An 18-year-old woman at 9 weeks’ gestation is brought to the emergency department because of an open fracture of the tibia and fibula. She is hemodynamically stabilized and referred to the orthopedic department She is scheduled for internal fixation of the tibia for the following day.
However, before the surgery she develops severe dyspnea and confusion. Her temperature is 37.r C (99 go F), blood pressure is 110/70 mm Hg, pulse is 110/min, and respirations are
22/min. Examination shows numerous non-palpable petechiae in the upper part of the body
Which of the following is the most likely diagnosis?
e; A Air embolism
6 B. Amniotic fluid embolism
e; C. Thromboembolism
6 D. Fat embolism
e; E. Acute respiratory distress syndrome
A 14years old girl presents to the clinic for annual well child examination
She expressed concern of thinning hair but otherwise denies any concern
She is well groomed and appears healthy
BMI 21
On examination you noticed yellowing of the teeth and calluses over the dorsal aspect of the 2nd and 3rd MCP joints
Which of the following disorder do you suspect
A. Body dysmorphic disorder
B. Bulimia nervosa
C. Metamphetamine abuse
D. Anorexia Nervosa
E. Binge eating disorder
Explanations for answers please
A 70 year old man with cerebral metastasis develops cerebral oedema and is being given dexamethasone and antihypertensive drugs. His blood glucose rises to 17-18 mmol/l. What is the appropriate management?
a. Low dose insulin
b. Optimal dose of insulin
c. Glibenclamide
d. Stop dexamethasone
A 4-year-old Caucasian boy has poorly controlled asthma, despite being on a high-dose steroid inhaler and a leukotriene receptor antagonist and compliant with his medication. He has recurrent chest infections and has significant nasal discharge. He also has poor growth, Harrison’s sulci, and finger clubbing.
Which is the single most appropriate next investigation?
A- Bronchial brush biopsy
B- Bronchoalveolar lavage
C-CT scan of the chest
D-Lung function tests
E-'Sweat test
A 72-year-old man underwent surgical repair of an aneurysm of the infrarenal aorta. He received perioperative prophylaxis with a second-generation cephalosporin antibiotic. On the first postoperative day he complains of progressive abdominal pain and bloody diarrhea. His temperature is 38.5° C (1 01 o F), blood pressure is 110/65 mm Hg, pulse is 11 0/min and respirations are 22/min. His abdomen is mildly distended and tender to palpation The tenderness is mostly in the left lower quadrant without rebound. Femoral pulses are full and symmetric His white blood cell count is 12,000/mm3. Which of the following is the most likely
diagnosis?
A Pseudomembranous colitis
B. Invasive infectious diarrhea
C. Aortoenteric fistula
D. Ischemia of the bowel
E. Perforation of the colon
A 24yo woman presents with deep dyspareunia and severe pain in every cycle. What is the
initial inv?
a. Laparoscopy
b. Pelvic US
c. Hysteroscopy
d. Vaginal Swab
Q. 1. What is the key?
Q. 2. What is the likely diagnosis?
A 14-year-old girl requests emergency contraception. She had unprotected intercourse with her 14-year-old boyfriend 2 days ago. She appears to understand the nature of emergency contraception.
Which is the single most appropriate management?
A - Advise her that she cannot have emergency contraception, as it is too long since intercourse took place
B - Advise her that she is too young to be legally prescribed emergency contraception
C - Prescribe emergency hormonal contraception and advise her about future contraception
D - Prescribe emergency hormonal contraception only after informing her parents
E - Prescribe emergency hormonal contraception only after informing social services
A 1 year old boy has been bought to the accident and emergency department with diarrhoea and vomiting for 5 days. For the past 24 hours he has been unable to tolerate and fluids. In the last hour he has become drowsy, his skin turgor is reduced and his skin is mottled. His eyes are sunken. His heart rate is 180 beats/minute and his capillary refill is prolonged. What is the single most appropriate immediate treatment? A. IV fluid bolus over 20 minutes B. IV fluids over 24 hours C. IV rehydration over 48 hours D. Nasogastric rehydration over 24 hours E. Oral rehydration solution over 48 hours
A 26years old presents with prolonged constipation, blood on the side of the stool and very painful defecation
PR exam very painful
What is the most likely diagnosis
A. CA colon
B. Ulcerative colitis
C. Crohns disease
D. Anal fissure
E. Constipation
53-year-old woman with hypertension is prescribed nifedipine by her primary care physician.
Which of the following is a common side effect of nifedipine?
A. Swelling of the feet and ankles
B. Agranulocytosis
C. Dilated cardiomyopathy
D. Diabetes insipidus
E. Seizures
A 62-year-old man is forgetful. He cannot remember how he got to the surgery, but is able to recall an address on testing of his memory. He has gynaecomastia and palmar erythema.
Diagnosis?
A. Mild cognitive impairment
B. Korsakoff synd.
C. Alzheimer’s
D. Pick’s
A 15year old boy who presented with pain in his leg and limping which has settled with use of Aspirin
What is the most likely diagnosis
A. Leomyosarcoma
B. Liposarcoma
C. Osteoid osteoma
D. Painful hip
E. Exostosis
Most specific test for SLE is :
A) ss DNA
B) ds-DNA
C) Anti- Smith Ab
D) anti SSA(Ro)
E) histone Ab (answer below)
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…Answer is C Anti -smith antibody
Anti-Smith antibody is the most specific antibody for SLE.
ANA screening test has sensitivity 95% not diagnostic without clinical features.
Anti-dsDNA antibody has high specificity, sensitivity only 70% and levels are variable based on disease activity.
AntiSSA (Ro) or anti-SSB (La) present in 15% of patients with SLE and other connective tissue disease such as sjogren syndrome
Anti histone : drug induced Lupus