1: Salmeterol longer duration of action: due to lipid solubility, efficacy, affinity,
2: lady with her left eye that was about to pop out with altered sensation over her left forehead. RAPD. HR 96 and BP up. What was going on there? Can anyone explain. ---- TFT? CT angiogram?
3: RF: IgM against IgG other options Igg against IgM
4: waxy subsubtance in eye, straight lines look wavy :wet macular degeneration, drusen deposits
5: Acne rosacea features -----Rx. metronidazole topical
7: Also active lupus: low C3 and low c4? Or normal C3 and low C4?
8: The patient with xs alcohol use who presented with bruising but had low Hb mcv up and wcc/platelets down. Question said what would correct the blood abnormalities. ?B12, folate, vit c
9: In GCA what symptom predicts neuro-opthalmic problems are likely? jaw claudication?
10: Sinusitis and recurrent productive cough with NO test outcome: very low levels,? ABPA? Asthma?
11: the palliative gentleman with pancreatic cancer and two day history or confusion and agitation… IV saline or SC midazolam
12: untreated UC and raised igG ? Protein electrophoresis?
13: the guy with CKD IHD double amputation and systolic murmur with Hb of 62 and normal ferritin levels. Transfuse packed red cells or EPO?
14: Sensorineural deafness in right ear. weber lateralized to left, tinnitus ? Meniere’s, cholesteatoma
15: Anal carcinoma? Cause---- HHV, HIV, HPV
16: elderly female, fall, long lie on floor, K high, what next investigation serum CK?
17: Gonorrhea rx ceftriaxone
18: Recurence of gastric ulcer, how to confirm-- urea breath test
19: sores mouth,---- Infection strep pneumonia, staph aureus, mycoplasma
20: sepsis which interleukin IL1,IL4, IL6, IL10
21: Anti TB drug causing arthritis: pyrazinamide , rifampicin, ethambutol
22: Pericarditis one q: ST depression, PR depression(PR depression: most specific ECG marker for pericarditis)
23: Pericarditis---- widespread STE elevation
24: S4 Heart Sound corresponding ECG ---- P wave
25: chronic COPD reason for neutrophilia: prednisolone
26: Gonadotrophic hypogonadism - anosmia?
27: immediate structure posterior to left atrium, esophagus, descending aorta
28: Painful Ulcer without border surrounded by erythema? Which ulcer venous or arterial e.t.c
29: Indian ink stain–> Cryptococcus–> amphotericin?
30: female pt with skin rashes for long time & brings jar to doc, been investigated all negative: Delusional parasitosis
31: Hereditary telangiectasia inheritance: autosomal dominant
32: neuropathic pain in DM: amitriptyline, pregabalin, gabapentin
33: Tourette syndrome:a boy with grunting in school, tibuation random noises family hx is oositive too.
34: Vit k dependent: 2, 7,9, 10
35: glucose 3.3, pt conscious but shivering; glucojuice, im glucagon, choclate
36: barrettes esophagus: ----squamous, adenocarcinoma
37: difference btw erythrocyte and reticulocyte : small size, pallor
38: Wilsons disease complications---- psychiatry
39: Ramadan fasting DM, metformin dose adjustment— 500mg morning 1000mg evening
40: features of locked in syndrome— paralyzed girl , only eye blinking positive,
41: low glycemic index, pasta with tomato sauce, porridge , orange juice
42: lithium htn pt what to give,— amlodipine , Ramipril
43: family concerned: terminally ill— s/c midazolam
44: women fell injury, daughter concerned: bed rails, low bed, quietapine,
45: Reactive arthritis— hx of diarrhea & multiple joints pain
46: pt on multiple drugs , now hematemesis cause: fluoxetine, lithium ,
47:bleeding from duodenal cap, blood supply: gastroduodenal Artery
48:female with base of thumb pain, in wrist round on movement— De quervian tenditonits, osteoarthritis, median cubital synd
49: AF with palpitation trop 16( cut 16 cause of raised trop ) AF, MI
50: ceftriaxone anaphylaxis: adrenaline
51: obese lady: OSA, investigation— polysomnography
52:HTN, hypokalemia renal artery stenosis: investigation : MR angiography
53: female on COCP malaria prophylaxis: atovaquone and proguanil
54: levothyroxine and calcium carbonate interaction dec absorption in GIT—calcium
55 hx of asbestosis, current smoker: next management: stop smoking, prednisolone
56: cryptococcal meningitis amphotericin and Flucytosine?
57 itching ans execration : iron studies?
58 old lady dyspareunia: dry vulva cause hypo estrogen
59 ciliary dyskinesia, azoospermia cftr gene abnormality— cystic fibrosis
60 Myotonic Dystrophia: trinucleotide repeat, frame shift mutation, AD
62 neutrophil action: phagocytosis, b cell
63 MHC1: T helper cell, T cytoctoxic
64 family hx +ve, blisters on hands, porphyria cutanea
65: Carbimazole MOA
66: Eplerenone site of action: DCT
67: dipaglifozone: renal reabsorption of glucose
68: Site of central immunological tolerance- spleen, thymus, bone marrow
69 Poor predictor in AS with AR, ? AR , LVH, Severe AS
70 absolute contraindication for pregnancy : pulmonary HTN, MS
71 mother SLE, baby has heart block cause: anti Ro
72 CK high ? Dermatomyositis / polymyositis
73 H/o dog bite rx: co-amox
74 L4 lumbar fracture: next investigation, PET scan, dexa scan
75 Denosumab: rank ligand
76 letrozole: side effects---- osteoporosis, endometrial cancer
77 odds ratio 16
78: acne rosacea case: topical metronidazole
79: Irritable bowel syndrome: symptoms resolved on bowel defecation
80: ? lead time bias, publication bia
81: glucose reabsorption takes place where: PCT
82: risk factor for further suicide: suicide note, previous suicidal attempt
83: IV drug abuser: botulin toxin injection
84 another where to give botulin toxin flexors: iliopsoas, vastus medias, Biceps femoris
85 recent trauma, clear edge deep ulcer cause? Traumatic ulcer, pyoderma gangrenosum
86 subacute degeneration: dorsal column
87 81 year old woman with ecchymosis, prolonged aPTT ? Hemophilia, von Willebrand
88 another similar menorrhagia apptt high what other test: factor 8
89 IDA treated with iron supplements n corrected. Mother has CA Colon. No gastrointestinal symptom. Faecal occult test, colonoscopy, upper GI endoscopy
90 minimal change disease treatment: prednisolone
91 small cell ca: renal nephropathy---- membranous nephropathy
92 PTH high and ALP: pagets, osteomalacia
93 Baclofen MOA:— GABA receptors on spine
94 Cardiac arrest on ECG------ prolonged QT
95 Docetaxel MOA: -----microtubule
96 recent MI evidence of heart failure next drug to add -----Eplerenone
97 Neuropathy paresthesia -----vincristine
98: Hemiballismus----- subthalamus
99: Alport anterior lens dislocation?----sensorineural deafness
100: pt on lithium ----Nephrogenic DI
101: polycythemia ?
102: cirrhosis case, Neutrophils positive -SBP------ ceftriaxone, therapeutic paracentesis,
103: methaemoglobinaemia toxicity , what antidote to give: methylene blue
104: Renal transplant from bother HLA probability:— 50,90, 100
105 smoking and percentage of lung cancer
106 GBS----- rx IVIG
107 GBS monitoring,---- FVC, VC , TLC
108 Left eye proptosis no adduction no elevation chemosis injections investigation of choice: usg , MRI head, xray
109 There was an ipsilateral 3rd nerve and contralateral sensory body —medial pons,
110 Obese lady with dizziness and raised papilloedema. Idiopathic intracranial htn
111 pt in nursing home diarrhoea: norovirus
112 delirium tremens: diazepam
113 ankylosing spondylitis diagnosis? x-ray lumbar, MR spine
114 irradiated blood: to avoid CMV or graft vs host
115 CEA------ colon cancer
116 Fastest conduction? SAN, AVN? Purkinje fibres
117 Ventricular rate 22, site of impulse generation? was this AV node?
118 Do you know phenytoin loading question? Phenytoin was 12 trough level was low, reload, increase
119 History of hearing voices since childhood?, multiple cuts depressive? Borderline personality, schizophrenia,
120 one scenario similar chicken pox, male on steroids, ,give immunogolibin?
Female pt had breast ca 2 years ago treated, now low back pain. Wedge shape vertebral fracture. Next step-- xray … Dexa scan… PET scan… Skeletal survey.
Aromatase side effect: osteoporosis?
Safest antihistamine with hepatic failure?- cetirizine, chlorpheniramine,
Eplerenone … mode of action.–Principal cells, intercalated discs, PCT, Loop of henle
One qs scenario about… locked in syndrome
Pt on fluoxetine, lithium …having hematemesis… causative agent — fluoxetine
Pericarditis----global st elevation
One case of pericarditis … asking about specific ecg change… PR depression ?
CNS case with india ink positive with budding yeast… asking tt…
Fluconazole with flucytocine
itraconazole, Amphotericin with flucytocine
voriconzole …
Female with base of thumb pain… dequrvain … osteoarthritis… septic .
Idiopathic intracranial htn …headache, obese… Optic n swelling …
Boy with grunting sounds …tourette syndrome
Small trauma to leg then red ulcer increasing … traumatic ulcer. Venous ulcer. Pyoderma gengrenosum ?
Ulcer at lat mallellous of left leg … ABI 0.87 … arterial ulcer .venous ulcer. Arteriovenous ulcer. Neuropathic ulcer
Non hodgkin’s lymphoma treated now he needs transfusion -transfusion only by irradiated cells why—to avoid cmv , to avoid GVHD.
Pt on anti tb drugs… now having joint pains … cause… pza. Rifampicin…ethambutol…
Female with fall… cant flex her thigh… which muscle to give botulinum toxin… biceps femoris…v.laterlis. ilio-psos muscle…
Mother with type 1DM… her daughter having chances of DM…% ? 20 % , 30% , 50 % 90 %
Female pt with diarrhea … feel relex after defecation… IBS .?
Plucked chicken skin syndrome… elastin fibers
Renal transplant …brother agreed to donate his kidney… HLA matching chances 20-50-100% ?
Hx of fall … leg weakness… dorsum foot dec sensation… common peroneal n .?
Meseals case… living in hall … others having chances … 20-30-50-70-100%
Child with varicella contact with pregnant mom… mom is varicella antibodies positive … Reassure?
Pregnant mother with liver failure picture …came back from nepl … hep A .B.C.E ?
Temporal arteritis case… asking about specific thing for dx… pain on chewing ?
Maleria … prophylaxis
Pt with seizures… iv carbamazipine given… now on phenytoin 100 mg bid … in bw having multiple seizures … serum level of phenytoin is very decreased … now what to do… inc dose to 200 mg bid phenytoin… add sodium valporate … ?
Old man 89 y …with UTI …acute confusional state… hospitalized …had fall from bed …her daughter asking about preventive measures for it… hand railings of bed. Make bed down level… quetipine to give… ?
Female pt with menorrhage… aptt inc… mild factor 8 inc…bt inc… vwd ?
Lupus nephrits … what to give… azithioprine. Cyclophosphamide…steroids …?
Case of thyroid swelling …moves up with deglutition… dx test to confirm it… fnac…radioidodine…xray…us
Dog bite… antibiotics …amoxiclave
COPD pt… with chest physiotherapy training …what will inc… FEV1… others options were too
Denosumab… mode of action… ? RANK ligand
Mode of action salmeterol … b2 agonists
Alcholic pt. Living alone… BMI 16 . Found unconscious … with low phosphate … reason… malnutrition …alcholism… vomiting …
Alport syndrome… what else pt can have… sensorineural deafness ?
Doclitaxel …mode of action… microtubule ??
Tricuspid regurgitation case --pulsatile liver
What is sign of hyperkalemia in ecg
Antibiotic for neisseria gonorrhea
Function of neutrophil
Chest pain… ecg changes in v5 v6 … artery involved—LCA
Pt on multiple drugs … and raised neutrophils… reason which drug… steroids.?
Pt treated for hodgkins lymphoma … now need blood transfusion… he said need irradiated blood …why… to avoid cmv infection… to avoid GVHD …bacterial infections
Pt with ca renal stones… how to prevent it … high fluid intake … thiazides …frusimide …
Anal cancer associations – HIV, Kaposi sarcoma, HPV
BRCA2 gene causes which cancer in men - Prostate ca
A man tried to cut his wrist, have depression, hearing voices talking about his actions…his dog juz passed away…forgotten the options given, 2 options were which makes confusion… drug induced psychosis … paranoid schizophrenia
Lung cancer case… needed surgery… what contraindications … FEV 1.6 L , horner synd
A lady tried to cut his wrist, binge drinker and drug use, appeared reactive on examination, what is the diagnosis
Asbestosis with currently still smoking, what is the management? Steroid, smoking cessation?
Pt with type 1 on insulin…lowest glycemic index food…ice cream, milk choco, pasts in tomati sauce, porridge, fresh orange juice?
Pt with brain hemorrhage…found collapse…gcs 3, spo2 100% on high oxgen mask…what is the next step? Ct brain, intubation?
One qs about dm … blurring of vision… i did lens swelling
Alcoholic and illicit drug use, came in.vomitting diarrhoea and appeared restless…what is the cause? Alcohol amphetamine, heroin ectasy?
One dm case with hypoglycemic picture … what to give her … 16% glucose… cholcolate … etc
Last qs of paper two… what drs will decide about pt condition … i did brathel index, Hospital anxiety depression score.
Two qs about abdominal pain with diarrhea with multiple joint pains … is it reactive arthritis or enteropathic arthritis
Female with dvt … next to check… lupus antocoagulant ??
question on lithium toxicity…management hemodialysis
bipolar disorder on lithium…polydipsia n polyuria…sodium was normal with normal urine osmolarity what is the dianosis? Nephrogenic di, psychogenic polydipsia, cranial di
peripheral neuropathy… i did vincristine
Case of alcholic female …incoherent …Wernicke’s encephalopathy , Wernicke, Alzheimer’s, subdural, frontal contusion frontotemporal dementia
Joint pains ovver back and buttock, improved with movement…what is the investigation? Xray spine, MR spine, HLA, CRP? is it ankylosing spondylitis? I put MR spine too…but seems answer is xray spine…features of sacroilitis on xray
boy who received cadaveric human growth hormone in his childhood , now myoclonic jerk –prions
One qs about frontal boses… neuropathy…seems pagets… next investigation …i did MR skull, Protein electrophoresis.
Alcoholic pt. Living alone… BMI 16 . Found unconscious… with low phosphate … reason… malnutrition …alcholism… vomiting … intracellularv shifting.
Barrett esophagus…35cm from incisor…what carcinoma? Squamous or adenoca?
Case of nephrotic syd minimal change gn… rx prednislone
Dapagliflizon mechanims if action — SGL2 kidney.
Treatment of severe Alzheimer’s—, donepzil or mementine .?
Inheritance pattern of heriditary hemoragic telangtasia
Patient with no known antibiotic allergy previously, treated for syphillis with penicillin then develops sob, lip swelling , urticaria . Treatment
Antihistamine , hydrocortisone , adrenaline.