A 2 month child with diarrhea and vomiting for 6 days is brought in looking lethargic. What is the
appropriate initial inv?
b. Random blood sugar
the key is A, Why it's not B? cuz the child is lethargic and Random blood sugar is easier and faster to get the result than BUE
A 79 yo lady who is otherwise well recently started abdominal pain. She is afebrile and
complains that she passed air bubbles during urination. A urethral catheter showed fecal
leakage in the urinary bag. What is the likely pathology?
c. Rectosigmoid tumor
d. Large bowel perforation
A lady who works at a nursing home presents with itching. Exam: linear tracks
on the wrist. She says that 2d ago she had come in contact with a nursing
home inmate with similar symptoms.What is the mechanism of itching?
b. Destruction of keratinocytes
c. Allergic reaction
.the key says C I think A
A 41yo man presents with longstanding foul smelling ear discharge and progressive hearing loss.
Otoscopy showed perforation of the pars flacida and a mass in the upper part of the middle ear.
What is the most likely dx?
c. Acquired cholesteatoma
d. Congenital cholesteatoma
A 31-year-old woman visits her GP in a tearful state. One month ago her 5-year-old son died after drowning whilst at a party with friends. Upon questioning the woman tells her GP that she is struggling to sleep, can't seem to function normally and at times suffers from bad stomach cramps. She expresses thoughts that she wishes she had died instead but denies any current suicidal ideation. She says that she has seen her son sitting on the sofa at home at times but knows that this is not real.
Which of the following conditions is she most likely to be suffering from?
Normal grief reaction
A lady with post-ileocolectomy closure of stoma has a small 4 cm swelling around the stoma. What is the most appropriate management of the swelling?
a. Local exploration of swelling
b. Exploratory laparotomy
c. Open laparotomy and re-closure
d. Abdominal binder
A 28-year-old has suddenly developed a red itchy rash with wheals all over her body. Her lips are swollen and she has noisy breathing. Her pulse rate is 124bpm, BP 90/70 mmHg and respiratory rate 30 breaths/min. What is the single most appropriate immediate treatment?
A- Adrenaline (epinephrine) 0.5ml (mg) 1 in 100 IM
B- Adrenaline (epinephrine) 0.5ml (mg) 1 in 1000 IM
C-Adrenaline (epinephrine) 0.5ml (mg) 1 in 10000 IM
D-Adrenaline (epinephrine) 0.5ml (mg) 1 in 100,000 IM
E-Adrenaline (epinephrine) 0.5ml (mg) 1 in 1000 000 IM
1. Dysphagia to both solids and liquids
2. Age around 40
3. Symptoms for 3-5 years
4. Weight loss around 9-11 lbs
5. Barium esophagogram - Dilated esophagus with smooth tapering
A woman comes to the emergency department with a severe headache starting one day prior to admission. On physical examination she has a temperature of 103°F, nuchal rigidity, and photophobia. Her head CT is normal. LP shows CSF with 1250 white blood cells and 50,000 red blood cells. What is the most appropriate next step in the management of this patient?
b. Ceftriaxone and vancomycin
e. Surgical clipping
f. Repeat the CT scan with contrast
g. Neurosurgical consultation
Please post an explaination with you answer.
A. Tetanus immunoglobulin
B. Tetanus immunoglobulin and vaccine
C. Complete tetanus course
D. Booster only
A 60 year old female presents with acute onset of bone and back pain following a rough journey in
car. On examination she has tenderness at mid-thoracic vertebrae with spasm, she feels better once
she bends forward. What is the SINGLE most probable diagnosis?
A. Osteoporotic fracture vertebrae
B. Myofacial pain.
C. Whiplash injury
D. Myocardial Infarction
A 70-year-old man with extremely severe parkinsonism comes by ambulance to the emergency department secondary to psychosis and confusion developing at home. He is maintained on levodopa/carbidopa, ropinirole, and tolcapone. What is the most appropriate next step in management?
a. Stop levodopa/carbidopa
b. Start clozapine
c. Stop ropinirole
d. Stop tolcapone
e. Start haloperidol
A 38-year-old man is evaluated for seizures. He achieves partial control with the addition of a second antiepileptic medication. He drives to work each day. What do you do about his ability to drive?
a. Confiscate his license
b. Allow him to drive if he is seizure-free for 1 year
c. Allow him to drive as long as his seizure history is noted on his license
d. Recommend that he find an alternate means of transportation
e. Do not let him leave the office unless he is picked up by someone; no further driving f. Allow him to drive as long as he is accompanied
A 38-year-old carpenter comes with pain near his ear that is quickly followed by weakness of one side of his face. Both the upper and lower parts of his face are weak, but sensation is intact. What is the most common complication of his disorder?
a. Corneal ulceration
b. Aspiration pneumonia
d. Otitis media
f. Dental caries
A 20-year-old African American man comes for a screening test for sickle cell. He is found to be heterozygous (trait or AS) for sickle cell. What is the best advice for him?
a. Nothing needed until he has a painful crisis
b. Avoid dehydration
d. Folic acid supplementation
e. Pneumococcal vaccination
I feel the need to come in for my brothers who have been finding ielts tough. You'd get a lot of advice, apply what's best for you without entertaining doubts.
Hereunder I'd proceed to drop my opinion on how to achieve minimum S8 L8 R7 W7 which is sufficient to enable you qualify for plab1. With just 6weeks to prepare, and despite a tedious job, I had S8 L8 R9 W7.5 by applying the principles I'm about to share.
First of all, the important resources that could be helpful are:
- Cambridge ielts (1st-10th ed)
- The liz blog via ieltsliz.com
- The Barrons ielts book
- Ace the ielts
- ielts advantage
The aforementioned were listed in order of importance to the ease of success.
On to the different subtests. Please note that the easiest parts to score high are the speaking and listening tests. As you practice, you'd understand.
S8. To achieve a minimum of 8 in speaking, you must utilize your mirror and your friends. There are prototype cue cards in all the materials above. Before going to sleep, rehearse answers to these questions in front of your mirror. Engage in intelligent discussions with friends who have at least basic knowledge in numerous fields. It aids cognition. After the basic questions about your life (origin, address, family, habits, interests, job, etc) a good performance should have lifted you to, say, 6. Doing well in the complex section of discussing a random topic is what would earn you 7 or even 8. While rehearsing, identify your weakpoints. You're allowed to be hard on yourself so as to polish yourself well. You can record your mirror conversations for effect. The mirror helps you overcome the need to cajole friends to listen to you while describing your family or home or hobbies when they just, for instance, want to drink and discuss football or women. In my speaking test I had 8.
L8. The Cambridge ielts books have sufficient practice tests for this. The only thing you need for listening test is to practice, and watch your marks soar as you go from 1st to, say 4th or 5th edition (I didn't get to 10th, infact I stopped at 4th). You'd also identify your weakness as you practice. For instance, I noticed I tend to drift in thoughts leading to loss of 2 or 3 consecutive points during early phase of practice. I thus only had to work on that. In my listening test I had 8.
R7. I was lucky to have gotten 9, as I didn't really practice reading tests. I found the texts in Cambridge book extremely boring. The Barrons book on the other hand offers very fundamental principles needed for a good outing at the test. You don't have to get used to Greek texts to understand the principles. Read Barrons, and if time permits, practice the prototypes in Cambridge ielts book. Please print the texts and questions out, and practice with 45mins instead of 1hr. In exam condition you'd spend more time naturally. Please ensure you read Barrons. Identify your weakness while practicing.
W7. The ultimate hurdle. The way forward is Barron's ielts book. Read the chapter on writing at least thrice, then practice with sample questions in Cambridge ielts book. Ensure you follow Liz too. During the exam, don't rush. Build your points on the question paper fully, then transfer. One of the exam supervisors was worried as, even with 20minutes gone, I had just started (transferring into) task1 answer sheet. I however finished both before it was 10mins to go. Task1 is equally as important as task2, don't fall for the trap of the higher score in task2. The truth is that you would likely score higher in task1 than task2. For example, 8 in task1 and 6.5 in task2 would fetch you 7 (8 plus 13, which is double of 6.5, amounts to 21, which when divided into 3, fetches 7). Please do not deprive yourself the juice in the easy task1. It's not so easy to overwhelm your examiner in task2. I did both tasks very well, yet had only 7.5 (I suspect it was 8 in task1 and 7 in task 2). Please read Barron's ielts book to master the principles. You'd be glad you did.
In summary, each test has its inherent obstacles, and no single material or method has a monopoly of the way forward, thus a careful application of selective principles would help. I wish you success.