Pt complaining of seeing spiders 2 days after admission. Dignosis?


Hi doctors! These are the questions which I can recall from today’s exam. Pardon for the wrong spellings, I have no time to recheck what I typed. Feel free to add other questions/choices not included here. :grin::grin::grin:anwsers plz

  1. Genetics: Alport, huntington, duchene’s muscular dystrophy, neurofibromatosis

  2. ECG: Inferior stemi, hyperkalemia

  3. Delayed growth of a child (9th centile). What to do?
    A. Re-evaluate after 3 weeks
    B. x-ray wrist for bone aging

  4. Patient with pracetamol overdose. Drug level now normal. Next single best action?
    A.refer to psych liason
    B. Compulsory admission to psych
    C. Discharge and outpatient referral

  5. 15 mos old, no discernible words. Only babbles
    A. Refer to speech therapy
    B. Refer to ENT
    C. book for audiology test

  6. 3 weeks hx of tonilitis. Managed with amox. Now presents with enlarged R tonsil. Diagnosis?

  7. Tonsillar Ca. Where will it metastasize?
    A. Carotid sheath
    B. Mandible
    C. Clavicle
    D. Cervical LN

  8. Pt with breast Ca and cerebral mets. Complained of headache and intractable vomiting. Most appropriate med?
    A. Dexamethasone
    B. Haloperidol
    C. Metoclopramide
    D. Prometazine

  9. 15 years old having sex with 23 y.o
    A. Inform police
    B. inform child protection service

  10. 23y.o man having insertive anal and oral sex. hep b and hiv test done. What other test determine STI?
    A. Early morning urine
    B. MSCC
    C. Anal swab
    D. Pharyngeal swab
    E. Urethral swab

  11. 28wk pregnant with hbg 110. What will you say to px?
    A. Folic acid
    B. Iron dextran
    C. reassure

  12. 2 question about A fib. What will give long term?
    A. apixaban
    B. Aspirin

  13. A fib and stroke. Initial management
    A. Aspirin
    B. Apixaban

  14. Woman with electric like pain in face esp when eating. Wht to give?
    A. anticonvulsant
    B. Antipsychotic
    C. Antidepressant

  15. Patient with ptosis and gaze paralysis on left eye and hemiparesis on right body. Where is the lesion
    A. Cerebrum
    B. Cerebellum
    C. Midbrain
    D. Medulla

  16. Pt with abdominal pain. Complians of purpuric rash on buttocks.
    A. HSP
    B. TTP
    C. ITP

  17. 4 y.o with conjunctivitis, palmar erythema, desquamation, cracked lips. Management?
    A. IVIG
    B. prednisolone

  18. Pt with diarrhea. Stool microscopy revealed gram + comma shaped bacteria. Management?
    A. Cipro
    B. Doxy
    C. Amox

  19. Woman with abdominal pain, fever, vaginal d/c. Management?
    A. Oflox + Metro
    B. Cipro

  20. 4 wks with vomiting and palpable abdominal mass. Next MOST URGENT investigation?
    A. S. K
    B. UTZ

  21. Pt complaining of seeing spiders 2 days after admission. Dignosis?

  22. Pt with cast. Complained of pain. PE distal limb is warm and well perfused. Next management?
    A. increase analgesia
    B. Remove cast

  23. Pt. with pain in distal foot 36hr ago. Now presented with pain on UE. Weak reflexes. Patophysio?
    A. Demylination of peripheral nerve
    B. Antibodies against receptors in the motor end plate
    C. Demyelination in CNS

  24. Pt with back pain. Labs shows increased calcium. (+) increased M protein in electophoresis. Confirmatory investigation?
    A. Urine culture
    B. Bone marrow biopsy

  25. Patient with jaundice after holiday in US. What is the most likely lab pattern?
    A. forgot the values in the choices for ALP, AST, bilirubin

  26. Teenager wants to use oral emergency contraceptive pills. What is the MOA
    A. inhibits ovulation
    C. Prevents implantatiom

  27. Contraception with lowest fail rate?
    A. IU Copper device
    B. CoCP

  28. 58 y.o with endometrial hyperplasia 8mm in UTZ. What to do next?
    A. Endocervical swab
    B. hysteroscopy and biopsy

  29. Post TURP. Most likely electrolyte abnormality?
    A. hyponatremia
    B. Hypokalemia
    C. Hyperkalemia

  30. Man with back pain and complains of hematuria. PSA = 15. Dx?
    A. prostatic Ca
    B. Bladder ca

  31. Patient with diarrhea and vomiting. She takes aspirin, ramipril, something something. What to do next?
    A. Stop aspirin
    B. Stop ramipril
    C. Add loperamide
    D. Add something

  32. Rh negative woman. When the latest time to give anti-D?
    A. 72 hrs
    B. 24h
    C. 48hr

  33. Patient on clozapine. Complained of fever, stiff neck, etc.
    A. neuroleptic malignant
    B. Serotonin syndrome

  34. Patient on atorvastatin. Given clarith for PNA. What to do?
    A. stop atorvastatin

  35. Pt with prostate ca and bone mets experience loin pain. Next best management?
    A. radiotherapy
    B. Bisphosphonate

  36. Pt. with multiple fractures with blue sclera
    A. Non-accidental injury
    B. Osteogenesis imperfecta

  37. When do you report case of meningococcemi to authority?
    A. After result of LP
    B. Upon suspicion
    C. After blood culture

  38. Woman with neck swelling, tremors, plpitation. TSH = 1, FT4 = 28. Already on propanolol. Most approp management?
    A. Carbimazole
    B. PTU
    C. Prednisolone
    D. Thyroxine
    E. Radioiodine

  39. Baby need urgent rehydration. Multiple failed IV insertion. What to do next?
    A. Intra-osseous insertion

  40. pt with facial flushing, distended neck vein. Most definitive investigation?
    A. CT
    B. MRI
    C. PET
    D. XRAY

  41. Pt with bp=80/60, distended neck veins and muffled heart sounds. Dx?

  42. Patient with taking several medication. Given metoclop for vomiting. Now complains of stiff neck. Dx?
    A. Metoclopramide side effect

  43. Ptient complained of bloody diarrhea. Now labs show low hgb, increased urea, low platelets. Dx?
    A. ITP
    B. HUS
    C. TTP

  44. Ptient with peristent nosebleeding. On warfarin with INR of 7. Single best management?
    A. Protamine
    B. Prothrombin complex concentrate
    C. Vit. K
    D. Fresh frozen plasma

  45. Patient came to buckingham place from scotland. Said he was ordered to visit prince Charles non of this is true on inspection. Dx:
    A. delusion of grandeur
    B. Delusion of reference

  46. Pt. with recurrent UTI (3x in the pst year). Now afebrile. What to do next?
    A. DMSA
    B. MCUG
    C. CT
    D. USS

  47. Pt fell from ladder. Now complains of gross hematuria. Next best investigation
    A. IVU
    B. CT abdomen
    C. Xray KUN

  48. Woman complains of right eye pain, left sided headache when combing and painful left shoulder. Next best management?

  49. Patient thinks his insides are rotting and that he does not exist. Diagnosis?
    A. nihilistic delusions
    B. Capgras
    C. Fregoli

  50. Pt. has plpitations when riding train and when going to mall. Dx?
    A: agoraphobia
    B. Social phobia
    C. Arachnophobia

  51. Patient cleans his hand 30 time each day thinking about germs, now his hand are red. Dx?

  52. Elevated PTH, elevated Calcium, low phosphate. Dx?

  53. COPD pt on long term oxygen treatment complains DOB. Give O2 by paramedics. His sats is now 96%. ABG shows po2 = 18, PCO2 = 8, pH: 7.3. Next management?
    A. Call anesthetist and intubate
    B. Non-invasive positive pressure ventilation
    C. Decrease O2

  54. Patient 7days post tonsillectomy, fbrile, came in because of bleeding. Next best management?
    A. admit and start IV antibiotics
    B outpatient antibiotics

  55. Patient on lithium complains of tremors. Dx?
    A. lithium toxicity

  56. Patient came in asking for pain meds. On inspection she has dilated pupils and decreased RR. Most likely drug overdose
    A. heroin
    B. Ecstasy

  57. 70 y.o patient with righ sided pupilary dilatation. Other eye is normal. Dx?
    A. SAH
    B. Epidural hematoma

  58. Pt complains for flare and floaters. Known myopic. No ocular pain symptoms. Dx?
    A. Acute glaucoma
    B. Iritis
    C. Retinal detachment

  59. Pt with painless transient unilteral vvision loss. What to give next?
    A. aspirin

  60. Asthmatic patient on SABA. Now needs SABA 4-5x a week next appropriate management?
    A. Add low dose ICS
    B. Increase SABA
    C. Add LTRA
    D. Continue management

  61. 8 mos present with fever, poor feeding, wheeze and crepitation. Management?
    A. Salbutamol neb
    B. IV fluid
    C. No futher management
    D. Antibiotics

  62. Patient with known liver failure and esophageal varices presents with hematemesis. BPWhat to give next?
    A. IM epinephrine
    B. IV terlipressin
    C. Subcutaneous fluids

  63. Pt with known IHD. Presents with depressive symptoms. What antidepressant to give?
    A. Sertraline
    B. Fluoxetine

  64. Pt with cirrhosis presents with acites. Next best investigation?
    A. ascitic fluid neutrophil count.
    B. blood culture

  65. Elderly whose husband died 6 months ago. Now presents with depressive symptoms and memory impairment. Dx?
    A. pseudodementia

  66. Patient presents with left sided facial pain with ptosis and eye pain. Dx:
    A. Cluster headache
    B. Atypical facial pain

  67. Patient with dry eyes. Schimer’s test shows 8mm (N > 15). (+) ANA. Management?
    A: hypromellose
    B. Timolol

  68. Neonate born at 36 weeks with chest retractions. Mother had ROM for 48hrs. Investigation needed to reach dx?
    A. Blood culture
    B. CXS

  69. Female complains of infertility. Have painful periods and UTZ shows ground glass appearance of ovary. Dx?
    A. ovarian endometrioma

  70. Man with prostate ca for 10 yrs. now complains with obstructive urinary symtopms. Investigation?
    A. Psa
    B. IVU

  71. Pt with hepatic mets. Given morphine and codeine for pain. Still painful. That to give next.
    A. ibuprofen
    B. Gabapentin

  72. Patient with osteoporosis. Now complains with pain on sleeping. What to give?
    A. Celecoxib
    B. Morphine
    C. Naproxen
    D. Codeine
    E. Paracetamol

  73. Ptient with painful hip presents with progressice pin and fever of 38.9. Dx:
    A. Septic arthritis
    B. Perthe’s disease
    C. Transient synovitis l
    D. Slipped femoral epiphysis

  74. Patient with pain on left leg. Blah2. Intact ankle and knee jerk reflex. Most likely nerve compression?
    A. L4
    B. L5
    C. S1
    D. Cauda equina

  75. Patient with mobile mas on the scapula. Best investigation
    A. Incisional biopsy
    B. Excisional biosy
    C. USS

  76. Pt with previous operation (forgot what operation). Now complains reducible swelling in groin. Dx?

  77. Pt. complains chronic constipation. Now with shooting rectal pain. Dx:

  78. Mother breastfeeding. Complains of fever and pus filled d/c. MCC:
    A. Staph aureus

  79. Patient with eczematous nipple-areolar area.
    Ans: Pagets

  80. Patient diagnosed incidentally with grade 3 Hemoroids. No symptoms. Management?
    A. Excision
    B. Sclerotherapy
    C. No futher management

  81. Pt complains chills and rigors. Had a holiday in sudan. Now presents woth jaundice. Dx?
    A. Malaria
    B. Leptospirosis
    C. Zika

  82. Patient jaundice after URTI treated with abx. Blood test show bite cells and howel jolly bodies. Dx?
    A. G6pd

  83. Patient complains of sudden onset SOB. No fever. Normotensive. Next best investigation:
    A. Cxr
    B. CTPA
    C. VQ Scan

  84. Pt. travelled from US to UK. NOW Presents with SOB. INVESTIGATION?
    A: CTPA
    B. VQ

  85. Question about levothyroxine. But I totally forgot

  86. Something about increased calcium

  87. 56 with hot flushes. Best management?

  88. Child with sudden server testicular pain for 6 hours presents with fever of 39 and testiculr tenderness and swelling. Next best management?
    A. USS
    b. Surgery
    D. Iv antibiotics

  89. Patient with multiple painless vaginal lesions
    A. Hsv
    B. Hpv

  90. Old woman with confusion and urinary urgency. Best investigation?

  91. Patient with thiazide diuretics. Electrolyte picture?

  92. Patient on long term steroids now has the ff labs. I forgot basta low sodium and potassium.
    A. dexamethason suppression test
    B. Synacthen test
    C. IGF measurement

  93. Patient with chest pain and cough with crepitations. Also has oedema (?). best investigation?
    A. Echocardiogram
    B. Cxr
    C. Ecg

  94. Management of TCA (amytriptiline) overdose.

  95. Management of DKA:
    A. crystalloid 1l bolus l
    B. Crystalloid 1l over 6h

  96. Screening test in pregnancy aside from HIV ans hep B
    A. Rubella
    B. Syphillis

  97. Pt. woth hx of Ulcerative colitis now presents with more irregulr bowels plus microcytic anemia. Best Investigation?

  98. Pt w/ t2dm present with LE weakness and atrophy. Dx?