one of your patient is concerned about her facial Acne.o/e Picture Given Below.You rate is as MODERATE in severity , The BEST APPROACH in treating this,
1.Topical Antibiotics mono therapy and review in 3/12.
2.Comedolytic mono Therapy and review in one month
3.Oral Antibiotics (Doxycyclin) + Topical tretinoin(comdolytic) combined therapy and Review in 3/12
4.Oral Antibiotics (Doxycyclin) monotherapy and review in 3/12
5.Referral to Dermatologis for Oral Tretinoin therapy.
70 yrs old lady c/o sudden onset of severe, diffuse abdominal pain for several hours.No nausea or vomitting.The pain is constant but unable to localise it.O/E HR 98/mi, Irregularly Irregular, Pulse Volume Irregularly Irregular ,BP 110/70,T 37.6, Abdomen soft mildly tender. WBC 12,000,Ht 38%,Plate lets 250/mcl what is the best Diagnostic Option of choice
1.XRAY Abdomen supine + Errect
2.CT Abdomen
3.USS Upper Abdomen
4.Barium Contrast study
5.Angiography .
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…
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
2 yrs old child presents to you in ED , with barky cough worse at night ,some times associated with vomitting, after URTI with runny nose and Fever(38.2). O/E He has stridor with retraction of chest wall ,but not looking toxic. You managed with 1:1000 Adrenaline 5 ml Nebulisation ,and his stridor resolves ,he is comfortable with normal SaO2,which is the best nest step
1.Admission into the ward for overnight Obsevation.
2.Observe at ED for at least 12 hrs
3.Observe at ED for atleaset 4 hrs then discharge with Dexamethazone 0.6mg/kg/day x 3 days+Review prn.
4.Can be discharged immediatly +GP Review following day
5.Should be Discharged with Broadspectrum antibiotics +Review
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
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
Menstrual cycle is controlled by
(1) oestrogen and progesterone of ovary
(2) FSH of pituitary
(3) FSH and LH of pituitary
(4) oxytocin hormone
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
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 .
75 yrs old woman presents with severe back pain sudden onset.This started after carrying a heavy bag at the Air-port one week ago.PMH of Asthama for which she takes Prednisolone and on steroids puffers as well .Heavy smoker 30 cigarettes/day.Also drinks 4 bottles of wine per week.O/E She has Thoracic Kyphosis, Tenderness over L4 Vertebra.Otherwise examination unremarkableCa2+,PO4+Serum Alkaline Phosphate all normal.what is your next step,
1.Use FRAX (WHO) Calculator and decide she needs treatment or not.
2.Non-Pharmacological treatment is as effective as Pharmacological treatment.
3.Order DEXA scan to Confirm the Diagnosis and untill then treat with VitaD+Calcium supplements.
4.Order DEXA and then Start the treatment with Bisphosphanates orSERM or Denasumab s/c Etc.
5.Pain relief and Physiotherapy then review in 6/52.