5 yrs old girl and her parents have come to see you her GP today .She has been feeling faint during dance practice,but never has actually fainted and is usually well with no medical problems.She says her chest felt heavy and heart went “boom”,and she was about to faint and stop dancing to avoid it .She was taken to hospital by ambulance but not admitted.The discharge information contains ECG shown below,Which is the best response regarding this condition
1.S.Electrolytes,Thyroid Function test,FBE,Echocardiography should be done to exclude any possible contributing factors.
2.Can be managed with Antiarrythmic medications like Sotolol,verapamil,amiodarone,Flecanide depending on the age,non-urgent.
3.May need Referral to Electrophysiologist for Radiofrequency ablation of accessory pathway.
4.wide complex tachycardias should not be treated by AV-Nodal blocking agents as it may precipitate sudden death.
5.All of the above .
a 50 yrs. old menopause lady with history of amenorrhea for past 2 yrs., 4 years ago has genitalia wart which completely cured and pop 2 years ago was normal has sex last night, no discomfort or pain, followed by post coital bleeding for the past 24 hours dx?
a. Vaginal atrophy
b. Cancer cervix
c.Cancer endometrium
d.Menstrual cycle
Picture given of cleft lip… mother takes carbamazepine and alcohol daily…asking the cause…
a) alcohol
b) carbamazepine
c) genetic.
The extent to which drug is absorbed and transported to target tissue is known as:
A. Steady-state accumulation
B. Therapeutic drug levels
C. Bioavailability
D. Distribution
A 49 yrs old Gentleman Recently diagnosed with T2DM. You as his GP initiated Diet therapy until he sees the Dietician .Which of the following is true
1.High Protein diet improves glycemic control
2.Low Carbohydrate diet improves glycemic control
3.High Fibre diet improves glycemic control
4.A formalised dietary program is more likely to produce long term sustained effects
5.Sucrose should not be included in the diabetic diet .
5yr old baby brought to you by the mother with crusted patches on face. Otherwise well. The
mother had used iodine antiseptic with no improvement. Whats the treatment?
a) Bactroban
b) Erythromycin
c) Beclomethasone
d) Acyclovir cream…
4-yrs with head trauma has swelling at site of trauma and vomit once, headache until now… mx
Discharge
Observe 4 hrs
Observe 24 hrs
CT head
32 yrs old woman presenting to you with painful distal aspect of her finger after having non-specific symptoms like low-grade fever ,malaise for 1/52 followed by pain+burning of the finger
O/E Small grouped vesicles on the erythematous base noted.what should be AVOIDED in this condition.
1.Perform Incision and drainage to prevent bacterial infection
2.Antiviral agent- Acyclovir
3.Dry dressing over the lesion to prevent transmission
4.Antibiotics if there is evidence of bacterial superinfection.
5.Splint the finger .elevation and analgesics
Pt with attack of MI, u started heparin and 12 hrs later abdominal sweeling developed, u
suspect hematoma, what to do
A. Stop heparin
B. Reassure
C. Stop heparin and give aspirin
D. Give FFP
E. Give platelet
22 yrs old Obese Girl presents with irregular menstrual periods for last 3 years . Intermenstrual periods lasting from few days to many months .Also she is troubled by hair growth on her face too .Menarche 13 yrs.no significant medical illness,no regular medications.She smokes 20 cigarettes/day.You order Trans vaginal USS to study the Ovaries,AND Hormonal assay,Picture is Given below, which is the hormonal analysis you expect the most.
1.FSH Slightly Elevated
2. LH Reduced
3.TSH Elevated markedly
4.LH Elevated more than twice the FSH levels
5.Testosterone markedly reduced .
70 year old lady who came for examination. No symptoms . Exam normal
HB 10 MCV 71 MCHC 21
A)CA stomach
B)CA endometrium
C)CA breast
D)Dietary
The Nurse at your GP Clinic wants you to see a Gentleman in the treatment room who presented for wound cleaning and dressing. The Nurse is concerned that he may need Antibiotics before he leaves.O/E The Picture is Given below . What is the NEXT STEP
- Regular wound swapping + Long Term Antibiotics
2.Compression Bandaging during day time
3.Referral to Vascular Surgery after US Doppler Studies
4.Advise the patient to Elevate the Leg when sitting
5.Referral to General Surgeon for skin Grafting .
A patient after thyroidectomy perioral tingling sensation and agitation. Ca: normal, K=3.5, Hco3=35(n=32) what is the most likely cause?
a. tetany
b. hypokalaemia
c.anxiety
d.hypothyroidism
18 year oldPatient develops protienurea after URTI …cause
1-IgAnephropathy
2-minimal change disease
3-glomerulonephritis
Young male presented in Emergency department with aggressive behaviour,high temperature and high Blood Pressure. He was shouting .His friends reported him of having amphetamines.What is the greatest risk for this patient?
Cardiovascular risk
Acute psychosis
Suicide
Drug abuse
Panic attack
Pregnant 40 weeks does not feel fetal movement for 36 hours, CTG normal fetal heart rate 140, the mother is still worried and not convinced with the CTG:
a) amniotomy
b ) repeat CTG
c) Come back in next routine followup
d) Come back in 24hr
Dupuytrens contracture and normal blood glucose next step
- Physiotherapy – after surgery or in mild cases
- Remove flexor retina column – it’s palmar fascia not the flexor retinaculum
- Steroid injection in tendon
A child 5 yrs fell on a graden bed and has multiple superficial abrasions and lacerations. He has hx of 2 doses of tetanus vaccine received at 2 and 4 months of age. Wts next? ��
a. DPT and booster after 2 months ��
b. tetanus toxoid and immunoglobulin ��
c. start benzylpenicillin ��
d. DPT and immunoglobulin