Concerned mother brought her daughter 16 yrs old with short stature, complaining of Not yet started menstruation and sexual infantilism. Other female members of the family had their periods around 12,13 yrs including her mother.O/E Picture given below.You their GP decided to do some blood work for hormonal study and Abdominal USS of the Uterus +Ovaries and Karyotyping before referring to specialist opinion/management .The results of the Karyotyping is expected to be,
1.45 XX
2.45 XY
3.45 XO
4 46 XXY
5.46 XXX
A patient is brought to the emergency with severe abdominal pain and a diagnosis of suspected perforation with peritonitis is made. He is advised urgent laparotomy but refuses to undergo the same. His wife is accompanying him and says that the patient is unable to understand the condition and asks to proceed with the surgery. What is the most appropriate action to take in this instance?
a. Listen to the wife and do the surgery
b. Respect patient wishes
c. Contact the hospital authorities and inform them of the situation
Nursing home resident patient with diarrheal for 4 days and faecal incontinency next step:
a.DRE (digital rectal exam)
b. Sigmoidoscopy
c.Colonoscopy
d.Barium enema
Mother came with his 15 y/o son.She says his son easily burns with sun and now has sunburn lesions. Seeking consult about the risk of melanoma in his son. Which is the most important factor to be considered?
a.Fair hair and skin
b.Family history of melanoma
c.Atypical nevous
9 years old child with long term asthma controlled with SABA and steroid inhaler. During blood test ketones and high sugar found. his random blood sugar is 8 g/dl. what test for follow up?
A. FBS
B. OGTT
C. HBA1c
7/12 old girl brought by her mother with the 2 day history of Fever ,copious nasal secretions,and wheezing .The babay has been healthy otherwise in the past .o/e T 38.5,RR 58/mi,Sa O2-95 % on RA,she looks dehydrated and Bilateral wide spread high pitched expiratory Ronchi+ .Managed with Nebulised Salbutamol x 3 with no improvement .which one is the recommended treatment for this condition .
1.Admission to the ward for IV Antibiotics
2.Admission for Regular Salbutamol Nebulisation
3.Admission for IV Hydrocortizone 6HRLY
4.Admission for Regular Iptratropium Nebulisation
5.Admission for Suportive care with Hydration,and humidified Oxygen .
Which of the following structure is not the part of cell body of neuronal cell?
A. Free ribosomes
B. Rough endoplasmic reticulum
C. Smooth endoplasmic reticulum
D. Chromatophobic Nissil granules
E. Plasma membrane
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Patient presents with back pain radiating to the buttocks and the lower leg. On examination he has loss of sensations on the outer aspect of leg and foot. Ankle reflex is absent. What is the possible nerve root involvement in this patient?
a. L 2,3
b. L 3,4
c. L 4,5
d. L 5, S1
A young male presented in Emergency with aggressive behaviour, high temperature n high BP, he was shouting that his life in danger n gang people will kill him, his friends reported him of having amphetamine. What is the greatest risk for this pt?
A. Cardiovascular risk
B. Acute psychosis
C.Suicide
D.Drug abuse
22 yrs old woman brought to ED by ambulance from a dance club.She was agitated and had a generalised seizures in the club according to the paramedics.BP 165/100,HR 119/mi,t 37.8,RR 17/mi,SaO2 98%on RA. RandomBGL 8 mmoles/l o/e She is hyperactive appear to be hallucinating.Pupills 6mm reacting to the light.Her Neck no stiffness.CVS Unremarkable except HR, Lungs clear,Abdomen soft non-tender,Moves all extremities, Bloods Na 109 mmol/l(135-145),K 3.5(3.5-5.0mmol/l),Cl 83(95-107),HCO3 21(23-32), WCC 12,000,Platelets 350
She is diagnosed to be OD Decided on suportive therapy,which of the following substances ,this patient most likely consume
1.Ketamine (“Vitamine K”)
2.HGB(“Grievous bodily Harm”)
3.Methamphatamine
4.Cocaine
5.Opioids
All the following drugs can induce SIADH except.
A. Carbamazepine.
B. Vinblastine
C. Clofibrate
D. Amiloride
E. Cyclophosphamide
60 years male not known allergy and chronic illness,suddenly developed Rt eye swelling,had cannines toothache since 10 days and small pastule on rt side of naso labial folds.
1.hypersensivity reaction
2.Immuno compromised patient
3.cellulitis reaction
4.dental caries.
Bluish discoloration of the skin and mucus membrane is :
A Hypoxia
B Cyanosis
C Anoxaemia
D Asphyxia
Heterotropic ossification or myositis ossificicans following trauma or surgery is prevented by 
A) indomethacin
B) aspirin
C) radiation
D) all of the above
Patient with red eye, decrease in vision, normal red reflex, what is the most likely diagnosis?
a. conjunctivitis
b. belpharit
c.glaucoma
d. keratitis
e. uveitis
Hereditory Spherocytosis scenario. Child had URTI. Pallor, no jaundice. Retics count 6% (increase), low HB, low platelets. On exam child had pansystolic murmur at left sterna border. Cause asked?
A.Parvovirus
B.Hep A
C.ITP
D. Subacute infective endocarditis
E.Folate deficiency