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. anwsers plz
Genetics: Alport, huntington, duchene’s muscular dystrophy, neurofibromatosis
ECG: Inferior stemi, hyperkalemia
Delayed growth of a child (9th centile). What to do?
A. Re-evaluate after 3 weeks
B. x-ray wrist for bone aging
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
15 mos old, no discernible words. Only babbles
A. Refer to speech therapy
B. Refer to ENT
C. book for audiology test
3 weeks hx of tonilitis. Managed with amox. Now presents with enlarged R tonsil. Diagnosis?
Tonsillar Ca. Where will it metastasize?
A. Carotid sheath
D. Cervical LN
Pt with breast Ca and cerebral mets. Complained of headache and intractable vomiting. Most appropriate med?
15 years old having sex with 23 y.o
A. Inform police
B. inform child protection service
23y.o man having insertive anal and oral sex. hep b and hiv test done. What other test determine STI?
A. Early morning urine
C. Anal swab
D. Pharyngeal swab
E. Urethral swab
28wk pregnant with hbg 110. What will you say to px?
A. Folic acid
B. Iron dextran
2 question about A fib. What will give long term?
A fib and stroke. Initial management
Woman with electric like pain in face esp when eating. Wht to give?
Patient with ptosis and gaze paralysis on left eye and hemiparesis on right body. Where is the lesion
Pt with abdominal pain. Complians of purpuric rash on buttocks.
4 y.o with conjunctivitis, palmar erythema, desquamation, cracked lips. Management?
Pt with diarrhea. Stool microscopy revealed gram + comma shaped bacteria. Management?
Woman with abdominal pain, fever, vaginal d/c. Management?
A. Oflox + Metro
4 wks with vomiting and palpable abdominal mass. Next MOST URGENT investigation?
A. S. K
Pt complaining of seeing spiders 2 days after admission. Dignosis?
Pt with cast. Complained of pain. PE distal limb is warm and well perfused. Next management?
A. increase analgesia
B. Remove cast
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
Pt with back pain. Labs shows increased calcium. (+) increased M protein in electophoresis. Confirmatory investigation?
A. Urine culture
B. Bone marrow biopsy
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
Teenager wants to use oral emergency contraceptive pills. What is the MOA
A. inhibits ovulation
C. Prevents implantatiom
Contraception with lowest fail rate?
A. IU Copper device
58 y.o with endometrial hyperplasia 8mm in UTZ. What to do next?
A. Endocervical swab
B. hysteroscopy and biopsy
Post TURP. Most likely electrolyte abnormality?
Man with back pain and complains of hematuria. PSA = 15. Dx?
A. prostatic Ca
B. Bladder ca
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
Rh negative woman. When the latest time to give anti-D?
A. 72 hrs
Patient on clozapine. Complained of fever, stiff neck, etc.
A. neuroleptic malignant
B. Serotonin syndrome
Patient on atorvastatin. Given clarith for PNA. What to do?
A. stop atorvastatin
Pt with prostate ca and bone mets experience loin pain. Next best management?
Pt. with multiple fractures with blue sclera
A. Non-accidental injury
B. Osteogenesis imperfecta
When do you report case of meningococcemi to authority?
A. After result of LP
B. Upon suspicion
C. After blood culture
Woman with neck swelling, tremors, plpitation. TSH = 1, FT4 = 28. Already on propanolol. Most approp management?
Baby need urgent rehydration. Multiple failed IV insertion. What to do next?
A. Intra-osseous insertion
pt with facial flushing, distended neck vein. Most definitive investigation?
Pt with bp=80/60, distended neck veins and muffled heart sounds. Dx?
Patient with taking several medication. Given metoclop for vomiting. Now complains of stiff neck. Dx?
A. Metoclopramide side effect
Ptient complained of bloody diarrhea. Now labs show low hgb, increased urea, low platelets. Dx?
Ptient with peristent nosebleeding. On warfarin with INR of 7. Single best management?
B. Prothrombin complex concentrate
C. Vit. K
D. Fresh frozen plasma
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
Pt. with recurrent UTI (3x in the pst year). Now afebrile. What to do next?
Pt fell from ladder. Now complains of gross hematuria. Next best investigation
B. CT abdomen
C. Xray KUN
Woman complains of right eye pain, left sided headache when combing and painful left shoulder. Next best management?
Patient thinks his insides are rotting and that he does not exist. Diagnosis?
A. nihilistic delusions
Pt. has plpitations when riding train and when going to mall. Dx?
B. Social phobia
Patient cleans his hand 30 time each day thinking about germs, now his hand are red. Dx?
Elevated PTH, elevated Calcium, low phosphate. Dx?
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
Patient 7days post tonsillectomy, fbrile, came in because of bleeding. Next best management?
A. admit and start IV antibiotics
B outpatient antibiotics
Patient on lithium complains of tremors. Dx?
A. lithium toxicity
Patient came in asking for pain meds. On inspection she has dilated pupils and decreased RR. Most likely drug overdose
70 y.o patient with righ sided pupilary dilatation. Other eye is normal. Dx?
B. Epidural hematoma
Pt complains for flare and floaters. Known myopic. No ocular pain symptoms. Dx?
A. Acute glaucoma
C. Retinal detachment
Pt with painless transient unilteral vvision loss. What to give next?
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
8 mos present with fever, poor feeding, wheeze and crepitation. Management?
A. Salbutamol neb
B. IV fluid
C. No futher management
Patient with known liver failure and esophageal varices presents with hematemesis. BPWhat to give next?
A. IM epinephrine
B. IV terlipressin
C. Subcutaneous fluids
Pt with known IHD. Presents with depressive symptoms. What antidepressant to give?
Pt with cirrhosis presents with acites. Next best investigation?
A. ascitic fluid neutrophil count.
B. blood culture
Elderly whose husband died 6 months ago. Now presents with depressive symptoms and memory impairment. Dx?
Patient presents with left sided facial pain with ptosis and eye pain. Dx:
A. Cluster headache
B. Atypical facial pain
Patient with dry eyes. Schimer’s test shows 8mm (N > 15). (+) ANA. Management?
Neonate born at 36 weeks with chest retractions. Mother had ROM for 48hrs. Investigation needed to reach dx?
A. Blood culture
Female complains of infertility. Have painful periods and UTZ shows ground glass appearance of ovary. Dx?
A. ovarian endometrioma
Man with prostate ca for 10 yrs. now complains with obstructive urinary symtopms. Investigation?
Pt with hepatic mets. Given morphine and codeine for pain. Still painful. That to give next.
Patient with osteoporosis. Now complains with pain on sleeping. What to give?
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
Patient with pain on left leg. Blah2. Intact ankle and knee jerk reflex. Most likely nerve compression?
D. Cauda equina
Patient with mobile mas on the scapula. Best investigation
A. Incisional biopsy
B. Excisional biosy
Pt with previous operation (forgot what operation). Now complains reducible swelling in groin. Dx?
Pt. complains chronic constipation. Now with shooting rectal pain. Dx:
Mother breastfeeding. Complains of fever and pus filled d/c. MCC:
A. Staph aureus
Patient with eczematous nipple-areolar area.
Patient diagnosed incidentally with grade 3 Hemoroids. No symptoms. Management?
C. No futher management
Pt complains chills and rigors. Had a holiday in sudan. Now presents woth jaundice. Dx?
Patient jaundice after URTI treated with abx. Blood test show bite cells and howel jolly bodies. Dx?
Patient complains of sudden onset SOB. No fever. Normotensive. Next best investigation:
C. VQ Scan
Pt. travelled from US to UK. NOW Presents with SOB. INVESTIGATION?
Question about levothyroxine. But I totally forgot
Something about increased calcium
56 with hot flushes. Best management?
Child with sudden server testicular pain for 6 hours presents with fever of 39 and testiculr tenderness and swelling. Next best management?
D. Iv antibiotics
Patient with multiple painless vaginal lesions
Old woman with confusion and urinary urgency. Best investigation?
Patient with thiazide diuretics. Electrolyte picture?
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
Patient with chest pain and cough with crepitations. Also has oedema (?). best investigation?
Management of TCA (amytriptiline) overdose.
Management of DKA:
A. crystalloid 1l bolus l
B. Crystalloid 1l over 6h
Screening test in pregnancy aside from HIV ans hep B
Pt. woth hx of Ulcerative colitis now presents with more irregulr bowels plus microcytic anemia. Best Investigation?
Pt w/ t2dm present with LE weakness and atrophy. Dx?