A 46 year old woman complains of abdominal discomfort and lower abdominal distension. She has regular menstrual cycles with no menorrhagia or dysmenorrhoea. She is mother of 3 children. Abdominal examination reveals a large cystic mass arising from the pelvis. USS reveals a 14 cm*16cm multilocular cyst arising from the right ovary with thin septa. There are no solid areas. There is no evidence of free fluid or metastatic lesions.CA 125 is 12.What is the most appropriate management?
a. Ultrasound guided aspiration and cytological examination of the fluid
b. Right salpingo oophorectomy
c. Total abdominal hysterectomy with right salpingo-oophorectomy
d. Total abdominal hysterectomy and BSO
e. Laparascopic cystectomy
Patient has neck stiffness, headache and petechial rash. Lumber puncture showed a high pressure , what would be the cause?
A-Group B strep
B-Neisseria meningitides
C-Mycobacterium tubecrlosis
D-Staphylococcus aureus
A 50 year old man presents with pain in his right ear. On examination there are blisters in the ear. What is the most likely cause?
a. Herpes simplex
b. Acute otitis media
c. Acute otitis externa
d. Herpes zoster
e. H. influenza
23-year-old man has a 2 cm ulcer in his oral cavity. He has lost 3 kg in weight over the last 3 months. The edge of the ulcer is biopsied and the histopathology result shows non-caseating granulomata.Which is the single most likely diagnosis?
A Actinomycosis
B Crohn’s disease
C Tuberculosis
D Ulcerative colitis
E Vitamin B12 de ciency
Drug of choice for Rheumatic fever prophylaxis in penicillin allergic patient
A-Erythromycin
B-Clindamycin
C-Vancomycin
D-Gentamycin
A 22 year old unmarried woman is admitted with a history of sudden onset of lower abdominal pain and vomiting of for 2d. She is febrile and ill looking. Pain did not respond to treatment by GP. She has no POA and denies sexual intercourse, Abdominal examination reveals a tender mass in the right iliac fossa. Ultrasound examination shows a cystic and solid mass 7 cm in diameter rising from the right ovary. The capsule of the tumour is smooth and intact. The other ovary is normal. There is no free Fluid.Ca 125 level is within the normal range. What is the most appropriate treatment?
a. Perform unilateral oophorectomy
b. Start analgesics and review in 24 hrs
c. Aspirate the ovarian cyst under ultrasonic guidance.
d. Review in the clinic if the pain subsides
e. Perform serum beta Hcg to exclude an ectopic
A 60 year old man had a myocardial infarction 2 weeks ago. He now presents with dyspnoea and chest pain. A pericardial friction rub was noticed on examination. ECG shows widespread ST elevation. A chest X-ray shows enlarged, globular heart. His pulse rate is 95 bpm and respiratory rate is 24/min. What is the single most likely cause of his symptoms?
A. Cardiac Tamponade
B. Dressler’s syndrome
C. Atrial fribrillation
D. Mittal Regurgitation
E. Pulmonary embolism
A 30-year-old female has right wrist numbness, tingling, and atrophy of the thenar eminence. Which one of the following nerves would you suspect to be an issue based on her symptoms?
A. Axillary
B. Brachial
C. Median
D. Radial
E. Post. Interosseous nerve
Best indicator for nutritional status for a child is
A-Mid arm circumference
B-Head circumference
C-Rate of increase of height and weight
D-Chest circumference
A 29-year-old woman has been generally tired and lethargic for the past year. She has had intermittent crops of mouth ulcers that coincide with a flare up of a skin rash over her cheeks. Her full blood count shows the following results:Hb 106g/L, WCC 2.3 × 109/L, Platelets 87 × 109/L.
Which single autoantibody is most consistent with the diagnosis?
A Anti-acetylcholine receptor
B. Anti-dsDNA
C. Anti-mitochondrial
D. Anti-Scl-70
E. Anti-smooth muscle
A 64-year-old woman has had loose stools, rectal bleeding, and weight loss for the last 6 months. The day after a colonoscopy, she has an episode of chest pain while getting washed and dressed. T 36.6°C, HR 105bpm, BP125/80mmHg, SaO2 93% on 2L O2.
Which is the single most appropriate initial management?
A CT pulmonary angiogram (CTPA)
B D-dimer
C Erect chest X-ray
D Therapeutic dose of low-molecular-weight heparin (LMWH)
E Ventilation/perfusion(V/Q)scan