23y/o male rolls his ankle after slipping off the curb and lands in a ditch. At the A&E, he complains of pain over the lateral side of his right ankle over the tip of the lateral malleolus. This is his first such incident. On examination, there is localized swelling, bruising and tenderness over the lateral malleolar tip. He walks with an antalgic gait, but is able to bear weight on the right lower limb and can walk about 10 steps before having to rest. Radiographs reveal no fracture or dislocation.
A. Ant. Talofibular ligament
B. Calcaneofubular ligament
C. Deltoid ligament
D. Sub talar joint
30 year old post op patient comes with chest pain and shortness of breath. what is the most definitive investigation
a. CTPA
b. Ventilation perfusion scan
c. D dimer
d. Pulmonary angiogram
e. Doppler ultrasound
30 year old presents with palpitaions at rest. resting pulse is 70 bpm and regular.holter ecg shows irregularities associated with palpitations?single ost likely diagnosis?
a. Atrial fibrillation
b. Atrial flutter
c. Heart block
d. SVT
e. Ventriculare ctopic
2 year old child has had uti.investigaiton shows vesicoureteric reflux.what will you tell the parents?
a.Requires antibiotic prophylaxis
b.Requires surgery
c.In most kidneys will be scarred by the age of 5
d.No further action required
e.It will resolve on its own
A retired ship worker has pleural effusion and pleural thickening on right side with bilateral lung shadowing. What would you do to improve his symptoms?
a. Aspiration
b. Chest drain
c. Chemotherapy
d. Diuretic
I took my IELTS exam on 20th May with British council and I received my results today via SMS with unbelievable scores:
Listening=7
Reading=7
Writing=6
Speaking=6.5
Overall=6.5.
What a shock for me!
I need a minimum of 7.5 for each section
Although I spent only two weeks on prepration, I expected higher scores especially in listening, reading and writing. While practicing, I used to score 35 < in reading and listening, and sometimes I got 40. I invested much time in both and I am sure I did very well. I expected to get at least 8!
Anyway, I will have to wait till I receive the test report form, hopefully I may find a discrepancy between both results.
Realistically, I am afraid I will have to take the test again, in this case I need your advice.
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How can I improve my scores, especially in reading and listening, while I don’t know exactly what are my weakness points.
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In your opinion should I retake the exam with IDP instead or just change the venue, does it make a big difference.
I really appreciate your help and I need to hear your opinions.
A man fell from 4 m height.he was stable and answering questions. suddenly he became unconscious. on auscultation there was decreased air entry on the right side of the chest. what is the most appropritate investigation?
a. CT scan
b. IV fluids
c. Thoracocentesis
d. Chest X ray
e. MRI brain
A 34yo man complains of arthralgia, abdominal pain and vomiting, a facial rash that is worse in the summer and hematuria. Urea and creatinine are slightly elevated with urinalysis demonstrating red cell casts. PMH is remarkable for
childhood eczema. Which inv is most likely to lead to a dx?
a. US KUB
b. Joint aspiration
c. Auto antibodies
d. IVU
e. Renal biopsy
A 32yo woman comes with intermenstrual bleeding. Her last cervical smear was 1y ago and was negative. What test would you recommend for her initially?
a. Colposcopy
b. Cervical smear
c. Endocervical swab
d. Transvaginal US
e. Pelvic CT
A 34yo woman who never had fits or high BP developed fits 6h after delivery of a term healthy child. What is the most likely dx?
a. Eclampsia
b. Preeclampsia
c. Epilepsy
d. Pulmonary embolism
e. Pregnancy induced HTN
A 7-year-old boy has a difficult time at school. He sleeps during most of the classes and doesn’t interact with his teachers in class. He is fighting with many of his classmates because of stealing their lunches but he has never started a fight. When teachers tried to contact his family, they found out that his family left a fake address and phone number.
What is the most likely cause of this boy’s behavior?
A- Attention-deficit-hyperactive disorder (ADHD)
B- Antisocial personality
C- Child abuse
D- Oppositional defiant disorder (ODD)
E- Mental retardation
44yo woman with breast cancer had an extensive removal and LN clearance. She needs an adjunctive tx. Her mother had cancer when she was 65. Which of the following factors will be against the tx?
a. Fam hx
b. Tumor grading
c. LN involvement
d. Her age
A 32yo man on psychiatric meds presents with coarse tremors and diarrhea. What is the most likely alt to the drug causing the prb?
a. Lithium
b. Diazepam
c. Haloperidol
d. Valproate
e. Citalopram
45 year old man has been withdrawn recently and feels that he is responsible for fllod in Thailand.what is the most likely diagnosis?
a. Schizophrenia
b. Depression
c. Schophrenia
d. Anxiety
e. Mania
30 year old lady with fresh blood per rectum after defecation.she has been constipated for 2 months.she has no pain.what is the most likely daignosis?
a. Anal fissure
b. Haemorrhoids
c. Inflammatory bowel disease
d. Colonic cancer
e. Rectal cancer