A 57 yrs old woman c/o Severe dizziness for last 2 days.When she sits up or rolls over in bed she has spinning sensation for few seconds and is followed by nausea.These episodes have occurred many times a day and prevent her from working.She takes no medications,and she denies any URTI Symptoms.When moved quickly from sitting to lying position with her head turned and hanging below the horizontal plane,she complains of dizziness and horizontal nystagmus noted.THE MOST LIKELY DIAGNOSIS
1.Orthostatic hypotension
2.Menieres disease
3.Acoustic Neuroma
4.Benign paroxysmal positional vertigo
5.Viral Labyrinthitis.
Pt came with diarrhoea and RLQ pain 3 days ago, now with RUQ pain. Dx?
a.Clonorchiasis
b.Shistozomiasis
c.Hydatid
d.Malaria
e.Ameboma
32 yrs old man presents with hypertension and peripheral oedema(mild).He is otherwise healthy and takes no medications.FHO His father and brother have kidney disease.His father was on hemodyalisis before his death at 68 yrs of stroke.O/E BP 174/96,and AV-Nicking on funduscopy.Soft S4 Gallop,Bilateral Flank Masses could be felt on ballotment.Urine RBC 15-20/hpf and trace of protein.But is otherwise normal.Recent eGFR 90ml/mi(Stage 1) You are his GP and the Management,
1.USS KUB+ Upper abdomen and referral to Nephrologist
2.Education and Genetic Couselling +Screening Family members with USS KUB.
3.Anti-hypertensives and monitoring for Systemic complications like Anaemia,Metabolic Acidosis,hyperparathyroidism.
4.Dietry advise to slow down the condition.
5.All of the above .
The most common cause of acute gastroentrietis in developed countries is ?
A. Bacterial
B. Parasite
C. Viral
D. Fungal
E. Reaction to certain medication
Deficiency of factor VIII
A Increases the bleeding time
B Is due to abnormal gene on the Y chromosome
C Causes small hemorrhages into the skin to cause purpura
D Affects the extrinsic, rather than the intrinsic, pathway for blood coagulation.
which one cant cause keratin scaling?
a) psoriasis
b) pitiryasis rosea
c) scc
d) bcc
e) solar keratosis
Old agitated alcoholic man , came in shouting , says he has been drinkingcheap street wine and thrown away food from garbage can ,next ?
a. iv glucose
b. thiamine
c. diazepam
d. droperidol
74 yr old man brought from resident home, for he is masturbating near nurses’ station, tried to cuddle & kiss the nurses while bathing him over 2mth. History of Alzheimer’s, taking donepezil & other Med .
A worsening Alzheimer’s
B Side effect of donepezil
C Side effect of other Med
D Frontal lobe infarct
The diseases notifiable to the WHO under the International Regulation Act are all except:
A. Cholera
B. Plague
C. Yellow Fever
D. Diphtheria
A 50 yrs old woman with sore throat presenting to you with some skin rashes in the hands and fore arms .what is your diagnosis
1.Impetigo
2.Erythema nodosa
3.Erythema multiforme
4.Erythema marginatum
5.Fungal Rash .
Image may contain: 1 person, close-up
ethics question ; you are locum doctor at some palce ; all the doctors there some marijuana
in their break; you are aware they have marital problem ; who will you report
Manager
Health authority
Discuss with them
A smoker man with bilat. Leg cramps when walking for 100 m. distance, he has no dorsalis pedis pulse on examination and his ABI in left leg is 0.8 and in the right leg is 0.4, wts the next best step in management ?
Doppler ulrasound
Angiography
IV heparine
Stop smoking
Known HTN pt presented with muscle weakness. K 6.5. what could be the cause?
a. Enalapril
b. Amiloride
c. Simvastatin
d. Thiazide
The doctor accidentally cuts the bowel during surgery. As a result of this action, the client develops an infection and suffers brain damage. The doctor can be charged with:
A.Negligence
B.Tort
C.Assault
D.Malpractice
A lady on lithium well controlled previously now poor compliance drug levels low ,and
hypomania
What to give
Lithium
Carbamezapine
Depot
Sodium valproate
Olanzapine
A client telephones the emergency room stating that she thinks that she is in labor. The nurse should tell the client that labor has probably begun when:
A.Her contractions are two minutes apart.
B.She has back pain and a bloody discharge.
C.She experiences abdominal pain and frequent urination.
D.Her contractions are five minutes apart.
Man experiences pain on walking for 100m. Pulse at popliteal fossa is weak and the dorsalis pedalis can’t be felt. Management:
A. Nifedipine
B. Propranolol
C. Surgery
D. Graduated walking program
15 year old girl comes to u for OCP advice…few days later her mother also ur patient comes to u and ask about her daughter’s health issue…what to do
1,make an appointment witg daughter again
2,tell mother that u cant tell anything
3,ask mother to discuss this with her daughter
72 yrs old woman presenting to discuss about the hand deformity to your office as a new patient.some times she complains pain in the evening after doing some garden work.
o/e Her hands are nodular and enlarged as in the picture.
1.Her Rheumatoid Factor likely be elevated
2.Uric Acid Likely be elevated
3.Her Laboratory Evaluation likely be Normal
4.Her ESR,CRP Likely be elevated Markedly
5.ANA Level likely be Elevated .
8/12 months old baby (born at term 3.6kg) presenting with intermittent diarrhoea ,irritability,poor weight gain for last 3/12.She was breast fed upto 4 1/2 months then solids introduced at 5 months.o/e pale looking,abdominal distension+,mild wasting around the buttock area. Labs Hb9,wcc9,plates 430,Na 137,k5.3 eGFR Normal,calcium 1.9,Albu 35 ,sweat test negative.Growth Chart Given below , most likely diagnosis and treatment,
- Viral Gastroenteritis-IV Fluid therapy
2.Giardiasis -Elixor Metronidazole therapy
3.Cystic Fibrosis-Antibiotics +pancreatic enzyme replacement +multi- team approach
4.Coeliac Disease (Jejunal biopsy)- Gluten free diet
5.Enterogenic E.Coli induced Diarrhoea-Antibiotics