Unanswered plab mcqs 251-300

  1. A 7yo is brought by his mother who says that he was well at birth but has been suffering from
    repeated chest and GI infections since then. She also says that he is not growing well for this age.
    What is the likely condition of this child?
    a. CF
    b. SCID
    c. Primary Tcell immunodeficiency
    d. Primary Bcell immunodeficiency
    e. Malabsorption
  2. A 3yo child has a high temp for 4 days and he had not seen a doctor. Then mother notices rashes
    on buccal mucosa and some around the mouth. What is the most appropriate dx?
    a. Measles
    b. Roseola infectiosum
    c. Rubella
    d. Chicken pox
    e. Impetigo
  3. A 70yo lady presents with fever for 3d and confusion. There is no significant PMH. What is the
    most probable dx?
    a. Delirium
    b. Hypoglycemia
    c. Alzheimers
    d. DKA
  4. An obese mother suffers from OSAS. Which of the following inv is best for her?
    a. ABG
    b. Overnight pulse-oximetry
    c. Polysomnography
    d. EEG
  5. A 28yo business man came to the sexual clinic. He was worried that he has HIV infection. 3 HIV
    tests were done and all the results are negative. After a few months, he comes back again and
    claims that he has HIV. What is the dx?
    a. Somatization
    b. Hypochondriac
    c. Mancheusens
    d. OCD
    e. Schizophrenia
  6. A 6wk child presents with progressive cyanosis, poor feeding, tachypnea over the first 2 wks of
    life and holosystolic murmur. What is the most appropriate condition?
    a. ASD
    b. VSD
    c. Tricuspid atresia
    d. PDA
    e. TOF
  7. A 29yo woman who was dx to have migraine presents with severe onset of occipital headache.
    She lost her consciousness. CT=normal. Neurological exam=normal. What is the most
    appropriate management?
    a. Repeat CT
    b. MRI
    c. LP
    d. XR
    e. No inv required
  8. A 19yo man has been happier and more positive than usual, with more energy than he has ever
    felt before for no particular reason. He has been getting more work done at the office today and
    has been socializing with his friends as usual. What is the most likely dx?
    a. Atypical depression
    b. Marked depression
    c. Bipolar syndrome
    d. Psychosis
    e. Hypomania
  9. A 35yo female attempts suicide 10x. There is no hx of psychiatric problems and all neurological
    exams are normal. What is the best tx?
    a. Problem focused tx
    b. CBT
    c. Antipsychotic
    d. Antidepressant
    e. ECT
  10. A 57yo man presents with weight loss, tiredness, fever and abdominal discomfort. Exam: spleen
    palpable up to the umbilicus. Labs: WBC=127, Hgb=8.7, Plt=138. What is the most likely dx?
    a. CML
    b. AML
    c. CLL
    d. AML
    e. Polycythemia
  11. A baby born at 34 weeks with a heart murmur is kept in the incubator for almost 4 weeks. There
    is no murmur at discharge. What is the likely cause of this murmur?
    a. PDA
    b. TOF
    c. Aneurysm of sinus of Valsalva
    d. Aorto-pulmonary septal defect
    e. AVM
  12. A 6yo girl who has previously been well presented with a hx of tonic-clonic seizures lasting
    4mins. Her mother brought heƌ to the hospital aŶd she appeaƌed ǁell. She is afeďƌile aŶd didŶ͛t
    lose consciousness during the episode of seizure. She has no neurologic deficit. What is the most
    appropriate inv for her?
    a. ABG
    b. Serum electrolytes
    c. ECG
    d. Blood glucose
  13. A 60yo woman was found by her son. She was confused and had urinary incontinence. She has
    recovered fully after 6h with no neurological complaints. What is the most likely dx?
    a. Stroke
    b. Vestibular insufficiency
    c. TIA
    d. Intracranial hemorrhage
  14. A 34yo woman presents 3 weeks after childbirth. She has had very low mood and has been
    suffering from lack of sleep. She also has thought of harming her little baby. What is the most
    appropriate management for this pt?
    a. ECT
    b. CBT
    c. IV haloperidol
    d. Paroxethine
    e. Amitryptiline
  15. A 65yo woman presents with headache. She also complains of dizziness and tinnitus. He has
    recently realized she has visual problems. There is hx of burning sensation in fingers and toes.
    On exam: splenomegaly, itchy after hot bath. Labs: RBC=87, Hgb=31.9, Plt=796. What is the dx?
    a. CML
    b. CLL
    c. Polycythemia vera
    d. Myelofibrosis
    e. NHL
  16. A 29yo male brought to ED in conscious state. There is no significant past hx. Which of the
    following should be done as the initial inv?
    a. CT
    b. Blood glucose
    c. ABG
    d. MRI
    e. CBC
  17. A 45yo woman comes with red, swollen and exudating ulcer on the nipple and areola of right
    breast with palpable lump under the ulcer. What do you think is causing this skin condition?
    a. Inflammatory cells releasing cytokines
    b. Infiltration of the lymphatics by the carcinomatous cells
    c. Infiltration of the malignant skin cells to the breast tissue
  18. A 20yo young lady comes to the GP for advice regarding cervical ca. she is worried as her mother
    past away because of this. She would like to know what is the best method of contraception in
    her case?
    a. POP
    b. Barrier method
    c. IUCD
    d. COCP
    e. IUS
  19. A 66yo man, an hour after hemicolectomy has an urine output of 40ml. However, an hour after
    that, no urine seemed to be draining from the catheter. What is the most appropriate next step?
    a. IV fluids
    b. Blood transfusion
    c. Dialysis
    d. IV furosemide
    e. Check catheter
  20. A 24yo pt presented with anaphylactic shock. What would be the dose of adrenaline?
    a. 0.5ml of 1:1000
    b. 0.5ml of 1:10000
    c. 1ml of 1:500
    d. 5ml of 1:1000
    e. 0.05ml of 1:100
  21. A 44yo woman complains of heavy bleeding per vagina. Transvaginal US was done and normal.
    Which of the following would be the most appropriate inv for her?
    a. Hysterectomy
    b. Endometrial biopsy
    c. CBC
    d. High vaginal swab
    e. Coagulation profile
  22. A 60yo woman presented to OPD with dysphagia. No hx of weight loss of heartburn. No change
    in bowel habits. While doing endoscopy there is some difficulty passing through the LES, but no
    other abnormality is noted. What is the single most useful inv?
    a. CXR
    b. MRI
    c. Esophageal biopsy
    d. Esophageal manometry
    e. Abdominal XR
  23. 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
  24. A 38yo woman, 10d postpartum presents to the GP with hx of passing blood clots per vagina
    since yesterday. Exam: BP=90/40mmhg, pulse=110bpm, temp=38C, uterus tender on palpation
    and fundus 2cm above umbilicus, blood clots +++. Choose the single most likely dx/
    a. Abruption of placenta 2nd to pre-eclampsia
    b. Concealed hemorrhage
    c. Primary PPH
    d. Secondary PPH
    e. Retained placenta
    f. Scabies
  25. A 32yo female with 3 prv 1st trimester miscarriages is dx with antiphospholipid syndrome.
    Anticardiolipin
    antibodies +ve. She is now 18wks pregnant. What would be the most appropriate
    management?
    a. Aspirin
    b. Aspirin & warfarin
    c. Aspirin & heparin
    d. Heparin only
    e. Warfarin only
  26. A 23yo presents with vomiting, nausea and dizziness. She says her menstrual period has been
    delayed 4 weeks as she was stressed recently. There are no symptoms present. What is the next
    appropriate management?
    a. Refer to OP psychiatry
    b. Refer to OP ENT
    c. CT brain
    d. Dipstick for B-hCG
    e. MRI brain
  27. A 16yo girl came to the sexual clinic. She complains of painful and heavy bleeding. She says she
    doesŶ͛t a ƌegulaƌ ĐLJĐle. What is the ŵost appropriate management?
    a. Mini pill
    b. Combined pill
    c. IUS
    d. Anti-prostoglandins
    e. Anti-fibrinolytics
  28. A 36yo man walks into a bank and demands money claiming he owns the bank. On being denied,
    he goes to the police station to report this. What kind of delusions is he suffering from?
    a. Delusion of reference
    b. Delusion of control
    c. Delusion of guilt
    d. Delusion of persecution
    e. Delusion of grandeur
  29. Which method of contraception can cause the risk of ectopic pregnancy?
    a. COCP
    b. IUCD
    c. Mirena
    d. POP
  30. A woman has pernicious anemia. She has been prescribed parenteral vitamin B12 tx but she is
    needle phobic. Why is oral tx not preferred for this pt?
    a. IM B12 is absorbed more
    b. Intrinsic factor deficiency affects oral B12 utilization
    c. IM B12 acts faster
    d. IM B12 needs lower dosage
    e. Pernicious anemia has swallowing difficulties
  31. An old man comes to the doctor complaining that a part of this body is rotten and he wants it
    removed. What is the most likely dx?
    a. Guilt
    b. Hypochondriasis
    Đ. MuŶĐhauseŶ͛s
    d. Nihilism
    e. Capras syndrome
  32. A 31yo woman who is 32weeks pregnant attends the antenatal clinic. Labs: Hgb=10.7, MCV=91.
    What is the most appropriate management for this pt?
    a. Folate supplement
    b. Ferrous sulphate 200mg/d PO
    c. Iron dextran
    d. No tx req
  33. A 47yo man who is a chronic alcoholic with established liver damage, has been brought to the
    hospital after an episode of heavy drinking. His is not able to walk straight and is complaining of
    double vision and is shouting obscenities and expletives. What is the most likely dx?
    a. Korsakoff psychosis
    b. Delirium tremens
    c. Wernickes encephalopathy
    d. Tourettes syndrome
    e. Alcohol dependence
  34. A 32yo woman of 39wks gestation attends the antenatal day unit feeling very unwell with
    sudden onset of epigastric pain a/w nausea and vomiting. Temp 36.7C. Exam: RUQ tenderness.
    Bloods: mild anemia, low plts, elevated LFT and hemolysis. What is the most likely dx?
    a. Acute fatty liver of pregnancy
    b. Acute pyelonephritis
    c. Cholecystitis
    d. HELLP syndrome
    e. Acute hepatitis
  35. A 57yo woman presents with dysuria, frequency and urinary incontinence. She complains of
    dyspareunia. Urine culture has been done and is sterile. What is the most appropriate step?
    a. Oral antibiotics
    b. Topical antibiotics
    c. Topical estrogen
    d. Oral estrogen
    e. Oral antibiotics and topical estrogen
  36. A pt came to the ED with severe lower abdominal pain. Vitals: BP=125/85mmHg, Temp=38.9C.
    Exam: abdomen rigid, very uncomfortable during par vaginal. She gave a past hx of PID 3 years
    ago which was successfully treated with antibiotics. What is the appropriate inv?
    a. US
    b. Abdomen XR
    c. CT
    d. High vaginal
    e. Endocervical swab
  37. A pregnant woman with longterm hx of osteoarthritis came to the antenatal clinic with
    complaints of restricted joint movement and severe pain in her affected joints. What is the
    choice of drug?
    a. Paracetamol
    b. Steroid
    c. NSAID
    d. Paracetamol+dihydrocoiene
    e. Pethadine
  38. A 24yo 18wk pregnant lady presents with pain in her lower abdomen for the last 24h. She had
    painless vaginal bleeding. Exam: abdomen is tender, os is closed. What is the most probable dx?
    a. Threatened miscarriage
    b. Inevitable miscarriage
    c. Incomplete miscarriage
    d. Missed miscarriage
    e. Spontaneous miscarriage
    Ϯϴϵ. A ϮLJo Đhild plaLJiŶg iŶ the gaƌdeŶ had a ĐleaŶ Đut. She didŶ͛t haǀe aŶLJ ǀaĐĐiŶatioŶs. Also, theƌe is
    no contraindication to vaccinations. Parents were worried about the vaccine side effects. What
    will you give?
    a. Clean the wound and dress it
    b. Give TT only
    c. Give DPT only
    d. Give DPT and tetanus Ig
    e. Give complete DPT vaccine course
  39. A 32yo female who has had 3 prv miscarriages in the 1st trimester now comes with vaginal
    bleeding at 8wks. US reveals a viable fetus. What would be the most appropriate definitive
    management?
    a. Admit
    b. Aspirin
    c. Bed rest 2 weeks
    d. Cervical cerclage
    e. No tx
  40. A 6yo girl started wetting herself up to 6x/day. What is the most appropriate tx?
    a. Sleep alarms
    b. Desmopressin
    c. Reassure
    d. Behavior training
    e. Imipramine
  41. A 27yo 34wk pregnant lady presents with headache, epigastric pain and vomiting. Exam:
    pulse=115, BP=145/95mmHg, proteinuria ++. She complains of visual disturbance. What is the
    best medication for the tx of the BP?
    a. 4g MgSO4 in 100ml 0.9%NS in 5mins
    b. 2g MgSO4 IV bolus
    c. 5mg hydralazine IV
    d. Methyldopa 500mg/8h PO
    e. No tx
  42. A 24yo lady who is 37wk pregnant was brought to the ED. Her husband says a few hours ago she
    complained of headache, visual disturbance and abdominal pain. On arrival at the ED she has a
    fit. What is the next appropriate management for this pt?
    a. 4g MgSO4 in 100ml 0.9%NS in 5mins
    b. 2g MgSO4 IV bolus
    c. 2g MgSO4 in 500ml NS in 1h
    d. 4g MgSO4 IV bolus
    e. 10mg diazepam in 500ml 0.9%NS in 1h
    Ϯϵϰ. What is the pathologiĐal ĐhaŶge iŶ Baƌƌet͛s esophagitis?
    a. Squamous to columnar epithelium
    b. Columnar to squamous epithelium
    c. Dysplasia
    d. Metaplasia
    e. Hyperplasia
  43. A 34yo male presents with hx of headache presents with ataxia, nystagmus and vertigo. Where
    is the site of the lesion?
    a. Auditory canal
    b. 8th CN
    c. Cerebellum
    d. Cerebral hemisphere
    e. Brain stem
  44. A 24yo girl comes to the woman sexual clinic and seeks advice for contraception. She is on
    sodium valproate.
    a. She ĐaŶ͛t use COCP
    b. She can use COCP with extra precaution
    c. She can use COCP if anticonvulsant is changed to carbamezapin.
    d. She can use COCP with estrogen 50ug and progesterone higher dose
    e. She can use COCP
  45. A 27yo lady came to the ED 10 days ago with fever, suprapubic tenderness and vaginal discharge.
    PID was dx. She has been on the antibiotics for the last 10days. She presents again with lower
    abdominal pain. Temp=39.5C. what is the most appropriate next management?
    a. Vaginal swab
    b. Endocervical swab
    c. US
    d. Abdominal XR
    e. Laparoscopy
  46. An 18yo man complains of fatigue and dyspnea, he has left parasternal heave and systolic thrill
    with a harsh pan-systolic murmur at left parasternal edge. What is the most probable dx?
    a. TOF
    b. ASD
    c. VSD
    d. PDA
    e. TGA
  47. A young girl presenting with fever, headache, vomiting, neck stiffness and photophobia. She has
    no rashes. What is the most appropriate test to confirm dx?
    a. Blood culture
    b. Blood glucose
    c. LP
    d. CXR
    e. CT
  48. A 65yo HTN man wakes up in the morning with slurred speech, weakness of the left half of his
    body and drooling. Which part of the brain is affected?
    a. Left parietal lobe
    b. Right internal capsule
    c. Right midbrain
    d. Left frontal lobe