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. Schizophrenia
c. Hypomania
d. Drug induced personality disorder
e. Delusion of grandeur
A 64yo alcoholic who has been dx with liver cirrhosis presents with a massive ascites. What is the mechanism of fluid accumulation in a pt with liver disease?
a. Cirrhosis
b. Portal HTN
c. Hypoalbuminemia
d. Liver failure
e. Hepatic encephalopathy
B OR C?
A 68yo man who is a known case of liver cirrhosis has developed ascites. What is the mechanism for the development of ascites?
a. Portal HTN
b. Hypoalbuminemia
c. Congestive heart failure
d. Liver failure
here key is B…?
WTS THE DIFFERENCE?
34 year old woman who is 16 weeks pregnant, ultrasound scan of shows semi
solid cystic mass. What is the most likely diagnosis?
a. Fibroid
b. Ovarian cyst
c. Gravida uterus
d. Adenomyosis
e.Dermoid cyst
A 65yr pt who had MI 1yr ago now come to the ED complaining that his neighbor is conspiring against him.when his son is asked,he denies it and also narrate that sometimes his father says that everybody in his office is always talking about him,which is not the case.What is the most appropriate med?
a)TCA
b)clozapine
c)olanzapine
d)lorazepam
Any explanation for this contradiction please?
-
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 hemorrhaged. Extradural hemorrhagee. Subarachnoid hemorrhage
Ans. [[[The key is D. Extradural hemorrhage (explained by :So though in elderly extradural hematoma is less common it remains the most logical option in this question]. [Opinion from neurosurgeon of this group]. -
A 74yo man has been admitted unconscious with no hx. He has a GCS=6 and a dilated left puil which becomes insensitive to light. What is the single most likely dx?
a. Extradural hematoma b. Meningitis
c. Opioid OD d. Pontine hemorrhage e. SAH
Ans. The key is E. SAH. [Extradural hematoma is very rare in elderly and there occurs lucid interval;
A 60yr male is admitted with a 2d hx of lower abdominal pain and marked vomitting.On examination he has abdominal swelling,guarding and numerous audible bowel sounds.What is the likely dx?
a)gallstone ileus
b)ischemic colitis
c)large bowel obstruction
d)sigmoid volvulus
e)small bowel obstruction
A 45yo male with epigastric discomfort has been given triple therapy. He has now returned after
4wks of epigastric discomfort. What inv would you do for him?
a. ECG
b. H.pylori breath test
c. Endoscopy and biopsy
d. US
A 40 year old man 24 hours after an operation of total hip
replacement present with temperature of 37.7C and shortness of breath. What is the single most appropriate investigation?
a. DEXA scan
b. CT scan chest
c. MRI scan chest
d. Nuclear bone scan
e. Chest Xray
A man rescued from a building on fire presented with unconsciousness without any evidence of burns or external injury or soot. What would you do next?
a. 100% oxyen inhalation
b. 24% oxygen by mask
c. Hyperbaric oxygen in a hyperbaric chamber
d. Intubation
e. Refer to specialist unit
A women with RA for 30yrs presents with tiredness,fatigue,and FBC shows hb:low,MCV:low,microcytic red cells.She has not being on any medications on recent.No other hx of note.What is the likely cause of her anaemia?
a)Anaemia of chronic disease
b)dietary deficiency of iron
c)GI bleeding
A 67 year woman presents with 2wk hx of loss of sensation over the lt side of her chest in the region of t4/t5,then pain.What is the most likely cause?
a)costochondritis
b)herpes zoster
c)osteoporotic vertebral fracture
A 6 year old boy was hit in the scrotum at school. He has severe
pain and acute
tenderness. What is the most appropriate investigation?
a. Early surgical exploration
b. Ultrasound scan
c. Reassure
d. Mid stream urine
e. CT scan scrotum
2 years old child was brought into A&E with coarse jerking movement of her limbs which lasted for about 10 secs followed by unconsciousness. She regained consciousness soon after and was disoriented but afebrile with no signs of meningeal irritation. What is the single best investigation in this child?
A- 24 hrs ECG
B- 24 hrs EEG
C- no inx required
D- CT scan
E- MRI scan
A 55-year-old man has weight loss, dyspnoea and syncope. He smokes 30 cigarettes a day. He is thin and breathless at rest. His blood pressure on standing is 110/60mmhg and on lying is 140/80mmHg. What is the most appropriate initial investigation in establishing a diagnosis?
a. ChestX-ray
b. Echocardiogram
c. Electrocardiogram (ECG)
d. Pulmonaryfunctiontests
e. 24hourstapedECG
A 10 years old has presented to the ER with complain of falling down after being hit on the head by a ball. On Examination he is gasping.The most appropriate initial step is?
A)check the carotid pulse
B) Give high flow O2
C)Give CPAP
D)Give shock
E) start Chest compressions
A woman is in her 9th week of pregnancy and lupus anticoagulant antibodies are found to be positive. What will you give her?
a. Aspirin only
b. Aspirin and heparin
c. Heparin only
d. Reassure
70 year old woman with breast cancer has had it spread to her lung, liver and bones. There is also constipation, weakness, thirst and anorexia for 3 days. She is only taking Haloperidol for hiccups. She is more disorientated today with notable left-sided weakness. What is the most likely diagnosis?
A. Cerebral metastases
B. Hypercalcemia
C. Spinal cord compression
D. UTI
E. Chest infection
A 10yr girl presents with hoarseness of the voice.She is a known case of bronchial asthma and has been on inhaled steroids for a while.What is the most likely cause of the hoarseness?
a)laryngeal candidiasis
b)infective tonsillitis
c)laryngeal oedema
d)allergic drug reaction
e)ludwigs angina