46-‐year-‐old woman with type 2 diabetes has proteinuria+++,creatinine
concentration of 250mmol/l and a serum haemoglobin(Hb) concentration of 16g/UL.
She has a mild ankle oedema and a blood pressure of 145/100mmHg.Her
abdominal ultrasound examination shows normal sized kidneys. Urine culture is normal.What is the single
most appropriate drug to include in her long-‐term management?
a. Angiotensin converting enzyme (ACE) inhibitor
b. Beta blocker
c. Calcium channel blocker
d. Loop diuretic
e. Potassium sparing diuretic
A pt on insulin is booked in for a hernia operation. What is the most appropriate management of insulin?
a. Give insulin and saline pre-op
b. Stop insulin for the duration of the op
c. Give IV insulin + dextrose + saline pre-op
d. Give insulin as usual pre-op
e. None
A 35yo man presents with progressive breathlessness. He gave a hx of polyarthralgia with painful lesions on the shin. CXR: bilateral hilar lymphadenopathy.
What’s the most likely dx? a. Bronchial asthma
b. Cystic fibrosis
c. Sarcoidosis
d. Bronchiectasis
e. Pneumonia
A 3yo boy presents with a 1d hx of being unwell. He appears shocked and has 3h old rash made
up of urticarial and purpural spots. His RR=30bpm, sat=94%, temp=39C, capillary refill time=1s.
Urine is clean on dipstick. What is the single inv most likely to lead to dx?
a. Blood for C&S
b. ESR
c. CXR
d. Urine for C&S
e. CSF analysis
A patient on warfarin due to past history of DVT is now scheduled for surgery. What is the most appropriate step to be taken?
A. Stop Warfarin
B. Continue Warfarin add Heparin
C. Stop Warfarin and Start Heparin
D. Increase Warfarin
A 7 year old boy who is up to date with all his immunizations comes to you 7 hrs after metal spike has injured his hand. Wound is 0.5cm deep. MOST APPROPRIATE ACTION?
A) tetanus ig+ vaccine + antibiotics
B) tetanus ig + antibiotics
C) tetanus ig + tetanus vaccine
D) Tetanus vaccine + antibiotics
E) antibiotics
A 64yo man has presented to the ED with a stroke. CT shows no hemorrhage. ECG shows atrial
fib. He has been thrombolysed and he’s awaiting discharge. What prophylactic regimen is best
for him?
a. Warfarin
b. Heparin
c. Aspirin
d. Statins
e. Beta blockers