Man admits to hospital with severe pain in RUQ for 3 hours and then resolves

  1. Man admits to hospital with severe pain in RUQ for 3 hours and then resolves.
  • Gallstones
  • Left renal tumour
  • Haemorrhage into the adrenal gland
  1. A question about Acute myeloid leukemia Blast cell >66%

  2. A 15 year old boy with frequent angry burstouts and condition keeps deteriorating.1st line in treatment
    -Haloperidol
    -Olanzepine
    -Risperidone

  3. A man comes to clinic with palpitations. He drink 3 cans of beer per day. BP erect 138/80 and supine 120/70. ECG features *sinus tachycardia *loss of P waves Meds: HCT and ARB
    -Hypertensive heart disease
    -Ischaemic heart disease
    -Medication
    -Alcoholic cardiomyopathy

  4. Acute case of psychosis in asks least likely effective drug
    -Haloperidol
    -Quetiapine
    -Fluphenazine
    -Olanzepine
    -Risperidone

  5. A mother recently changes her job to a night shift and child doesn’t go to school for weeks complaining of an abdominal pain and no organic cause of abdominal pain is found. He looks very happy on weekends.
    Reassure and say self-limited
    Tell mom to stop working
    Liaise with school to arrange a returned plan.

  6. A scenario a man complains severe anal bleeding with pain on defecation. He doesn’t allow to examine. Pain persists for an hour after defecation

  • GTN cream
  • Lateral sphincterotomy
  • Saline wash and high fiber diet
  • Corticosteroid cream
  1. 9 year old brought by his grandmother complaining he has very weird behaviour with aggression and he is small for his age. His mom had been drinking alcohol since she was 15
  • Foetal alcohol syndrome
  • OPD
  1. A nursing student think he has brain tumor, he has an exam coming up on in three weeks but he complains of headaches, diplopia. No organic cause and all of the examinations are normal. Still he is fearful he has a tumor.
  • Hypochondriasis
  • Somatoform disorder
  • Somatoform pain disorder
  1. A lady brings by her husband saying she wants to participate her niece’s wedding but she is anxious and palpitates when she goes out. She spends at home all the time reading, gardening. The initial treatment
  • Alprazolam
  • Haloperidol
  • Droperidol
  1. A BMP with low Na+, low K+, low HCO3-. Patient has a surgery yesterday.
  • A result taken near IV site
  • SIADH
  1. Eye scenario inferior and lateralized. Pupillary doesn’t relative to light
  • PCA aneurysm
  • Midbrain Infarct
  • DM2
  1. SLE scenario. Most definitive test to diagnose SLE
  • ANA
  • Anti-Sm
  1. SLE with malar rash picture, symmetrical rash. Tx?
  • Hydroxychloroquine
  • Methotrexate
  • Azathioprine
  1. A man admits to clinic with a Ct given a large malignancy in the abdomen, asking most likely reason to cause a post op DVT complication
  • B/l varicose veins
  • His drugs
  • His BMI 36
  1. TB positive mom with child highly positive for IGRA
  • CXR in 3 months
  • Isoniazid for 9 months
  • Tuberculin skin test now
  1. 2 year old what language development is achieved
    Use sentences with 4 syllables
    Can say 2 or more pronouns
    Can name 4 colors

  2. Renal vein thrombosis scenario

  3. Man with chronic weight loss and fatigue. Vomits clear fluid and now it has become undigested food particles. Back pain.

  • Cancer of duodenum
  • Cancer of body of stomach
  • Cancer of the head of pancreas
  1. A man’s spine found with two lesions. Nuclaer scan only uptook by the two lesions. What else to check. On lab ESR 140mm/hr, Platelets 400
    PSA
    Bone marrow biopsy

  2. Thyroid gland with psamomma bodies 25mm lesion. Tx

  3. Thyroid tumor 3.5cm with no lymph nodes. Tx-
    Radio ablative I
    Total thyroidectomy
    Radioactive followed by thyroidectomy

  4. Motor vehicle accident woman’s all four limbs doesn’t work. Suspected fracture, 98% O2 saturation. Before transfer by flight to tertiary hospital most likely to be done
    IV access
    O2 by mask
    Blood tests

  5. MVA, patient’s breathing become laboured and shallow. Left chest recedes on inspiration. Trachea midline Tx:
    Intubation and ventilation
    Chest tube under water
    Needle thoracostomy

  6. Plumber comes with 40 years smoking Hx to clinic with non bronchodilator respondent dyspnoea. FEV!/FVC 0.7
    Pleural whitish single plaque on Left middle lobe on XRay
    Pleural biopsy
    Bronchoscopy

  7. Lewy body demetia

  8. Resting tremor tx

  9. Schizophrenia negative symptoms

  10. Paranoid delusion man comes what to ask from the relatives

FamilyHx of mood disorders
Poor social interaction in school
30. Migraine with aura scenario

  1. Scenario with a woman 76yrs Afib, brother has a stroke recently taking 5mg ramipril. BP on exam 160/90mmHg, set of drugs mention. Lipids are within normal scenario
    Most likely to reduce risk of stroke
    Statins
    Aspirin
    Warfarin
    Increase Ramipril.

  2. B/l lung consolidation CXR asking for abx

  3. Long hx of Bronchiectasis with yellow green sputum. Abx treatment?. He is acutely ill.
    -OP amoxicillin
    -OP cephalexin
    -IV ticarcillin+tazo

  4. Long term management of glaucoma
    Laser iridotomy

  5. Melanoma metastasis on brain

  6. Mild Alzheimer lady, Both son and she disregards the need for medications. What to do?

  • Send a community nurse everyday to give meds
  • Send her to a nursing home
  • Emphasis the need of medication for son
  • Explain more about it to lady
  1. Lady who is on venlafaxine overdose, what to give next? Mirtazapine

  2. Lady who is on SSRI took tramadol from husband and on hospital. The most likely to be seen on Examination
    Hyperreflexia
    Muscle weakness
    Muscle fatigue

  3. A girl change 2-3 times clothes. Go to gym daily and do 200 sit ups. BMI 19, now complains weakness and fatigue with fainting. Eat only high protein and carbs. The most likely diagnosis
    OCD
    Body dysmorphic disorder
    Anorexia Nervosa

  4. 25 yrs, smoking Obese woman comes asking for risk of breast cancer. Grandma dx at age 75yeas
    Stop smoking
    Loose weight
    Change low oestrogen pill
    Self breast examination

  5. A 27years man comes with chronic discomforting scrotal lump. Next diagnostic test
    USS
    Tumor markers

  6. Man with infertility who had a orchidopexy with 1 million sperm on count
    What test done to treat?
    Testosterone
    Fsh &lh
    USS

  7. 78 Man comes with high bowel sounds constipation no pic given. Large dilation of transverse ascending descending colon. PMH* appendectomy, cholecystectomy. Reason?

Sigmoid volvulus
Caecal volvulus
Adhesion obstruction

  1. 78 Man comes with high bowel sounds constipation no pic given. PMH* appendectomy, cholecystectomy.
    Most likely reason?
    Same set of options

  2. Couple bring a child who is 4 years old nausea and vomiting. They say two hours ago they were at a party and saw the kid drink from guest’s cups. Initial investigation of choice

  • Drug test
  • Blood culture
  1. A lady comes with complaints of infertility. Takes risperdone. MRI is normal of the brain
    High prolactin level above 2000mIU/L. Most likely reason to explain her blood results
  • Risperidone
  • Slightly producing pituitary adenoma
  • PCOS
  1. A man comes with chronic cough with yellow and green sputum. Abx of choice.
    IV ticarcillin tazobactam
    OP cefazolin
    OP amoxicillin