A 28yo woman has delivered with rotational forceps after an 8h labor and 3h second stage.
Choose the single most likely predisposing factor for PPH for this pt?
a. Atonic uterus
b. Cervical/vaginal trauma
c. Retained product
d. Preterm labor
e. Uterine infection
A man with fever, neck stiffness,.photophobia but no raised intracranial pressure. What will you do next?
A. Give antibiotics and FBC
B. Give antibiotics and LP
C. Give antibiotics only
D. Give antipyretics
A 74yo smoker presented to his GP with cough and SOB. Exam revealed pigmentation of the oral
mucosa and also over the palms and soles. Tests show that he is diabetic and hypokalemic.
What is the most probable dx?
a. Pseudocushing syndrome
b. Conns disease
c. Ectopic ACTH
d. Cushings disease
In lyme disease,which complication ismost likely to lead to collapse?
a.Dilated CM
b.AVblock
c.Mild encephalitis
d.Meningitis
e.Myocarditis
26 yr man with long history of substance abuse has been stable for six yrs.He has a job and wishes to stop using drugs
A neltrexon
B refer to self help group
C methadone mixture
D notify police
E advice on harm reduction
An 82yo woman has been admitted from a nursing home with dense hemiplegia and homonymous hemianopia. She is dysphasic. What vessel is most likely to be involved?
a. Ant cerebral artery
b. Mid cerebral artery
c. Post cerebral artery
d. Internal carotid artery
e. Post inf cerebellar artery
A 36-year-old man visits his physician complaining of chronic gastric pain for several years. Physical examination is unremarkable. Serology studies are positive for Helicobacter Pylori. Endoscopy reveals gastritis with no ulcers or tumors. Treatment starts with omeprazole, clarithromycin and metronidazole.
What is the most appropriate noninvasive test to check for H. pylori eradication?
A-Rapid urease test
B-Stool analysis and culture
C-Examination and culture of gastric contents
D-Urea breath test
E-Serum test for IgG antibodies against H. Pylori
A lady presents with a swelling below the groin crease that can be reduced. There is no med hx of note. What is the most probable dx?
a. Inguinal hernia
b. Strangulated hernia
c. Testicular tumor
d. Epidydimal cyst
e. Femoral hernia
A 47-year-old man with a history of heavy smoking complains of chronic cough. A “coin lesion” is discovered in his right upper lobe on chest X-ray. Bronchoscopy and biopsy fail to identify a mass, but the bronchial mucosa displays squamous metaplasia. What is the most likely outcome of this morphologic adaptation if the patient stops smoking? (A) Atrophy (B) Malignant transformation © Necrosis and scarring (D) Persistence throughout life (E) Reversion to normal
A 65yo man presents with painless hematuria, IVU is normal, prostate is mildly enlarged with mildfrequency. What is the most appropriate next step?
a. US Abdomen
b. Flexible cystoscopy
c. MRI
d. Nuclear imaging
e. PSA
A 63 yo female is noted to have left pupil irresponsive to light and is dilated. What is the most probably dx?
a. Pontine hemorrhage
b. Subdural hemorrhage
c. Cerebellar hemorrhage
d. Extradural hemorrhage
e. Subarachnoid hemorrhage
A 55 yr old man who suffered MI a few days ago is now ready for discharge.his med history is insignificant other than the MI he had.he has no drug allergies.he has already been put on aspirin and clopidogrel.what is single most appropriate med to be given to him on discharge
A.statin
B.statin and warfarin
C.statin and acei
D.warfarin
E.heparin
A 32 year old man presents with confusion, ataxia and ophthalmoplegia. What is the most probable diagnosis?
A. Wernicke’s Korsakoff
B. Meningitis
C. Stroke
D. TiA
A 35yo is agitated and euphoric. He claims to be helping the prime minister with economic policy, although this is not true when checked. What is the most likely dx?
a. Mania
b. Delusion of grandeur
A patient was diagnosed with pyloric stenosis. What is the initial investigation?
A. Electrolytes
B. Urea
C. FBC
D. USG
A 72yo presents with polyuria and polydipsia. The fasting blood sugar is 8 and 10mmol/l. BP=130/80mmHg and the level of cholesterol=5.7mmol/l. There is
microalbuminuria. What is
the single most appropriate next management?
a. ACEi and sulfonylurea
b. Statin and biguanide
c. Statin and glitazone
d. Insulin and ACEi
e. Statin and ACEi
A 2 year old child aspirated a foreign object which was removed at the hospital the parents are now asking how to remove it if that ever happens at home.
What do you advise ?
a. hemlich maneuver
b. bring to the hospital
c. turn the child on his back and give thumps
d. cpr
e. remove manually by fingers
A man presents with massive hepato splenomegaly ans pancytopenia. Which investigation would be diagnostic?
A. Bone marrow biosy
B. FBC
C. Lymph node biosy
D. CT