerve Injury
C. Pain syndrome
D. VAscular

Answer 141

A. Brachial Plexus Injury

The brachial plexus is a complex network of nerves that originates in the neck and shoulder area and extends down the arm. Trauma or injury to this area can result in damage to the brachial plexus and lead to symptoms such as burning sensation, mild swelling, weakness, or paralysis of the affected arm. Radial nerve injury typically presents with symptoms specific to the distribution of this nerve, such as difficulty extending the wrist or fingers.

Question 142

5 yo girl, mild swelling above umbilicus picture. Nontender and soft, what is the diagnosis?

A. Lipoma
B. Umbilical hernia
C. Epigastric hernia
D. Cyst

Answer 142

B. Umbilical hernia

Question 143

3 day history of pain RIF pain. With loose stool and mucus. Similar 3 episode in last 4 months. On examination mass in RiF mild tender. What is the diagnosis?

A. Salpingitis
B. GE
C. Appendicitis
D. Crohn’s

Answer 143

C. Appendicitis

While Crohn’s disease can present with similar symptoms, such as abdominal pain, loose stools, and mucus in the stool, the presence of a mass in the right lower quadrant along with tenderness is more concerning for acute appendicitis. Appendicitis is a common cause of right lower quadrant pain and typically requires surgical intervention. Crohn’s disease is a chronic inflammatory condition that can affect any part of the gastrointestinal tract and usually has a more insidious onset with recurring symptoms over a longer period of time.

Question 144

Student behaving aggressive thinks examiners fail him in exam because he was super intelligent. He thinks he knows all answer. What should we look in his diagnosis?

A. Pressure of speech
B. Low Mood
C. Hallucination

Answer 144

A. Pressure of speech

Based on the given information, the most likely symptom that we should look for in the diagnosis is A. Pressure of speech. Pressure of speech is a symptom commonly seen in individuals with bipolar disorder or mania. It involves rapid, continuous, and loud speech, which is often difficult to interrupt. The student’s belief that he knows all answers and aggressive behavior also suggests the possibility of grandiosity, which is a common symptom seen in manic or hypomanic states.

Question 145

Diffuse pain NO diarrhea

Question 146

Question 147

Question 148

Answer 148

Question 149

Answer 149

Cholelithiasis

Question 150

Answer 150

Pericarditis with pericardial fluid?