A 65-year-old man presents with gradual low back pain increasing in intensity for the last six months. X-ray shows several osteoblastic lesions on lower vertebra and pelvic bones. Additional investigations reveal that those lesions are metastases.
Which of these is most likely the primary cancer in this patient?
A-Chronic lymphocytic leukemia
B-Hodgkin’s lymphoma
C-Prostatic cancer
D-Renal cell carcinoma
E-Thyroid follicular carcinoma
A 5 year old boy was diagnosed with urinary tract infection, which was later found to be due to E.Coli. What is the most appropriate treatment?
A. Trimethoprim
B. Nitrofurantoin
C. Amoxicillin
D. Cefalexin
E. Metronidazole
A 4 yr old boy presents with sharp metal injury.he never had any vaccinations as his parents were worried about side effects .what would be the next step ?
a. tetanus toxoid +full course dpt
b.TT immunoglobulin
c.A+ B
d. no treatment
What is the best drug to prescribe a hypertensive patient who has liver cirrhosis, lower limb edema and ascites?(A) Hydrochlorothiazide(B) Hydralazine© Angiotensin converting enzyme inhibitors. (
D) Beta-blockers.
A 2 day baby started to have jaundice but is breast feeding well and gaining weight. She is passing white stool 2-3 times per day. What is the single most likely cause of jaundice?
A. Biliary atresia
B. Haemolysis
C. Physiological
D. Congenital spherocytosis
E. Breast milk jaundic
A 17 year old girl is admitted to the hospital with a right lower lobe pneumonia.
She gives me a history of recurrent pneumonias, some of which have kept her in the hospital for weeks, and of chronic productive cough that occurs every day. Her parents inform me that she had loose stools since childhood. On the examination she is thin and distress. There are diminished breath sounds on the right lower lobe with rhonchi…
A 14 year old girl has not developed secondary sexual characteristics. This is likely due:
Constitutional
PCOS
Ovarian failure
A 14 yr old boy has been diagnosed with nephrotic syndrome. five days later he presents with flank pain,hematuria and fluctuating urea level .a diagnosis of renal vein thrombosis is made. what is the most likely cause for renal vein thrombosis ?
a.protein c deficiency
b.vasculitis
c.loss of antithrombin iii
d.high estrogen levels
e.stasis
A 23 year oldman has been stabbed in the back and has shortness of breath.the trachea is not deviated,he has engorged neck veins and absent breath sounds on the right. what is the most appropriate diagnosis?
a.tension pneumothorax
b.cardiac tamponade
c.simple pnemothorax
d.hemothorax
e.pleural effusion
The body of a 65 yr old man, who was treated for T.B and bronchitis,was seen at autopsy? his legs were swollen and his liver shows signs of transudate fluid. what was thecause of transudate ?
A.liver cirrhosis
b.alcoholic liver cirrhosis
c.cardiac failure
d.budd chiari syndrome
e.tuberculosis
A one month old boy has been brought to the Emergency Department. He is conscious but with cool peripheries and has heart rate of 22 beats/minute. He has been irritable and feeding poorly for about 24 hours. His chest x-ray shows a borderline enlarged heart with clear lung fields and ECG shows a regular narrow complex tachycardia. It is difficult to identify p wave on the tracing. What is SINGLE most appropriate immediate treatment?
A. Administer fluid bolus
B. Administer oxygen
C. Oral beta blocker
D. Synchronised DC cardio-version
E. Unilateral carotid sinus massage
68yo man gets repeated attacks of LOC and TIA. What is the most likely cause for this?
a. Atrial fib
b. Mitral stenosis
c. Aortic stenosis
d. HOCM
e. Carotid artery stenosis
65yo known case of liver ca and metastasis presents with gastric reflux and bloatedness. On bone exam there is osteoporosis. He also has basal consolidation in the left lung. What is the next appropriate step?
a. PPI IV
b. Alendronate
c. IV antibiotics
d. Analgesic
e. PPI PO
26 yr old male presented with pain in scrotum, left side for 4 hours. He has h/o similar pains over past 2 months but never took treatment. He is sexually active with multiple partners. What will be the management for this patiet?
A. Send home with antibiotic cover
B. Ultrasound of scrotum
C. Urgent surgical exploration
55 year old lady with chest pain,shortness of breath and palpitations.ecg shows SVT with HR 220/min.No response to carotid message.what is the next step in managememt?
a.DC shock
b.IV adenosine
c.verapamil
d.PCI
e.amiodarone
A 20 year old man received multiple fractures and crash injuries in motor vehicle collision. 4 days later he has enuria with pulmonary edema. Investigation shows Na 150mmol/l, K 7.2mmol/l, Urea 60, Glucose 4.2. What is the single most appropriate management?
A. Dialysis
B. Fluid challenge
C. Plasma expanders
D. IV normal saline and hydrocortisone
A 27yo waitress has pelvic pain, dysmenorrhea and increasingly heavy periods. She also
complains of dyspareunia. There is generalized pelvic tenderness without peritonism. Pelvic US
is normal. What is the most likely dx?
a. Endometriosis
b. Uterine fibroid
c. Pelvic congestion syndrome
d. PID
e. Tubal pregnancy
A 55 year old alcoholic man complains of severe abdominal pain radiating to his back. He also passes lose stool, pale stools and has weight loss. What is the most likely diagnosis?
A. Acuite pancreatistis
B. Chronic pancreatitis
C. Esophagitis
D. Pancreatic carcinoma