Diabetic pt on metformin 1gm twice daily with microalbuminuria,creatine:high,and HTN,already on aspirin and statin.Best drug to improve renal condition?
a)beta blocker
b)insulin
c)diuretic
d)ramipril
A 35y man skidded on a wet road while riding his motorbike at a speed of 70mph. He has a large hematoma on temporal scalp bruises on chest wall and abdomen and a deformed thigh. GCS 11/15. High via mask given. Most immediate investigarion required during initial resuscitation phase?
CXR
CT BRAIN
CT ABDOMEN
XR FEMUR
A 4 year old girl is brought to the clinic by her mother complaining of fever and abdominal pain since yesterday. Today, she looks uncomfortable during micturition. On examination, her temperature is 99.4, her pulse is 100/min. and her suprapubic area is soft and tender. Her blood analysis shows increased neutrophils. Her urinalysis is positive for organisms and leukocytes.
What is the drug of choice for this condition?
A- Ciprofloxacin
B- Chloramphenicol
C- C0-trimoxazole
D- Rifampin
A 19-year-old man has exercise-induced asthma. This has previously been controlled by using a salbutamol inhaler as required but now he gets attacks with exercise. What is the single most appropriate management?
a. Regular salbutamol
b. Regular salbutamol and budesonide
c. Sodium cromoglycate
d. Oral steroid
e. Inhaled steroid
A four-year-old boy is about to start nursery school. He wets the bed every night and also
wets himself about once a week when he gets excited. What is the single most appropriate?
Management?
a. Amitriptyline
b. Behavioural modification treatment
c. Blood sugar
d. Desmopressin
e. Reassurance
A 5yr child presents at the ED having sustained 6% burn following hot fluid which poured on her chest.What will you do?
a)refer to burn unit
b)give iv fluid
c)give analgesia
d)give no fluid
79yo anorexic male complains of thirst and fatigue. He has symptoms of frequency, urgency and terminal dribbling. His urea and creatinine levels are high. His serum calcium is 1.9 and he is anemic. His BP is 165/95 mmHg. What is the most probable dx?
a. BPH
b. Prostate carcinoma
c. Chronic pyelonephritis
d. Benign nephrosclerosis
A 32 year old woman has had a febrile illness and swelling of the snall joints of her hands, feet, wrists and knee for two days. She has a maculopapular rash and a few palpable small cervical lymph jodes. She was previously well. There is no hx of relevant travel outside the UK, she has two young children. What is the single most likey dx?
A- psoriasis
B- reactive arthritis
C- RA
D- sarcoidosis
E- SLE
A 53 year old woman with wide spread metastatic breast cancer
develops rattling noise from the throat. Suction does not help. What is the single most appropriate management?
a. Normal saline 0.9 % nebulisers
b. Hyoscine injection intramuscular
c. Antimuscarinic
d. Antibiotics
e. Reassure
A man who collapsed but now conscious presents with hx of palpitations and chest pain,bp:normal,pulse:100bpm.what drug will you give him?
a)synchronous cardioversion
b)iv amiodarone
c)iv adenosine
d)beta blocker
e)digoxin
An 80-year-old lady had stroke and she was put on aspirin 75 mg once a day. She presents with another TIA. She has been treated successfully and she is now ok. What is the single most appropriate next action?
A. dipiridamole
B. Clopidogrel
C. Warfarin
D. Warfarin and aspirin
A 72yo man has been on warfarin for 2yrs because of past TIAs and strokes. What is the most imp complication the pt should be careful with?
a. Headache
b. Osteoporosis
c. Ear infection
d. Limb ischemia
e. Diarrhea
A pregnant lady at her 39wk GA present with eclampsia. Soon after her arrival in the labour suit, IV MgSO4 and IV hydralazine has been prescribed. The pt then develops another fit in the hosp and maintenance dose of MgSO4 has been started. What is your next step in management?
a. Mg SO4 bolus
b. Delivery of baby
c. MgSO4 loading dose
d. Diazepam
A 6 year old girl presents to the emergency room with her mother for a deep wound on her right forearm. Her mother tells you that her daughter was playing at school today and wounded herself when she fell on a big rock. When you ask her about her vaccination, she tells you that her daughter had all her vaccinations before the school started this year.
What is the most appropriate therapy for this girl?
A- Tetanus toxoid
B- Tetanus antitoxin
C- Both tetanus toxoid and antitoxin
D- Neither tetanus toxoid or antitoxin
A 47-year-old man presents to accident and emergency department with full thickness
burns calculating up to 10% of his lower limbs from steam pipe. Analgesia has been given.
What is the most appropriate immediate management?
a. Escharotomy
b. Intravenousfluids
c. Refer to burns to unit
d. Admit to general ward
e. Discharge home with analgesia and follow up in clinic
A middle aged Asian presents with episodes of fever with rigors and chills for last 1yr. Blood film: ring form of plasmodium with schuffners dots in RBCs. What is the drug to eradicate this infection?
a. Doxycycline
b. Mefloquine
c. Proguanil
d. Quinine
e. Artesunate
A 54-year-old patient presents with a lump in the neck, which moves on swallowing. What
Investigation will you do to establish diagnosis?
a. Ultrasound
b. FNAC
c. CT
d. MRIscan
e. X-rayneck