PLAB-1-Past-Papers 2001-7 PDF

PLAB 1 past papers 2002-2007
Jan 2007 Plab

Theme on terminal care:
Theme on x-ray features of diff. diseases:

6. a person with htn, different bp in both arms and chest pain
7. a ptateint with diverticulosis long standing,came with abdominal pain
incearing , bowel sounds not heard.
8. A person undergoes espohageal dilataion
and the presents with pain in chest but abdomen was soft.
9.a person with post MI
Options:
a) normal cxr
b) gas under diaphgram
c) widening mediastinum
d) free medisatinal gas
Theme on cells of origin
Options A. Adipocyte
B. Neuroglial cells
C. Plasma cells
D. Megakaryoblast
E. Skeletal muscle
F. Lymphocytes
G. Erythroblast
H. Monocytes
I. Schwann cells
J. Neutrophil precursors
K. Astrocytes
10. Lipoma
11. Glioblastoma multiforme
12. Myeloma
13. AML
2011
1.pt with SVC Obs

2. Pateint with intractable hiccups
3.pateint with fugatinating breat ca
4.pateint with unable to cough up secretions.
5.A pateint of ca breat with pathological fracture
Options:
a) dexacmetasone tab
b) bisphosphates.
c) haloperidol
d) metronidozole get
e) hyoscine

14. Rhabdomyosarcoma
16) A man thinks he has rash due to HIV...has been tested thrice...not
convincd.
1.hypochondriasis
2.malingering
THEME on feeding
17) A pt with signs of liver failure
18) A pt with parkinsonism having dysphagia
OPTIONS
1-Total parentral nutrition
2-PEG
3-gluten free diet
4--low protein diet +antibiotics
5--nasogastric feeding
Theme Mechanism of Disease
Options
A. Infection
B. Allergy
C. Genetic
D. Immune process
E. Chloride channel defect
F. Alpha-1 antitrypsin def.
19. Asthma
20. Cystic fibrosis
21. Bronchiolitis
Theme on Treatment Of Post MI
Options:
A-Atropine
B-Pacemaker
C-Streptokinase
D-Altepase
E-Valve replacement
F-Nitrates
G-Angiography
H- Pacemaker replacement
I- Naproxen
J-Steroids
22. Myocardial infarction but no chest pain
23. Myocardial infarction with Heart block
2011
Theme on Psychiatry
15) A young girl complaints of sudden onset visual loss after witnesing an
RTA the last day.
1.conversion disorder
2.somatization disorder.
Theme on diagnosis of Upper GI diseases

Options:
A. Barrett's esophagus
B. Achalasia cardia
C. Plummer Vinson syndrome
D. Scleroderma
E. Hiatus Hernia
F. Peptic ulcer
G. Parkinsonism
H. GORD
29. Transformation of squamous epithelium to columnar epithelium
30. A 50-year-old female presents with pallor and fatigue, blood smear
shows microcytic and hypochromasia. She has post cricoid webs and has
difficulty in swallowing.
31. A boy with dysphagia, an organ protrusion into the thoracic cavity
32. A layer of submucosal hyaloid fibrosis
33. Absent Aurbex myenteric pluxes in lower part of oesophagus
SBA
34. A patient presents with pain in epigastrium, weight loss and on
examination left supra clavicular lymph nods.
Options:
Gastric Ca
Others
Theme on GYN Management
Options:
A- Cervical smear
B- Cervical biopsy
C- Laporoscopy
D- Per speculum exam
E- Colposcopy
35- Lady with diagnosed CIN-1. CA cervix 6 months back now comes for
follow up
36- Lady with CIN-2 diagnosed 6 month back now comes for follow up
37- Post menopausal women with bleeding & dyspareunia
38- Pre menopausal women with ectropion & bleeding
2011
24. Myocardial infarction with murmur

25. A pt. with chest pain, ECG showed T wave depression in L III, aVF & L II
has pain & nausea for 2 hrs & it subsidies completely. Now he presents in
the A & E after one hour. What do you give next.
26. A pt. develops chest pain, which subsides. He has an ejection systolic
murmur, BP 110 /60-mmHg, low volume pulse. The Next step.
27. A pt. recovering from MI, collapses & O/E has a pulse of 36 / min. Next
step.
28. A pt. develops pyrexia & pleural effusion one week after inferior
Myocardial infarction.

39-A 60 year old man with sudden onset calf pain on upper medial side..no
swelling...he can dorsiflex and planter flex his foot easily.
40- A patient with oral ulcer and onantion there are white striae on it.
Optios:
lichen planus
aphthous ulcer
41- 63 years old man with 20 years h/o smoking just retiered from minery
profesion, now present with s/s of bladder cancer and on biopsy its
transitional call carcinoma
options:
a) smoking
b) minery
44- themes on unconsciousness in elderly...not very difficult...but very
tricky!!!
Theme on Diagnosis of cervical cancer
Options
A.Abdominal x-ray
B.Cervical brush smear
C.Cervical spatula smear
D.Colposcopy and biopsy
E.Cone biopsy
F.Cystoscopy
G.Examination under Anaesthesia
H.Intravenous (IV) urogram
I.Magnetic resonance imaging (MRI)
J.Outpatient hysteroscopy
K.Sigmoidoscopy
L.Transvaginal ultrasound scan
45. A 54 year old woman is referred with irregular vaginal bleeding.
Vaginal examination has proved impossible as she has never had a sexual
relationship. She has diabetes and a body mass index (BMI) of 34 kg/m2
46. A 62 year old woman reports episodes of post menopausal bleeding
and discharge. Two years ago, she had a negative smear but there is an
obvious ulcer on her cervix.
47. A 44 year old healthy woman is referred with intermenstrual bleeding
and discharge. At the age of 32 she was successfully treated for
carcinoma in situ. She has had regular follow-up with no recurrence. A
recent smear was negative.
2011
Options
a) Ruptured popliteal cyst
b) Gout
c) Psudogout
d) other options which I dont remember
48. A 38 year old woman had a severely dyskaryotic cervical smear but
visually and colposcopically her cervix appears normal. The repeat smear
shows the same result.
50. A 26 year old woman has been promoted at work to a job that requires
regular public speaking. she is worried and anxious about it and feels she
will faint.
single MOST USEFUL intervention
a.CBT
b.diazepam
c.flouxetne
d.psychoanallytic psychotherapy
e.relaxation.
Theme on reasons for heamaturia.
51.Old man on warfarin latest standard I.N.R about 1 or 2 presented with
painless haematuria some mention of somkinf history also Diagnosis?
52. Old man on warfarin, I.N.R markedly deranged about 5 prsents with
painless haematuria diagnosis?
53. Old man with history of renal colic and raised serum urate Diagnois?
54. Young child with recurrent heamaturia, think some some mention of
throat
Infection Diagnosis?
Options
a .warfarin overdose
b. transitional cell CA
c. Acute glomerulonephritis
c. oxaliosis
d. renal stones
Theme on basis of diseases
55. Childhood asthma
56. Bronchiolitis
57. Emphysema in person who has had neonatal jaundice
58. Cystic fibrosis
Options
a. infection
b. allergy
c. alpha 1 anti trypsin deficiency
d. Chlorine ion excess or something?
Theme on lumps in neck
59. multiple discharging sinuses ,associated with night sweats, diagnosis?
2011
49.A 58 year old woman has a carcinoma of the cervix confined to the
ectocervix. The uterus is mobile, no masses are palpable and her chest is
clear.
Options:
a. thyriod ca
b. gastric ca
b. pleomorphic adenoma of salivary gland
c. mesothelioma
d. tuberculous adenitis
theme on electrolyte imbalance

64. A girl presented with vomiting drowsy some other symptoms????
Na decrease by 2 points
K by one point or so
Glucose 5 mmol
65. A girl presented dehydrated, rapid breathing glycosuria
Na and K increased
Glucose 30mmol
66. A child with sever gastroenteritis
Na and k both decreased
67. An old man on thiazides,
K was decreased
68. A girl presented with multiple fractures and trauma after Rta is
hypotensive???? forget rest
Options:
a. 5% Dextrose water
b. Insulin with normal saline
c. Potassium supplements with normal saline
d. Oral potassium supplements
e. Plasma expanders
Theme on I.V access
69. 2 year old undergoes repeated attempts of IV cannulaization? Next
step?
70. A 12 year old require resuscitation , hypotensive, failed IV cannulation.
Options:
a. Interroseous line.
b. Cvp line
c. Endotracheal intubation
2011
60. A person with symmetrical unilateral swelling behind angle of jaw,

mumps had been ruled out diagnosis?
61. A supraclavicular swelling( very much suggesting virschows node)in
old man with weight loss and abdominal pain ,diagnosis?
62. A supra clavicular lump with ipsilateral associated pleural effusion in
aship yard worker,diagnosis?
63. A lump in midline between sternocleadomastoids invading the muscles
,moves with swallowing.,diagnosis?
72. A man after prostatectomy, requires D.V.T prophylaxsis, what would

be the range on I.N.R to be maintained?
Options:
a. INR 1
b. INR 2-3
c. INR 3-4
d. INR 4-5
73. A young woman having H.I.V, patchy bilateral lung shadows, what
treatment to give?
Options:
a. Cotrimoxazole
Theme on nerve injury
74. A patient on crutches...having difficulty in dorsiflexion and loss of
sensation over index and middle finger...most likely nerve injured.
Options:
a) Median Nerve
b) Radial Nerve
c) Ulnar Nerve
Theme on Trauma Organ
a) urethra
b) bladder
c) spleen
d) pancreas
e) kidney
f) diaphragm
g) aorta
h) liver
74. A person who met with a accident and is in A & E with pain in RUQ and
hypotension.
73) A person after an accident when NGT was tried, not successful. And X
rays were take on which tube coiled in side chest.
Theme on burns...slightly twisted repeat theme....
74. A child with 10% scald.
75. A child with dehydration with low BP
Options:
a) Intubation
b) I/V fluids
2011
71. A girl with recurrent UTI, her urine is negative for culture and she is
diagnosed as bilateral vasicoluretheral reflux? What would be
management?
a. Prophylactic antiobiotics
b. reassurance
c. surgery to correct
Theme on investigation of breast lump (little bit twisted)

A. FNAC.
B. MRI
C. USG.
D. Mammography.
E. Stereotactic Biopsy.
F. Stereotactic Fine needle biopsy.
G. Excisional biopsy.
H. Lumpectomy.
76.
77.
78.
79.
A
A
A
A
pt. With fibrocystic disease with symptoms related with menses.

pt. With breast lump but has morbid fear of needles.
pt with no obvious palpable lump but with axillary lymph nodes.
pt with retraction of nipple.
SBA
80. A child with orbital tumor, as understood from the history, or proptosis,
what is the best investigation to be done
Options:
a) CT Scan
SBA
81.
A patient presenting with sudden onset of pain swelling in lid, proptosis
and they were asking immediate management?
options:
a. iv morphine
b. morphine pus antibiotics
c. morphine plus emergency referral to opthamology team
d. morphine plus referral to opd opthamology.
Sba
82. A person present with pain in eye associated with backache i think
a.conjuctivitis
b.scleritis
c.iritis
theme on dyspepsia investigations:
2011
SBA
75. A child having diarrhoea for 24 hrs. drowsy ,sunken eyes. and capillary
refill decreased.
a. bolus 20ml/kg.
b. rehydrate over 24 hr.
c. oral fluid.
83. A patient 61 yrs old come with dyspepsia, weight loss and abdominal
pain, what investigation will u do?
86. A person 38 yrs old been self treating with antacids but nothing better,
which test would u do?
87. A patient with Rh. Arthritis on NSAIDs, already taking PPI but still have
dyspepsia, what investigation would you do?
88. A patient with barrats esophagus, what investigation would you like to
do now?
options:
a.endoscopy.
b.ambulatory oesophageal ph monitoring
c.oesophageal manometry
d.test for h pylori
c gastrin levels
theme on dementia: (repeated theme)
89. A women who had history of low mood ,sleep disturbance and
presented this time with agitation and irritibilaty
90. A lady aged 61yrs years who was depressed and to doctors questions
was answering "i dont know"
91. A person who is being asked for his age and he replied 80, but after
that whatever question was asked about his life, etc. he replied same 80.
options included:
a. dspression with psychotic symptoms
b. shizo effective
c. major depression
d. pseudo dementia
SBA
92) A man who is HIV positive and has been seperated from other patients
alone in a room. A doctor needs to see him.
options
a) put on the apron and mask, wash hands and open door then wear
gloves.
b)wash hands, wear gloves, wear mask and apron then open the door.
c)wear mask and apron, open door, wash hands and wear gloves
d)open door, wear gloves, then apron then mask and gloves.
93.
pH-7.25 and Pco2 also reduced.
options
2011
85. A person who has under gone fundoplication and endoscopy was
normal what to do now?
SBA on epistaxis
94. A young boy presents with acute nose bleed and is brought to the A
and E, he is stable and talking.
a) pinch the bridge of the nose
b) reassure
c) cotton in the nose
d) pinch the soft part of the nose
e) ice packs.
95. A patient with hydronephrosis due to stones....asking for
management
96. A two year old kid who had a bead in his ear which was found out by
otoscopy and he was irritated.
A) remove under GA
B) reassure
C) syringing
D) suction
97. A woman after delivery becomes very fearful and sleepless and avoids
going out. Avoids eating something like that
options
1postpartum psychoses
2.postpartum blues
3.postpartum depression
4.acute stress reaction
[snip]. A lady presents with Floating stools n Lethargy diagnosis
1FBC
2TFTs
3Endomysial Antibodies
4stool examination
99. A young man presents with sudden onset of chest pain n
breathlessness. There is reduced air entry on 1 side n trachea is deviated
to the left..next step in management
a chest drain on rt side
b chest drain on lt side
c chest xray
2011
a)metabolic acidosis
b)metabolic alkalosis
c)normal
d)resp acidosis
e)resp alkalosis.

d needle thoracocentesis on rt side
e needle thoracocentesis on lt side
101. A person suffering from some pneumonia like s/s

and was allergic to pencillin.
options
amoxicillin
ceftizadine
clithromycin
102. A young girl who was suffering from itchy and scally rash on the
extenser surfaces of her limbs, her aunt was also suffering from some skin
problem.
options
eczema
psoriasis
103. An old lady who is in a old house with other mates and had some
rash on her back, and she is not in the condition to give you history. What
next should be done?
Options:
a) check her hands (Scabies)
104. A lady who said that she is being controlled by some outside force
who tells her to do every thing
options
dellusion
thought insetion
thought broadcasting
acute anxiety
105. A person with epigastric pain radiating to back and on ct enhanced
lesion in abdomen.
106.A lady who did not improve after cholestectomy and her O2 level was
droping despite high ICU care.
107. A patient in recovery unit after laprotomy, 10days back, now
presents with pain in right shoulder and right epigastric pain, not
improving with antibiotics, having high fever.
108. A patient with verisella zoster infection, now presenting with supper
added infection, with black lesions in the vesicular area.
109. A patient with chronic pancreatits now presents with pain in
epigastric region radiating to back, on CT abdomen fluid around tail of
pancrease found(psedopancreatic cyst).
2011
100. A girl who was breast fed and became sick, probably jaundice, what
should next be done
options
continue breast feeding
discontinue it
110. A young boy who swallowed some grams(sorry dont remember the
dose)paracetamol and he was stable when after 4 hours his blood conc.
showed the upper limit of paracetamol. how u will manage
options
methionine
n-acetyl cystiene
charcoal
theme regarding ECG changes
111. A patient with chest pain for 1 hour with st elevation on ECG in I, II,
III, v1, v2
112. A person with ecg changes in v1 to v3.
Options:
a) anterior MI
b) Inferior MI
c) Others
113. An old man who was a chronic case of COPD and had pneumonia in
every winter and came for advice for the coming winter
options
flu vaccine
ipratropium nebuliser
salbutamol inhaler
114. A young guy having purulent discharge, itching in the eyes with
congested cunjectiva.
Options:
a) topical antibiotic
b) topical antibiotic and steriods
c) steriods
d) I/V antibiotic
Theme on management of weight loss
Options:
A. PEG
B. NG tube feeding
C. Total Parenteral nutrition
D. Oral sips
E. Gluten free diet
F. Low protein diet with salt restriction
G. Low protein diet with antibiotics
H. High caloric diet
I. Lactose free diet
115. A 5-year-old girl comes with a history of abdominal pain,
steatorrhoea, vomiting, poor growth and apthus ulcers. Jejunal Biopsy
shows villous atrophy
2011
options
a) laparotomy and excision of dead tissue
b) percutaneous drainage
C) exision of dead tissue
120. A person with peroral rash, vesicular and in groups, yellow secretions,
crust formation.....
options:
cluster impitigo
vericela or shingles
others
but there was no option of Herpes Sipmlex
121. 19 years old boy lives in hostel, presents with cough, on examination
lymphadenopathy found and on chest X ray bilateral consolidations
options:
legionella
mycoplasma pneumoniae
122. 12 years old boy, present with testicular pain without h/o trauma, he
is afebrile, severe lower abdominal pain, painful when touch but o/e Rt
teties slightly higher than Lt. one. and there was no abdominal tenderness
on examination.
options:
testicular torsion
epidydmidorchitis
Theme on chioce of antibiotic treatment
123. Trichomonas veginella
124. Diplococci
125. Pencilline resistant case
options:
metronidazole
ciprofloxacine
ceftexime
clithromicine
Theme on non-accidental injuries
same from previous papers
126.(retinal hge. on fundoscopy --- do skull xray)
127.(brusis on body diff. sizes and shpes)
(others)
128. there was a question in which patient with s/s of live disease and liver
biopsy shows plemorphic neoclei and alph 1 antitrypsin secreting cells.
options:
Secondary CA
hepatocellular carcinoma
cholengiocarcinoma
2011
116. A 70-year-old heavy alcoholic presents with hepatic encephalopathy,

he has jaundice and ascites
117. A 60-year-old patient with long standing Parkinson's disease presents
with intractable dysphagia
118. A 68-year-old male patient suffered a hemorrhagic stroke. After 5
days he is offered food, but is found to be still aspirating fluids.
119. A 74-year-old patient who underwent resection of the colon and
ileostomy for carcinoma is now in the ITU as he develops septicemia. He
has not been eating anything since the past 2 weeks

Hepatoma
hepatits C or B
Theme on Breast Cancer investigations repeat one.
Theme on burns, its been discused erlier but there was another Q. in that
theme.
130. multiple ulcers in the stomach after burn
131. Pt with multiple ulsers in stomach and duodenum, and was being
treated with various dyspeptic drugs.
Invetigation...
132. Nerve supply of lateral lower half of leg and dorsiflexion of ankle joint
options:
L4-L5
L5-S1
133. Pt. with abnormal insertion of uteter in urinary bladder.
I could not get the answer if anybody know it please let me know.
134. Pt. with palpitations, agitation and atrial fibrilations....S/S of
hyperthyriodism, Treatment ?
Options:
carbimazole and propanalol (written together)
135. A shipyard Pt with unilateral plural effusion...........mesothelioma
136. Pt. with anemia, thyriod...........Pernacious
anemia......invetigation......antibodies against intrinsic factor.
137. Increase serum Ca+ ......renal caculi.....
138. Backache, bone marrow findings.........
options:
Gout
Myloma
Theme on bleeding disorders
139. von Willibrand disease
140. prifollicular patichiae/bleeding.........Vit. C deficency
Theme on vertigo
141. Cerebellar
142. vestibulobassilar ischemia
143. post cerebral artery
Theme on alcohol abuse and withdrawl treatment
144. pt wants to alcohol treatment, has been taken all medical treatments
and already joined alcohol withdrawl groups, now came to you but not
want anything with unpleasant reactions.
options:
2011
129. An old lady with family h/o anemia with MCV 120.....
investigations (sorry I don't remeber options)

Disulpham
Acomprosate
naltrexone
Vitamins
Options:
a) parotid gland adenoma
b) thyroglossal cyst
c) cystic hygroma
d) parapharangeal carcinoma
e) thyroid nodule/ca
f) carotid cyst/swelling
150. Child brought with 8 hr Hx of sorethroat, saliva dribbling, what to do

next?
a- Call anesthetist
b- Give penicillin
C- do a mouth examination
151. The steps to be followed before entering the room of an
immunocompromised patient, who is quarantined?
wear mask, enter the room,wash hands and wear the gloves
Pasted from <http://www.rxpgonline.com/postt64126.html>
Nov. 2006
FROM ALL NOVEMBER PLABBERS
2011
theme on midline neck swellings

145. A patient presents with swelling in front of neck, on protusion of neck
it moves.
146. A patient presents with swelling at the angle of mouth, unilateral, no
h/o mumps, slow growing, become prominent while chewing food.
147. A patient present with swelling on upper and anterior triangle, which
is fast growing.
148. A patient present with hard anterior midline swelling.
149. A pulsatile swelling on upper end of sternoclidomastiod muscle.
2.A woman gives vaginal birth at term to a baby boy. She has Hepatitis B
and is Concerned about the risk of transmitting it to her baby. What do
you do? C
A. Give Hep B vaccine
B. Do Hep B antibody test
C Give Hep B vaccine + Hep B immunoglobulin.
D. Give Hep B immunoglobulin only
E. do noting
DX of dyspnea
A Asthma
B Hyperventilation
C Tension Pneumothorax
D Simple Pneumothorax
E DKA
F Laryngeal oedema
G LVF
H Pneumonia
I Pleural effusion??
3. A 19y/o woman comes to A&E unconscious. She has deep sighing resp
at 28/min. Temp is 39C
4. A woman was in a fire. She has singed eyebrows, stidor and soot in
mouth and nose
5. A woman has right sided Chest pain and SOB. He has a temp of 39C and
pleural rub in rt mid zone
6. An eldery woman is short of breath. She has an apex beat displaced to
the left and an apical systolic murmur
7.A town has a population of 500,000. In five year period 1250 people
present with cancer(I think that it was bronchial carcinoma). During the
same period the coroner diagnosed additionally 500 people with the same
cancer.
What is the annual prevalence of that cancer per million in this population.
A. 500
B. 350
C. 700
D. 450
E. 800
8. A mother who gave birth a couple of weeks ago feels as though she
doesn't like the baby and doesn't want to feed it. Those thoughts keep
coming back to her very often and she does not like these thoughts. How
will the doctor explain her symptoms to her? C
2011
1.A man's foot has been pierced by a metal spike, right through his foot.
He has had 4 tetanus vaccinations, with the last being 8 years ago. Since
injury has passed 10 hours. Which is the most appropriate management: D
A. Tetanus toxoid
B. Tetanus toxoid + immunoglobulin
C. Tetanus immunoglobulin
D. Tetanus toxoid + Immunoglobulin + Antibiotics
E. Tetanus Immunoglobulin + Antibiotics
9.A man has been stabbed in the back with a knife. He presents to
accident and emergency with an increased JVP, blood pressure of 90/60,
pulse rate of 120 per minute and very distressed. His SaO2 saturation is
85% and the trachea is not displaced. What is the most likely diagnosis?
A. Tension pneumothorax
B. Laceration of the aorta
C. Cardiac tamponade
D.Surgical pneumothorax
10. a 38 yr old 18 wk pregnant women wants to know bout her fetal
malformations if ne
1,chrionic villlous sampling
2.amniocentesis
3. nuchal thickness
4.anomly scan
11. A child on a low dose of steroid and B-mimetics still has symptoms
during the night ( and/or during excersice). He is using the correct
technique to take his medication.
What will be your next step in managing his asthma symptoms?
A. Low dose steriod
B. double dose of steroid
C. Theophylline
D. Long acting B-mimetics
12. During the past three to four years a middle aged man has had two
episodes of mania and three of depression with several hospital
admissions. What is the best management in this case?
A. Flupentixol
B. Chlorpromazine.
C. Lithium
D. ECT
E. Haloperidol
MANAGEMENT OF DYSPEPSIA
A. Fundoplication
B. H2 antagonista drugs
C. simple antacid
D. triple therapy for Helicobacter Pylori
E. Proton pump inhibitors
F. refer for endoscopy
G. Barium swallow
H. Oesophageal pH monitoring
I. Oesophageal manometry
J. Serology for Helicobacter Pylori
Choose the single most appropriate management.
2011
A. Delusions
B. Hallucinations
C. Obsessions
D. Illusions
E. Psychosis

13. A 56 year old man presents with a persistant complaint of dyspeptic
symptoms. 18 months ago he underwent triple therapy for helicobacter
pylori after a positive serology.
15. A 40 year old man with sporradic symptoms of dyspepsia. Has been
taking PPI for a long time and still symptomatic
16. I am not sure but I think that it was something about Barrett's
oesophagus. I am sure that some else with remember a bit more about all
the options and stems. Please feel free to add or modify anything.
17.a man keeps bees ,bee stung him several time ,have not had any
problem before,10 days ago a bee stung on his face ,and face was swollen
for 10 days options
1: carry adrenaline
2:antihistamine tablets
3:steroids
4ibubrofen
5:antihistamine cream ,
18.white man had lump on his nose from ,that gradualey increase in size
progressively it was a pearly nodule wirh 8 mm centrel depression whats
most likely diagnosis?
1: basal cell ca
2: saq cell ca
3: malignant melanoma
4. Moluscum contiosum
19.A woman 5 days after either hemicolectomy or histerectomy(I am not
sure) presents with pain on deeply breathing and temperature of 38.5 C
and yellow sputum. I think that the question mentioned that the wound
was cleared.
What is the most appropriate investigation?
A. FBC
B. Blood culture
C. Sputum culture
D. MRI
E. Wound swab
INvestigation of harmones
20-old lady with constipation and polyuria---parathormone
21-woman with galacctorrhea,ammenorrhea and infertility---prolactin
22-hypernatremia and hypokalemia,plasma renin low---aldosterone(conn's
syndrome)
23.hyponatremia,hyperkalemia,hyperpigmentation---cortisol(addison's
disease)
24-smoker with polycythemia---erythropoieten
2011
14. A man of 32 years old with a long history of chronic arthritis on long
term Non-steroidal anti inflamatory drugs. He has symptoms of light
headedness and dizziness.
26.man with cervical spondylosis,has a painful eye,intraocular pressure is

16 mm/hg---iridocyclitis
A-episcleritis
B-conjunctivitis
C-glaucoma
D-iridocyclitis
27.boy with laryngeotracheobronchitis,if left untreated, wt is the
outcome?----A-resolution
B-bronchiectas
28.An young man tree days after intercourse complaining of testicular
pain. i think that they mentioned something about nause and vomiting.
What is the most appropriate management?
A. USG
B. Laparatomy
C. Urethral swab
D. Biopsy
E. Antibiotics
29.middle age man presents with with splenomegaly and hepatomegaly,
bleeding , infections and a very high leukocyt counts (mainly neutrophile).
What is the most likely diagnosis?
A. AML
B. ALL
C. Aplastic anaemia
D. CML
30. A man was diadnosed post partum that he dies of postoperative
paralytic ileus what is the the cause for it --is it due to
A.hyponatremia ,
B.hypokalemia,
C.hypomagnesmia
D. hypo calemia
31. A man has standind BP 140/90 and lying down RP 100/70 what is the
cause reason for it
A.hyponatremia ,
B.hypokalemia,
C.hypomagnesmia
D. hypo calemia
2011
25.treatment of trichomoniasis---metronidazole
A-doxycycline
B-erythromycin
C-metronidazole
D-tetracycline
THEME: MANAGEMENT OF DEVELOPMENTAL DELAY

A. Hearing test.
B. Refer to ENT
C. Developmental assessment
D. Refer to social services
E. Psychiatric assessment
F. Reassure
G. Refer for genetic assessment
H. Dietary assessment
Choose the most appropriate manegement
33. An 18 month old boy still is not able to walk unaided. His milestone
developments seem OK. The mother is worried.
34. A 3 month old baby seems to be developing normally, is gaining
weight but shows no interest in the mother when she is feeding him. The
mother is concerned about the situation.
35. A 2 year old boy has reached his developmental milestones, he
interacts with his siblings and others. When the mother calls him he seems
to ignore her.
36.baby of 10 kg,having sum syrup 50ml/5mg,, dose should b 4ml/kg,wat
would b the dose?
1.o.8ml twice daily
2.4ml twice daily
3.4ml once daily
cause of subdural haemorrhages
1.subdural haemorrhage
2. extra dural
3. chronic subdural
4.depressed fracture of skull
5. temporal bone fractutre
37. a man was hit by a hammer in the head ....
38.an alcohlic brought by his wife unconscious was fine when came home
then deteriorated
39. a man wearing a helmet had rta ,hit in the head, gcs was 3 but other
vital are normal
Causes of rash in children
a.ebv
b. parvovirus
2011
32.middle aged woman presents with some weakness in her left arm
following an injury. Which vertebrae should be the lowest to be included
on the cervical xray to diagnose the level of injury?
A. C2/C3
B. C3/C4
C. C5/C6
D. C6/C7
E. C7/Th1

c.measles
d .meningitis
e.herpes simplex1
f herpes zoster
43. man involved in rta ,his gcs at sceen was 11 ,walked home and his gcs
after 2/3 hours was 3 wots most likely diagnosis,no neurolgical finding.
a:extra dural haematoma
b:sdh
c.fracture base of skull
d.cerebral haematoma
44. a man was depressed and is taking medications developes rigidity,
mask face and rollind hand tremors. what causes the symptoms
A. antipsychotic
B. Antidepresssent
C. Anticholinergics
theme on dementia
45-alziehmers dementia
46-man with HTN---vascular dementia
47-man with dementia and preservation of visuospatial ability---frontal
dementia
49.pregnant women with paraesthesia and numbness in both hands
(carpal tunell syndrome feature)asking for treatment
a. no action
b. wrist splint
c. local anasthesia
d. paracetamol
50.-A 30 yr old lady who was some athlete playing tennis game now
presents with Floating stools n Lethargy..what Definitive tests u do to
reach a diagnosis..?
1--FBC
2--TFTs
3--Endomysial Antibodies
51.The pt after some URTI respiratory infection got hematuria i think it is
features suggestive of HUS and asking for the investigetions and options
were
a.FBC
b.CLOTTING PROFILE
c.RENAL FUNCTION TEST
d.RENAL BIOPSY LIKE THAT .
52.pt with senserineural hearing loss and loss od cornear reflex on the left
side what is the most defenitive investigation?
a.CT SACN OF INTERNAL AUDITORY MEATUS
2011
40..a child having rash around the mouth and gingivo stomatitis.
41.a child having rash on neck and face and pyrexial.
42. a child having purpuric rash and fever

b.MRI OF INTERNAL AUDITORY MEATUS
c.NUCLEAR IMAGING OF BRAIN
54.2. A child with several knee and foot articulation swelling alternately
over time needs a definitive investigation
a. aspiration of joint
b. esr
c. RF
55.An older woman fell at home and cannot bear weight on her left leg
how can you prevent from this happening again
a. dexa
b. alendronate
c. serum calcium
56.Another woman after a period of treatment for breast cancer presents
and an treatment with tamoxafin with a pathological fracture.
a. seum calcium
b. sterioda
c. alendronate
57.A past breast cancer patient with metastasis comes with a persistant
pain in her back
a, dimorpline
b, asprine
c. radiotherapy
58.A woman with kidney symptoms rash on her face and photophobia
a. anticetomere
b. anti dnas
c. rhomatoid factor
d. esr
59. A young man present with seizure only when other people are present.
(SBA)
Ans. 24 hr video ecg monitoring
60.A patient present with pancosta tumor symptoms has ptosis and ehe
problem
a. destruction of the sympatic truncus
b. oculmotor paiesis
c. horners
61. A boy presents at dentist with bleeding and long APTT
a. hemophilia
b. liver disease
2011
53. A 3 month old baby needs to be ressuscitated CPR.

a. 2 fingers on lower sternum
b. whole wrisr
c. three fingers
d. palm of hand

c. von willberg
66.A woman with symptoms of polidypsia, constipation and confusion after

the diagnosis of carcinoma of the breast
a. hypocalemia
b.hypercalcemia
67. An alcoholic who has been kicked in the perineum area has got acute
urinary retention and smells of amonia and is very distressed but per
rectum examination was unremarkable.
68.Theme: Management of cardiac arrhythmias
69. There was a sba:
pt with some trauma with bleeding from his ear and having conductive
deafness and asking for the bone which is fractured and options were
parietal bone
temporal bone
petrous temporal bone
occipitalbone
not sure of the exact options and
i gave the answers as petrous temporal bone
70-there was a theme with pt having dminished vision and funduscopy is
not done properly
i gave the ansewrs as catarct
another 3 questions relted to diabetic retinopathy
proliferative ,non proliferative like that not able to remeber exact
questions
it was a theme with 4-5 questions
71-SBA
The pt after some URTI respiratory infection got hematuria i think it is
features suggestive of HUS and asking for the investigetions and options
were
FBC
CLOTTING PROFILE
RENAL FUNCTION TEST
RENAL BIOPSY LIKE THAT .
i choosed renal biopsy but the answer is clotting profile i think
72-1. A 3 month old baby needs to be ressuscitated CPR. (SBA)
Answer with 2 fingers
73- A child with several knee and foot articulation swelling alternately over
time needs a definitive investigation. (SBA)
Ans. Aspiration of articulation for crystal microscopy
2011
Complication of breast cancer malignancies

62. a wommen after breast cancer comes with edema of arm lymphedema
63. also after BC with wakness of both legs spinal comression
64 comes with pathological frscture bone metesteses
65. comes with head ache and blurring vision cerebral metesteses

74- An older woman fell at home and cannot bear weight on her left
leg. ???? (SBA)
76- A past breast cancer patient with metastasis comes with a persistant
pain in her back.(SBA)
Ans. Radiotherapy
77- A woman with kidney symptoms rash on her face and
photophobia(SBA)
Ans. Anti-ds antibody
78- A young man present with seizure only when other people are present.
(SBA)
Ans. 24 hr video ecg monitoring
79- A patient present with pancosta tumor symptoms. (SBA)
Ans. destruction of the sympatic truncus
80- Diagnosis of varicoses vein
(MCQ )about varicose vein with pregnant women, about 5 or 6 different
questions.
81- ( MCQ) Theme : Poisoning and self harm diagnosis. Repetition/modified
question about poisoning with six different stems.
82- A 3 months pregnant woman presents with bleeding after intercourse.
She was stable with no additional other symptoms.(MCQ)
83- Theme :Anti partum haemorrage investigation. About 4 0r 5 questions.
(MCQ)
84- A boy presents at dentist with bleeding and long APTT.(SBA)
Ans. Haemophilllia
85- Complication of breast cancer malignancies:
(MCQ) about breast cancer with lymphoedema. About 5 4 stems with
options as acute lymphoedema, chronic lymphoedema and ect.
86- A woman with symptoms of polidypsia, constipation and confusion
after the diagnosis of carcinoma of the breast.(SBA)
Answer: Hypercalceamia
87- Theme: Diagnosis of epistaxis (MCQ)
Was a repeated theme with a couple of modifications with 5 stems
88- Theme : Migraine Investigation with 5 or 6 stems.(MCQ)
89- (SBA) A pregnant woman with anaemia symptoms and high MCV.
2011
75- Another woman after a period of treatment for breast cancer presents
with a pathological fracture.
(SBA)
90- A woman or a man with hearing impairment and no corneal reflex.

Answer: acoustic neuroma
92- (SBA) a woman after 1 or two years post or premenoupausal with a

positive family history of osteoporosis asking for advice.
93- (SBA) A woman (perhaps after an operation) with a pain on deep
inspiration but chest clear after C-xray ???
94- (MCQ)Theme: Side effect of antiepileptic medication.
Repetion about side effects of antiepileptic drugs with 3 stems
95- (MCQ) THEME: Diagnosis of Hernias with 5 stems.
96- A woman with rib fracture with comlications, bleeding. I think the
answer was Ultrasound for a bleeding spleen. I don't remembere if this
question was an SBA or an MCQ
97- An alcoholic who has been kicked in the perineum area has got acute
urinary retention and smells of amonia and is very distressed but per
rectum examination was unremarkable.
I think answer was Urethral Catheterisation.
[snip]- There was a question of anaemia during pregnancy with
hb=10.6gms asking for treatment and the options were ferrous sulfate
oral,im folic acid oral etc. Ans- No action
99- pregnant women with paraesthesia and numbness in both hands
(carpal tunell syndrome feature) asking for treatment .dont remember the
options. Ans- wrist splint
100-sba 1-A 30 yr old lady who was some athlete playing tennis game now
presents with Floating stools n Lethargy..what Definitive tests u do to
reach a diagnosis..?
1--FBC
2--TFTs
3--Endomysial Antibodies- Answer
101- An young man tree days after intercourse complaining of testicular
pain. i think that they mentioned something about nause and vomiting.
What is the most appropriate management?
A. USG
B. Laparatomy
C. Urethral swab
2011
91- Theme: Management of cardiac arrhythmias with 5 stems.

D. Biopsy
E. Antibiotics
What is the most likely diagnosis?

A. AML
B. ALL
C. Aplastic anaemia
D. CML Answer?
E. NHL
2011
102-A middle age man presents with with splenomegaly and

hepatomegaly, bleeding , infections and a very high leukocyt counts
(mainly neutrophile).
July 2006 PLAB 1
2-Prevalance population in one area is 500000.no.of pts reporting to gp

with cancer y in that area in 5yrs is 50.but in the same period no. of
deaths reported due to y=1250?.the 1yr survival of y=0.what is the
prevalance of y in a yr.
1.800
2.1000
3.200
4.1250?
5.600
6-500 -----------------------2theme Psychiatry drug side effects:
1==A pt receiving treatment for bipolar affective disorder his tsh level is
increased and t3 and t4 levels are reduced. Ans: lithium. 2== Pt: having extrapyramidal effects complains of reduced sexual libido
and erectile impotence his prolactin is raised. Ans: chlorpromazine.
3==A pt on treatment for depression complains of dry mouth, blurred
vision, constipation and tremors. Ans: Amitriptyline. 4== Pt: with h/o of schizophrenia receiving an antipsychotic agent
becomes physically unwell and is found to have an elevated body temp:
unstable blood pressure excessive sweating and a raised white blood cell
count and raised cpk. Ans: chlorpromazine. haloperidol wasnt a option...
------------------------------3 THEME -Cell of origin
1. Multiple myeloma 2. AML 3. Rhabdomyosarcoma 4-glioblastoma multiforme-options
1-astrocytes
2-schwaan cells
3-plasma cells
4-skeletal muscle cell
4-neutrophil precursor
5-smooth muscle cells --------------------
2011
-THEME--MULTIPLE TRAUMA
1--27 yr lady had car accident b hitting head on to a car in front.she hit the
front windscreen.now complains of epigastric pain.most likely injured
organ.
(2 more of these were there but were more obvious)
1.diaphragm
2.spleen
3.liver
4.pancreas
5.ub
6.small intestine
7.large intestine -------------------------------------------------
5 Theme--Treatment of varicella infections

1--Varicella in pregnancy
2--old lady with only discolouration n no complaints she is well now--3--young boy with Leukaemia --4--one pt with ophthamic involvement in shingles
5--post herpetic neuralgia
options
A-oral aciclovir n seek expert opinion
B-IV aciclovir
C-Varicella immunoglobulins
D-Topical aciclovir
E--Oral [email address in profile] 2 days
F-Oral [email address in profile] 7days
G-Reasuurance
H--Carbamazepine
I--Steriods ------------------------------6 theme sba
woman after pregnanacy becomes very fearful and sleepless and avoids
going out.has frequent emotional outbursts,sleeeplessness and clings to
her child claiming inadequate bonding etc. 1postpartum psychoses
2.normal reaction
3.depression
4.acute stress reaction -------------7 theme sbaDiagnosis A 64 yr old lady presents with Floating stools n Lethargy..wht
Definitive tests wht u do to reach a diagnosis..?
1--FBC
2--TFTs
3--Endomysial Antibodies ----------------------
2011
4--theme -Prenatal screening

a-chorionic villus sampling
b-fetal heart monitoring
c-fetal blood sampling
d-no investigation
e-kliehauser's test
f-rheuses
d- status
1-previous child with cystic fibrosis.pregnant mother is concious for this
child.
2-previous child with congenital hypothyroidism.again pregnant want
about risk for next child?
3-previous child has suffered from anaemia and jaundice.on ultrasoud
foetus is doing well?
4-pregnant lady in early trimeter with some fresh red vaginal bleeding?
------------------
9-theme-sba
A Lady presents within 96hrs of unprotected intercourse...she is on the
12th day of her menstrual cycle,,,how can u help her with contraception...
1--emergency contraception {levonorgesrtol}
2--IUCD
3-- COCPS
4--IUS --------------10-thememanagement Ayoung man presents with sudden onset of chest pain n
breathlessness.there is reduced airentry on 1 side n trachea is deviated to
the left..next step in management
1--chest drain on rt side
2--chest drain on lt side
3-chest xray
4-needle thoracocentesis on rt side
5-needle thoracocentesis on lt side --------------------11--theme :
Aortic dissection..
1--A man presents with sudden onset of abdominal pain radiating to the
back...An emergency USG showed dissecting AA..next step in
management
1--abd ct scan
2--immediate surgery
3--abd usg
4-ercp -------------12-theme
A lab report showing foll..comment pH--7.25 pco2--reduced on comparing
with pH n pCO2 values given on the back of question booklet it looked
both ph n pco2 were reduced the options were
1-met acidosis
2-met alkalosis
3-normal
4-resp acidosis
5-resp alkalosis ----------------13 theme
2011
8--theme sba
A lady presents within 36hrs of unprotected intercourse she wants sum
contraception.She had an attack of Migraine sum days back..She had a
history of ectopic pregnancy...whts is the best u can offer her?
1--emergency contraception {levonorgesrtol}
2--IUCD
3-- COCPS
4--IUS ---------------------

A pt with many years of monoarticular attacks of joint pain presents with
swelling in the ear pinna...the diagnosis
1-Gout ------------------
15--theme
A child presents witha foreign body in the ear .HE is agitated.on
examination u see a bead.wht next will u do
1-removal under GA
2-reasure
3-syringing
4-refer to ENT --------------16 THEME
A child presents with sudden onset of breathlessness while playing..the
mother then notices tht a bead frm the toy is missing..wht will be ur next
step in management?
1--chest xray
2-pefr -----------
17 THEME -- :
feeding
1--A man after ileostomy
2--a pt with signs of liver failure
3---a girl with loose stools n biopsy shows villous atrophy
4--A pt with parkinsonism having dysphagia OPTIONS
1-Total parentral nutrition
2-PEG
3-gluten free diet
4--low protein diet +antibiotics
5--nasogastric feeding -------------
18 themeurinary incontinence1-A woman 3 days after abd hysterectomy presents with wetting her pants
without her knowledge
2-A35yr lady with 3 children all born vaginally n weighing ard
4kg..presents with wetting after sneezing...
3--A 60 yr old lady presenting with dysuria n dysparaneuia.A msu cultured
no organisms
2011
14 themeepistaxis
A young boy presents with bleeding frm the nose ...wht will u do?
1--pinch the bridge of the nose
2-reassure
3--cotton in the nose
4--pinch the soft part of the nose
5--ice packs -------------------------
19 theme CVS
1---pt with fever n a new murmur-2--pt with breathlessness n bicuspid aortic valve3-Alchoholic -pt with a ht n large heart-4--pt with prosthetic heart valve n sum value of INR..whiich was raised..-5--pt with swelling in leg n hoarse voice-options A-hormonal B infective C -congenital D degeneration E acquired F warfarin overdosage ----------------
20--THEME
Post htyroidectomy, pt presents with hoarseness of voice and on
laryngoscopy showing U/L vocal cord palsy.
1: Recurrent laryngeal.N
2-superior laryngeal.NP
3-vagus nerve ------------
21 theme uti
A young pt complaining of frequency of micturition...urine examination
shows presence of nitrates
1-klebsiella uti
2-proteus uti
3 DM 4 DI -----------
22 theme-A/ Allow out of bed to go to Toilet.

B/ Dopamine @ 3 mcg/kg/minute iv
C/ Fluid Challenge
D/ Echocardiogram
E/ Furosemide IV
F/ Intra Aortic Baloon Pump
G/ Mannitol 20% 500 ML IV
H/ O neg Blood
I/ Suprapubic catheter
J/ Swan-Ganz Catheter
2011
options
1--fistula
2--vag estrogens
3--urge incontinence
4--pelvic floor weakness ----------------

K/ Urethral catether
2/ A 66 year old man undergoes abdominal aneurysm repair. Over the

next four hours hourly urine volumes from a bladder catheter were 30 ml,
20 ml, 10 ml, and 15 ml. His BP is 105/70 mmhg, his heart rate is 110
beats/minute and CVP 2mm\Hg.
3/ Eight hours after blunt chest trauma and multiple injuries a 24 yr old
man's hourly urine vol has fallen to less than 20ml in two consecutive
hours. His BP is 90/60 mmHg, pulse rate 125 beats/minute and CVP 18
mmHg.
4/ A 32 year old miner is rescued after being trapped under a fallen rock
for four hours. After bladder catheterisation he is passing 15-20 ml of
reddish brown urine each hour. He has a tachycardia of 120 beats/minute
and a systolic BP of 100 mmHg.
5/ A 62 year old man feels the need to urinate eight hours after a hernia
repair but cannot pass urine in the bottle provided by the nurse.
---------------------
23 themevaccination a child 2 yrs who never had any immunisations cause parents
were worried abt the side-effects..n now he presents with a wound...
option
1==tetanus immonogglobulin
2--dtp 3--tt -------------
24 theme :UTI
A child 2 yrs old presents with UTI which is treated with Trimethoprim n
now culture showed sterile urine...A Micturating cystourethrogram
{MCUG} been done n it shows reflux..how will u treat this pt..
1--surgery for the reflux
2--prophylactic antibiotics..
2011
1/ A 45 year old man with multiple injuries including a fractured pelvis has
a little blood at the urethral meatus. He has passed no urine three hours
after his admission.
March 2006
1** a lawyer getting fearful and anxious to talk in public which was
affecting her career.
2** a female getting increasingly anxious, tearful and unable to cope with
anything., early morning waking and hardly any sleep at night
3** mother had to fly to attend daughter s wedding in 2weeks but is
fearful of getting into the plane.
4** man admitted in the ward is delirious.......
5** A young boy (sorry forgotten the age) has a painless soft swelling in
the rt. scrotum, it is blue in colour and compressible.
wat is the best management?
1. surgical exploration
2. ct abd.
3. hernoitomy
4. reassurance
5. antibiotics
theme: X ray picture for the following clinical pictures

6** driver in a car acident hit the steering wheel, B.p and pulse in both
arms were different.
options
widened mediastinum
globular heart shadow.
theme : palliative management.

this is a repeat theme.
7*** man having untractable hiccough
8*** terminal stage breast CA women having malodourous discharge
causing trouble.
9*** Lung Ca treated with radiaotheraphy leads to super vena cava
syndrome.
10** bleeding per rectum following Rx for IBD/ or some such condition with
radiotheraphy.
11** dont remember.
options:
haloperidol
hyoscine
2011
management of anxiety.

dexamethazone tablets
prednislone suppository
metronidazole topical
12***.
13***.
14***.
15***.
about a typical presentation of acute appendicitis.

typical presentation of ruptured ectopic
abt ruptured peptic ulcer-typical Q.
pancreatitis
theme on urinary retention.

16***. 85yr old bedridden man with palpable distended bladder, stoke pt.,
with a soft indenting mass felt on the LIF. no loss of wt or bldg p/r.
ans was fecal impaction.
another theme on hematuria.
17***. 55y man with macroscopic hematuria........ i think ans was bladder
ca
18***. man has hematuria and mass felt in lt. loin.........i think ans was
renal cell ca.
19***. one Q on ureteric colic
eme: Chest X ray findings:
20***- Male with antero septal infarction----Normal Chest xray
21***- 2- Women undergoing oesophageal dilatation, now unwell -----free
mediastinal gas
22***- Patient with Hx of diverticulitis, now present with rigid abdomen----Gas under diaphragm
23***- Women stabbed in chest---now breathless----Pneumothorax
24***- Patient, fever 39 C, mid zone consolidation---pneumonia
Theme: Oncological Emergencies:
25*** - Fungating odour from breast---metronidazole gel
26***- Haloperidol-----intractable hiccups
27*** Man presents with signs of sup vena cava Obs , has Hx of bronchial
Ca--- dexamethasone tablets
28***- Man underwent radiotherapy for prostate CA, now comes with P/R
bleeding----Prednisolone supp
29***- Increased thirst, polyurea, with Hx of some CA------Bisphosphonates
Theme: Burns:
30***- 2 yr child, cant get I/V line----interosseous line
31***- Child aged 12cant get IV line----Central venous line
32***- Child with burns on chest, upper limbs 10 %-----20 ml /? Bolus
33***- Burns patient with soot, signed nasal hairs, noisy breathing-----Endo
intubation
34***- Burns child, low BP--------Dobutamine
Theme: Toxicity:
35***- arrythymiasm dry mouth---amytriptiline
2011
there were Qs on abd. pain in a female

36***37***38***39***-
pin point pupils, hypotension------Morphine

Ataxia, slurred speech ----alcohol
Visual disturbances, bradycardia-----Digoxin
Hypotension only, no dec R/R-----atenolol
Theme: orthopaedics:
44***- Achilles tendon rupture-----surgical repair
45***- Child, pain in knee while playing football, next day walking normal,
only pain, no swelling, pain not relieved by paracetamol-----Ibuprofen
46***- Child, pain in knee, already getting 50% NO and 02, patella found
to be laterally shifted----manipulation???
47***- Female, 14 weeks pregnant, falls, with swelling on ankle-----crutches weight bearing support
Theme: Inguinal swelling:
48***- female with swelling in inguinal region, abdominal pain and
distension----hernia repair ( urgent)
49***- ship yard worker, with discomfort swelling in inguinal region
-----Hernai repair ( planned)
50***- child 9 month old, on crying, swelling appears----Herniotomy
51***- Female with Hx of MI, had hysterectomy done, lower abd scar,
swelling protruding beneath it, reducible------abdominal support
52***- Male 9 yr old, swelling inguinal region-----Hernia repair (planned
53*** one typical Q about ruptured aortic anuerysm: pulsatile abd. mass
with low bp and increased pulse. young man thin and tall.
Qs on imaging of spinal cord lesions like :
54*** .back pain, weakness in knees and ankles.
55*** .some Q about optic neuritis few yrs back and now some lesion.......i
m sorry abt this group of Qs, i really cannot recall much.
options were
ct brain
mri brain
mri spinal cord.
mri cervical spine
mri lumbar spime
mri lumbosacral spine
xray lumbar spine. WAS THE ANSWER FOR THE YOUNG MAN WITH
ANKYLOSING SPONDYLITIS (AS U CAN TELL FROM HISTORY)
2011
Theme: Antibody:
39***- telengectisias, raynauds phenomena------Anti centromere Antibody
( got this one wrong)
40***- female, pruritis, increased gamma GT------Antimitochondrial
antibody
41***- rash on cheeks, photophobia-----Anti dsDNA
42***- Something about thyroid Sx----anti thyroid peroxidase
43***- Male patient, pale looking, with some paresthesia..?? in
lowerlimbs---antibody to intrinsic factor
60*** Child sits at back of class, cant read the black board----spectacles
with concave lens
61*** Patient, headache, pain in eye since 2-3 days, dilated and fixed
pupil-------Glaucoma surgery
62*** Patient with SLE on steroids, presents with bilateral opacities-----cataract operation with lens implantation
63*** Man, can see distant vision well, but cant read newspaperin artificial
light----**i think its astigmatism *** cylindrical lens
another repeat theme abt vaginal infections/discharge.
64*** clue cells in the smear of the discharge- bacterial vaginosis.
65*** white discharge in a female which shows mycelia on microscopycandida
66*** vulval shallow painful ulcers- herpes
67*** last one was iwth h/o PID and on investigation no gonococcus
found ...........ans chlamydia.
1
68*** Man with increasing abdominal distention, general condition well,
spider nevi present, which Rx would u like to starta-cephalosporin
b-spironolactone ( is this right)
c-vitamin K
69***
Child brought with 8 hr Hx of sorethroat, saliva dribbling, what to do next?
a- Call anesthetist ( right ans) **EPIGLOTTITIS
b- Give penicillin
C- do a mouth examination
70***
Child 18 months old episode of sweet getting stuck up In the throat, has
been cleared now, parents are worried and ask if it happens again, what
do we do?
a- hemilich meneuvre
b- back blows with chest compression with patient on laps ( right ans)
typical Qs on asthama
71*** pt symptomatic despite using 2-3 times inhaled bronchodilator , also
wheeze at night
72*** women with chronic asthama comes with severe wheeze and
cough.-nebulised beta blocker.
2011
A repeat theme abt electrolyte imbalance

56*** villous adenoma- hypokalemia
57*** pyloric stenosis , vomitting, dehydration- metabolis alkalosis
58*** post radiation confusion, constipation, thirst in a female rx for breast
ca- hypercalcemia
59*** after operation breathlessness and jvp raised.fluid overload

73*** pt develpos oral candidiasis while being stable using 1000microg of
steroid
Theme about ENT :

79*** - teacher, presents with hoarseness-----vocalcord nodules
80*** - smoker, 8 weeks Hx of hoarseness-----laryngeal CA
81*** - Hoarseness following thyroidectomy----recurrent laryngeal nerve
palsy
82*** - 1 week Hx of resp tract infection, coryza------acute laryngitis
83*** - Female, husband died 5 weeks agom whispers on and off, can
cough normally-----functional dysphonia
organisms responsible for:
84*** swollen leg hot, painful and indurated. STREP PYOGENES
85*** axillary abcess STAPH AUREUS
86*** i think there was one on candida ???
87*** pt previously healthy with dry cough, increasing breathlessness, xray shows patchy consolidation all over the lung feild.......
(MYCOPLASMA))))
88*** PT ON ANTIBIOTIC develops diarrhoea -> clost. difficile
89*** there was a Q in the hematuria theme:
Asian male with cough and loss of wt shows microscopic hematuria.
ans: kidney TB
There was an SBA:
90*** A man brings his wife into A&E after finding her unconscious at
home. He says that at breakfast time, she had complained of a sudden
headache and had vomitted. She took paracetamol and aspirin for the
pain. She is now in A&E with a low GCS.
What is the single most appropriate Inx:
A. ECG
B. Drug levels
C. FBC
D. CT head (right ans)
2011
74***
Female 68 yrs old, has had a low level Right forearm FRACTURE , what will
u do to prevent more fractures in future:?
A calcitonin
B Ca + suppl
C Bisphosphonates ( I think this is right b/c acc to OHCSthey reduce risk
of hip and wrist #)
D HRT *** IS THIS ALSO AN ANSWER??????

91*** there was a question regarding a young child with non blanching
erythematous papules on the lower extremities with facial erythema. what
investigation will u do for him?????
93*** child with ???? orbital tumor, as understood from the history, or
proptosis, what is the best investigation to be done --> CT scan i believe.
94*** and a child whos short for his age with some other features--> not
typical of cystic fibrosis, but i believe that was the closest answer.
95 *** psychiatry.
the pt whos anorexic. --> compulsory detention was my answer. b/c in
ohcs it mentions, if there is any danger to one owns life we must detain.
96*** and other psychi question regarding the pt in the medical ward had
an operation or something done for him. and hes worried or in panic. what
method of treatment will u use.
Theme: Toxicity:
97*** - arrythymiasm dry mouth---amytriptiline
98*** - pin point pupils, hypotension------Morphine
99*** - Ataxia, slurred speech ----alcohol
100** - Visual disturbances, bradycardia-----Digoxin
101** - Hypotension only, no dec R/R-----atenolol
102** - liver failure after 4 days....paracetamol
Theme: Antibody:
103** - telengectisias, raynauds phenomena------Anti centromere
Antibody ( got this one wrong)
104** - female, pruritis, increased gamma GT------Antimitochondrial
antibody
105** - rash on cheeks, photophobia-----Anti dsDNA
106** - Something about thyroid Sx----anti thyroid peroxidase
107** - Male patient, pale looking, with some paresthesia..?? in
lowerlimbs---antibody to intrinsic factor
DEMENTIA THEME (REPEAT)
108** . Most common form of dementia in UK ............ Alzheimer's
Dementia
109** . Characterized by neurofibrillary tangles and senile plaques.......
Alzheimer's
110** . Hypertensive patient ............ multi infarct
111** . Respond to anti depressant............ pseudodementia
112** . Increased disinhibition and preservation of intellect....... frontal
113** one was the SBA for the child who plays football, then developed
itchiness - something like that
2011
92*** child with 5 % burns what is the treatment of choice?

114** BEST TIME TO MEASURE SERUM PROGESTERONE FOR MARKING
OVULATION
Answer... 21 day Progesterone
116** something about a gardener who got a thorn prick...in A&E initial
resuscitaion done...getting his finger dressed....and suddenly develops
perioral itching ,hunger and collapses? He was given anti tetanus and
penciliin oral
Answer is anaphlaxis other close option was staphlocoocus sepsis but
anaphlaxis is da right answer
options....anaphylaxis...cant remember all of them
117** girl complaining of primary dysmenorrhea

118** women aged 30 compalinign of menorrhagia
Options
a.mefenamic acid
b.TRANEXAMIC ACID
c.norethisterone releasing IUCD
D. cocp
119** - 123** ANAEMIA THEME
Options
a.iron deficiency due to malabsorption
b.iron def due to diet
c.B12 def due to diet
d.B12 def due to malabsorption
e. intrinsic factor deficient
1.person on vegan diet with macroytosis and anemia ....... b12 diet def.
2. Pernicios anemia one....... b12 malabsorption
3. .patient complaining of weight loss,loss stools with microcytinc
hypochromic anemia with anti endomysial antibodies positive! .... iron
malabsoprtion
124**- 127** THEME on Myocardial complications came
with choices such as -Ventricular rupture
-dresslers syndrome
-etc
128** occupational asthma, where the patients symptoms are resolved
after he goes on holiday
2011
115** QUESTION ON HOW TO MONITOR A PATIENT (MOLAR PREGNANCY

AS DEDUCED FROM THE HISTORY)
A)SERUM HCG
B) URINARY HCG
130** Pt, 20s, female, with wt loss and loose bowel motion with mucus for
3 months. Lower abdominal pain also.
My answer::: Inflammatory bowel DISEASE...
131** Pt , asthmatic, on inhalers of steriods and beta agonists, still
symptomatic
My answer::: Oral theophylline (agree with yasir)
132** eldery pt, after stroke, in some kind of a hostel or eldery care
house, developed sever itching and erythema on her body, lines on her
hand and feet.
My answer::: ***chlorpheneramine*****..
Other questions in asthma theme

133** . pt symptomatic despite using 2-3 times inhaled bronchodilator ,
also wheeze at night----inhaled corticosteroids
134** . women with chronic asthama comes with severe wheeze and
cough.----nebulised beta blocker.
135** . pt develpos oral candidiasis while being stable using 1000microg
of steroid---decrease inhaled steroids
136** A man brings his wife into A&E after finding her unconscious at
home. He says that at breakfast time, she had complained of a sudden
headache and had vomitted. HER MOTHER DIED AT THE AGE 40 SUDDEN
DEATH She took paracetamol and aspirin for the pain. She is now in A&E
with a low GCS.
IT COULD BE A RUTURED BERRY ANEURYSM --> SUBARACHNOID
HAEMORRHAGE.
137** ADULT POLYCYSTIC kidney DISEASE (U make it out from history)
138**- 141** investigation of neck masses
1.branchial cyst
2.cystic hygroma
3.thyroglossal cyst
4.hard thyroid mass
options were
a.biopsy
b.fine needle aspiration cytology
c.ultrasound
2011
129** There was also a cardiology theme........ I remember only 1 question

sumthing abt SVT and carotid sinus massage and valsalva man.
unsuccessful..............next step................ADENOSINE (no doubt abt that)

d.aspiration with cytology and microscopy
options
a.apical granuloma on CXR
b.pleural effusion
c.bilateral hilar lymphadenopathy --> S A R C O I D O S I S
143** patient with excessive bronchial secretions....not able to
expectorate....the answer was hyoscine
144**
A young woman fainted in the street and was brought into A&E. She
weighs 33kg. She is alert and well in A&E and states she is on a diet and
admits to not eating or drinking anything for 48 hrs. She says she wants to
reach her target weight of 30kg. She is annoyed she has been brought to
the hospital and adamantly states she wants to leave. What is the most
appropriate step?
A. Detain her under the mental Health Act. (CORRECT ANSWER I THINK)
B. Refer to dietician
C. Refer to her GP
D. Allow her to be discharged
E. I cant remember
145**-147** Diagnosis of Diabetes
A Conns Syn
B Cushings Syn
C Cystic Fibrosis
D Diabetes Insipidus
E Impaired Glucose Tolerance
F Type 1 Diabetes
G Type 2 Diabetes
H Nephrotic Syn
1. A 30 yr old business man has palpitations and urinary frequency. He is
sweating. His urine dipstick is +ve for glucose and ketones. His plasma
glucose is 26mmol.
ans) type 1 diabetes
2. A 65 yr old woman has a recurrent vaginal itch. she has BMI of 33.
Random BLOOD GLUCOSE is 15 mmol.
ans) type 2 diabetes
2011
142** diagnostic x ray finding of a patient with signs and symptoms of

tuberculosis...cant remember the exact scenario

3. A 55 yr old man has glycosuria. After a two hr glucose tolerance test,
his plasma glucose is 9mmol.
ans) impaired glucose tolerance
Options
a.met acidosis
b.metabolic alkalosis
c.resp acidosis
d.resp alkalosis
dont remember, exact stem of the question, but i also chose metabolic
acidosis as my answer
149** SBA abt the man with the panic attack?
Rebreath into an airbag IS THE TREATMENT
150** a young child with 5% (I DONT REMEMBER 10%) burns --> CAN
ANY1 PLEASE TELL US WHAT THE ANSWER FOR THIS WAS??
WAS ADMISSION ONE OF THE CHOICES??????
151** a man in fire accident with soot particles-anaes help?.
2011
148** about salicylate poisoning

determine the acid base abnormality
1,question describing skin lesion in one pt who went for a holiday and
remember some tick bite --lyme disease
2,skin lesion in a man which is there for a long period and now bleeds on
touching ---malignant melonama ,basal cell carcinama ,squamous cell
ca ,pyoderma gangrenosum were the option
3-treatment for the newborn with weeping eczema --i think hydrocortisone
1% is the answer
4-treatment for broad complex tachycardia with hypotension palpitation
chest pain ---(is the answer dc cardio version )
5,treatment for atrial fibrialltion with some pulse rate ---(digoxin is the
answer )
6-treatment for supraventricular tachycardia with pulse rate 240(adenosine i have written)
7-question abt pt taking antibiotic for pneumonia and developing diarrhoe
and mucus ----(pseudomebraneous colitis )
1 child with pertussis - appropriate drug, there was erythromicin and
others
2 child with exercise-induced asthma well controlled initially with B2
bronchodilator but now several doses of same drug with no good effect,
what next to give - Na cromoglycate, inhaled salmetrol, and others
3 Pre-op managment of some conditions - healthy Afrocarribean for
ingiunal hernia - no investigation required, sickling test etc
4. preop for a prosthetic cardiac valve patient (i think for cystoscopy)
5. RTA head-on collision with hypotension and widened mediastinum ruptured oesophagus, ruptured aorta etc
6.Those questions on head injuri diagnosis - extradural hematoma, SAH,
chronic subdural hematoma, brainstem injury, this wasnt difficult.
7. man with mild led oedema, papulovesicuar rash all over the body non
blanching with some necrotic ones - diagnosis; herpes zoster, systemic
vascilitis, meningoccocal septicemia etc (a real crazy question)
8. many questions on Psychiatry - unfamiliar and familiar ones like the
female lawyer losing confidence in self and believes shes a failure appropriate management
2011
JAN 06
9 postnatal woman with some delusional problems - believes husband is

planinning harming mother and baby - appr mgt
11. question on testicular torsion - immediate mgt, there was our usual
option of surgical exploration and others
12. question on testicular tumor - diagnosis from a histological description
- a man has atrial fib and mitral stenosis also found to have finger clubbing
and splinter haemorrhages. i answered infective.
2- A homeless man has cardiac failure also has spidernaevi on his chest
cxr shows very large heart his bp is normal.
3- Man with several episodes of fainting echo demonstrated aortic valves
has two cups. I did congenital.
4- Woman has recently had mitral valve prosthesis inserted devolopes
high temp severe cardiac failure and a new cardiac murmur. I did infective
- A woman has pallor and abdominal pain and floating stools. She
previously was a tennis player but now she can not finish the full game her
diet is ok. Thyroid function test and endomyseal antibodies were the
options.
1-a brain tumour with some histology which says some psamomma bodies
in it
2-a question abt the lesion between internal carotid and middle scerebral
artery ...is it berry aneurysm
-the following question abt the abtenatal diagnosis ,
3-hypothyroidism
4-e previous baby with jaundice and anaemia and now mother worried abt
the present fetus what is the investigation
5-cystic fibrosis
Retension of urine.
1- man living on his own who has been constipated for the last 3 years
developed urinary incontinence his bladder is painlessly enlarged to the
level of umbilicus and the sigmoid colon is easily palpable.
I did Faecal impaction
1- brain showing multiple areas of demyelination.
Ans: multiple sclerosis.
2- circumscribed lesion composed of a gland like structures lined by
columnar cells with pleomorphic nuclei.
Ans: secondary carcinoma.
2011
10 Those popular stab injuries on the chest and abdomen with

hypotension - most appr management

3- a mass indenting the surface of the brain and on microscopy exam:
composed of elongated cells with regular nuclei. Psammoma bodies are
seen.
Ans: meningioma.
5- a lesion at the junction of internal carotid and middle cerebral arteries.

Ans: berry aneurysm
Child of 5 years of age: picks up objects in his palm, but not between
finger and thumb, responds to parents, but is afraid of strangers, sits
assisted, but not unassisted, he coos but has no words.
Your dx:
a. motor delay
b. global delay
c. social delay
d. language delay
e. normal
I chose normal
Lower GI bleedz.
1- woman in the hospital being treated for persisting pneumonia with
prolonged course of antibiotics the fever recurs and she develops bloody
diarrhoea with mucus.
Ans: pseudomemb colitis.
2- woman with bright red rectal bleeding the blood is on the surface of the
stool and also splashes in the toilet she has a long h/o constipation with
passage of heard faeces.
Ans: Haemorrhoids.
3- a man age more than 70 with 4 months h/o increasing frequency of
defecation also complains of urgency and sensation of incomplete
evacuation.
Ans: rectal ca.
4- woman with recurrent bloody diarrhoea 2 minor but similar episodes 2
years previously.
Ans: ulcerative colitis.
5- woman returns from overseas holiday develops fever and diarrhoea.
After returning to uk she noticed fresh blood mixed with stools.
Ans: Campylobacter infection.
Upper GI conditions.
1. A disease characterised by metaplasia from squamous epithelium to
columnar epithelium.
- barretts
2011
4- a wedge shaped area of discoloration occuping both grey and white

matter.
Ans: infarct.

2. Abnormal oesophageal motility bcz of a loss of ganglion cells an
auerbachs plexus
- Achalasia.
4- a disease char: by displacement of part of the stomach in to the thorax.

- Hiatus hernia.
5- a disease char: by accumulation of hyalins fibrous tissue in the
submucosa of the viscus.
- Scleroderma
a man 80 years old smoked heavily for many years is waiting to be
admitted to the hospital for resection of bladder tumour he suddenly
unable to pass urine and has lower abd: pain.
- Ans: clot retension.
- a man smoked since child hood has had haemoptysis has lost weight and
has a shadow on his chest x-ray following a fall he has developed sensory
loss in both legs and has difficulty in walking he also is unable to pass
urine.
- Ans: spinal cord compression.
- A man with h/o haematuria marked nocturia and urine diffculty his PSA is
elevated an abd: ultrasound shows residual urine of 400 ml.
- Ans: BPH
HERNIA MANAGEMENT.
- Man 3 months h/o right groin swelling he is otherwise fit takes regular
exercises has no past medical history. Exam: confirms rt: inguinal hernia.
Ans: no investigation.
- an African Caribbean has bilat: inguinal hernias his hb is 11 g/lit.
ans: sickle cell testing.
- man is admitted for the repair of left inguinal hernia he regularly uses
recreational drugs administered intravenously.
- Ans: hepatitis screen.
- woman is to undergo right femoral hernia. Previously had severe
bleeding after a dental extraction.
Ans: coagulation screen
Adverse drug effects.
- A man with longstanding h/o schiopherenia treated with an antipsychotic
agent. He complains of a sore throat and fever and have a low blood count
wbc and reduced neutrophils.
2011
3. a disease characterised by post cricoid web arising with iron deficiency

anaemia.
- Plummer-vinson synd.

Ans: clozapine.
- A pt receiving treatment for bipolar affective disorder his tsh level is
increased and t3 and t4 levels are reduced.
- Pt: having extrapyramidal effects complains of reduced sexual libido and

erectile impotence his prolactin is raised.
Ans: chlorpromazine.
A pt on treatment for depression complains of dry mouth, blurred vision,
constipation and tremors.
Ans: Amitriptyline.
- Pt: with h/o of schizophrenia receiving an antipsychotic agent becomes
physically unwell and is found to have an elevated body temp: unstable
blood pressure excessive sweating and a raised white blood cell count and
raised cpk.
Ans: chlorpromazine
a cyclist had an rta. he had an injury. he was wearing a helmet... the
choices were.. fracture of the base of the skull. sub dural haemorrahge,
intra cerebral haemorrhage, occipital etc.. i dont remember much..
there was another.. a patient had her bp checked a few days back. she
was normal.. a couple of days later her bp rose up..
Diagnosis of emergencies.
- an 17 year old boy collapsed in the street and was brought by ambulance
to A&E on arrival he is unconscious his pulse is 50 and regular. His bp:
90/60 he has constricted pupils are non reacting to light his R/R is 4
beats/min.
- ans: Opiate overdose.
- 17 years old girl attends the A&E she is abusive and tearful. She states
that she has lost her regular medicine. Se complains of severe aches and
pins all over and she cannot sleep. She demands immediate pain relief.
- Ans: Opiate withdrawal
A girl in A&E complaining of difficulty in breathing her pulse is 86 and
regular. Her R/R is 25 her peak flow rate is 450. she is frightened and
describes pins and needles in her hands and face.
ans: panic attack
:-1) management of labour:
a:- patient at term,has passed meconium, cervix is 3 cm dilated.
2011
Ans: lithium.

b:- patient at term,head had been delivered, but baby has shoulder
distocia.
4) patiend with previos h/o of HT,membrane ruptures,meconium passed.

cervix is 3cm dilated.
Theme 5 Investigation of Unconsciousness
Options
a. CT scan
b. MRI scan
c. Blood Glucose
d. Toxicology Screen
e. Xray Skull
f. U&E
g. Blood Alcohol
Questions
19. 21 year old Female found unconsciousness next to her 22 year old
husband, who was found dead. Her ECG shows evidence of Acute MI
20. 42 year old Female, previously normal, was suddenly found
unconscious. Brought to the A&E shows respiratory depression, dilated
fxed pupils and extensor plantar response
21. 21 year old rugby player, had suffered from an episode of brief
unconsciousness. Comes to the A&E the next day with paresthesias of the
left arm.
my answers
19. toxicology screen
20. toxicology screen
21. CT scan
Pt: with h/o of schizophrenia receiving an antipsychotic agent becomes
physically unwell and is found to have an elevated body temp: unstable
blood pressure excessive sweating and a raised white blood cell count and
raised cpk.
young man in his early twenties comes to see you, he is in good health,
but his girlfriend reports that he looks jaundiced from time to time. I don't
believe you find anything on exam. What investigation do you choose.
I'm interested in finding out what other people thought about this
question. I assumed he had Gilbert's syndrome and as such chose
2011
c) patient at term,membranes ruptured,meconium passed. cervix 3 cm

dilated.

unconjugated bilirubin as the investigation, but I couldn't be certain. Your
thoughts?
Next management in the following conditions
A rugby player was hit in the back & come with loin pain & haematuria.
management
Young man with one episode of frank haematuria & he was stable but
presented with anuria.
A male with anuria brought to A&E after injury with brusing on perineum,
the digital rectal exam was normal next step
A pt with h/o RTA have FRACTURE of Left lower ribs. Pt is having left sided
abdominal pain & progressive guarding of Left hypochondrium. O/E,
PR=110/min & BP 90/60. What is the next step?
q 120 i was thinking at usg to see if there is any damage,but why not ivu?
121. catheterization or ascending urethrogram. i don't know which one is
more indicated here as is it a case of trauma. it could be a urethra rupture.
one episode of frank hematuria and after this anuria.so? could it be
urethra rupture?
Pt with frank hematuria and kick to back, I was puzzled by. Didn't think the
u/s abdomen would do us much good (as kidneys are retroperitoneal), and
wasn't sure that IVP was a good option as it may spill blood into body
cavity if a major artery had been avulsed. I believe I cut my losses and
chose nephrectomy and moved on quickly.
The gentleman with anuria, injury and a bruised perineum. I can't
remember what I chose in all honesty, perhaps MRI or some other
imaging. I stayed away from anything that required a tube insertion
(including catherization) as I believe this is CONTRAINDICATED in possible
urethra damage/rupture (as you may inflict more damage with the
insertion).
The hypotensive man with with fractured left lower ribs. I presumed
injured spleen and hemodynamically unstable as a result. Figured the best
way to get control of bleeding would be to do an emergency splenectomy
2011
A- USG abdomen
B- Catheterisation
C- Ascending urethrogram
D- Splenectomy
E- Laparoscopy
F- Observation
G. Abdominal tapping
H. Laparotomy
I. Blood transfusion
J. Get an expert opinion
K. IVU
L- MRI
2011
May 2005 Exam

Theme 1: Abdominal Injury
A. Aortic rupture
B. Splenic rupture
C. Diaphragmatic rupture
D. Cardiac tamponade
E. Renal contusion
F. Renal pedicle avulsion
G. Bladder rupture
H. Pancreatic rupture
1. A Boy was riding his bicycle when he was hit by a car. After examination
in the A & E, he was found to have left upper quadrant tenderness.
2. A Man fell off a ladder, has diffuse pain on right side of the trunk. IVU
shows no excretion on right side.
3. A Man was stabbed with a 10cm knife in the left upper quadrant, stable
for 20min after which BP falls to 90/60mmHg.On USG, no free fluid seen in
abdomen.
Theme 2: Diagnostic visual tests
A. Colour vision test
B. Computed tomography (CT) scan of the brain
C. Electroencephalogram (EEG)
D. Erythrocyte sedimentation rate (ESR)
E. Full blood count FBC
F. Intraocular pressure measurement
G. Serum calcium concentration
H. Serum urea and electrolyte concentration
I. Visual acuity assessment
J. Visual field mapping

4. A 76-year old woman presents with symptoms of feeling generally
unwell and anorexia with weight less. She complains of sudden loss of
vision in her left eye. On the left side the pupillary light reaction is
sluggish.
6. A 22-year-old woman complains of afternoon headaches, which have

progressively worsened. She works as a visual display unit (VDU)
operation.
7. A 72-year-old woman presents with tunnel vision and severe headache
nausea and vomiting of recent onset. She has noticed colored haloes for
six-months.
8. A 27-year-old woman presents with severe morning headaches for two
months. Full neurological examination is normal apart from bilateral
papilloedema. Her blood pressure is 120/70-mmHg
Theme 3: Needle Stick Injuries

A. CD4 count
B. Full blood count (FBC)
C. Hepatitis-B core antibody
D. Hepatitis-B e antibody
E. Hepatitis-B e antigen
F. Hepatitis-B surface antigen
G. Hepatitis-C antibody
H. Hepatitis-C ribonucleic acid (RNA) antigen
I. Human immunodeficiency virus (HIV) antibody test
J. Human immunodeficiency virus (HIV) viral load
K. Liver function tests (LFTs)
L. Retain serum sample
M. Thick blood film
9. A nurse suffers a needle stick injury while taking blood from a patient
known to have late stage human immunodeficiency virus (HIV). Post
exposure prophylaxis with analysis is being considered. However, the
nurse now admits to the possibility of already being HIV positive.
10. A nurse, who is known to be hepatitis B immune, suffers a superficial
scratch while taking blood from a patient. The patients own hepatitis and
human immunodeficiency virus (HIV) markers are negative. The nurse is
advised to have a human immunodeficiency virus (HIV) antibody test in
three months time.
11. A doctor suffers a needle stick injury while taking blood from a patient
said to be a chronic hepatitis-B carrier. The patient needs a test so that
the doctor can be advised of his risk of acquiring hepatitis-B infection.
2011
5. A 40-year-old woman presents with sudden onset of severe occipital

headache photophobia and vomiting.

12. A doctor suffers a needle stick injury while taking blood from a patient
known to be hepatitis-C antibody positive. The doctor needs a test to know
his Hepatitis-C status.
A. Bisphosphonates intravenously
B. Cyclizine injection
C. Dexamethasone tablets
D. Haloperidol injection
E. Hyoscine injection
F. Indomethacin suppositories
G. Loperamide capsules
H. Metronidazole gel
I. Midazolam injection
J. Nystatin suspension
K. Peithidine injection
L. Prednisolone suppositories
13. A 57-year-old man with carcinoma of the bronchus develops superior
vena cava obstruction following radiotherapy.
14. A 49-year-old man with metastatic carcinoma has intractable hiccough
15. A 49-year-old woman has fungating malodorous breast cancer. The
odor is distressing to her and her relatives.
16. A dying 57-year-old man with bronchial carcinoma is unable to cough
bronchial secretions.
17. A 78-year-old man has a bloody rectal discharge following
radiotherapy for carcinoma of the prostate.
Theme 5: Fractures in Children
A. Fracture of clavicle
B. Fracture of mid radius and ulna
C. Fracture of neck of humerus
D. Fracture of shaft humerus
E. Buckle fracture of distal radius
F. Non-accidental injury
G. Scaphoid fracture
H. Subluxation of radial head (pulled elbow)
I. Supra condylar fracture of humerus
18. A seven-day-old girl baby, born after a difficult home delivery, is not
moving her left arm. She cries each time she is picked up.
19. A three-year-old girl tripped while holding her mothers hand. She has
not used her right arm since.
2011
Theme 4: Terminal Care

20. An eight-year-old boy fell from a tree. He is in severe pain. The radial
pulse is not palpable on the injured arm.
22. A four-year-old boy fell in the playground. He has been using forearm
normally but complains of pain. There is no deformity or swelling and
there is minimal tenderness on examination.
23. A three-month-old baby. Whose mother says he has been crying since
he rolled off the bed two days ago, is found to have bruises on his legs.
Theme 6: Natural history of Epistaxis
A. Anticoagulant overdosage
B. Coagulopathy
C. Hypertensive disease
D. Local infection
E. Maxillary antral carcinoma
F. Nasal polyposis
G. Nasopharyngeal angiofibroma
H. ORF
I. Sarcoidosis
J. Septal perforation
K. Trauma
24. A 50-year-old man presents with epistaxis. He has an artificial heart
valve.
25. A 50-year-old furniture maker presents with anesthesia of the left
check and repeated left sided episodes of epistaxis.
26. An actor presents with repeated episodes of epistaxis as associated
with whistling on breathing in through the nose.
27. A 45-year-old sheep farmer presents with unilateral epistaxis.
Inspection reveals a bleeding polyp attached to the anterior nasal septum.
28. An 80-year-old man presents with epistaxis of two hours duration.
Theme 7: Endocrine Abnormalities
A.Adrenaline
B. Adrenocorticotropic hormone (ACTH)
C. Aldosterone
D. Calcitonin
E. Cortisol
F. Follicle stimulating hormone (FSH)
G. Glucagon hormone
2011
21. A 16-year-old boy fell on his outstretched hand. His forearm was put in
a plaster a week ago at another hospital and he has got it well. He has
come to the Accident and Emergency Department to have it repaired. He
says his initial x-rays were normal. On repeat x-ray an abnormality is
found.
29. A 55-year-old woman presents with increasing obesity. On

examination, she has central obesity with a round moon face.
30. A 42-year-old man is found at routine medical examination to have a
blood pressure of 170/120 mm Hg. He has been complaining of
intermittent headaches,palpitations and intermittent diarrhoea for some
months.
31. A 60-year-old woman is found to have and elevated calcium level on a
routine biochemical profile. Repeated measurements confirm the finding.
32. A 40-year-old man presents with thirst, polyuria and marked muscle
weakness. His blood pressure is 150/110-mmHg. His serum sodium
concentration is normal and his serum potassium concentration is low. His
blood glucose is normal.
Theme 8: Pain relief
A Acupuncture
B Bolus of intravenous opiate
C Carbamazepine
D Corticosteroid
E Hypnotherapy
F Intramuscular non-steroidal anti-inflammatory drugs
G Oral non-steroidal anti-inflammatory drugs
H Oral opiate
I. Proton pump inhibitor
J Selective serotonin re-uptake inhibitor
K Simple analgesic
L Subcutaneous opiate infusion
M Transcutaneous electrical nerve stimulation (TENS) machine
N Tricyclic antidepressant drug
33. A 70-year-old man presents with severe, retrosternal chest pain and
sweating. An electrocardiogram (ECG) shows acute myocardial infarction.
34. A 70-year-old man with inoperable gastric cancer causing obstruction,
and multiple liver metastases, is taking a large dose of oral analgesia.
Despite this, his pain is currently poorly controlled.
35. A 30-year-old woman has just been diagnosed as having rheumatoid
arthritis and her rheumatologist has begun giving her gold injections. She
2011
H. Insulin
I. Luteinising hormone (LH)
J. Prolactin
K. Serum parathyroid hormone
L. Somatostatin
M. Testosterone
N. Thyroid stimulating hormone (TSH)
O. Thyrotrophin releasing hormone
P. Thyroxine

continues to complain of joint pain and stiffness, particularly for the first
two hours of each day.
37. An 80-year-old woman reports severe paroxysms of knife-like or

electric shock like pain, lasting seconds, in the lower part of the right side
of her face
Theme 9: Differential Diagnosis of Ectopic Pregnancy
A. Appendicitis
B. Inevitable miscarriage
C. Missed abortion
D. Septic abortion
E. Acute PID
F. Diverticular disease
G. Torsion of an ovarian cyst
H. Irritable bowel syndrome
I. Incomplete abortion
J. Ectopic pregnancy
38. A pregnant woman with an LMP of 9 weeks and a positive home
pregnancy test presents with an enlarged tender uterus and bright red
bleeding per vagina. on examination her cervical os is fully open
39. A 16 year old with right iliac fossa pain has a vaginal ultrasound which
demonstrates an echogenic cystic mass just superior to the right fornix.
40. An 18 year old girl is doing her exams and is very stressed. she has
missed her last period. Her pregnancy test is negative. She complains of a
three month history of generalised abdominal pain and bloating
41. A 22 year old girl with a history of two terminations of pregnancy, now
pregnant again complains of right iliac fossa pain and a watery brownish
vaginal discharge.
42. A 27 year old girl reliably on oral contraceptives develops a high white
cell count, fever and a malodorous vaginal discharge.
Theme 10: Bites and Stings
A. Thick and thin blood film
B. Chest Xray
C. Full blood count
D. Hepatitis A serology
E. Hepatitis B serology
F. Leptospirosis serology
G. Lyme disease serology
H. MRI Skull
I. Nasal swab
J. Skin prick test
2011
36. A 60-year-old man with a known hiatus hernia presents with recurrent,
sever, burning retrosternal chest pain associated with acid regurgitation
and increased oral flatulence.

K. Skin swab culture
44. A 16 year old girl has a lesion on her right leg. She removed an insect
from her leg after walking through a forest 3 weeks ago. The lesion is red
and raised.
45. A 52 year old business man presents to A&E with fever and rigors ten
days after returning from a trip to Zambia.
Theme 11: Jaundice in Childhood

A. Alpha 1 anti-trypsin deficiency
B. Biliary atresia
C. Breast milk jaundice
D. Congenital spherocytosis
E. Galactosemia
F. Congenital viral infection
G. G6PD Deficiency
H. Hepatitis A infection
I. Hypothyroidism
J. Physiological jaundice
K. Rhesus haemolytic disease
L. UTI
46. A previously well 10 year old girl presents with 2 day history of fever,
nausea, anorexia, loose stools. She has yellow sclerae and is tender in the
right upper quandrant on abdominal palpation.
47. A baby becomes jaundiced and pale on the 2nd day of life. Cord blood
tested at birth is Coombs positive.
48. A one month bottle fed baby is found to be deeply jaundiced. His
weight gain is poor and his stools are pale and urine is dark yellow.
49. A two month baby is noted to have jaundiced, He is breast feeding well
and has gained weight, His stools are yellow and his urine is pale straw
coloured.
Theme 12: Infectious Diseases
A- Lyme disease
B- Brucellosis
C- Plasmodium vivax
D- Plasmodium falciparum
E- Plasmodium Malaria
2011
43. A 28 year old police officer is bitten by a heroin addict during the
course of an arrest to theft. The police officer presents to A&E with a deep
wound on his right hand.

F- Tuberculosis
G- Lymphoma
H- Bronchial CA
51. A pt coming back from Africa complains of recurrent fevers, loss of

appetite & fits
52. A patient presents with fevers night sweats & malaise &
lymphadenopathy
53. A pt with haemoptysis & cough story like TB but chronic without travel
history
Theme 13: Pre-Operative Investigations and Preparations

A- Stop smoking
B- Refer to alcohol dependency group
C- Give Vitamin k
D- Stop Smoking
E- S/C heparin
F- Withdraw some blood Pre-Op
G- Empty bowels Pre-OP
H- Total Bed Rest Pre-Op
I- Antibiotics Pre-Op
J- Admission to addiction Center,
K- Loose weight
54. A patient has to undergo a hernia repair and has been given
graduated compression stockings.
55. A pt is going to have femoral neck replacement & is obese
56. A woman who is at term needs analgesia for pregnancy termination
57. Pt with incisional hernia, BMI - 28 planned of repair & smokes 40
cigarettes
58. Pt with to be operated for thyroid drinks 30 units alcohol
59. A 60-year-old man with BMI 34, who drinks 20-units of alcohol per day
& smokes 20 cigarettes/day for the last 5 years going for a hip
replacement surgery which will last for > then 2 hrs
Theme 14: Management of Trauma in Children
2011
50. A patient coming back from holiday in a farm presents with malaise &
fevers & spleenomegaly
60. A 4 yr. Old child with 10 % scalds on chest.

61. 2 yr. Old with hypovolemic shock, unable to get iv access.
62. 13 yr. Old in shock, unable to get iv access.
63. 6 yr. Old, intubated after RTA, BP low, pulse high
Theme 15: Psychiatry Next step
A. Chlorpromazine.
B. Clozapine.
C. ECT
D. Benzhexol.
E. Continue the same drug orally.
F. Stop the treatment.
G. Hyoscine.
H. Stop the drug
I. Review medication
64. A patient after treatment with antipsychotic says he develops hyper
salivation.
65. A patient after treatment with haloperidol, a man develops stiffness of
limbs.
66. A patient stabbed his father in acute psychosis, & then was treated
with anti psychotic, now believes himself to have recovered from the
illness.
67. A patient who has recurrent hiccups, due to anti psychotic treatment
Theme 16: Toxicology side effects
A- Salicylates
B- Paracetamol
C- Metoclopramide
D- Opioids
E- Tricyclic Antidepressants
F- Digoxin
G- CO
H- Diazepam
I- Carbamizipine.
68. Development of hepatitis 3-4 days after indigestion
2011
A. I/V morphine.
B. Endotracheal intubation.
C. Intraosseous line.
D. CV line
E. Oropharyngeal airway.
F. Nasopharyngeal airaway.
G. Dobutamide.
69. Dystonia, occulogyric crisis

70. Pinpoint pupils respiratory depression, bradycardia
72. Visual problems, & bradycardia

Theme 17: Anatomy of Heart
A- Left atrium
B- Right atrium
C- Left ventricle
D- Right ventricle
E- Mitral valve
F- Tricuspid valve
G- Coronary arteries
H- Interatrial septum
I- Interventricular septum
J- broncho pulmonary displasia
K- SA-node
L- AV-node
M- Bundle of His
73. Endocarditis in IV drug abuser
74. Patent foramen ovale
75. Site of Cardiac aneurysm
76. Complete heart block
77. Some question regarding Mitral valve
Theme 18: Thyroid Disorders
A. Anaplastic carcinoma
B. Follicular Ca
C. Papillary Ca
D. Hashimoto's thyroiditis
E. Thyrotoxic goitre
F. Autoimmune hypothyroidism
G. Drug induced thyrotoxicosis.
78. Female,41 yrs old, presents with hard, irregular fixed swelling, stridor,
dysphagia since 3 months.
79. Old lady with smooth neck swelling, bradycardia, spare coarse hair,
macrocytic anemia.
80. Female on treatment for supraventricular tachycardia C/O seeing dots
& glare on driving at night, exophthalmos, no goitre.
2011
71. Women on neuropsychiatric drugs at night now c/o agitation &

dizziness
81. Female, swelling in the neck, tremor irritability, diarrhoea, bruit.

Theme 19: Treatment of Menstrual Disorders
82. A 13 year old school girl presents with primary dysmenorrhoea who
skips school because of pain.
83. A 30 year old with heavy painless bleeding with regular cycles but with
passage of clots.
84. A 25 year old girl presents with irregular cycles with heavy painless
bleeding
Theme 20: Diagnosis of Dementia
A. Alzheimer's dementia
B. Alcoholic dementia
C. Huntingtons chorea
D. Creutzfeldt-Jakobs disease
E. Pick's disease
F. Lewy body dementia
G. Multi infarct dementia
H. HIV
I. Frontotemporal dementia
85. A 40-year-old lady with right handed involuntary writhing movement
with strong family history
86. A 55-year-old man with no previous history of disease brought to A&E
by his wife who says that he has become progressively more forgetful
tend to lose his temper and emotionally labile
87. A 77-year-old man with weakness in his arm and leg from which he
recovered within few days with short term memory loss has extensor
plantar response. He has similar episodes 2 yrs ago and became unable to
identify objects and make proper judgments
88. A 70-year-old man with early loss and speech and memory with
visuospatial orientation preserved
Theme 21: Rectal Disorders
2011
A. COCP
B. Tranexamic acid
C. Mefenamic acid
D. Levonorgestrol containing pills
E. Norethisterone
F. Danazol
G. Myomectomy
H. Hysterectomy
I. IUCD
J. Mirena coil
89. A patient with myocardial infarction develops sudden severe bleeding

per rectum. PR normal
90. A young patient with chronic diarrhea presents with bleeding per
rectum
91.A 40-year-old man with painful defecation and blood streaked in the
stool
92. A pt with chronic diarrhea and left iliac fossa pain presents with
bleeding per rectum and tenesmus and mass in the rectum.
Theme 22: Investigations of Renal Problems
A. Ascending urethrogram
B. Micturating cystourethrogram
C. IVU
D. KUB Film
E. Dexa scan
F. CT Scan Pelvis
G. MRI
H. Mid stream urine culture
I. Trans urethral resection of prostate
J. Trans rectal biopsy of prostate
93. A 30-year-old woman fractured her pelvis following a road traffic
accident five years ago. She is experiencing increasing difficulty in passing
urine
94. An 80-year-old man has been admitted from long stay residential care
with a history of diarrhoea and recent inability to pass urine
95. An 80-year-old man has a two-month history of intermittent
haematuria, low back pain and a high prostate specific antigen.
96. A patient presents with lower abdominal pain, mild haematuira. The
IVU shows an opacity in the lower portion of the bladder.
Theme 23: Diagnosis of Hearing Loss
A. Noise induced hearing loss
B. Presbyacusis
C. Otosclerosis
2011
A .Angiodysplasia
B .Inflammatory bowel disease
C .Hemorrhoids
D .Diverticulosis
E .Carcinoma rectum
F. Carcinoma caecum
G. Anal fissure
H. Ulcerative colitis
I. Crohns disease

D. Acoustic neuroma
E. Otitis media
F. Drug induced hearing loss
[snip]. Patient with bilateral sensori neural hearing loss which resolved
spontaneously.
99. Patient with bilateral conductive hearing loss with family history of
hearing loss
100. Patient with bilateral sensori-neural hearing loss.
Theme 24: Investigations for Cervical cancer
A Cancer cell surface antigen 125 (CA 125)
B Cervical smear
C Colposcopy
D Day 21 progesterone
E Endometrial sampling
F Full blood count (FBC)
G High vaginal swab (HVS)
H Laporoscopy
I Pregnancy test
J Serum estradiol concentration
K Serum follicle stimulating Hormone (FSH)
L Vaginal ultrasound
101. A 68-year-old woman presents with a single episode of postmenopausal bleeding.
102. A 20-year-old woman who has been using the oral contraceptive pill
has had three episodes of bright red post coital bleeding.
103. A patient who has had a cerivial smear one year back now presents
with bleeding.
Theme 25: Investigations of Breast disease
A. FNAC
B. Mammography
C. Ultrasound
D. BRCA-1&2
E. Triple examination (palpation, scan, cytology)
F. Reassurance
G. Antibiotics
H. Incision and drainage
104. A 55-year-old woman presents with a two-month history of a lump in
her right breast. On examination there is a firm, irregular lump in the
upper outer quadrant of the right breast; in addition, there are small,
palpable mobile nodes in the right axilla.
2011
97. Patient with unilateral sensory neural hearing loss
105. A 20-year-old female student presents to the breast clinic having

noticed lumps in the left breast, which has been painful pre-menstrually.
107. A patient who has no complaints but the radiologist found some
calcification in the left breast on the Chest Xray
Theme 26: Treatment of Pneumonia

A. Erythromycin
B. Tetracycline
C. Flucloxacillin
D. Benzyl penicillin
E. Prednisolone
F. Rifampicin+Isonaizid+Pyrizanamide and Ethambutol
G. Cotrimaxazole
H. Ciprofloxacin
I. Salbutamol inhaler
108. A 30 year old man with AIDS presents with fever, dry cough and
dyspnoea. CXR shows diffuse bilateral alveolar and interstitial in the
perihilar region.
109. A 20 year old student with fever, malaise and dry cough presents
with bilateral patchy consolidation.
110. A woman working in a parrot shop complains of fever, dry cough and
breathlessness.
111. A man just returned from a conference with fever, dry cough and
patchy consolidation.
Theme 27: Causes of Haemoptysis
A. Pulmonary edema
B. Tuberculosis
C. Mitral stenosis
D. Foreign body inhalation
E. Pulmonary embolism
F. Bronchogenic carcinoma
G. Pneumonia
H. Bronchiectasis
I. Good Pasteurs syndrome
2011
106. A 75-year-old woman presents to the breast clinic having noticed that
she has had a blood stained discharge from the left nipple, together with
dry skin over the left areola. On examination there was a blood stained
discharge with dry, flaky skin noted on the left areola. The nipple was
noted to be ulcerated.
112. A woman post surgery presents with severe chest pain, shortness of
breath and haemoptysis.
114. A 70 year old smoker presents with cough, haemoptysis and weight
loss. There is clubbing.
115. A patient presents with cough, haemoptysis and haematuria.
Theme 28: GIT
A. Ulcerative colitis
B. Crohns disease
C. Irritable bowel syndrome
D. Carcinoma caecum
E. Sigmoid carcinoma
F. Rectal Carcinoma
G. Coeliac disease
H. Gall stones
116. A 40 yr old obese multiparous woman presents with malabsorption of
fat food and flatulence.
117. A disorder which began at an young age with systemic
manifestations which improved on following a certain diet.
118. A low residue diet causes this associated with bleeding per rectum.
SINGLE BEST QUESTIONS
119. A mother brought her child 2 hrs after paracetamol ingestion. When
do you check the blood levels?
A. After 2 hrs
B. After 4 hrs
C. After 1 hr
D. After 8hrs
120. A mother wants to know the risk of their second child developing
cystic fibrosis.
A. No risk
B. 1:8
C. 1:2
D. 1:4
121. A random study on Pulmonary embolism shows
10 pt. out of 1000 died who did not get treatment
5 pt out of 1000 died who got proper treatment
A. Absolute risk 5%
B. Absolute risk 10%
C. Absolute risk 2 %
2011
113. A 55 yr old smoker with a history of recurrent chest infections

presents with haemoptysis and greenish sputum. He had clubbing.

D. Relative risk 5%
E. Relative risk 10%
A. Thiazide diuretics
B. Beta blockers
C. Calcium channel blockers
D. Potassium sparing diuretics
123. Calculation of Trimethoprim dosage for a child quite straight
forward
124. A woman with long standing Rheumatoid arthritis on Naproxen and
Methotrexate. With Hb 8mg/dL and few more values.. What type of
anemia
F. Aplastic anemia
G. Anemia of chronic disease
H. Iron deficiency anemia
I. Macrocytic anemia
125. Interpretation of ABG
pH : 7.2
pCO2: 4kpa
pO2: 10kpa
Base excess: -15
A. Metabolic alkalosis
B. Metabolic acidosis
C. Respiratory Acidosis
D. Respiratory Alkolosis
126. A patient is back from Africa after holidays presents with fever, night
sweats, neck stiffness, photophobia. He has already taken malarial
prophylaxis.
A. CT Scan
B. MRI
C. Lumbar puncture
D. Pheripheral blood picture
127. Time taken by SSRIs to have an effect on depression.
128. A mother whose previous child died asks how to protect the present
child from SIDS
A. Apnoea monitor
B. Allow child to sleep in supine position
2011
122. A Type 2 Diabetic, BP 140/90, raised creatinine, ankle oedema which

Anti hypertensive drug would you prescribe?
2011
Sep. 2005
1.A35 year old lawyer became increasingly axious before court
appearances.she is now very reluctant to speak in public.wants long term
solution.
2.45 yrs old woman has become tearful.feels unable to cope.she worries
about very thing.difficult to get sleep.always tired.
3.55 yr old wishes to attend daughters wedding in newzealandin 2 weeks
time.she is frightened to flying.
4.18 yr old in a state of terrorcame to a&e.he is concinced that he is
pursued by people who are out to kill.
5.50yr old man in surgical ward suddenly became axious and agitatted .he
was admitted 3 days ago with hematemesis which is now settled and
there apears no other physical cause to explain.
options:
A.chlorpromazine.
Bcognitive behavioural therapy.
Ccounselling.
d.desensitisation
e.diazepam.
f.hypnotherapy.
g.intersonal therapy.
h.lofepramide
i.phenelezine.
j.propranolol
k.psychoanalysis
l.relaxation therapy.
answers:
theme:causative agent.
1.8yr old boy has cellulitis of both hands with well demarcated
edges,pyrexia&increased wbc.
2.24 yr old with dry cough skin manifestations bone and muscle
aches.chest x ray shows patchy shadows.
3.60 yr old male has pyrexia and axillary abscess.
4.patient in hosp given with third generation cephalosporins.it resulted in
diarrhea.
options:
a.staphylococci
b.mycoplasma
c.strepto cocci
d.clostridium difficile
answers:
1.c
2.b
3.a
4.d
- postural hypotensionmeasure lying standing BP
2- fluid overload
3- tension pneumothorax
4-cardiac tamponade
5-pin point pupil- give nalaxone
6- arrythmia , dilated pupil- amitrytalline
7- IV bisphosphonates patient shows sclerotic changes in pelvis
8- case of over anticoagulation inr 5.1
9- reduce dose of insulin
10-cystic fibrosis
11- coeliac disease
12- patientt with panic attack- rebreath in air bag
13- case of alzhemer disease
14 - another alzhemer disease
15- pseudodementia
15-multiinfarct -hypertension
16-lady h/o miscarriages- do antiphospholipid
2011
1.b
2.h
3.d
4.a
5.e
17- patient with dry eyes- do autoantibodies

18- patientt on bendro develop hot knee- check uric acid
20- case og acute GN

21- side effect- alcohol- dysarthria cerebellum,
22- tiredness- beta bloker
23- case of haemchromatosis, increase risk of liver cancer
24-case of aortic stenosis
25-case of mitral stenosis
26-median nerve demage- index middle finger
27-Ca head of pancreas involve- common bile duct
28-diabtic amyotrophy
29-breast Ca complications- lymphoedema
30-cerebral metastases
31-patho fractures
32-hypercalcaemia
33-foul smelling discharge from breast- give metronidazole gel
34-case of pulmonary embolism- investigation of choice CT
35- renal colic ist line drug - oral paracetamol/ diclofenac suppository
36-lady on thyroxine- monitor -TSH
37-dx of vaginal discharge -actino, nisseria,chlamidia,trichomona
38.managent of incontinence
39.staph ,strp pyogenes- repeat
40.immobilisation- tibia fibula fracture in a chld, crying wth pain
41.distraction- catherisation in a child 6 yrs
42.terminal pain relief-hyoscine,haloperidol,metrondazil,oral
dexamethasone
43.inv of vaginal bleed
44.repeat themes about Anatomy of bile duct
45.anemia- pernicious,aplastic,vitb12 difficiency
46.investigations of red eye
47.shingles management- topical acyclovir,oral aci,7 days etc
48.investigations of syncope
49.heart failure managemnt-aortic valve surgery,iv digoxin,propranolol
50.antibody to intrinsic factor-pernicious anemia
51. management of tension pneumothorax -needle thoracocentesis
52.man working in a metal factory/foreign body in eye investigation-xray
orbit
53.s/s of meningitis/inv
54. man with hypoglycemia blood sugar-2.0 mmole tt-50%dextrose
55.a ?6 month baby with lethargy .constipation inv- tsh
2011
19-case of crf- initial investigation- do u/s abdomen
64. a 3 yo with crust and lesions 10-20 mm peribuccal. with yellowish

secretion (diagnosis)
65. 8 yo fell and complains of severe pain in middle tibia. there is no
abnormality at exploration. ]
66. 14 yo boy unable to swallow, fever, pain in lower end of right jaw,
faetor oris and swelling gum.
67.9. 28 yo girls complains of infertility, laparoscopy shows perhepatic
adhesions
68.-perifollicular haemmorhages- vit c def
69-eczema resistent to antibiotics-? defiecency mg/vit a / ?
70-sba 57 yr old male tierd and pale urine 2 plus protein and 2 plus blood,
haemoglobin
71- vitamine deffecieny,b6 b12 iron mg......
72-mediacl ttt of supravetricular tachycardia,vetricualr tahycardia.atreial
fiberlation
73-c125 cancer ovaries
74- epimediology of dementia
75-pain reliefing of bronical ca.ca breast with offensive vaginal
discharge...etc
76-sba - multiple myeloma bence jone protein?
77-child with bilateral facial swelling- parotitis?
78-child with gum swelling and pain in right side of lower jaw- dental
abscess?
79-34 yr buisnessman has recurrent episodes of palpitation every 2
months- do 24hr ecg monitoring?
80- treatment of svt- dc cardioversion
81-lady with ra pain not responding to paracetamol- give nsaid oral
82-a lady afraid to fly has to go to her daughter's wedding in nz. treatment
83-a man on warfarin complains of painless haematuria, inr 2.1(dx)
84-a woman on warfarin has painless haematuria inr 5.1
85-a man thinks there is a metal foreign body in his eye (investigation)
86- a man complains of eye pain while gardening
87- a woman complains of blurred vision, eye pain and vomiting. she has
history of migraine
88-3. terminal care (treatment) -lady with malodourous breast ca
89-terminal care (treatment)- man dying of bronchial ca has cough
90-complications of breast ca (diagnosis) - lady with a swollen arm
91-complications of breast ca (diagnosis)- lady with headache and
papilloedema
2011
56.a presents with c/o urge incontinence when she plays tennis
57.bloody diarrhoea after tt cyclosporine- clostridium
58.a child presents wihh vomiting /pyloric stenosis metabolic alkalosis
59.villous adenoma - metabolic acidosis
60.inv for cystic fibrosis .sweat test
61. copd acute exacerbation -24% oxygen
62.18 yr old boy presents with 4 hrs h/o red swollen testes
63-anemia in vegetarians - Vit B 12 defeciency

92-complications of breast ca (diagnosis)- lady unable to pass urine, back
pain and weakness in legs .
X-RAY FINDINGS:
POSTERIOR MI- IS IT NORMAL?WIDENED MEDIASTINUM?
STABBED CHEST (A CASE OF PERICARDIAL EFFUSION)- GLOBULAR HEART
BP DIFFERENT ARM- WIDENED MEDIASTINUM
DIVERTICULITUS- FREE GAS BENEATH DIAPHRAGM OR MEDIASTINAL GAS??
VAGINAL DISCHARGE
-PTN HASA GEERN VAGINAL DISCHARGE,HER PARTNER HAS A PURULENT
DISCHARGE
-CANDIDASIS,PREGANANT ,WHITE DISCHARGE ,SORE VAGINA
-MULIPTE VAGINAL ULCERS
-WHICH ORGANISM AFTER IUD INSERTION
6-A GARDENER WITH PHOTOPHOBIA AND PELPHROSSPAM

PTN TREATED FOR A LONG TIME RHEMATIC ARTHERITIES,RED PAINFUL EYE
A METAL WORKER COMPLAINS OF SUDDEN PAINFUL EYE
SBA- 20 YR GIRL,FOUGHT WTH BF,TOOK PARACETAMOL NOT EXCEEDING

LIMITS,CONCIOUS,AGREES THAT IT WAS INCORRECT, WHAT IS UR NEXT
MANAGEMNT
1.DISCHARGE HOME
2.REFERAL 2 PSYCHTRY OPD
3.COGNITIVE BEHAVIORAL THERPY
4.ADMISION IN Psychiatry (I DONT REMEMBER EXACTLY)WARD
9.5, SERUM CREATININE 350, WHICH URGENT INVESTIGATION U DO
-MSU
-URINE FOR BENCE JONES
-U/S ABDOMEN
I PUT U/S ABDOMEN TO SEE WEATHER THIS IS ACUTE OR CHRONIC RENAL
FAILURE?
SOME PUT URINE BENCE JONES, VERY TRICKY QS
10. MAIN CAUSE OF DEMENTIA
INVESTIGATION FOR CURABLE DEMENTIA
IT RESPONDS TO TRYCICLICS.
2011
AETIOLOGIC AGENT:
AXILLARY ABSCESS- S. AUREUS
TENDER WARM LEG- S. PYOGENES (NOT REALLY SURE)
WHITE CURDY VAGINAL DISCHARGE- CANDIDA

A DEMENTIA WITH PERSONALITY CHANGES AND MINIMAL INTELECTUAL
DETERIORATION
A DEMENTIA WITH NEUROFIBRILARY TANGLES IN CORTEX
Management of herpes zoster
1
2
3
4
5
a 30 wks pregnant patient with thoracic eruption

an immunosuppressed child exposed to chicken pox
a pt with healed lesions and only discoloration
a pt with thoracic eruption came within 24 hrs
a pt with opthalmic shingles
there was a new theme on hernia treatment

inpatient mesh hernia repair
herniotomy
orchidopexy
(i can't remember the other options)
1. child with inguinal hernia not having any difficulty
2.a healthy man having inguinoscrotal hernia
3. a man with repeated hernia
i think there were 2 more ques in this theme
Diagnosis of ulcer
arterial
venous
basal cell ca
traumatic
squamous cell ca
decubitus
1. a man with ulcer on medial malleolus
2. a man with motor neuron disease since 5 yrs now ulcer on lateral
malleolus
3 a smoker with leg ulcer
4 another man with leg ulcer with raised edges
5 ulcer which occurs after trauma but not healing
Quote:
A MAN TREATING HIMSELF FOR DYSPEPTIC SYMPTOMS.NO H/O WT LOSS.
ON ENDOSCOPY. NARROWING OF LOWES END OF OESOPHAGUS N
INFLAMMATION.HE IS ALCOHOLIC N SMOKER N BMI IS 34.
A. BARRETS OESOPHAGUS
2011
oral acyclovir
acyclovir and urgent referral to specialist
reassurance
immunoglobulins

B. OESOPHAGEAL STRICTURE (I THINK THIS IS CORRECT??DUE TO
ALCOHOLISM??
C. CA OESOPHAGUS D. HIATUS HERNIA. ROLLING TYPE
Quote:
Quote:
SHINGLES OPTIONS AV ACYCLOVIR ORAL ACYCLOVIR FOR 2 DAYS ORAL
ACYCLOVIR FOR 7 DAYS IMMUNOGLOBULIN STEROIDS(HIGH DOSE)
REASSURE N ADVISE
1.30 WKS PREGNANT WOMEN WITH SHINGLES..ORAL ACYCLOVIR FOR 7
DAYS
2.AN ELDERLY MAN IN INSTITUTION. STEROIDS
3. A CHILD WITH LEUKEMIA HAS SHINGLES. IMMUNOGLOBULINS
4. A MAN WITH SHINGLES ON CHEST N TRUNK - ORAL ACYCLOVIR FOR 7
DAYS
5. A MAN WHOSE SHINGLES HAS RESOLVED ONLY SCRATCH MARKS LEFT REASSURE N ADVISE.
Post Options: Reply

Quote:
A CHILD OF 6 DRINKS A LOT OF MILK EVERY DAY BUT EATS NOTHING ELSE
, HE IS LETHARGIC: VIT B6 VITB12 VIT D CA IRON AND SO ON THE
QUESTION OF RESISTANT ECZEMA WAS FROM THE SAME THEME BUT
THERE WAS NOT AN OPTION OF VITA
Quote:
NASAL BLEEDING-30YR OLD LADY WITH H/O NASAL SEPTAL BLEEDING 2-3
TIMES IN TWO DAYS WITH RASH. LADY WITH NASAL BLEEDING,HER
FATHER HAD H/O REPEATED BLOOD TRASFUSION.
Quote:
54 YR OLD MAN WITH PROGRESSIVE DYSPHAGIA SMOKES 15-20 CIG. /DAY
ON EXAM LAR CORDS PALSY SINGLE MOST INVESTIGATION OF CHIOCE
A.BARIUM SALLOW B.CT SCAN C.MRI
Quote:
A LADY AFRAID TO FLY HAS TO GO TO HER DAUGHTER'S WEDDING IN NZ
AFTER 2 WEEKS.TREATMENT: DESENSITIZATION - AS ITS PHOBIA A LAWER
CANT SPEAK INFRONT OF PPL-COGNITIVE BEHAVIOURAL THERAPY A GIRL
COLLAPSED IN ASSEMBLY ALSO COLLAPSES IN DENTIST'S CLINIC. A MAN
COLLAPSED AFTER DONATING BLOOD. VASOVAGAL SYNCOPE
Quote:
2011
A BOY WITH VESICLES AROUND MOUTH WHICH HAVE BURSTED N

DISCHARGE COMING OUT FROM THEM. A. [bleep] IMPETIGO - ans? B.
SHINGLES C. CHICKEN POX

MAN USING CRUTCHES, LOSS OF SENSATION OVER DORSUM OF MIDDLE N
INDEX FINGER.WHICH NERVE INJURES. 1. MEDIAN 2. RADIAL??
ACID BASE
PYLORIC STENOSIS--MET ALKALOSIS
VILLOUS ADENOMA--HYPOKALEMIA
WOMEN BREATHLESS AFTER HYSTERECTOMY--FLUID OVERLOAD
A WOMEN PRESENTS WITH C/O URGE INCONTINENCE ONLY WHEN SHE
PLAYS TENNIS
? DETRUSOR ?ANXIETY
Quote:
EAR INFECTION.. A. A BOY WITH FEVER N EARACHE BUT TYMPANIC
MEMBRANE WAS NORMAL. OTITIS MEDIA B. A BOY WITH EARACHE N
DISHARGE. OTITIS EXTERNA
Quote:
A WOMEN 48 YRS WITH IRREGULAR VAGINAL BLEEDING, HOT
FLUSHES..ETC. CYCLICAL HORMONES
Quote:
A WOMEN POST MENOPAUSAL WITH HOT FLUSHES..CONTINOUS
HORMONAL THERAPY.
Quote:
WHAT CAUSES LIVER CANCER IN 3-4 YEARS- -ALCOHOL DRINKING
NASAL BLEEDING- 30YR OLD LADY WITH H/O NASAL SEPTAL BLEEDING2-3
TIMES IN TWO DAYS WITH RASH. MOTHER ALSO HAD THIS PROBLEM--VON
WILLIBRAND LADY WITH NASAL BLEEDING,HER FATHER HAD H/O
REPEATED BLOOD TRASFUSION, BLEEDIG DISORDER.
Quote:
DISEASE INHERITANCE HAEMOPHILIA...X LINKED RECESSIVE
Quote:
TREATMENT OF SVT-AMIDARONE
Quote:
POISONING : DIGOXIN , AMYTRYPTALINE ETC
2011
Quote:
A BOY HAD ACCIDENT CAME TO A & E WITH FRACTURED TIBIA N FIBULA N
CRYING WITH PAIN Ans-PARACETAMOL or IMMOBILIZATION
Quote:
A PT WITH HEART FAILURE.MEDICAL TREATMENT FAILED -HEART
TRANSPLANT
Quote:
VAGINAL DISCHARGE-GREEN COLOURED-TRICHOMONAS, IUCD RELATED ,
ACTINOMUCES ISRAELI
Quote:
SBA: 57 YR OLD MALE TIERD AND PALE URINE 2 PLUS PROTEIN AND 2
PLUS BLOOD, HAEMOGLOBIN 9.5, SERUM CREATININE 350, WHICH
URGENT INVESTIGATION U DO -MSU -URINE FOR BENCE JONES -U/S
ABDOMEN 24 HR URINARY PROTEINS
Young woman presents in hospital after taking some tabs of paracetamol
on breaking up with her boyfriend. Tests indicate n-acetylcystiene is not
necessary. next step?
a: cognitive behavioral therapy
b: admission to psychiatric ward
c: discharge and follow up
d: place on psychiatric drugs
d: place on antipyschotic medication
2011
Quote:
A DIABETIC WITH HAEMOCHROMATOSIS HAS RISK OF CANCER OF WHICH
ORGAN-PANCREAS
2011
July 2005
Theme : Non Accidental Injury Investigations
Options
A. CT head
B. FBC & Coagulation profile
C. Serial height & weight measurment
D. No Investigations
E. MSU cytology & culture
F. Skeletal survey
G. Look for blue sclera
H. Nutritional history
1. A child just started living with her foster mother was found have weight
in the 3rd percentile. The child appears well and no abnormalities found.
2. A child with bleeding from mouth was found to have torn lingual
frenulum.
3. A child brought with complaints of sudden stoppage of breath.
Opthalmoscopy shows multiple retinal hges.
4. An 18 month baby brought to A/E with bronchiolitis has 6 posterior rib
healing fractures.
5. An 8 yr old boy sustained a wrist FRACTURE following a fall in rugby
match. He has a history of
6 FRACTURE in previous 3 years. Father is deaf.

6. A child with multiple bruise on her body. Parent fail to explain the
cause.
Theme : Pathology : cells of origin
A. Adipocyte
B. Gangion cells
C. Plasma cells
D. Megakaryoblast
E. Skeletal muscle cell
F. Lymphocytes
G. Erythroblast
H. Monocytes
I. Schwann cells
J. Neutrophil precursors
K. Astrocytes
L.Erythrocyte Precursor
M.Lymphocyte Precursor
N.Smooth muscle cell
7. An elderly with bone pain & visual loss. Pathologist gives a diagnosis of
multiple myeloma after bone marrow biopsy.
8. A young male with recent onset seizures. brain biosy done to give a
diagnosis of Glioblastoma multuiforme.
9. A young female with lymph node enlargement & splenomegaly.
Diagnosed to be suffering from Acute myeloid leukemia.
10. A small baby with paravaginal mass. Biopsy was done to come to a
diagnosis of rhabdomyosarcoma.
SBA
11. A mentally retarded child puts a green pea in his ear while having his
dinner. The carer confirms this. Otoscopy shows a green colored object in
the ear canal. Most appropriate single best approach to remove this :
1)
2)
3)
4)
5)
by a magnet
syringing
under GA
by hook
by instilling olive oil(?)
12. A trocar inserted midway b/w umbilicus n anterior superior iliac spine,
which structures are likely to be pierced :
2011
Options
13. An alcoholic takes 10 units of alcohol per day; on examination he has

raised alkaline phosphtase and bilirubin. Most likely cause could be:
1.alcoholic hepatitis
2.chronic hepatitis
3. viral hepatitis
4. Primary sclerosing cholangitis
Theme Mechanism of Disease

Options
A. Infection
B. Allergy
C. Genetic
D. Immune process
E. Chloride channel defect
F. Alpha-1 antitrypsin def.
14. Asthma
15. Cystic fibrosis
16. Bronchiolitis
17. A boy develops barking cough associated with inspiratory & expiratory
stridor; A diagnosis of laryngotrachebronchitis is reached. What is the
single most likely prognosis of the disease if left untreated ?
a) bronhciectasis
b) complete resolution
c) lung abscess
18. A boy develops generalized edema with proteinuria ++++1. He is
started on steroids & improves. What is the single long term prognosis of
the disease?
a) complete resolution
b) recurrence with gradual resistant to steroids
c) recurrence with complete resolution wid steroids
Theme : Management of Acute eye Conditions -Topical eye drops
Options
2011
a-The rectus abdominis muscle

b-The linea alba
c-The Ext oblique aponerosis and internal oblique ms
d-The Ext oblique ms and the internal oblque ms
e-the conjoint tendon
....
19.
20.
21.
22.
23.
24.
Acute bacterial conjunctivitis

Acute allergic conjunctivitis
Acute angle closure glaucoma
Keratitis (non infective)
corneal abrasion
Uveitis (?)
25. A diabetic with blood pressure 140/90 wid proteinuria 0.2 mg/day.
Single most likely agent to offer him benefit :
a) ACE inhinbitors
b) angiotensin inhibitors
c) beta blockers
d) fibrates
e) statins
26. A 30 yr old lady treated for CIN 2 , two years back was a heavy smoker
till few months back. She was on oral contraceptives all these years, but
now her partner uses condoms. She is anxious as her aunt died of ovarian
carcinoma at the age of 48. The most important factor which puts her at
the risk of ovaian cancer is :
a) age
b) family history
c) CIN 2
d) smoking
e) oral contraceptives
Theme : Overdosages/ poisoning
Options
A.Paracetamol
B.Sailcylate
C.sodium hypochlorite (bleach)
D.paraquat
E.oraganophosphorus
F.Digoxin
G. Tricyclics
H.Methanol
I. Ethanol
27. Child with nausea/ vomiting and features of heart block.
28. Farmer with excessive sweating, abdominal pain and other cholinergic
symptoms.
2011
A. Antibiotic
B. Mast cell stabilizer
C. Prednisolone
D. Mydriatic
E. Miotic
F. Prostaglandins
G. NSAIDs
F. carbonic anhydrase inhibitor

29. A man with sore mouth, pulmonary edema & renal failure.
30. A girl with hyperventilation & acidosis.
31. A girl with right upper quardrant pain with raised biochemical
parameters for liver functions.
A. calcium 2.2 mmol/l

B. potassium 2.4 mmol/litre
C. sodium 128 mmol/litre
Theme : Side Effects of Antipsychotics
Options
A. Clozapine
B. Chlorproamzine
C. Amitryptiline
D. Fluoxetine
E. Lithium
33. A chronic schizophrenic on treatment develops sore throat &
agranulocytosis.
34. A schizophrenic on treatment develops galactorrhea and loss of libido.
35. A schizophrenic on treatment develops stiffness of limbs, raised
temperature and raised creatinine kinase.
36. A patient with long term bipolar disorder complains of lethargy, weight
gain & hypothermia.
37. A female patient on treatment for depression develops dry SKIN &
mouth.
Theme : Side effects of anti epileptics
Options
A.Carbamazepine
B.Sodium Valproate
C.Phenytoin
D.Ethosuximide
E.Vigabatrin
D.Tigabain
38. An epileptic patient with raised levels of urea, creatinine.
39. A boy on treatment for generalized tonic clonic epilepsy, develops
features of hepatic failure in few weeks of starting treatment.
40. A lady on treatment for epilepsy develops ataxia, gum hypertrophy.
Theme: Seizure Investigations
Options
A.EEG
2011
32. An elderly underwent an operation for rectal carcinoma (?), has not yet
opened bowels. complains of abdominal distension & NG tube aspirating
large amount of fluids . Most single likely cause for his condition :

B.ECG
C.CT head
D.
Theme : Diagnosis of Dementia

A.Depression
B.Alzeihmers Disease
C.Frontal Lobe syndrome
D.Vascular dementia
E.carbon monoxide poisoning
F.Huntingtons Disease
G.Picks disease
H.Crudjefelt Jacob Syndrome
I. Delirium
44. Elderly with history of stroke & falls, now confused and cant remember
things.
45.Elderly with normal memory on examination; wife complaints of him
becoming aggressive and talking abt their sexual life publicly.
46. Elderly lady with no medical complaints, is found entering shop at odd
hours of early morning.
47. An elderly man refuses to talk. says that its no point talking to him as
he is a complete failure and that his memory has given up.
48. A man admitted in hospital develops features of disorientation & visual
hallucinations on 3rd day of admission.
49. A man brought to OPD wid features of disorientation & hallucinations.
Wife says he was ok till few days before when he caught cold(?).
Theme Incontinence
A.Fistula
B.Pelvic floor weakness
C.Multiple scleorsis
D.UTI
E.Detrsuor Instability
50. A lady post hysterectomy deveopls continuous dribbling of urine.
51. A lady after child birth complains of passing urine on coughing and
stressing
52. A young girl with history of visual loss & limb weakness complains of
not able to pass urine at all.
53. A lady with frequency & unavoidable desire to urinate at a few
seconds' notice
but no dysuria;
SBA
2011
41.An adult with recent onset seizure. O/e papilloedema present.

42. A child with 2 episodes of jerking limb movements. teacher says he
does not concentrate in the class.
43. Adult lady with jerking of thumb, followed by limb and then
generalized convulsions.

54. A lady with unilateral weakness of arm & headache. On examination
brisk reflexes & increased tone of the affected arm. Rest all examination
appears normal. Single best investigation to do :
Theme : Endocrinology
Options
A.Aldosterone
B.Cortisole
C.Erythropoetin
D.Parathormone
E.Prolactin
55. A heavy smoker with raised hematocrit & hemoglobin.
56. Hypokalemic hypertension.
57. hypotensive, muscle weakness present.
58. lethargy, bone pain, polyuria, polydyspia
59.Galactorrhea, amenorrhea, infertility
60.Female with carcinoma breast complains of polyuria ,polydyspia
confusion. single best way to manage ;
a. Dexamethasone
b. palmidronate
c. Fluid restriction
Theme : Dermatology Colored Slides
61. A lady with breathlessness & perihilar shadow. (slide showed :
erythema nodosum)
62. A man with chest pain & rash on thoracic dermatome. (herpes zoster)
63. A man with generalized neurofibromatosis & caf lau spots
64. A child with features of meningococcal septicemia.
65. A lady with history of liver disease. (slide showed : spider nevi)
SBA
66. A man fell from scaffold to lnjure his spine. Investigation revealed
damage to S1. Which single symptom will correspond to this level of injury
:
a) bladder dysfunction
b) bowel dysfunction
c) limb weakness
d) numbness of sacral area
e) numbness of sole of foot
Theme: Treatment of pneumonia
2011
a. Skull X ray
b. CT scan
Options
67. Man wid right lower lobe pneumonia, allergic to pencillin.

68. HIV positive drug abuser wid bilateral expanding shadows on CXR.
Theme : Choice of Anaesthesia

A. General Anaesthesia
B. Epidural
C. IV ketamine
D. Peribulbar infiltration wid (?)
E. Bupivacaine linfiltration
F. Topical Xylocaine
71. COPD wid cough, posted for cataract extraction.
72. Removal of corneal FB.
73. A pregnant lady posted for LSCS
Theme Psychiatry Epidemology
Options
A. Major Depression
B. Acute Psychosis
C. Bipolar Disorder
D.Dysthymia
E.Cyclothymia
F. Recurrent Brief depression
G. Seasonal Affective disorder
H. Mixed anxiety n depression
74. More common in females; associated with low mood & depression
which lasts for at least 2 weeks.
75. More common in females; characterised by low mood, insomnia,
palpitations and sweating.
76. More common in females; charactersied by annual recurrence of
depressive symptoms.
there wer 2 more questions in this stem, jus cant recollect! may b one was
bipolar disorder(?)...jus not sure!
2011
A.Benzylpenicillin
B.Cotrimoxazole
C.Ciprofolxacin
D.Clarithromycin
E. Fluconazole
F. Griesofulvin
Theme Epidemiology of Joint Diseases

Options
77. More common in females; wid incidence of 20% in Caucasian females

& associated wid change in body shape. (i hope, am getting the words
correct!!)
78. More common in females, affecting 1% of population, associated wid
loss of activity in 10 years.
79. More common in males, associated wid stiff joints & positive HLA B27.
80. Associated wid heavy work & pulling & pushing & psychosocial factors.
81. With incidence of more than 70% & more than 90% show complete
recovery.
SBA
82. A male complains of sudden onset dysphagia after eating bread which
gets relieved by vomiting. He had 2 similiar episodes in last 3 years while
having steaks. His BMI is 32. The single most likely investigation which
wud lead to the diagnosis of his condition is :
a) Barium Swallow
b) Chest X ray
c) Motility Studies
83. A vagrant man, dishevelled, sweating & fizzy.
(There were more symptoms).
The most likely agent to cause these symptoms cud be:
a) alcohol
b)heroine
c)cocaine
84. An alcoholic is brought to A/E in agitated state, picking at imgainary
things. He is started on chlordizepoxide. The other most important agent
to be added to his treatment regimen shd be :
a) chlormethiazole
b) thiamine
2011
A. Rheumatoid Arthritis
B. Osteoarthritis
C. Osteoporosis
D. Osteomalacia
E. Ankylosing Spondylitis
F. Benign Back Ache
G. IVDP

Theme Management of PPH
85. A female with instrumental delivery, lost 800 ml blood. Uterus well
contracted.
86. A multi-para wid previous 2 histories of PPH.
87. A lady on 10th day post LSCS, brought with bleeding lasting for 24 hrs.
She has suprapubic tenderness.
88. A lady bled 600 ml blood after placenta was taken out. (dont
remember if any more details were mentioned here).
SBA
89. A female fainted while painting her bathroom wall & hit her head. She
was brought to emergency, regained her consciousness & well otherwise a
small laceration on her skull. The single most important investigation to be
done at this stage is :
a)CT scan
b) skull X ray
c) Doppler
90. A 70+lady shopping in a supermarket fainted suddenly and fractured
neck of femur. Her daughter who was with her said she went pale before
faintingA. Dysrythmia (adam-stokes)
another one with history suggestive of vertebrobasilar insufficiency?
Theme Nephrology Diagnosis
Options
A. Henoch Scholein Purpura
B. Hemolytic Uremic Syndrome
C. Chronic Renal Failure
D. Acute Glomerulonephritis
E. Nephrotic Syndrome
F. SLE
91. Anemia
Thrombocytopenia
Fragmented Red Cells
2011
A. IM Synometrine
B. Prostaglandins
C. Synotocin Drip
D. IV fluids
E. Blood Transfusion
F. Laparotomy

92.Normochromic Normocytic Anemia
Hypertension
Low erythropoetin (?)
94. Proteinuria
Hypercholesterolemia
Edema
95. Hematuria
wid raised Urea & Creatinie
Hypertension
Theme Investigations in Nephrology

A. Ultrasound Abdomen
B. Catheterize
C. IVU
D. Cystoscopy
E. PSA(?)
96. A boy suffered a blow to his flank during some match. He later
complained of one episode of frank hematuria. He is normal otherwise.
97. An elderly wid painless hematuria.
[snip]. An elderly wid symptoms suggestive of BPH (? not really sure abt
this one).
99. A man comes wid acute retention of urine following blow to perineum.
On examination preineum swollen & bruised.
Theme : Diagnosis of PID
A.Candidiasis
B.Gonorrhoea
C.Chlamydia
D.Herpes
E.Cervical ectropion
F.Trichomonas
G.Bacterial Vaginosis
100. Lady wid sore vagina & whitish discharge; smear shows mycelia.
101. Lady on OCPs wid mucoid discharge.
102. A young lady wid recently developed dysmennorhea & deep
dyspareunia. Purulent dischrge from cervical Os. Tested negative for
gonorrhea.
2011
93. Features of
renal failure +
positive ANA.
103. Lady wid multiple painful, vescicular lesions at the introitus wid
scanty offensive discharge.
Theme Blood supply

A. Cavernous Sinus
B. Internal carotid Artrery
C. Superficial temporal artery
D. Middle meningeal artery
E. Central retinal artery
F. Facial artery
G. Middle cerebral Artery
H. Vertebral artery
105. A guy wid abscess near upper lip.
106. A diabetic/hypertensive wid sudden visual loss. On examination,
fundus appears pale.
107. A laceration near the angle of mandible in front of masseter wid
profuse bleeding.
108.A person wid features of transient loss of vision, dysphasia .
109. A person with # petrous temporal, confusion
110. Bipolar disorder (Theme - Epidemology of Psychiatric Conditions)
111. Malignant Melanoma (Dermatology Colored Slides)
112. Anaesthesia Required during excision of Meibomian Cyst eye (Theme
Choice of Anaesthesia )
113. Legionella Pneumonia (?) (Theme Treatment of Pneumonia)
Theme : Next step in management of dyspeptic symptoms
Options
A.Anti helicobacter therapy
B.Esophagodudenoscopy
C.measure serum gastrin
D.IV propton pump inhibitors
E.Oral proton pump inhibitors
F.Pancreatectomy
G.Antacids
H.H2 antagonists
114. A patient wid hematemesis following 40% burns. His vitals stable now
& esophago-duodenoscopy shows multiple superficial ulcers in stomach.
(Curling's Ulcer; IV PPIs)
2011
104. Lady wid discharge per vaginum wid clue cells present.

115. A female wid hematesis now stable. On treatment for rheumatoid
arthritis.
117.Male wid severe dyspepsia. not responding to usual anti-dyspeptic

measures. Gastro-duodenoscopy shows several ulcers in esophagus,
stomach and small intestine.
Theme : Interpretation of Chest findings
A. Pulmonary embolism
B. Myocardial Infarction
C. Simple Pneumothorax
D. Tension pneumothorax
E. Pneumonia
F. hemothorax
G. Pulmonary Edema
H. Esophageal rupture
118. Temp 37
JVP raised
CXR normal
ECG T inversion in some (one) lead
BP 100/60; PR 130 bpm
119. Temp 37
JVP normal
CXR normal
BP 120/80 PR 110 bpm
ECG Q waves in V1, 2, 3
120. Temp 39
JVP normal
CXR consolidation of some lobe
BP 120/90 PR 100 bpm/irregular
121. Temp 37
JVP (?)
CXR reduced markings on right side
BP 130/80 PR 90 bpm/regular
122. Temp 37
JVP normal
PR 120 bpm regular
BP 90/60
CXR shows left sided effusion
surgical emphysema present on neck palpation (?)
123. Temp 37
JVP low
PR 90 bpm /regular
2011
116.Male wid dyspeptic symptoms. Cytological brushings from stomach

postive for gm negative spiral organisms.

BP 100/90
CXR bilateral shadows
Basal creptitions
124. A man wid sudden onset breathlessness following RTA. His

breathlessness not relieved even after putting chest drain. Single most
likely cause could be :
a)Tension pneumothorax
b)bronchial rupture
c)aortic rupture
125. A neonate wid temp 38.5, is otherwise appearing normal. Single best
next step wud be :
a) reassurance
b) discharge wid broad spectrum antibiotics
c) admit for full infection screen
d) admit for full infection screen & start broad spectrum antibiotics
e) admit and observe
126. A man wid chronic atrial fibrillation develops features of pulmonary
edema. (think it was mentioned dat he was on digoxin). Single best next
step to wud be:
a) DC cardioversion
b) anticoagulation & digoxin
C)digoxin
Theme Diagnosis of Neck Lumps
Options
A. Thyroid carcinoma
B. Goitre
C. Cystic Hygroma
D. Branchial cyst
E. Tuberculous Lymphadenitis
F. Lymphoma
G. Ca Stomach
H. Ca Lung
I. Mesothelioma
127. A lady from Asia wid lumps in her neck, FNAC of which revealed
center of casseous material surrounded by fibrosis.
128. A man wid lump in supra-clavicular region and decreased appetite.
He has lost 5 kg weight recently.
129. A man with lump in front of his neck which moves up on swallowing.
Scan shows a mass replacing the left lobe of thyroid & spreading to
sternomastoid & adjacent muscles.
2011
SBA
130. another one on cystic hygroma (?)
SBA
132. A patient wid long history of GORD, underwent esophagoduodenoscopy & Barret's Esophagus was diagnosed. The single most
appropriate term to define this condition wud be :
a) Squamous metaplasia
b) Columnar Metaplasia
c) dysplasia
133. A 30 yr old heavy smoker with previous history of treatment for DVT
& varicose veins develops swelling/ulcer(?) just above her medial
malleolus surrounded by lipodermarosclerosis and induration on her right
foot . She is currently on OCPs. The most likely cause for her foot condition
is :
a) varicose veins
b) DVT
c) peripehral vascular disease
Theme Management of Electrolyte Imbalances
Options
A. Insulin only
B. Insulin wid Normal Saline
C. Normal saline wid hydrocortisone
D. Oral Potassium
E. IV Potassium
F. dialysis (?)
G. Saline and Potassium Supplementation
134. A 20 yr old girl wid hypotension, hyperkalemic and mildly
hyponatremic. She has recently lost weight and her SKIN appears
hyperpigmented.
135. A young boy with polyuria, has very high BLOOD GLUCOSE levels.
136. A patient has diarrhea, appears to be dehydrated wid low potassium
levels.
137. A patient of vigorous diuertic therapy deveopls hypokalemia.
138. A person develops anuria and pulmonary edema after severe
crushing injuries-and his urea was around 60
was ther one wid sever hyperkalemia (? wid K >7 mmol/L)
2011
131. A shipyard worker develops shortness of breath and a lump in his

neck/supraclavicular fossa (?) wid a small pleural effusion on the same
side of the lump
Theme : Scientific Basis of Diseases
139.a child with childhood liver failure now comes with emphysema
140.Respiratory distress syndrome of pre-maturity
141. A young girl complains of abdominal pain whenever in school. She is
otherwise normal in public holidays. Her epigastric (?) pain is associated
wid nausea and no vomiting. She was needed to be sent home from school
bcos of this abdominal pain on a number of occasions. The single most
likely diagnosis could be :
a) Abdominal Migraine
b) coeliac disease
c) Appendicitis
d) mesenteric adenitis.
142. A patient after a fall on his outstretched hands complains of pain in
his wrist. X ray of the wrist appears normal. No fractures seen. Most
appropriate next step to do :
a) discharge wid reassurance
b) scaphoid cast for 6 weeks
c) take X ray at a later date (?)
d) plaster and review after 2 weeks
Theme Managment of Arrythmias
Options
A. Adrenaline
B. Adenosine
C. Digoxin
D. Carbimazole plus beta blockers
E. Implantable pace maker
F. external pacemaker
143. A man after falling unconscious on a number of occasions was found
to have a heart rate of 40 bpm(?).
144. Female sweaty, wid tremors & weight loss. heart rate is 140
bpm/irregular.
145. there was one on SVT(?)
2011
A. Alpha 1 anti-trpysin deficiency

B. Surfactant deficiency
Theme Investigations of Palpitations

Options
146. A young girl, sweaty, tremors and weight loss, says dat her heart
races.
147. A woman experiences 'thumping' in her chest associated wid
breathlessnes, while asleep. She sits up to get symptoms resolve in few
minutes time.
148. A woman wid a family history of coronary artery disease. She has
noticed palpitations especially during the night. She describes a sensation
of her heartbeat momentarily stopping, and then racing.
149. A man complains of episodes of palpitations which last for few
minutes & leave him dizzy. His pulse appears to be normal at the point of
examination.
SBA
Theme Diagnosis of Coma
150. An elderly traveling alone was brought to A/E from Airport in
unconscious state. There are needles & a syringe in his hand baggage.
there were more in this theme.
A. Plasma Glucose Levels.
Theme Diagnosis of Accidental Injuries
151. A man after high speed automobile injury, CXR shows widened
medistinum.
A. Aortic rupture.
Theme Diagnosis of Prenatal Conditions
Options
A. fetal Blood Sampling
B. Chorionic Villous Sampling
C. Amniocentesis
D. USG
E. check serum anti-d
F. Fetal echo
2011
A. ECG
B. ECHO
C. 24 hr Holter monitoring
D. Thyroid Function tests
E. CXR

G. Fetal Blood at birth
152. Pregnant lady 16 wks, Scan shows nuchal folds & double bubble sign;
Most reliable way to diagnose Down's syndrome?
154. Pregnant lady wid previous baby wid severe anemia and jaundice.
155. A lady 24 weeks pregnant with a previous child dead from congenital
heart disease156. A lady wants to know about hypothyroidism .
SBA
157. A man wid ear ache & on examination his left tonsil is ulcerated wid
rolled out edges.
A. Tonsillar tumour
B. Quinsy
C. Lymphoma
Theme Pelvic Inflammatory Diseases Investigations
Options
A. Endocervical Swab
B. High Vaginal Swab
C. Contact Tracing
D.Laparoscopy
158. A lady wid pelvic pain & offensive vaginal discharge.
159. An asymptomatic lady says her husband had a purulent urethral
discharge and doesnt wants to talk abt it.
160. An elderly wid bleeding per vaginum. USG shows thickened
endometrium.
Theme Diagonis of Abdominal pain
Options
A. CXR
B. Abdominal Xray
C. Barium Enema
D. Laparotomy
E. USG
161. A man underwent sigmoidoscopy after which he develops features of
peritonitis.
2011
153. Pregnant lady wid previous baby affected wid cystic fibrosis, wants to
confirm if her present baby is ok.

162. A man wid features of peritonitis; Erect CXR shows gas under
diapragm.
164. A lady in RTA, wid hypotension & rigid abdomen. broken left ribs 1012.
SBA
165. A pt comes again n agian to g.p and is saying hes got aids wen all his
results r negative for 3 times
options
A) ocd
B) hypochondriasis
C) others i dont remember
Theme Ovarian Carcinoma Investigations
Options
A. Pelvic USG
B. Pelvic CT
C. CA 125
D. CA 153
E. Laparotomy
F. Laparoscopy
G. Paracentesis
166. A lady wid family history of ovarian carcinoma. Pelvic USG fails to
reveal any abnormality.
167. A lady had undergone abdominal hysterectomy wid bilateral
salpingo-oophorectomy wid omentectomy for Ca ovary, now comes for
follow up. Her CA 125 had come to normal levels after Surgery.
168. A lady underwent debulking Surgery for ovarian carcinoma now
presents wid signs of intestinal obstruction.
169. Another lady wid previous history of treated ovarain Ca, now we need
to rule out recurrence(?).
170. Theme Blood supply (q 105-109) --- A person has injury over temple
reigon
Ans. C. Superficial temporal artery
2011
163. A child wid abdominal pain & current jelly stools. sausage shaped
mass palpable per abdomen.
SBA
A. pleural effusion
B. uti
C. thrombophlebitis
D. sepsis
174. A tall guy wid acute onset scrotal pain associated wid vomiting.
Single most likely diagnosis wud be:
a)testicular torsion
b)torsion of appendicualr appendage
c)epididymorchitis
d)UTI
175-a 40 year old lady with a painless non growing swelling in the post
superior part of neck.
A. Pleomorphic adenoma
176- DEMENTIA theme.
a 40 year old man brought in with his wife because of his clumsy
movements and his father also had same problems.
A. Huntintons chorea.
177. An elderly living wid grandaughter comes to OP wid bruises on both
wrists.
A - Non accidental Injury
Theme : TREATMENT OF PNEUMONIA:
Options
A. salbutamol inhaler
B. ipratropium inhaler
C. flu vaccine
D. clarithromycin
178.An elderly man with COPD having attacks of pnuemonia every winter
for the past 2 years.He wants ur advice for this winter.
179.An 18? year old comes with fever ,myalgia-half of her hostel is
similarly ill.(something like flu)
2011
173: A patient post op has fever after 48 hours with mild abd
distension.most likely cause is:

Theme : Childhood Rashes
Options
180. Child wid colicky abdominal pain wid arthritis and purpuric rashes on
extensor surface. Family history of atopy present.
181. Child taken MMR 2 weeks before, now comes wid fever, headache,
photophobia and a rapidly spreading purpuric rash.
was ther one suggesting ITP, in this same theme?
Theme Headache Diagnosis
Options
A. Petrous Temporal FRACTURE
B. Base of the skull FRACTURE
182. A man in RTA wid CSF rhinorrhea , ..
183. A man after fall wid hemotypanum , ..
in this same theme was the question on Unilateral temopral headache
(which we already discussed and landed on temporal arteritis as answer).
Theme Gastro Diagnosis
A. Irritable Bowel disease
B. Carcinoma Caecum
C. Carcinoma Rectum
D. Crohn's Disease
E. Ulcerative colitis
F. Solitary rectal ulcer
184. A 37 yr old lady wid chronic histroy of constipation, diarrhea and
passing bloody stools intermediately. Barium enema shows rose thorn
ulcers.
185. A man with recent change of bowel habits, weight loss and occult
blood in stools positive.
186. A young girl wid features of alternating diarrhoea & constipation. No
weight loss.
187.A man wid recent change of bowel habits, tenesmus & bloody stools.
Sigmoidoscopy shows ulcerative mass in rectum.
2011
A) HSP
B) Meningococxemia

188. (continuation of Theme Mechanism of Disease) A boy wid mental
retardation & learning difficulites. father & uncle had similar probs?
190. Male with needle marks, brought in coma wid pinpoint puplis.
ans. A: heroine
(continuation of Diagonsis of Coma)
191. one was on wid history of repeated falls.
A. subdural hematoma
was der one on extradural too?(apart frm the one associated wid petrous
temporal FRACTURE?)
192. then one lady in PID theme, was having bilateral iliac fossae pain wid
terminal hematuria (blood at the end of micturation).
193. Then another guy in Mechanism of Disease wid repeated respiratory
tract infections & infertility.
A. ciliary diskinesia ~ Young's Syndrome.
194. Another patient in Endocrinology theme had features of Acromegaly.
195. In some chest theme a patient wid with a lymph node wid its calcified
circumference (typical of egg shell calcification).
A. Sarcoidosis
196. In Theme Treatment of Pneumonia
An alcoholic wid hemoptysis; CXR shows right upper lobe consolidation.
ans. A: Anti Tuberculous Therapy
197. (continuation of Overdosages/ poisoning theme,,q27-31).
Male, presents with metabolic acidosis , dilated pupil , elevated serum
amylase, hyperglycemia.
Ans. I. Ethanol
ANSWERS
1.
2.
3.
4.
H
D
A
F
2011
ans. A. Trinucleotide repeats

(hinting at Fragile X syndrome).

5. G
6. B
11.3
12.C
13.1/4
14.B
15.E
16.A
17.B
18.C
19.A
20.B
21.E
22.C
23.G
24.C
25.A
26.
27.F
28.E
29.D
30.B
31.A
197.I
32.B
33.A
34.B
35.B
36.E
37.C
38.A
39.B
40.C
41.C
42.A
2011
7. C
8. K
9. J
10.E

43.
50.A ?
51.B
52.C
53.E
54.B
55.C
56.A
57.B
58.D
59.E
60.B
61-65 - colour slides
66.E
67.C
68.B
69.
70.
71.F
72.F
73.A/B
74.F
75.H
76.G
77.B
78.A
79.E
80. G/B
81.F
82.A
83.A
84.B
2011
44.D
45.C
46.B
47.A
48.I
49.I

85.E
86.C
87.F
88.A
90.A
91.B
92.C
93.F
94.E
95.D
96.A
97.D
[snip].E
99.B (suprapubic?)
100.A
101.E
102.C
103.D
104.G
105.A
106.E
107.F
108.
109.
110.
111.
112.
113.
114.D
115.E
116.A
117.F
118.A
119.B
120.E
121.C
122.F
123.G
124.B
125.C
126.A
2011
89.A
132.
133.A
134.C
135.B
136.G
137.D
138.F
139.A
140.B
141.A
142.B/C
143.F
144.D
145.B
146.D
147.B
148.A
149.C
150.A
151.A
152.C
153.B
154.A
155.F
156.G
157.
158.A
159.B
160.A
161.A ?
162.D
163.C
164.E
2011
127.E
128.G
129.A
130.C
131.I

165.B
170. C
171.
172.
173.B/D
174.A
175.A
176.A
177.A
178.B
179.C
180.A
181.B
182.B
183.A
184.D
185.B
186.A
187.C
188.A
189.
190.A
191.A
192.A
193.A
194.A
195.A
196.A
2011
166.C
167.B
168.E
169.A
197.I
2011
March 2005
Themes of March 2005 EMQ and SBA PLAB 1 Paper
March 2004
2011
Hey guys. How did everyone do the paper? It was ok I guess. I just pray
and hope we all will make throughThese are the themes i can recollect for
now
1. Side effects of medication in pain relief
2. Clinical features of poisoning
3. History of weight loss (somewhat familiar)
4. Another one in Ophthalmology about concave convex lens cataracts etc
5. Epidmilogical data in dementia
6. Diagnosis of anaemia
7. Electrolyte abnormalities
8. Limb ischemia
9. Fever and rash
10. Diagnosis of shock
11. Vertigo
12. Cervical Pathology
13. Chest X ray in shock this was also been reposted from November or
January not sure
14. Another drug side effects some with lithium tricyclics etc
15. Preoperative test for hernia
16. Wrist injuries
17. Diagnosis in dizziness
18... another about syncope in children i guess?
19. Vaginal discharge treatments
19. Acute dyspnoea
20. Another themes with croup epiglottis etc
21aetiolog of infection repeated from November 2004
22. Retention treatment (mixed questions from past paper)
23. One more horrible statistics one bone pain
24. One SBA about faecal impaction. Options were oral
laxative...phosphate enema. High fibre diet and questions was immediate
management
25. Another SBA was administration of adrenaline 1.1000 i.m.
26. One more SBA about epiglottis i hope i
27. Hey one more on diff diagnosis of acute abdomen in women or
something the typical one
27 emq in pyschiatry about major depression... etc
28. SBA in pyschiatry i answered propranol if anybody can recollect
29. Ante partum haemorrhage
30. Was on terminal care...biphosphonates, haloperidol, hyoscine etc?
31. Investigation in anaemia

1 Theme: Scientific basis of CNS disease
1. It is characterized by large areas of demyelination throughout the brain"

2. A circumscribed and limited lesion with glandular columnar cells with
pleomorphic nuclei
3. A wedge shaped area of discoloration involving both gray and white
matter
4 A mass present on the outer aspect of the brain with pressure over the
brain. Psammoma bodies are present
5. Present at the junction of internal carotid artery and middle cerebral
artery (or Mid cerebral art & Ant cerebral art)
2 Theme: Scientific basis of Heart disease

Options
A. Nutritional
B. Congenital
C. Autoimmune
D. Infective
E. Hormonal
F. Degenerative
G. Neoplastic
H.
6. A 55-year-old lady has palpitation, weight loss despite increased diet.
7. A 24-year-old female presents with pyrexia, finger clubbing and splinter
hemorrhages:
8. A 34-year-old patient underwent valvular replacement surgery,
afterwards she presents with fever, a newly developed murmur and
altered intensity of heart sounds.
9. A 34-year-old man has symptoms of syncope, he has a bicuspid aortic
valve
10. An alcoholic 60-year-old man who is on his own, with no one to look
after him, has raised JVP, pedal edema and spider neavei. On C-XR he is
found to have massive cardiomegaly (globular heart)
2011
Options
A. Berry aneurysm
B. Multiple sclerosis
C. Alzheimers dementia
D. Toxoplasmosis
E. Meningioma
F. Glioblastoma multiforme
G. Cerebral infarct
H. Cerebral hemorrhage
I. Secondary carcinoma
J. Astrocytoma
K. Meduloblastoma
3. Theme: Diagnosis of Eye Conditions
11. Metal sheet worker complains of pain photophobia and lacrimation

12. A welsh farmer has fleshy bilateral swellings on the white of the eye
13. A patient presents with pain in the eye and decreased vision along
with photophobia and lacrimation. He has painful vesicular eruptions
around the mouth
14. A female patient wakes up from sleep to find blurring of vision along
with pain and lacrimation in the eye. 12 months back she was treated for a
scratch in the eye by her daughter's nail while playing
15. A patient has a history of sore throat along with flu like symptoms. He
now has a red eye:
4. Theme: Management of Ear complaints

Options
A. Admit & IV antibiotics.
B. Oral Amoxacillin
C. Oral Amoxacillin + Metronidazole.
D. Syringing.
E. Pack the ear.
F. Surgical intervention
G. Out patient review.
16. Girl with fever, earache not able to swallow
17. A 24-year-old man newly joins swimming classes and presents with
earache and diminished hearing. On exam he is found to be normal except
for some wax in the ear
18. A 24-year-old Rugby player has ear discharge and loss of hearing in
right ear, on exam there is small ragged perforation in the tympanic
membrane
19. A 34-year-old woman presents with high fever, vomiting, headache
and rigors. She has already been having earache along with ear discharge,
tenderness over mastoid antrum
2011
Options
A. Corneal Abrasion
B. Dendritic Ulcer
C. Foreign Body
D. Viral Conjunctivitis
E. Limbal Dermoid
F. Pterygium
G. Interstitial Keratitis
H. Band Keratopathy
I. Herpes zoster
J. Keratoconus.
K. Interstitial keratitis.
L. Degenerative changes.
5. Theme: Management of cardiac Arrhythmias

Options
A. Heparin
B. Warfarin
C. Atenolol
D. Streptokinase,
E. Alteplase
F. Heparin + Cardioversion
G. Adenosine
H. Isosorbide mononitrate
I. Glyceryl trinitrate
J. r-TPA
K. Low dose Asprin
L. NTG Patch
22. A 40-year-old male presents with chest pain for 2 hours, now after 1
hour he has no chest pain. But the ECG shows T wave inversion in L II, III,
aVF
23. Patient with previous history of MI treated with thrombolysis now
presents with ST segment elevation
24. Post MI patient, with narrow complex tachycardia.
25. A patient presents with an irregular pulse, HR. 160 /min., BP. 100/70
mm Hg [Atrial Fibrillation]
26. A patient has his apical impulse shifted to the Left and has difficulty in
breathing and L V H.
6. Theme: Diagnosis of post MI complications

Options
A. Papillary muscle rupture
B. Atrial Fibrillation
C. Ventricular Fibrillation
D. Complete Heart block
E. Pulmonary Embolism
F. Acute pericarditis
G. Congestive cardiac failure
H.
27. Five days after myocardial infarction a patient presents with collapse.
O/E pansystolic murmur
2011
20. A 33-year-old female undergoes root canal treatment at a dentist. 5

days afterwards she has tenderness over the maxillary sinus associated
with earache.
21. A 32-year-old boxer has bleeding in the ear after an injury sustained in
a boxing match.

28. Pt presents 12-hours after MI with recurrent chest pain, breathlessness
& heart rate of 40/min
29. Post MI with irregularly irregular pulse
2011
7. Theme: Diagnosis of chest infection

Options
A. M. Tuberculosis
B. Pseudomonas.
C. Strep pneumoniae.
D. Mycoplasma pneumoniae.
E. Legionella.
F. Chlamydia.
G. Pneumocystis carinii.
30. A 30-year-old patient looses weight within the last 4-months, presents
with dry cough and bilateral interstitial marking on C-X ray
31. A 20-year-old previously very healthy has general malaise, dry cough
and breathlessness. No significant changes on examination. Chest X-ray
shows patchy consolidation throughout the lung fields.
32. Patient with history of travel, presented with diarrhea vomiting and
chest infection.
33. A 50 kg weight looses 5 kgs weight and has night sweats, fever and
hemoptysis & cough. C-X ray shows upper sided lesion
34. Cystic fibrosis severe cough
8. Theme: Infections Causative agent

Options
A. Strep pneumoniae
B. Strep pyogenes
C. Staph aureus
D. Chlamydia
E. E. Coli
F. Gonococcus
G. Clostridium difficile
H. Campylobacter
I.
35. A 14-year-old boy presents with a circumscribed swelling on his arm. It
is erythematous and the margins are very limited. Pyrexia is present.
112. A 25-year-old presents with an axillary abscess
36. 25-year-old male patient having pus from axilla
37. Old hospitalized lady on cefuroxime now developed bloody diarrhea

38. A patient has very severe lower abdominal pain along with pyrexia
after changing her sexual partner.
39.
2011
9. Theme: Management of asthma

Options
A. Nebulized Beta2 agonist
B. Long acting inhaled B2 agonist
C. Inhaled Steroid
D. Reduce inhaled steroid dose
E. Inhaled cromoglycate
F. Oral Steroids
G. Reassurance
H. Inhaled short acting B2 agonist
I. Iv steroids
J. Leukotrienes antagonist
K. Antibiotics
L. Oral Theophylline
41. A 7-year-old child has intermittent asthma, he has been using inhaled
B agonists and oral steroids. He is allergic to asprin and is still having
symptoms
42. Patient well maintained on 1000ugm inhaled steroid but develops
thrush
43. A 25-year-old man is taking inhaled B agonist 3 times in a day. Still he
wakes up at night with wheezing.
44. A 36-year-old woman is a known asthmatic. She is on treatment with
oral steroids. She presents to the A&E breathless and wheezing
45. A 45-year-old man suffering from chronic asthma is unwell, he has
pyrexia and green sputum. His PEFR is <80% of his normal value.
10. Theme: Diagnosis of Upper GI Diseases (Dysphagia)

Options
A. Barrett's esophagus
B. Achalasia cardia
C. Plummer Vinson syndrome
D. Scleroderma
E. Hiatus Hernia
F. Peptic ulcer
G. Parkinsonism
H. GORD
I.
46. Transformation of squamous epithelium to columnar epithelium
47. A 50-year-old female presents with pallor and fatigue, blood smear
shows microcytic and hypochromasia. She has post cricoid webs and has
difficulty in swallowing.

48. A boy with dysphagia, an organ protrusion into the thoracic cavity
49. A layer of submucosal hyaloid fibrosis
50- s/s achalasia
2011
11. Theme: Appropriate investigation in constipation

Options
A. Rectal biopsy
B. Reassure
C. Barium meal + follow through
D. NM studies of gut
E. Sigmoidoscopy
F. CT scan
G. USG abdomen
H. UGI endoscopy
I.
51. An 8-year-old girl with weekly abdominal pain, no h/o diarrhea or
vomiting. Physical examination was unremarkable.
52. A 6-year-old child had been having repeated constipation which is not
being relieved by treatment with laxatives. O/E there is no ano-rectal
anomalies
53. A 8-year-old child presents with epigastric pain a/w food. It appears
before eating and is relieved by eating food
54. A patient presents with a painless bladder, which is distended up to
the umbilicus. The patient has been suffering from constipation since the
last 3 months and his sigmoid colon is palpable per abdomen
12. Theme: Rectal bleeding

Options
A. Hemorrhoids
B. Diverticulitis
C. Diverticulosis
D. CA rectum
E. CA colon
F. U C
G. Campylobacter jejuni.
H. Pseudomembranous colitis.
55. A 45-year-old male with loose stools, blood, and progressive feeling of
incomplete defecation
56. A 54-year-old man presents with altered bowel habits and bleeding PR.
57. History of chronic constipation, hard stool passage now presenting
with bleeding PR. Feces coated with blood and splash in pan
58. A 28-year-old woman returns from Thailand, she had an episode of
bloody diarrhea there, then she was all right. She came back and has
similar episode
59. Young boy with bloody diarrhea and vomiting for one day.
Options
A. PSA
B. Serum acid phosphatase
C. Serum alkaline phosphatase
D. Transrectal USG guided biopsy
E. Serum Calcium level
F. Isotope bone scans
G. Full skeletal survey
H. X ray pelvis and lumbar spine
60. A patient with CA. Prostate presents with urinary incontinence along
with weakness of lower legs and backache
61. Known case of CA Prostate presents with humerus fracture. On x-ray
we find two osteosclerotic lesions
62. Male with high PSA levels and on rectal exam has loss of median
sulcus + on USG some nodularity in prostate next step
63. A 56-year-old has a family h/o of prostatic CA. He presents for
examination and wants to know if he has prostatic CA. He is found to have
a normal per-rectal exam and no lymphadenopathy.
64. Man on GnRHs for prostate cancer comes after 2 months for follow up
14. Theme: Cause of urinary retention

Options
A. BPH
B. Prostatae Ca
C. Fecal impaction
D. Clot retention
E. Ureteral stricture
F. Bladder stone
G.
H.
65. An old patient with the history of constipation with palpable sigmoid
colon & bladder palpable till umbilicus
66. A patient with Bladder Ca. wants to undergo surgery. A day before the
admission to hospital he presents with inability to pass urine.
67. A patient is unable to pass urine after drinking 5 pints of beer. Earlier
he had difficulty in micturition, dribbling and nocturia.
68. 75-year-old male with bladder outflow obstruction with other BPH s/s
69.
2011
13. Theme: Investigation of complications CA prostate
15. Theme: Investigations of Postop complications
16. Theme: Pre-op investigation

Options
A. ECG
B. 24-hr ECG
C. EEG
D. Echocardiography
E.
F.
75. A 10-year-old child is posted for Herniorrhaphy. He is clinically normal,
but has an irregular pulse.
76. A person wants to undergo surgery. He is evaluated and found to be
completely normal. His ECG however shows RBBB. Next step.
77.
2011
Options
A. Blood Culture
B. Ultrasound abdomen
C. Wound swab
D. Doppler study
E. CT scan
F. Venogram
G. Serum Creatinine level
H. Chest X-ray
I. Blood Glucose
J. ECG
K. Full blood count
L. VQ scan
70. A 64-year-old woman underwent an emergency laprotomy for
peritonitis. On the 6th day after surgery she is noted to a have a
serosanguinous discharge from the wound. There is no surrounding
erythema & she has normal temperature
71. A 50-year-old woman underwent surgery for Ca. Rectum, 10 days
back. She has low-grade fever of 37.5 deg. C and is complaining of pain in
the left calf. She has oedema of the left leg and ankle.
72 A 24-year-old man underwent appendicectomy 7 days back. He was
making good recovery, but suddenly developed high fever. O/E there is no
abnormality except for slight lower abdominal tenderness.
73. A 55-year-old man underwent emergency repair for an abdominal
aortic aneurysmal rupture. Before the surgery his BP was 60/40 mm Hg.
During the surgery and after, his blood pressure was satisfactory, but his
urine output was < 5-ml in the first hour after surgery.
74. A 75-year-old woman underwent left hemicolectomy for Ca. Sigmoid
Colon. On the 4th day after surgery she becomes sick. On exam she is
having fever 38.6oC, BP. 60/40, PR. 130/min., her hands and feet are
warm.
17. Theme: Diagnosis of Fractures
78. A 43-year-old lady oversteps the footpath while carrying her shopping
bags and falls. She presents with pain in arm and no deformity but
movements are slightly restricted.
79. A 16-year-old girl falls on the outstretched hand and complains of pain
from shoulder to the elbow, she is unable to use her arm.
80. A man hit by baseball bat while protecting himself using his hand in a
fight.
81. A patient has a fall on a outstretched hand. He is unable to lift his wrist
placed on the table.
82. A Rugby player injures his hand during the game. He has pain swelling
and tenderness in the region distal to the lower end of radius. On the X-ray
there is no evidence of fracture.
83. Guy presents with pain after punching his fist on the wall
18. Theme: Management of traumatic injuries

Options:
A. Shoulder-Wrist Sling
B. Collar & Cuff Sling
C. Simple Sling
D. Reassure
E. Immobilization in cast
F. Resuscitation
G. Resuscitation and External Fixation
H. Manipulation
I. POP Cast
85. A patient undergoes a RTA and has fracture pelvis.
86. A 3-year-old boy his father pulls his hand while swinging him in the
garden. He has a displacement at the elbow region.
87. A child is knocked down and run over by a bus over his pages, he is
tachycardia and hypotension. Next step.
88. After injury, pain distal to radius, initial investigations seem normal.
2011
Options
A. Transverse Fracture ulna
B. Fracture clavicle
C. Spiral Fracture humerus
D. Fracture neck of humerus
E. Scaphoid Fracture
F. Bennetts Fracture
G. Supracondylar Fracture humerus
H. Fracture Metacarpals
I. No evidence of fracture
J.

89. Clavicle or some joint dislocation
2011
19. Theme: Trauma investigation

Options:
A. Abdominal CT
B. Thoracic CT
C. Pelvic CT
D. Chest x-ray
E. Neck x-ray
F. Abdominal X-ray
G. IVU
H. Urethrogram
I. Skeletal Survey
J.
90. A 10-year-old boy is knocked down by a car while cycling, brought to
A&E. He is vomiting, upper abdominal pain and tenderness.
91. A child from RTA pain in upper abdomen with pain in lt shoulder tip.
92. A patient had an episode of epilepsy following which he has difficulty
in breathing and cant swallow his saliva. O/E his dentures are missing
93. A 32-year-old man has a kick in loin region, developed hematuria, no
blood at urethral meatus, no perineal injury seen.
94. A patient was wearing a soft neck collar and is involved in a RTA and
she had been sitting in the rear seat. After 10 days she presents with neck
pain.
20. Theme: Etiology of Arthritis

Options:
A. Rheumatoid Arthritis
B. Osteoarthritis
C. Reactive arthritis
D. Septic Arthritis
E. Degenerative Osteoarthritis
F. Psoriasis
G. Psoriatic arthritis
H. Myeloma
I. Gout
J. Pseudo gout
K. Reiters disease
L. Ankylosing spondylosis
M. Chondromalacia Patella
N. Inflammatory arthritis
95. A 47-year-old lady with arthritis of the small joints has swelling of the
fingers and pitting of nails
21. Theme: Management of HERNIA

Options
A. Herniotomy
B. Herniotomy + orchidopexy.
C. Herniorrhaphy+ orchidectomy
D. Elective herniorrhaphy.
E. Emergency herniorrhaphy
F. Abdominal binder.
G. Truss
H. Reassure.
I. Observe
102. A 68-year-old woman is a known smoker. She had an attack of MI 10
yrs back and is known to have peripheral vascular disease. She presents
with a reducible herniation over the incision region of a surgery which she
underwent in childhood
103. A 38-year-old lady presents with an irreducible hernia in the right
groin region. She is vomiting and has constipation since the last 3 days.
Her abdomen is distended and is tender to palpation
104. A 9-month-old child is brought to the A&E with an irreducible firm
swelling, which descends into the left groin when the child is crying
105. A 45-year-old mechanic presents with a reducible swelling in the
groin, impulse on coughing is present. He has mild dragging pain in the
abdomen, otherwise he is normal
22. Theme: statistics of psychiatric disorders (Dementia) in UK

Options:
A. Alcoholic dementia
B. Alzheimers disease
C. Cerebral secondaries
D. Creutzfeldt-Jakobs disease
E. Frontal lobe dementia
F. Lewy body dementia
G. Multi infarct dementia
H. Myxoedema
2011
96. A 27-year-old woman during her postpartum period presents with

symmetrical small joint swelling associated with edema
97. Patient with steroids now having a swollen painful joint which is hot &
tender associated with pyrexia
[snip]. A 45-year-old male patient has a history of gout. His metacarpal
joints are swollen and hot after an episode of trauma..
99. A 76-year-old patient has knee problem for 10 years, it is not hot but
during the attacks it swells and subsides
100. An 80-year-old lady with knee pain. Knee is inflamed but no rise of
temperature.
101. A 68-year-old patient has hypercalcemia, along with low backache
and proteinuria.
106. A condition associated with hypertension

107. The commonest from of dementia in the UK.
108. A condition characterized by senile plaques and neurofibrillary
tangles in the cortex and hippocampus.
109. A condition, which may respond to treatment with antidepressants.
110. A condition characterized by early personality changes, usually of
loss of inhibitions and relative intellectual sparing.
23. Theme: Treatment of psychiatric disorders

Options:
A. Mental status examination
B. Couple therapy.
C. Cognitive therapy.
D. Cognitive and behavioral therapy
E. Psychodynamic Physiotherapy
F. Exercise therapy
G. Hypnotherapy.
H. Martial therapy.
I. Flupenthixol.
J. E C T.
K. Imipramine.
L. Lithium
M. Tricyclic antidepressant
N. Bed rest
111. A 25-year-old mother, had puerperal blues in her first pregnancy.
Now in her second pregnancy after delivery, she has lost weight and
believes that her husband intends to kill her and her baby. She feels
completely worthless. She is currently on antidepressant medication
112. A 68-year-old female has received antidepressants for depression at
the age of 30 in 10 cycles. She presents now with loss of interest in her
activities and refuses to eat or drink any thing.
113. A 23-year-old female is always tearful and weeping. She cries on her
own, without any reason and is not able to do any work
114. A man with anxiety, lack of concentration at work, but no somatic
symptoms of depression.. what do we do?.
115. Doctor with problem in dealing with patiens no past history of any
treatment.
116. Man with manic depressive symptoms
117. A 10-year-old child has spasmodic torticollis.
118. A patient with Alzheimer's disease presents with coarsening of habits.
2011
I. Normal pressure hydrocephalus

J. Pseudo-dementia
K. Viral encephalitis
L. Wilsons disease
M. Schizophrenia
24. Theme: Psychiatric disorders Diagnosis
25. Theme: Diagnosis/Causes of Anemia

Options
A. Pernicious anemia.
B. Sideroblastic anemia.
C. Sickle cell anemia.
D. Vit. B12 malabsorption.
E. Vit. B12 dietary deficiency.
F. Decreased Fe Intake.
G. Fe malabsorption.
H. Folate def
I. Hemolytic anemia.
J. Hereditary Spherocytosis.
K. Aplastic anemia
123. A 32-year-old female presents with macrocytosis, she has anti
intrinsic factor antibodies.
124. A 42-year-old vegans with macrocytic anemia and normal serum
folate.
125. A 23-year-old patient has Microcytic hypochromic anemia, he has
diarrhea and is sensitive to gluten containing diets. With endomysial
antibodies.
126. A 23-year-old patient has iron deficiency anemia, he has diarrhea and
is sensitive to gluten containing diets
127. A 54-year-old patient is on Cyclophosphamide therapy, he presents
with a platelet count of 25 * 10 ^ 9, and a WBC count of 2*10^9
2011
Options
A. Paranoid Schizophrenia
B. Anxiety
C. Depression
D. Gilles La Tourette syndrome
E. Schizophrenia
F. Hypomania
G. Delirium
H.
I.
J.
119. A 30-year-old has periods of elation and depression. He goes to a
bank and demands money from the cashier and says that he is the owner
of the Bank. --- Hypomania / Schizophrenia.
120. A male with suspicion and schizophrenic features
121. Patient with ticks shouts obscene

26. Theme: Management of bleeding
128. A 45-year-old male patient has Mitral Stenosis and Atrial Fibrillation,
he presents with epistasis and his blood pressure is normal. The bleeding
stops on packing the nose. His INR is 9.4
129. A 10-year-old boy presents with bleeding into his knee joints. On
investigation his bleeding time is found to be normal, but his clotting time
is prolonged. His grand father is also known to have the same disorder
130. A 34-year-old woman presents with perifollicular hemorrhages.
Serum coagulation factor levels are normal
131. A 48-year-old woman undergoes hysterectomy. She has 2 attacks of
TIA from which she has recovered. O/E she is found to have an irregular
pulse
132. Widower with bleeding tendencies ()
27 Theme: Management of SEIZURES

Options
A. Carbamazepine.
B. Phenobarbitone.
C. Ethosuximide.
D. IV Diazepam.
E. IM Diazepam.
F. Oral Diazepam.
G. Rectal Diazepam.
H. Non Pharmacological intervention.
I. Lamotrigine.
J. Paraldehyde.
K. Valproate.
L. Phenytoin
133. A 9-year-old child with tonic clonic convulsions brought to A&E, iv
access failed
134. A 4-year-old child with history of absences episodes in school
reproducible on hyperventilation)
135. A 24-year-old college student who is about to start university has first
episode of generalized convulsions
136. A 34-year-old female is having continuous seizures without any gap
137. A woman with 25 min of epilepsy with loss of consciousness
138. Rx of status epilepticus
2011
Options
A. Factor IIIV
B. Vitamin K
C. Warfarin.
D. Vitamin C.
E. Vitamin. E.
F. FFP.
G. Heparin.
H.
28. Theme: HEADACHE investigation
139. A 44-year-old man with history of migraine now have a sudden pain
in right eye for 36 hrs.
140. A 72-year-old lady with a history of migraine has aches all over her
body along with severe headache. She had some visual problem a week
back
141. 85-year-old lady with h/o headache accompanied a few times with
vision problem now has a headache
142.
29. Theme: Causes of Renal stones

Options:
A. Multiple myeloma
B. Uric acid
C. Primary hyperthyroidism
D. Secondary Hyperthyroidism
E. Iatrogenic (Drugs)
F.
143. A Female with renal stones, recurrent pancreatitis and hypercalcemia
144. An old aged lady with a long h/o of knee pains is on treatment for it.
She presents with stone in the kidney along with loin pain..
145. Male with back
pain hypercalcemia ESR-108-mm
146. A patient with gout with loin pain
30. Theme: Diagnosis of purpuric rashes

Options:
A. ALL
B. Non accidental injury
2011
Options
A. CT scan
B. MRI scan
C. EEG
D. Temporal artery biopsy
E. CSF examination
F. Tonometry
31. Theme: Vaginal Bleeding

Options:
A. Endometrial polyp.
B. Cervical polyp.
C. CIN.
D. Cervical CA.
E. Endometrial CA.
F. Cervical Ectropion.
G. Atrophic Vaginitis
153. A sexually active lady recently divorced having many sexual partners
presents with episodes of post coital bleeding. O/E there is an ulcer at
cervix that bleeds on touching
154. A 30-year-old lady on OCPs referred by her GP after he found that she
has bleed on touching while taking cervical smear. Cervical smear was
normal.
155. A 62-year-old lady presents with post coital bleeding. She had
intercourse for the first time after 15 years.
156. A 58 years postmenopausal woman bleeding PV. On trans vaginal
USG scan cervix is 15-mm in thickness.
32. Theme: Vaginal Discharge

Options:
A. Candidiasis Rx
2011
C. Measles
D. Meningococcal Septicemia
E. Henoch Schnlein Purpura
F. Idiopathic Thrombocytopenic Purpura
G. Hemophilia
H. DIC
I. Acute Glomerulonephritis
J. NAI
K. Pertussis
148 10-year-old boy developed a purpuric rash over his legs, also has
intermittent abdominal & joint pains with proteinuria & diarrhea. Never
been immunized and has a past history of allergy.
149. A 2-year-old girl presents with purpuric rash over the body and has a
WBC count of 20x109. She has cervical lymphadenopathy and
splenomegaly.
150. A 5-year-old boy has purpuric rashes over his body following a URTI.
FBC is normal except for very low platelets
151. 8-year-old girl developed bruises all over her body of different ages,
also has a circular spot on her hand.
152. 18-year-old boy developed a purpuric rash and fever after moving in
a hall of residence. has a past history of vaccination of meningococcal C
vaccine.

B. Trichomoniasis vaginitis Rx
C. Gonorrhea treatment
D. Bacterial vaginosis
E. Chlamydia
161.A female with low abdominal pain temp of 39oC. Basic investigations
done.
33. Theme: Management of miscarriage

Options
A. Cervical encirclage
B. Low dose aspirin
C. Bed rest
D. Reassurance
E. Warfarin
F. Antibiotics
G. Myomectomy
H. Heparin
I. Counseling
J. Uterine septum removal
163- 26-year old pregnant lady with history of 3 abortions, last one at 18
weeks. Now presents with watery discharge PV at 14 weeks of gestation
for regular check up, o/e cervix is 1-cm long & admits one finger.
164- A pregnant lady had past history of premature rupture of membranes
at 23 weeks of gestation with infection followed by abortion. What will be
your advice?
165- A 23-year-old female with past history of 2 abortions in midtrimester, she has anti-phospholipid antibody. Now she wants to try for
pregnancy again.
166- A female with past history of abortion, no specific cause was found at
that time which needed treatment
167. A 38-year-old female with the history of three previous normal
pregnancies, followed by 2 abortions O/E uterus distorted with multiple
fibroids
34. Theme: Postpartum hemorrhage

Options:
2011
158. A female patient has greenish vaginal discharge & itching on vulva
along with lower abdominal pain
159. A diabetic female has mild lower abdominal pain, since a long time,
for which she had antibiotic treatment with not much of a response. She
develops vulval swelling and rashes along with cheesy vaginal discharge.
160. Female with vaginal discharge, dysuria and urethritis.
169. A 23-year-old female who was delivered by rotational forceps had

PPH.
170. A female with abruption delivered a dead baby
171. A 25-year-old primigravida delivered by induction of labour after 26
hours it is followed by PPH.
172. Secondary bleeding 10 day after normal delivery uterus well
involuted
173. A 23-year-old diabetic delivers a baby of 4.8 kgs. Uterus well is
normally involuted and retracted but she has PV bleeding post delivery.
174. A 30-year-old female delivers a stillborn baby after 3 days of IUD.
This is followed by PPH
35. Theme: Management - weight loss

Options:
A. PEG
B. NG tube feeding
C. Total Parenteral nutrition
D. Oral sips
E. Gluten free diet
F. Low protein diet with salt restriction
G. Low protein diet with antibiotics
H. High caloric diet
I. Lactose free diet
175. A 5-year-old girl comes with a history of abdominal pain,
steatorrhoea, vomiting, poor growth and apthus ulcers. Jejunal Biopsy
shows villous atrophy
176. A 70-year-old heavy alcoholic presents with hepatic encephalopathy,
he has jaundice and ascites
177. A 60-year-old patient with long standing Parkinson's disease presents
with intractable dysphagia
178. A 68-year-old male patient suffered a hemorrhagic stroke. After 5
days he is offered food, but is found to be still aspirating fluids.
179. A 74-year-old patient who underwent resection of the colon and
ileostomy for carcinoma is now in the ITU as he develops septicemia. He
has not been eating anything since the past 2 weeks
2011
A. Uterine Atony.
B. Large Placental surface.
C. Placenta praevia.
D. Abruption
E. Uterine Rupture.
F. D I C.
G. Vaginal or Cervix Tears, (Trauma).
H. Endometritis.
I. Retained products of conception.
J. Septic abortion.

36. Theme: Diagnosis
(Acid Base Balance)
181. A 5-year-old child has projectile vomiting due to pyloric stenosis with
hypokalemia and base excess
182. A 43-year-old man has profuse watery diarrhea and is dehydrated. He
has a villous adenoma of the colon
183. Patient with dry mouth, hiccups, toxic & unable to pass urine
184. A 56-year-old man had general anesthesia now presenting with
tachycardia, hypotension and breathlessness and dyspnea.
185. A 46-year-old woman undergoes cholecystectomy under general
anesthesia. Post operatively she presents with breathlessness and
peripheral edema and crepitations in the lungs.
186. A 45-year-old man presents with pallor, fatigue and has a dry skin
and is anuric since the past 3 days
37. Theme: Pain management

Options:
A. Oral NSAIDs
B. IV NSAIDs.
C. IM NSAIDs.
D. IV bisphosphonate
E. Beta Blockers.
F. Oral Dexamethasone.
G. Local steroid injection
H. Methotrexate.
I. PCA-Morphine (syringe deliver).
J. Radiotherapy.
K. Nerve blocks.
L. Physiotherapy or exercise training
187. A 70-year-old male, known smoker, presents with small cell bronchial
carcinoma with bony metastasis his backache not relieved by simple
analgesic and NSAIDs
188. A 45-year-old male has lumbar backache, with pain radiating to the
thigh, he undergoes laminectomy and discectomy for a prolapsed
intervertebral disc, but has no relief
189. Patient with symmetrical polyarthritis pain does not decrease with
simple analgesia.
2011
Options:
A. Metabolic Acidosis.
B. Metabolic Alkalosis.
C. Respiratory Acidosis.
D. Respiratory Alkalosis.
E. Hypokalemia.
F. Renal failure.
G. Dehydration.
H. Fluid Overload.

190. A 24-year-old female has migraine. It is getting worsen and she is
taking more time off her work.
191. A 34-year-old pt develops very severe headache followed by neck
rigidity & is found to have a SAH
2011
38. Theme: Investigation of poisoning

Options
A. Serum salicylate level
B. Serum iron levels
C. ECG
D. Serum oestradiol levels
E. Reassure
F. Toxicology screen
G. EEG
H. Urea & Electrolytes
I. ABGs
J. Serum Creatinine
192. A 7-year-old girl swallowed some tablets, which her father was taking
for treatment of depression, which he is suffering since a long time. She is
brought to the A&E and she looks drowsy and ill.
193. A 6-year-old child accidentally swallows five combined oral
contraceptive pills and is brought to the A&E
194. A heavily pregnant lady brings her 2 year old son to the A&E in a
serious condition. His vomitus is dark brown in colour
195. A 10-year-old is brought to A&E in a comatose condition, his mother
is an IV drug abuser. Next step.
196. A 4-year-old child was playing with a bottle of Aspirin tablets and is
brought to the A&E by the mother with tachypnoea, vomiting, dehydration
and sweating
197. A teenage girl took some of her moms tablets after a fight with
boyfriend now having palpitation
39. Theme - investigations

Options
A. Doppler flow study
B. Blood Culture
C. Ultrasound
D. CT Scan
E. Lumber puncture
F. Cerebral angiogram
G. Neck vein angiogram
198. Post cholecystectomy patient of mitral valve disease presents with
feature of stroke what investigation to be done
199. A patient has 3 episodes of loss of consciousness with recovery after
2 hours. O/E carotid bruit.

200. A s/s of infective endocarditis
201. A small baby on fundoscopy shows multiple retinal hemorrhages, she
is unconscious.
Options:
A. Bone Scan
B. Skeletal survey
C. Blood glucose
D. Thyroid function tests
E. Liver Function Test
F. IVU
G. MSU
H. X-ray KUB
I. Cystoscopy
J. Echocardiography
K. 24 hr ECG
L. RAST
M. Blood culture
202. Boy with history of drinking vodka at party presents with signs
symptom of hypoglycemia
203. A lady with Alzheimers disease. presents in a and e with collapse.
next morning demands sherry with morning tea
204. A child has swellings with varied colors on the back of his arm, hand
and legs is brought to A&E.
205. A patient has an injury on walking astride and presents with inability
to pass urine, has an enlarged abdomen. There is no blood at the tip of
penis..
206. A child has difficulty in standing on his leg and has a fractured thigh.
207. A 65-year-old says that he is loosing weight despite eating well. On
exam. he has an irregular pulse and atrial fibrillation.
208. Investigation of allergic ?
41. Theme: Management of inguino-scrotal swelling

Options:
A. MSU culture & microscopy
B. IVU
C. USG
D. CT scan abdomen
E. Urethral swab
F. X-ray KUB
G. X-ray abdomen
H. Urgent surgical exploration
209. A 14-year-old boy presents with unilateral severe pain in the right
testis along with vomiting. On examination, the right testis is swollen and
tender to palpation.
2011
40. Theme: Misce Investigation
42. Theme: Investigation of neck swelling

Options:
A. CT scan
B. X-ray neck
C. MRI
D. FNAC
E. Lymph node biopsy
F. Chest V-ray
G. Digital computerized angiography
214. Single nodule in front of neck
215. Swelling moves on protruding the tongue, lies between tongue and
the hyoid bone
216. Pulsatile swelling moves from side to side at carotid bifurcation
43. Theme: Mixed ??/??????
217. Patient with singed eyebrows, soot in the throat and nasal passage,
he presented with breathlessness dyspnea and stridor (laryngeal edema)
218. Patient with circumferential burns on his right hand ( escharotomy)
219. A 4-year-old child with 10% scalds on chest
220. A patient with myeloma has back pain and presents with raised ESR,
and proteinuria. He has a distended bladder and is unable to pass urine.
He has sensory disturbances in his lower legs. Spinal Cord Compression ?
44. Theme about -strains and sprains is missing
Answers
1-B
2-F/I,
3-G,
4-E
5-A
6-E,
7-C/D (most likely autoimmune as acute RH fever but can be infective if
endocarditis )
2011
210. A patient undergoes TURP surgery and presents 5 days latter with
bilateral swelling and pain in the testes. He is febrile.
211. Boy testis removed now presents with epigastric mass
212. A patient presents to the A&E on the evening of surgery for right
hydrocele, which was tapped. He has a tense scrotal swelling on the right
side, the other side is normal.
213. A patient presents with rigors, pyrexia and has a tender and painful
epididymis, on palpation. Investigation.
2011
8-D,
9-B,
10-A/G (dilated cardiomyopathy nutritional due to beriberi or can be
neoplastic)
11-C
12-F
13-B
14-C/H
15-D
16-A,
17-D
18-E
19-F
20-C
21-?
22-D
23-H/J
24-G
25-F as it is the only choice with cardioversion in it
26-?
27-A (bcoz VSD)
28-D
29-C/B
30-G
31-D
32-E
33-A
34-B
35-B (cellulitis)
36-C
37-G
38-F/D/E
394041-E
42-D
43-C
44-A
45-K
46-A,
47-C,
48-E,
49-D,
50-B
51-B
52-A
53-H
54-?
55-D
56-E
57-A
58-G not sure this was the only option of infective agent
59-G
60-F/H
2011
61-G
62-D
63-A
64-A
65-C
66-D
67-B/A
68-A
6970-C
71-D
72-B
73-G as a case of ATN
74-?
75767778-B
79-G
80-A
81-C
82-E,
83-H
85-G
86-?
87-D
88-(her it is a scaphoid fracture, so is the answer reassure/cast? since
there was no scaphoid cast scaphoid x-ray mentioned)
89-?
90-A (CT Abdomen as option of u/s abdomen was not there)
91-A
92-D
93-C
94-?
95-F/I,
96-A
97-D
[snip]-E
99-?
100-N/E?
101-H
102-F/G
103-E (a case of strangulated hernia immediate repair)
104-A
105-D
106-G
107-B
108-B
109-J
110-E
111-D,
112-J,
113-?
114-C as no somatic symptoms,
2011
115-M,
116-L,
117-E/N/F,
118-A
119-E/F (Note: Mania or Bipolar disorder options not given)
120-A
121-D
123-D/A
124-E
125-G a case of celiac disease)
126-K
127-?
128-B
129-A
130-?
131-?
132-Vit-C deficiency _?
133-G
134-C
135-H
136-?
137138- D (iv lorazepam)
139-?
140-B/F
141-?
142143-C
144- E (Ca+ tablets ingestion Iatrogenic)
145-A
146-B
148-E,
149-A,
150-F,
151-B,
152-? (Meningitis) this was a tricky one, guys what do u think was the
ans.. other options were measles, HSP, ITP, etc which didnt co-relate
except meningitis in a closed contact place ,but why give the h/o
immunize if it were meningitis? im darn confusedMAY BE MEASLES
153-D
154-F
155-G
156-E
157158-B
159-A
160-C
161-E/D (endocervical swab or admit for parenteral antibiotics PID )
162163-A
164-C/?
165-B
166- D,
167- G
2011
168169-G
170-D
171-A
172-I
173-B
174-?
175-E
176-G (cirrhosis Low Protein Diet + Antibiotic)
177-A
178-B/C
179-C
180181-B
182-E
183-F
184-(pulmonary edema H / C)
185-H
186-G
187-I (as opioids should be avoided coz of respiratory depression syringe
deliver morphine)
188-K
189-A
190-E
191192-C
193-D/E
194-B
195-F
196-E
197-?
198-B
199-F/G/A carotid artery stenosis
200-B
201-D
202-C.
203-C.
204-B.
205-F/I.
206-A.
207-D.
208-L
209-H
210-H
211-D
212-H
213-A
214-D
215-?
216-E
2011
Jan 2004
THEME 1:CAUSES OF DYSPHAGIA
a) Parkinsonism
b) Motor Neuron Disease
c) Stroke
d) Achalasia
e) Chaga,s disease
f) Esophageal carcinoma
g) Reflux oesophagitis
h) Pharyngeal carcinoma
i) Scleroderma
j) Foreign body
1) A man complaints of dysphagia He is unable to protrude his tongue and
has difficulty in speaking. He is unable to move his all 4 limbs.
2) A man complaints of sudden dysphagia, he cannot protrude his tongue
and has difficulty in speaking.
3) A 110kg lady complains of many years of heartburn but now complains
of painful dyspahgia. Barrium swallow doesnt show any stricture.
4) A man complaints of dysphagia, he has foetor oris and there is
occasional regurgitation of undigested food particles.

5) A man complains of sudden dysphagia after eating meat and chips.
There is dribbling of saliva.
a) Fracture distal end of radius

b) Metacarpal fracture
c) Supracondylar fracture of humerus
d) Scaphoid fracture
e) Postrior dislocation of shoulder joint
f) Ant dislocation of shoulder joint
g) Peri-lunate fracture
6) A man complained of pain in hand after punching a wall yesterday..
7) A young girl fell from a tree and now complains of pain in the arm. her
radial pulse cannot be felt .
8) A man having seizures came to the A&E complaining of pain in the
shoulder. There was no obvious visible deformity.
9) An old lady complained of pain in the wrist and hand after she fell on an
outstretched hand. her wrist and hand are swollen.
10) A 3 yr old girl tripped while holding her mothers hand. She has not
used her arm since then.
THEME 3:
11) A pt with chronic constipation, and severe pain when defecating./ Pain
is sever and cannot undergo examination
12) Patient with severe anal pain and a swelling in the peri-anal region#
13) Patient with weight loss and change in bowel habits. Sigmoidoscopy
shows ulcer
14) Patient with bleeding rectum. And features of Crtohns
15) Sudden deep pain faecal shooting pain.
THEME 4: Contraception- mechanism of action
16) Depot vera
17) OCP
18) Post-coital pill
THEME 5: Cell of origin
19)
20)
21)
22)
23)
Lipoma
Glioblastoma multiforme
Myeloma
AML
Rhabdomyosarcoma
2011
THEME 2 : DIAGNOSIS OF FRACTURES
THEME 6: Ascites
2011
24)
25)
26)
27)
28)
A man with some cancer developing ascites

Ascites with numerous neutrophils
Immigrant from India developing exudative ascites and loss of weight
Signs of CCF with ascites
Chronic stigmamat of liver diseases and ascites
THEME 7:
29) A boy with learning disabilities and staff are concerned about
increasing number of head bangings
30) A man with schizophrenia hears voices telling him to have bleach.
31) a 17 yr old girl whose parents separated is brought to the A&E after
she took 5 tablets of diazepam.
32) A man is admitted to a surgical ward after an accident where he
sustained a minor injury. After few days he is unsmiling and unresponsive
to staff.
33) A 27 yr old has 2 small children . She has no family support. She is
recovering from influenza and her washing machine has broken down. She
comes to A& E saying she took 8 aspirin tablets.
Theme 8 :Pain Relief
a) Paracetamol oral
b) IV morphine
c) SC morphine
d) oral morphine
e) oral diclofenac
f) codeineand paracetamol
g) diclofenac pr
h) carbamazepine
34) A 8 yr old boy is being investigated for failure to thrive, complains of
ear pain.
35) A young lady felt dizzy and she fell down. She has swelling in her ankle
and pain, but she is able to walk.
36) Child presenting with s/s of appendicitis.
37) A pt with s/s of MI.
38) A pt with Ca bronchus, now c/o pain and it is intolerable to
Paracetamol and brufen.

39) Post herpetic neuralgia
Theme 9 Eye Investigations
2011
40)
41)
42)
43)
Typical history of temporal arteritis.

Pt with intermittent episodes of amaurosis fugax.
Upper lobe hemianopia
s/s of acromegaly
Theme 10 Ear Treatment

a) Amoxcillin
b) Oral acyclovir
c) Topical acyclovir
d) Paracetamol
e) Flucloxacillin
f) Immediate referral to specialist
g) Routine referral to specialist
44) Diabetic pt with features suggestive of furunculosis.
45) A pt had syringing done and complains of sudden acute pain now.
46) A pt with varicella and has vesicles on the pinna and the eardrum.
47) A pt with a chronic history and on exam has a scarred eardrum and
has a mass seen.
Theme 11 Preop care
a) Cancel the operation
b) ECG recording for 24 hrs
c) cardiology opinion
d) BP record for 24 hrs
48) A pt admitted for a prostectomy and his BP is 190/110 the previous

day.
49) A pt with controlled angina since 10 yrs. Has had 2 attacks of angina
in the last one week. He is posted for a prostaectomy.
Theme 12 Obs & Gynae Treatnent

a) Calcium supplement
b) HRT

c) Vaginal lubricant
d) Vaginal estrogen
Theme13 Non acc Injury

a) Refer to childcare center
b) Nutritional assessment
c) Coagulation screen
d) Continue regular child care
e) EUA
f) Inform police
g) CT scan
53) A child is brought with a fracture femur, no evidence of trauma.
54) A bruise is noted on a childs hand, mother stopped the child from
running.
55) A child of unemployed parents, exam reveals no improvement from
last check up.
56) A child brought with bleeding p/v and her vagina is sore and shows
excoriations.
57) A 18 yr old mother brings her one yr old child to the A&E. Child id
drowsy, and left pupil is dilated.
Theme 14 Rheumatology Diagnosis
58) Typical history of RA

59) Typical features of Ank spondylitis
60) Punched out erosions on XR
2011
50) A 55 yr old female who attained menopause 2 yrs ago . Family history
of osteoporosis present. She is worried and has come for counseling.
51) A 32 yr old pt with family history of osteoporosis and she has lactose
intolerance.
52) A pt who has postmenopausal dyspareunia, urine culture is negative.
She is not willing to take systemic hormones.

Theme 15 Relation to obesity
61) Wt loss would help night sleep in this condition and improve marital
harmony.
62) Wt loss wld help to stop the medication
63) Stopping this wld help in wt loss and vitamin deficiency.
64) Surgery in this condition will help in wt loss.
Theme 16 Psychiatry
a) Acute confusional state
b) PTSD
c) drug induced psychosis
d) Mania
e) schizophrenia
65) A Pt undergone surgery for some condition and is receiving medicines
for pain relief. On 3rd postop day he has features of delirium tremens.
66) A kosovian who gets startled easily when he hears any loud noises etc
67) A person who is being stopped by the police and goes on talking
jumping from one topic to another.
68) Something about a man running to the police station and saying that
his house is not safe, but on checking thats not the case.
Theme 17 Surgery
a) Femoral hernia
b) Indirect inguinal hernia
c) Direct inguinal hernia
d) mal-descended testis
69) A lump that is seen below and medial to the pubic tubercle
70) A mass attached to the spermatic cord.
2011
a) Type 1 DM
b) Type 2 DM
c) Alcohol
d) Cushings
e) PCOD
f) Obstructive sleep apnoea
Theme 18 Trauma Organ
71) A person who met with a accident and is in A & E with pain in RUQ and
hypotension.
72) A builder falls astride on a scaffolding bar.
73) A person after an accident when NGT was tried, not successful.
74) After an accident fullness in the loins & pain.
Theme 19 Scientific basis

a) Obstruction
b) Papillary necrosis
c) Hypercalcemis
d) Infection
e) Dehydration
75)
76)
77)
78)
79)
A pt with s/s of sarcoidosis.

Something about analgesia
A marathon runner.
A person having recurrent attacks of UTI.
Something about obstruction.
Theme 20) Seizures

a) Check drug level
b) EEG
c) CT
d) MRI
80) Child has had one episode of grand mal epilepsy now presents with
another attack.
81) A girl who is being treated for absence seizures has had recurrent
seizures and she is obese.
82) A child is unwell since the last few days, is brought to A&E with
seizures. Child is irritable.
Theme 21 Seizures
2011
a) urethra
b) bladder
c) spleen
d) pancreas
e) kidney
f) diaphragm
g) aorta
h) liver
83) A person who has been treated for carcinoma ? now comes with pain
and numbness in his left leg and then , cant remember the next bit.
84) A child having otitis media with seizure
85) A child at school suddenly stops midsentence for a few seconds and
then starts off where she stopped.
86) A person with generalised seizures.
Theme 22 Haematuria
a) ASO titer
b) Creatinine clearance
c) USG
d) Cystoscopy
87) A 8 yr old boy comes with complaints of fever, oliguria and edema.
88) A person with hematuria , he says there is family history.
89) A diabetic pt with pitting edema.
Theme 23 Psychiatry
a) Low mood
b) Chronic fatigue syndrome
c) Thought broadcasting
d) Thought insertion
e) Insight
f) Judgment
g) Paranoid delusion
90) A lady who lacks energy and has disheveled hair and appearance.
91) A woman who is admitted and feels that the staff knows what she is
thinking.
92) A man has Psychiatry problem and he knows he ha sit.
93) A pt keeps on talking and he jumps from one topic to another.
Theme 24 Respiratory Asthma
94) A 6 yr old boy presents with recurrent bouts of asthma, his parents are
smokers.
2011
a) Febrile convulsions
b) Petit mal
c) Grand mal
d) Complex seizure
e) Pseudo-seizure

95) A boy presents with recurrent attacks on playing football.
96) A child presents with acute attacks of asthma, her brother rears
rabbits during holidays.
a) CO poisoning
b) Hypoglycemia
c) meningitis
d) Subdural haematoma
e) Subarachnoid heamorrhage
f) Intracerbral he
97) An alcoholic who has had falls with fluctuating consciousness.
[snip]) A person who has been hypertensive since last 10 yrs and not on
any t/t, presents with sudden loss of consciousness.
99) A student at hostel in the university has come back home, he has
fever , rash? ..
100) A 8 yr old child with diabetes
101) A student at the hostel CO poisoning
102) A person with a severe headache like he has been hit at the back of
his head.
Theme 26
103) Post op hernia pt has difficulty in voiding urine.

104) A person in a mining accident
105) A person in an accident with blood seen at the tip of the urethra.
106) pt with frequency and hematuria . On cystoscopy red patches are
seen, no infection and no signs of inflammation.
107) Fluid requirement in an Addisonian pt. (levels given)
108) Fluid requirement in a diabetic pt.
109) A person with gastroenteritis since 24 hrs, fluids needed.
Theme 27 Trauma
a) Control bleeding with external pressure
b) Vascular access and infuse normal saline
c) Vascular access and infuse blood
d) Intubate and ventilate
2011
Theme 25 Loss of consciousness

e) Maintain open airway
f) Needle thoracocentesis
g) Splint fracture
There were other themes on cervical ca, pregnancy and complications,

ECG findings , pulse, BP, JVP,CXR for diff conditions, thyroid..
Theme 28 Infection Diagnosis
a) Lymphoma
b) TB
c) Brucellosis
d) Lyme
e) Plasmodium falciparum
f) Plasmodium vivax
g) Plasmodium ovale
115) A 8 yr old boy from somlia has complaints od haemoptysis, cough
and fever.
116) A pt with cervical lymph nodes and has night swets , fever low grade.
117) A person working in a farm comes with splenomegaly and fever.
118) A pt with intermittent fever , splenomegaly
119) Pt with long history of dyspepsia since 10 yrs, takes cimetidine but
no relief.
120) A pt who has been on triple therapy for H Pylori comes now with
complaints of dyspepsia.
Theme 29 Choose the cell that proliferates .....
1)
2)
3)
4)
5)
6)
7)
8)
9)
Adipocyte
Lymphocyte
Erytroblast
Megakaryoblast
Monocytes
Neuroglial cells
Schwann cells
Astrocytes
Plasmacell
2011
110) A 10 yr old boy fell onto broken glass and is bleeding from his wrist.
111) A girl has been hit by a car , neck is immobilized. She is receiving
100%oxygen. Berthing is noisy.
112) A child fell from a horse. Her neck is immobilized and she has been
given oxygen. She has a swollen thigh, and she has cool peripheries.
113) A 15 yr old girl has cut her wrists and bled profusely. She is pale and
tachycardic.
114) A boy was involved in an accident in which another person was killed.
He is brought to A & E with a oxygen mask . He is talking. He is pale and
tachycardic.

10) Muscle
11) Neutrophil precursors...
answers.....???
a)adipocyte
b)plasmacell
c)nueroglial cell
d)???/
e)muscle
the ans are:
1. adipocyte
2. plasma cell
3. astrocytes( GBM is classified as a astrocytic tumor)
4. neutrophil precursors,AML has inc myeloblasts which are the first
recognisable cells in neutrophlic series
5. muscle
Answers
1, mnd
2 stroke
3?
4, pharngeal pouch
5 foreign body
6 metacarpal
7 supracondylar fra
8 ,postr dislocation
9 fracture distal end of radius
10 pulled elbow
11 ,anal fissure
12 ,perianal hematoma
13 rectal ca
14 crohns
15 , pratalgia fugax
16 ,cervical mucus
17 ,prevents ovulation
18 implantation
19 fat cells
20 astrocyte
21 plasma cell
22 megacaryocyte
23 skeletal muscle
24 carcinomatous peritoneii
25 subacute bac. peritonitis
26 tuberculosis
27 ccf
28 alcohol
29 sedation
2011
a) cell that proliferates in lipo sarcoma

b) multiple myeloma?
c) glioblastoma multiforme
d) AML
e) rhabdomyosarcoma..?
2011
30
31,dont remember the ans
32, refer to psy
33 ?
34 oral paracetamol
35 diclofenac
36 codiene n paracetomol?
37 im morphine
38 sc morphine
39 carbamazepine
40 carotid doppler
41 temporal lobe mri
42 pituitary
43 fluclaxacillin
45 , immetiade referal
46 oral acyclovir
47 routine referal
48 ?
49 cardiology opinion
50 ?
51 ?
52 vaginal oestrogen
53 continue child care
54 coagulation screen
55 nutritional ass.
56 refer to child care center
57 ct scan
58 RA
59 anklosing
60. OSTEOSARCOMA??
61.F
62.B
63.C
64.D
65.C
66.B
67.D
68.E
69.A
70.D
71.H
72.A
73
74. E
75.C
76.B
77.E
78.A
79.D
80.C
81.A
82.C
83.E
84.A
Pasted from <http://www.rxpgonline.com/postx64126-0-10.html>
2011
85.B
86C
87.A
88.C
89.B
90.A
91.C
92.E
93.G
94.AVOID SMOKING
95.AVOID ALLERGEN??
96.AVOID ALLERGEN
97.D
[snip].F
99.C
100.B
101.A
102.E
103.POST OP RETENTION
104.CATHETERISE
105.URETRAL RUPTURE,SUPRAPUBIC CATHETERISATION
106.TB
107?
108?
109?
110.A
111.D
112.B
113.C
114.E
115TB
116.A
117C
118MALARIA??
119PROTON PUMP INHIBITORS
2011
Nov. 2003
Theme-1: Diabetes mellitus
A- Excess insulin
B- Relative deficiency of insulin
C- Absolute deficiency of insulin
D- Deficiency of catecholamines
E- Excess of catecholamine
F- Deficiency of glucocorticoids
G- Excess of glucocorticoids
H- Hypoglycemia
I- Hyperglycemia
1- Young man, obese, hyperglycemia but no ketosis
2- Female with all signs/symptoms of Cushings disease
3- Old man with signs & symptoms of hypoglycemia
4-
Theme-2: Causes of hypertension.

A- Renal artery stenosis
B- Conns Syndrome
C- Pheochromocytoma
D- Pregnancy
E- Cushings
F- Steroids induced
56789-
45-year old obese women with moon face, hirsuitism & hypertension
Pt with Hypertension, hypokalemia & altered serum phosphate
Young pt had Hypertension with bruit in abdomen.
Hypertension with pallor palpitation
Theme-3: Differential Diagnosis of thyroid disease
10- 45-year-old female with palpitation, tachycardia & diarrhea.

11- Pt with exophthalmus, but no other signs of hyperthyroidism.
12- Thyroid disease following amiodarone for arrhythmias
13- 75-year old female with hard fixed thyroid-swelling shows poor
response to medicines.
14- Lady presented with diarrhea, all investigations done but no cause
found.
Theme-4: Investigation Bites-Repeat
A- HIV antibodies
B- Skin prick
C- Skin swab culture
D- Blood film for malaria parasite (thick smear)
E- Lyme serology
F- Immunization
GH16- Girl walks in forest & bitten from an insect, develops a red lesion.
17- A middle age Police officer bit by an i/v drug user
18- Man returns from Zambia with fever & rigors
19- A pt returning from ancola & with some symptoms
______________________,
Theme-5: Chronic renal failure management
A- Erythropoietin
B- Captopril
C- Haemodialysis
D- Beta Blockers
E- Ca++ channel blocker
F- Spironolactone.
GHI-
2011
A- Hypothyroidism
B- Drug induced
C- Treated hyperthyroidism
D- Anaplastic CA
EF- Papillary CA
G- Thyrotoxicosis
HI-
Theme-6: Palliative Care (Analgesia)

A- i/v morphine
B- i/v benzodiazepines
C- Paracetamol
D- TENS
E- Oral benzodiazepines
F- S/C morphine thru syringe driver
G- i/m morphine
H- Steroids
I- Radiotherapy
J- S/C opioid
25- Man with CA prostate wants relief from skeletal pain as opioids failed.
26- Man with CA pancreas in last stages but suffering from pain, not
responding to i/v morphine
27- Man with CA bronchus c/o anorexia & breathlessness after surgery.
28- Pt with CA breast c/o edema & pain in arm.
29- CA bronchus with metastases, critical stage, & high doses of opiates
did not help him.
30- CA stomach with pain on oral morphine.
Theme-7: Prognosis & natural course of respiratory disease
A- 80% chance having wheeze in adult life
B- 50% chance of becoming normal by 6 yrs
C- If untreated leads to abscess
D- Very bad prognosis
E- 70% chance of getting clubbing in adult hood
F- Complaints end by the age of two
G- Complaints end by proper feeding
H- Prognosis not known
I- Extrinsic allergic alveolitis
J- Double auto Anti body
K- 10% chance of COPD
L- 60% chances of developing COPD in future
31- A mother brought her 6-month old girl with difficulty in breathing &
vomiting related to feed.
32- A 5-year-old boy having exercise & cold induced wheeze mother has
eczema
33- A 2-year-old boy with respiratory wheezing, coughing during winter, &
hyper inflated lungs.
2011
20- Pt with hypertension, asthma & Renal failure what will be the next
step?
21- HIV positive pt with serum Cr 1300 & serum-K 7.0 what will be the
next step?
22- End stage renal failure with anemia
23- Renal failure due to polycystic kidney & hypertension
Theme-8: Cause (Toxicology)

A- Salicylates
B- Paracetamol
C- Metoclopramide
D- Opioids
E- Tricyclic Antidepressants
F- Digoxin
G- CO
H- Diazepam
I- Carbamizipine.
41- Development of hepatitis 3-4 days after indigestion
42- Dystonia, occulogyric crisis
43- Pinpoint pupils respiratory depression
44- Women on neuropsychiatric drugs at night now c/o agitation &
dizziness
45- Visual problems, & bradycardia
46- Man with shingles in thoracic area 2nd day
Theme-9: Neurological diagnosis
A- Glioma
B- Menigioma
C- Multiple sclerosis
D- Stroke
E- Hydrocephalus,
F- Cerebrovascular
G- MND
H- Alzheimers
I- Meningitis
J- Parkinsonism
K- Creutzfeld Jacobs
48- 40 year old lady is having progressive weakness of limbs for the last
18 months & she also developed slurring of speech. now presented with
loss of vision on Right eye
49- Patients age around 40 is having headache & vomiting is waiting for
neuro-surgery & radiotherapy.
50- Dysarthria head ache dysphagia
51- Hoarseness dysphagia LL paresis
52- Wheel chaired with neurology problems blurring vision
53- Bed ridden with increasing forgetfulness
2011
34- Child normal was playing suddenly developed breathlessness &

monophonic wheeze
35- A 6-month old boy with nocturnal wheeze, not controlled by steroids.
36- 4-year old develops wheezing & chest tightness following exposure to
pollens.
37- One question about Sjogrens investing.
38- Allergic symptoms in bird fancier
39- Child with purulent sputum & cough
40- 2-year old boy who has started Rx for recent onset of asthma.

Theme-10: Child hood convulsions management
54- Child with high fever & fit

55- Child with recurrent febrile, convulsions.
56- Child with fever, fits, rashes, confusion.
57- Obese Child taking valrproate but epilepsy still not controlled.
58- Child with seizure before arrival at hospital but all right now. GPE &
systemic exam was unremarkable.
Theme-11: Diagnosis of anaemia
A- Macrocytic anemia
B- Sickle cell anemia
C- Iron def anemia
D- Aplastic anemia
E- Spherocytosis
F- Sideroblastic anemia
GHI6061626364-
Lady presented with sore tongue

Old man with bruising on chest, infection & low Hb
Lady presents with menorrhagia with brown clots.
Something about sickle cell anemia
CA. stomach with anemia
Theme-12: Enzyme Defect

A. Creatinine phosphokinase
B. Troponin-T
C. Phenylalanine hydroxylase
D. Aspartate aminotransferase
E. Alanine aminotransferase
F. The MM isoenzyme of creatinine kinase
G. The MB isoenzyme of creatinine kinase
H. The BB isoenzyme of creatinine kinase
I. Cystathionine synthetase
J. Lactic dehydrogenase
2011
A- EEG
B- Drug levels
C- i/v Diazepam
D- Cerebral angiography
E- Lumbar puncture
F- Teach parents of rectal diazepam
GH-
Theme-13: Types of emboli

A. Thrombus emboli
B. Fat emboli
C. Amniotic fluid emboli
D. Malignant emboli
E. Atheromatous emboli
F. Septic emboli
G. Paradoxical emboli
H. Fibrin emboli
I. Bone fragment emboli
J. Air emboli
71. A patient with DVT, was complicated by cerebral & extremity emboli.
On ECHO he was noted to have a patent foramen ovale. The combination
of DVT , PFO & arterial emboli suggest which phenomenon
72. A 28 year old with known congenital heart disease, develops small
tender subcutaneous nodules in the pulp of the digits. On examination the
nodules were red & tender. The patient was noted to have splenomegaly
& a new heart murmur. The finger tip nodules are most likely secondary to
73. A 30 year old in her 3rd trimester of pregnancy presents with chest
pain & dyspnoea increasing in severity over the last 24-hrs. She has no
lower limb pain or swelling. The pt is likely to have what
74.
Theme-14: Diagnosis of peripheral vascular disease

A- Mural thrombus
2011
66. Which enzyme occurs in high concentration in the sarcoplasm of

skeletal muscle?
67. Which enzyme regulates the Ca-mediated contractile process of
striated muscle & is most specific for minor degrees of myocardial
necrosis?
68. A Middle Eastern male child with fair complexion adopted soon after
his premature birth, is noted to have delayed milestones at 8 months of
age. He is also noted to have eczema. At 2 years of age the child has
severe mental retardation with no pyramidal or extra pyramidal signs.
Mental retardation in this child is more likely to be a defect in which
enzyme?
69. A 20-year-old male with mild mental retardation has had 2 successive
strokes within a year. On examination he had a marfinoid habitus, with
long limbs & pectus excavatum. What is the most likely enzyme defect?
70. Liver congestion is most commonly associated with the elevation of
which enzyme?
7576777879-
Young smoker with peripheral vascular disease.

AF with pulselessness pallor of extremities.
MI with claudication & angina with ischemia of lower limb.
Old age with gangrene following chiropody.
Pregnant lady with sudden breathlessness & calf pain.
Theme-15: Anatomy Of Heart (causes)

A- Left atrium
B- Right atrium
C- Left ventricle
D- Right ventricle
E- Mitral valve
F- Tricuspid valve
G- Coronary arteries
H- Interatrial septum
I- Interventricular septum
J- broncho pulmonary displasia
K- SA-node
L- AV-node
M- Bundle of His
80- Location of endocardidits in iv drug abuser
81- Location of patent foramen ovale
82- Blood spurts into left atrium & increase left atrial pressure
(regurgitation from LV).
83- Site of Cardiac aneurysm
84- Regurgitation of blood in the left ventricle
85- Structure responsible for heart rhythm in third degree, complete heart
block.
86- Increased pulmonary pressure
Theme-16: Management of cardiac conditions
A- Surgical ablation of tracts
B- Verapamil
C- Digoxin
D- Enalapril
E- Amiodarone
F- DC cardioversion
G- Adenosine
H- Atropine
I- Lignocaine
87- A patient with heart failure presents to you with afibrillation....
88- A patient having SVT with BP 90/60. Sinus massage & adenosine has
failed. Whats next?
2011
B- Acute thrombus
C- Burgers
D- Diabetes
EF- DVT

89- A patient with Myocardial Infarction presents with recurrent Ventricular
tachycardia controlled with lignocaine now need maintenance.
90- WPW no response to drugs
A- Aortic rupture
B- Tension pneumothorax
C- Spontaneous pneumothorax
D- Ruptured EsophagusE
E92- Chest trauma with absent breath sounds & tracheal shift & absent
radial pulse
93- Young tall thin worker with signs of pnemothorax
94- Injury to sternum with steering wheel widened mediastinum
Theme-18: Acute abdomen diagnosis

A-X-Ray KUB
B- Chest x-ray
C- X-ray abdomen
D- Pregnancy test
E- Sigmoidoscopy
F- Laparoscopy.
G- Urine R/E.
H- Colonoscopy.
I- Usg Abdomen.
J- Barium enema.
96- 32-year old male with nausea, vomiting, colicky abdominal pain &
distention O/E abdominal tenderness, high-pitched bowel sounds
97- 60-year old male with signs of ileus & peritonitis following diverticulitis
[snip]- Carcinoma colon investigation
99- 23 year old female presents with left sided abdominal pain for 4
hours , her last period was 7 weeks back
Theme-19: Management Of Sprains & Injuries
A- Paracetamol
B- Suture repair
C- Cast
D- No weight bearing use crutches
E- NSAIDs
F- Manipulation
G- Morphine
H- Observe
2011
Theme-17: Chest Trauma
Theme-20: Investigation orthopaedics

A- Spine x ray
B- DSA scan
C- Serum electrophoresisi
D- MRI
E- CT
F- Serum Ca
GHI106- Man presents with foot drop on x ray there is narrowing b/w l4 & l5
foot drop does not resolve in 2 weeks
107- Pt present with back pain x ray gives sacroilitis like picture
108- Old aged male Pt with back pain, fractured spine & high ESR
(Ankylosing spondylitis)
Theme-21: Pre-Op Investigation

A- Do nothing
B- FBC
C- ECHO
D- ECG
E- Sickle screening #
F- CXR
G- Hepatitis serology
H- Coagulation screen
110111112113-
British fit man for bilateral inguinal hernia

Afro-Caribbean man bilateral inguinal hernia
Man on list for hernia repair who takes recreational i/v drugs
Man with irregular pulse having hernia
2011
100. A Pt with dislocated patella & he is on inhaled analgesia (nitrous

oxide).
101. Pt had rupture Achilles tendon earlier, which was managed medically,
now presented with rupture again. Medical treatment is not responding
now.
102. Pregnant lady had fall, pain, mild swelling & bruising at medial
maleuolus. On x-ray no #.
103. During a match rugby player injured his knee, on x-ray no fracture
but pain++.
104. A 4 year old child brought to A&E with knee trauma & in pain despite
Paracetamol.

114- Lady for some surgery h/o antibiotic prophylaxis in a dental
extraction
A- Serum ca
B- Serum phosphate count
C- Parathyroid level
D- Urine cystine
F- Urine oxalate count
G- IVU
H- X ray KUB
I- 24 hr urine
J- Ultrasound
K- Urine culture
L- Isotope scan
M- Nephrostomy
115- A patient with right loin pain & pyrexia. recent IVU showed Right
hydronephrosis. Next investigation that may help in the management?
116- Man with h/o ca prostate on x ray nothing on IVU bilateral
hydeonephrosis
117- Man with recurrent renal stones & high serum Calcium levels.
118- Post-op CA cervix with anuria. B/L obstruction of the ureters & B/L
hydronephrosis
Theme-23: Next step in the following conditions
A- USG abdomen
B- Catheterisation
C- Ascending urethrogram
D- Splenectomy
E- Laparoscopy
F- Observation
G. Abdominal tapping
H. Laparotomy
I. Blood transfusion
J. Get an expert opinion
K. IVU
L- MRI
120- A rugby player was hit in the back & come with loin pain &
haematuria. management
121- Young man with one episode of frank haematuria & he was stable but
presented with anuria.
122- A male with anuria brought to A&E after injury with brusing on
perineum, the digital rectal exam was normal next step
123- A pt with h/o RTA have fracture of Left lower ribs. Pt is having left
sided abdominal pain & progressive guarding of Left hypochondrium. O/E,
PR=110/min & BP 90/60. What is the next step?
Theme-24: diagnosis of GI conditions
2011
Theme-22: Investigations (Renal Stones)
Upper GI bleeding (miscellaneous)

- UGI bleeding with primary billiary sclerosis (Inv. )
- UGI bleeding with h. pylori (Mx)
- UGI bleeding with spiral forms in microscopy (BA meal)
- UGI bleeding with retching & vomiting (Mgt )
- Dyspepsia with NSAID (Erosions)
Theme-25: CT-scan findings in a Pt with hearing Loss
A- Acoustic neuroma
B- Metastatic CA breast
C- Pagets disease of bone
D- Otosclerosis
E- Cholesteatoma
F- Noise induced deafness
G- Otitis media with effusion
H- high frequency hearing loss
IJ128- 9-year-old boy CT-scan of petrous bone shows air on mastoid cells
malleus, incus & stapes normal, collection of fluid found
129- 40-year-old lady. CT petrous bone normal. Maleus & incus normal.
Cochlea with rarefaction & densities
130- 19-year-old boy with mass in the antrum resolution of some bone
131- 60-year-old man CT of petrous bone normal with both contrast
Theme-26: Diagnosis of Epistaxis
A-Septal perforation
B- Hypertension
C- ORF
D- Coagulopathy
E- Nasopharyngeal CA
FGHI-
2011
A- Achlasia
B- GORD
C- Esophagitis
D- Peptic ulcer
E- Duodenal ulcer
F- H Pylori
G- Strongyloides stercolaralis
124- Pt with pain in epigastrium endo scopy confirm spiral shaped
organisms.
125- Change of epithelium from columnar to
126- Female with pain in epigastrium at night relieved by eating.

Sheep farmer with epistaxis
Boxer with gurgling sound & epistaxis
Chrome factory worker with epistaxis
Old man with epistaxis
Young girl with h/o bleeding fol. dental extraction
ENT Miscellaneous Qs
A- CA maxillary antrum
B- Sarcoidosis
C- Nasal polyposis
-Man with swelling over cheek.& signs/symp of ca maxillary sinus
-Sheep keeper got a polyp in nose
Theme-27: Red Eye Investigation

A- X-Ray orbit
B- Conjunctival swab cytology
CD- Fluorescin stain
E- Refer to ophthalmologist
FG- Fundoscopy
H- Measure IOP
138- Hedge gardener develops sudden photophobia & blepharospasm
139- A man working of a metal factory c/o something in his eye
140- Pt with herpes zoster c/o ophthalmic shingles terrible conjunctivitis &
is unable to close eye
141- Headache, photophobia, diminished vision
Theme-28: Prenatal screening [Repeat]
A- Downs syndrome
B- Cystic fibrosis
C- Duchennes muscular dystrophy
D- Spina bifida
E- Spinal muscle atrophy
F- Patau syndrome
G- Klinefelters syndrome
H- Webers syndrome
I- Multiple sclerosis
J- Neural tube defects
143- Raised AFP & very high HCG
144- Previous sibling has some disease now mother pregnant with boy &
she wants to know whether the new comer will have it
145- Raised HCG & low AFP
146- Previous child has recurrent infection & below percentile. Mother
wants to know whether next child has it
147- This disease is related with increased risk of Alzheimers disease
2011
132133134135136-

148- Pregnant mother given folic acid to prevent some disease.
Theme-29: Treatment of STDs
149150151152153-
Essential drug to be included in Gonococcal cervicitis

Lady with Chlamydial Infection
Drug Rx in Pregnant lady with Chlamydial infection
Lady with bacterial Vaginosis
Lady with candidiasis
Theme-30: Next step of management GYN

A- Cervical smear
B- Cervical biopsy
C- Laporoscopy
D- Per speculum exam
E- Colposcopy
F-
155- Lady with diagnosed CIN-1. CA cervix 6 months back now comes for
follow up
156- Lady with CIN-2 diagnosed 6 month back now comes for follow up
157- Post menopausal women with bleeding & dyspareunia
158- Pre menopausal women with ectropion & bleeding
Theme-: Miscellaneous Qs Diagnosis GYN

A- Stress incontinence,
B- Urge incontinence
C- True incontinence
D- Fibroids
E- Ectopic pregnancy
F- Endometrial carcinoma
G- Uretro vaginal fistula.
H-
2011
A- Single dose long acting Penicillin

B- Ciprofloxacin
C- Doxycycline
D- Erythromycin
E- Metronidazole
F- Topical co-trimazole
G- Nystatin oral
H- Steroids
After surgery dripping of urine

Lady presented with urine voided on coughing.
Africo-caribian lady with problem of heavy menorhagia.
Post menopausal women with bleeding pervaginum
Theme-31: Epidemiology in Psychiatric disorders

A- Depression
B- Schizophrenia
C- Obsessive Compulsive Disorder
D- Anorexia Nervosa
E- Bulimia Nervosa
F- Anxiety
G- Starvation
H- Alcohol
I- Drug Addiction
163- Most commonly seen in developed countries where the females are
more conscious than men about weight gain.
164- The psychiatric disorder occurs less in elderly & 4-time more in
women.
165- A student preparing for the exam for the last 4 weeks & having
weight loss of 10 kg. But feeling perfectly alright.
166- A business man presents to you having trouble sleeping & poor
appetite Due to some changes in his business.. dont remember exactly.
167- This disease is more common in females increases as age advances
Theme-32: Causes of confusion
A- EDH
B- Hypothyroid
C- Alzheimers
D- UTI
E- DM
F169170171172173-
Confusion with intake of drugs prescribe for his parents

Alcoholic with confusion
Confusion with increased forgetfulness
Confusion with incontinence
Confusion with constipation hoarseness hypotonia
Theme-33: Alcoholism & Drugs Addiction

A- Less coffee
B- Starvation
C- Diazepam
D- Admit
E- Methadone
F- Chlorpromazine
G- Benzodiazepines
2011
159160161162-

H- Increase oral vitamin doses
I- Naltraxone
JK-
Theme-34: Treatment in skin lesions (Eczema)

A- Hydrocortizone 2%
B- Topical antibiotis
C- Topical hydrocortisone 1%
D- Systemic steroids
E- Topical aciclovir,
F- i/v aciclovir,
G- Oral aciclovir,
H- Flucloxacillin,
I- Emollients
J- Carbamazepine
K- Amitryptaline.
185- A boy with eczema wiping vesicles, redness.......etc
186- A boy with eczema, intense itching & scratch marks
187- A man with eczema that topical hydrocortisone 1% did not help
188- A child with herpetic whitlow come with some blisters over the trunk,
Rx?
189- 80 yr old lady with herpetic rash appearing 5 days back on the back
of her trunk. Rx.
190- HIV with herpes
191- Qs about Herpetic neuralgia
192- Pregnancy with shingles
Miscellaneous EMQs
193- Factory worker with loss of wt thickened plueru etc
194- African with supra clavicular LN enlargement & weigh loss
Chest pain
2011
175- Shaking after alcohol abstinence

176- Alcoholic been to support groups before & not helped. Wants to give
up alcohol
177- An alcoholic who was on a 36 hr non stop alcoholic binge, came to
A&E after 2 days(when he didnt drink )but he is prone to getting violent
when drunk,. He comes with drowsiness
178- An alcoholic who has features of Korsakoffs comes with auditory
hallucinations; he is already taking oral vitamin supplements.
179- Cocaine user willing to stop
180- A heroin addict wants to quit
181- Student with more tremors before exams
182- Old man with nutritional deficiencies
183- Delirium tremens treatment

Angina MI Peptic ulcer
195- A young man p/w pain in chest radiating to left jaw
196- Old man p/wpain in epigastrium related to exertion
198- Appendicular mass in child afebrile management
Answers November 2003
1
2
3
4
5
6E
7B
8A
9C
10 G
11
12
13 E
14
15
16 E
17 C
18 A
19 A/D
20 C/F
21 C
22 A
23 B
24
25 I
26 D
27 B
28
29 I
30 F
31
32
33
2011
197- Lady with breast cancer presents with confusion investigation,

S. calcium
Dexa bone scan
S. urate
bone X-rays
H
J
I
L
B
C
D
H
F
B
D/C
G
C
H
C
F
E
B
A generalized convulsions
C
C
G
B
G
F Infective endocarditis
C
C
A
B
D
F
F
H
E
C
E
M
J
C
2011
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
A
K
C/K
A/H
? As Berette,s Oesophagitis was not in options
G
C
A
E
B
D
2011
88 F
89 E
90 A
91
92 B
93 C
94 A
95
96 C s/s of perforation of diverticultitis
97
[snip] E
99 D
100 F
101 B
102 D/A
103 C
104
105
106 D
107 E
108 A
109
110 D
111 E
112 G
113 D
114 C
115 ? acute pyelonephritis
116
117
118 M

D
A
E/B
H
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
A
D
F
E
A
G
A
D/A
C
A
J
A
C/D
D
E
F
A
E
G
E
A
C
D
B
C
E
A
B
C
C
B/C
A
2011
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
F
J/K
E
mesothilioma
TB
2011
189
190
191
192
193
194
195
196
197
198
199
200
conservative management
Sep. 2003
Theme-1: Non Accidental injuries
A- Child physical abuse
B- Normal
C- Accidental injury
D- Malnutrition
E- Sexual abuse
F- Elderly abuse
G- Henoch Schenlon purpura

H- Idiopathic thrombocytopenic purpura
Theme-2: Investigations of Hoarseness

A-No investigations
B-Laryngoscopy
C-Lateral neck x-ray
D-Fiberoptic Laryngoscopy
E-Chest radiograph
F-Bronchoscopy
G7. A singer is having hoarseness of voice since the past 6 moths. What
investigation will you do next..
8. A man reports to the A & E with hoarseness of voice. He had been to a
football match the previous night. Next investigation..
9. A 60 yr chronic smoker complains of hoarseness of voice, shortness of
breath, cough. Laryngoscopy is normal. Next investigation.
Theme-3: Bites Initial management

A- Tourniquet
B- Anti-rabies
C- Wash with soap & water
D- Anti-histamines
E- Adrenaline
10. Bite by weaver fish - ?
2011
1.A few days old child has multiple dark bluish patches on the buttocks.
The maternal grandparent is worried. The child's mother is white & the
father black.
2.A 10 yr. girl is confused and has repeated fresh bloody staining of her
panties. She is also reported to have incontinence of urine. Her parents
think it could be due to her recently joining horse riding lessons.
3. A girl is unable to move her leg, which is swollen on examination X-ray
reveals a spiral # femur, with no callus formation.
4. A 8 yr old ran into a door & hit his forehead & there is no loss of
consciousnesses. He develops a swelling & pain on the head.
5. A 7 yr old is brought to the A & E with repeated bruises on his hand &
wrists. Parents are having some bleeding disorder. On doing a
venepuncture for taking blood, the kid develops a big bruise at the site.
6. An old man living with his daughter comes for the third time with
bruises on his forearm & face

11. Bite by a bee to a woman who has severe reaction previously, now in
stridor
12. Pt with dog bites.
13. An 8 yr old bites his elder brother.
2011
Theme-4 : Stroke Prevention

A- Blood pressure control
B- Cholesterol reduction
C- Carotid end arterectomy
D- Warfarin
E-Manage in Stroke rehabilitation unit
F-Aspirin
G-Heparin
H-Weight Control
14. A patient having hemorrhagic shock. Now you want to decrease the
further morbidity
15. A pt. with stroke, which would help improve in life from morbidity.
16. A pt. has TIA., CAD & ___. Which measure will help reduce mortality.
17. In a pt. with Atrial fibrillation & h/o TIA, which measure helps in
decreasing mortality.
18. A pt. with 80% carotid artery stenosis. He will have improved survival
if
Theme- 5: PPH - Initial most appropriate step
A- Ergometrine iv
B- Syntocinon Infusion
C- Inspection of placenta
D- Give fluids
E- Give blood
F- Genital tract examination under GA
G- USG Pelvis
H- Syntometrine iv.
I- Ergometrine IM
J- Intramyometrial prostaglandin
K- Oxytocin
20. PPH after forceps delivery, Uterus is fully contracted & placenta
complete 21. A 34 yr female has had postpartum hemorrhage during the last two
deliveries. Now what will you do after the delivery of the baby in the
present pregnancy.
22. A 28 yr female pt. bleeds 600-ml after delivery of the placenta. Next
step.
23. A lady with fever & discharge after 10 days of delivery Theme-6 : Thyroid management
24. 70-year lady with TSH 4 times normal

25. A woman with signs of graves disease & asthma
26. Lady with goiter, no symptoms & the tests are also inconclusive
27. A man with a 2 cm discrete nodule in the right thyroid
28. Pt having 2-cm swelling in the neck moves with swallowing. What
investigation do you do to be sure it is not malignancy.
29. A pt. with loss of wt. despite appetite, increased sweating, diarrhoea is
an asthmatic. TSH decreased but increased T3, T4, on investigation. Next
step in treatment is. ______?
30. A pt. with a simple goiter. No signs of hyper or hypothyroidism. No
antibodies to thyroid. TSH, T3, & T4 are normal.
Theme-7: Eye management & steps taken to stop further eye problems
A-Eye surgery
B-No management
C-Oral steroids
D-Beta blockers
E-Laser photocoagulation
F-Observation
31.
32.
33.
34.
35.
Lady with headache & vision loss

80 year old man with vision loss
Man with haloes around light
Woman suffering from SLE, & lens opacity
Diabetic with Proliferative Retinopathy
Theme-8 Psychiatry
A-Multi infarct dementia
B- Pseudo dementia
C-Alzheimer's dementia
D-Delirium
E- Frontal dementia syndrome
F-Schizophrenia
G- Depression
H37. A 80 yr. female is healthy & being taken care by her neighbours. They
say that she is trying to go shopping at 4 am in the morning. They think
2011
A- FNAC
B- Carbimazole
C- Thyroxine
D- Observation
E- Explore immediately
F-Propranolol
G-Thyroidectomy
Theme 9: Psychiatric epidemiology

A-Multi infarct dementia
B- Pseudo dementia
C-Alzheimer's dementia
D-Delirium
E- Frontal dementia syndrome
F-Lewy body dementia
G- Depression
H44. Most common dementia in UK
45. This dementia is characterized by neurofibrillary tangles & senile
plaques.
46. A pt. is depressed & dementiated & responds a little to
antidepressants.
47. Dementia with hypertension
48. Dementia with Parkinsonism like signs -
Theme-10: Causative agent

A-Streptococcus pneumoniae
B-Mycoplasma pneumoniae
C-Staphylococcus Aureus
D-Streptococcus pyogenes
E-Clostridium difficile
2011
that she is otherwise normal, except that her memory is not as good as
before, & they think it may all be do to her old age.
38. A man living alone collapses, is brought to the hospital. After 3 days he
starts talking to people whom others cannot see. He is not oriented in time
& place.
39. A 45 yr man develops a viral infection. He has cough & fever since 2
days. His wife tells that he is confused & has decreased concentration &
has no orientation about the place or time. She says he was alright one
day before.
40. An elderly pt. with recurrent faints, with deteriorating mental
functions.
41. A 40 yr female brings her husband to the A & E He talks about their
sex life, but does not care about the problems at home which his wife tells
about..
42. A 70 yr man says that his life is not worth living & asks others not to
talk about him as it was a waste of their energy & time & he is not worth it
too. He does all his work very slowly & has lost 5 kgs of wt.
Theme-11: Side effects of anti-psychotics

A- Lithium
B- Amitriptyline
C- Chlorpromazine
D- Imipramine
E- Phenelzine
F-Fluoxetine.
G-Clozapine
H55. A Schizophrenia pt. develops decreased WBC count, sore throat &
increased sedation after being on a drug.
56. A pt. of mania is on a drug to prevent it as prophylaxis. she develops
polyuria & other symptoms. Decreased TSH Increased T3 & altered T4.
57. Drug which causes Malignant hyperpyrexia
58. Drug which has anticholinergic side-effects
59. A schizophrenic female is on some drug, she develops discharge from
breast & loss of libido.
60. A pt. of depression on a drug develops tremor, Blurred vision, dryness
of mouth, eyes, tachycardia.
61. A Schizophrenic is on a drug, she develops tremors, Increased
temperature, increased muscle Creatine kinase, Increased WBC.
Theme-12: Side effects of drugs
A- Rash
B-Reye's syndrome
C-Bronchoconstriction
D- Liver demage
E-Dry mouth
63. Tricyclics
64. When aspirin is taken by 6 year old child
65. Ibuprofen
66. Chlorpromazine
67. A 30 yr female swallows 12 gm of Paracetamol tablets, after a heated
argument with her husband.
Theme-13: Mechanism behind
A-Drugs
B-Cilliary immobility
2011
50. A 8 yr boy has cellulitis in his both hands with well-demarcated edges,
pyrexia & increased WBC
51. A 24 yr old with dry cough, skin manifestations & bone, muscle aches.
C X-ray shows patchy shadows.
52. A 60 yr male has pyrexia & an axillary abscess.
53. A patient in hospital is given a 3rd generation cephalosporin & it
results in diarrhoea & other symptoms due to it. Most probable

C-Decreased immunity
D-_____ Channel blockade
E-Nasal polyps
F-Eczema
67-D, 68-? 69-? 70Theme-14: Skin conditions

A-Lentigo maligna
B-Solar keratosis
C-Malignant melanoma
D-Kaposi's sarcoma
71. A 16 yr girl has many multiple coloured moles of various sizes on the
back of her trunk.
72. Farmer with skin problems
73. Man with a brown patch on forehead skin which grows slowly
74. HIV with?
71-A/C, 72-B, 73-A, 74-D
Theme-15 : Joint problems
A-Psoriatic arthropathy
B-Degenerative Osteoarthritis
C-Chondromalacia patella
D-Septic arthritis
75. An old patient has knee pain for 10 yrs but knee is not hot & swollen
-?
76. A patient on steroid, has hot & swollen knee -]
77. A man with 10 years pain in joints 78. Pitting of the nails with arthropathy of distal interphallangeal joints
Theme-16: Myocardial infarction

A-Atropine
B-Pacemaker
C-Streptokinase
D-Altepase
E-Valve replacement
F-Nitrates
G-Angiography
H- Pacemaker replacement
I- Naproxen
J-Steroids
79. Myocardial infarction but no chest pain
80. Myocardial infarction with Heart block
2011
68. Mechanism behind Cystic fibrosis. .

69. Broncholitis in children Mechanism.
70. Asthma in infants. Mechanism.
Theme-17: Blood
A- Pernicious anemia
B- Aplastic Anemia
C- B12 deficiency
D- B12 malabsorption
E86. A 40 yr vegetarian presents with Macrocytosis, plasma folate levels
are normal.
87. A known pt. with antibodies to intrinsic factor shows R B C of large
size.
88. A pt. on treatment with Cyclophosphamide has anemia with decreased
WBC count & decreased platelets.
Theme-18: Vaginal bleeding Investigation of choice

A- Cervical inspection
B- Cervical smear
C- Endometrial sampling
D- Hysteroscopy
E- Pregnancy test
F- USG
G- Gonadotrophin levels
H- Endometrial swab
89. A woman with irregular vaginal bleeding for 3 months, cervical smear
6 months ago was normal. what is the investigation of choice)
90. A Ca. Breast pt. is on tamoxifen & has vaginal discharge. Next step.
91. A 49 yr old presents with a 9 month history of prolonged slightly
irregular periods. On clinical examination. normal sized uterus with no
adnexal masses. Next investigation.
92. A 52 yr woman presents with a history of offensive vaginal discharge &
intermittent vaginal bleeding over the past 3 months. her last cervical
smear was taken 4 years back. Next step.
93. A 26 yr old with a 6 wk history of amenorrhoea presents in the A & E
with vaginal bleeding. U S G has an empty uterus.
94. A 24 yr female is on OCP for 6 months without any problems. She
changes her partner 2 wks back. She develops inter-menses bleeding &
discharge. Investigation.
2011
81. Myocardial infarction with murmur

82. A pt. with chest pain, ECG showed T wave depression in L III, aVF & L II
has pain & nausea for 2 hrs & it subsidies completely. Now he presents in
the A & E after one hour. What do you give next.
83. A pt. develops chest pain, which subsides. He has an ejection systolic
murmur, BP 110 /60-mmHg, low volume pulse. The Next step.
84. A pt. recovering from MI, collapses & O/E has a pulse of 36 / min. Next
step.
85. A pt. develops pyrexia & pleural effusion one week after inferior
Myocardial infarction.
Theme- 19: CA breast management
96. A 35 yr woman on 1-yr treatment for breast cancer with 12/20 lymph
nodes positive, presents with a history of increasing confusion. She is
drowsy & disoriented. Her husband reports of her complaining of severe
thirst for the past week.
97. A 50 yr female pt. with Ca. Breast has metastases in the lumbar spine
& has back pain.
Theme- 20: Renal area involvement
A- Renal interstitium
B- Renal cortex
C- Renal medulla
D- Renal papilla
E- Bladder
F- Urethral
G-Prostate
H-Ureteric
[snip]. In sickle cell anemia which part of the kidney is involved.
99. A pt. with chronic hypertension, which part of the kidney is involved.
100. A pt. has dilated calyces & renal pelvis (hydronephrosis). Urinary
bladder is full. He has incontinence. Cause is.
101. A female pt. presents with edema & proteinuria. Defect lies at
102. A 70 yr old man has difficulty in passing urine, nocturia & dribbling.
The site of the defect is.
Theme-21 : Trauma next step
A-# reduction
B-. Immediate removal of plaster
C- Tapping out Blood
D- Angiography
E- Rapid I V fluid bolus
F- Splint the femoral #
104. Patient with RTA. has a # in the tibia. A POP cast is applied. He
develops severe pain & loss of pulse below the cast. Next step.
105. A pt. has # at the head of fibula. P O P cast is applied & he is put
under observation. After 8 hrs he develops foot drop. Next step.
106. A motorcyclist arrives in the A & E after a R T A. Airway is patent. He
has deformed thigh on the Lt side. Next step.
2011
A-Radiotherapy /
B-TENS
C-Bisphosphonates
D-

107. A 23 yr old has a RTA. He is confused & smells alcohol.
108. A sportsman injures his knee. At the hospital, it is noted to be very
painful to movement, & is swollen & has haemarthrosis. Rx. Tapping out
Blood.
A-Metabolic acidosis
B-Hypokalaemia
C-Metabolic alkalosis
D110. A pt. with villous adenoma has profuse diarrhoea & is dehydrated.
111. A 45 yr man with pyloric stenosis has profuse vomiting & shows
increased plasma HCO3 levels with hypokalaemia.
Theme-22: ENT (vertigo-hearing loss, tinnitus)

A- Anxiety
B- Vestibular Neuronitis
C- Migraine
D- Acoustic Neuroma
E- Meniere's disease.
F112. A 35 yr female develops vertigo every day, just before she has to
leave to office..
113. A 40 yr pt. has hearing loss & vertigo, but as days pass hearing loss
becomes more prominent than vertigo..
114. A pt. develops URTI following which she develops vertigo.
115. A 40 yr old presents with recurrent episodes of deafness & tinnitus..
Theme-23 : Head Injury

A- Brain stem injury
B- Cerebral hemorrhage
C- Depressed # skull
D- Extradural haematoma
E- Intracerebral haematoma
F- Acute Subdural haematoma
G- Chronic Subdural haematoma
H-Extradural hemorrhage.
I-.
117. A pt. is hit on the head by a hammer & has vomiting...
118. A young man fell over & there is an injury over his temple. He is alert
& conscious.
119.A pt. with GCS-3, Bilaterally dilated pupils is on ventilator after RTA.
Pulse 58/min, B P 110 / 80.
2011
Theme-:

120. A 40 yr man sustains a head injury & becomes unconscious. Then he
recovers to go home where after 3 hrs his wife finds him unconscious.
A-Chest X ray
B-VQ scan
C-Surgical exploration
D-Observation
E121. A patient already on steroids now having shock postoperatively?
122. pt. undergoes caesarean section for the delivery of a child. After 10
days she presents with bleeding. On USG, there is hemoperitoneum. Next
step.
123. A 65 yr man after 10 days post hip replacement surgery presents
with sudden breathlessness & collapses. On examination pleural rub,
increased JVP, swollen right leg are seen. Next investigation.
124. A 70 yr gardner collapses while doing garden work. Afterwards O/E he
is noted to be in profound confusion.
125. A man with hydrocele undergoes tapping. After one day he is pyrexial
& the swelling has re appeared.
Theme- 25: acute abdomen
A-Abdominal X-ray
B-Barium enema
C-Small bowel enema
D-Mesenteric Angiogram
E-Chest X-ray
126. A 1 yr boy presents with vomiting, central abdominal pain with
distention. He has blood & mucus per rectum.
127. a pt. has intermittent Abdominal pain, 30 min after meals. He also
has a history of pain in the abdomen radiating to the back, O/E there is an
abdominal bruit. The pt. also has intermittent claudication.
128. A 45 yr woman complains of abdominal pain. She has been having
altered bowel habits recently. On examination the thickened sigmoid colon
is palpable.
Theme: Mixed
130. A 5-year-old child comes with vomiting & confusion with 2 rashes
behind his neck (Investigation)
131. A person is admitted in an I T U for being comatose. He has recently
been on a holiday trip to Ghana. Next investigation.
132. A premature baby develops diarrhoea with blood in stools, after she
is fed on formula feeds on the 4th day.
133. A 48 yr female is an IDDM pt., has been on treatment for 20 yrs. She
has recurrent 3 episodes of hypoglycemia. She is on the same dose of
insulin. Diagnosis.
2011
Theme-24: Post-operative complications
142. A pt. is confused & drowsy, he has flapping tremor & asterexis. What
do you investigate for..
143. A pt. has a pan-systolic murmur, increased JVP, liver is palpable 3 cm
below the rib margin.
144. A 4-month child develops dribbling of saliva from the mouth. He has
severe abdominal pain & is pyrexial & refuses to eat or drink...
Theme-: Kidney investigation
A-Plasma Urea
B-Electrolytes
C-Serum Creatinine
D-Plasma glucose levels
E-IVU
F- Cystoscopy
G-Mid stream urine culture
H-Urethral swab
151.A pt. who has been normal has glucosuria & mild ketonuria..
152. pt. who has never been to the hospital has a RBS 17.5 m mol / l . She
has mild proteinuria & on ophthalmoscopy there is non Proliferative
retinopathy...
153. A female child presents with frequency & dysuria. It's the 3rd such
episode. On culture of urine E.coli are seen...
154. A man has pyrexia, dysuria & pus at the external urethral meatus.
Both testes are swollen & tender.
Theme- : Urinary Retention
A-Spinal cord compression
B-Renal Failure
2011
134. A 67 yr diabetic on Metformin C/O severe epigastric pain, drowsiness

& confusion. Diagnosis.
135. A 60-yr female pt. suddenly collapses while shopping in a
supermarket. Her daughter says that her face was pale just before
collapse. What could be the likely cause.
136. A 44 yr female undergoes hystrectomy under General Anesthesia
after the surgery she complains of breathlessness & increased JVP.
Diagnosis.
137. A pt. with irregular pulse, radial pulse rate is 90 / min. Next step..
138. A 22 yr old is involved in a R T A & is brought to the A&E. He appears
stable, but while sitting up & talking he becomes progressively breathless.
Reduced air entry on the Lt side. Next step.
139. A 24 yr woman who is taking O C pills for 5 months presents with
palpitations & On examination he has a diastolic murmur & a thrill. Next
step.
140.A 32 yr woman on OC pills for 9 months develops swelling of legs,
pain in the calf, bilateral pedal edema. Investigation.
141. A 20 yr old has been taking OCPs since the last 5 months. She comes
with a history of cough producing green sputum & fever over the last 2 - 3
days. Next investigation.
1- B/A,
2- E,
3- D,
4- C/B,
5- H,
6-F
7-B/A
8- A
9- E/F
1011- E it may be life saving as anaphylaxis
12- B/C
13- C
14- E
15-E
16-A/B/H
17- D/F/G
18- B/A/C
20- F,
21- J/I,
22-A/I/J,
23-G (endometritis)
24-C,
25-B,
26-D,
27-A,
28-A,
29-F/B,
30-D/G/A
31- C,
32- B,
33- D,
34- A,
35-E
37-C,
38-D,
39- D,
40- A,
41 E,
42- G
44-C,
45- C,
46-B,
2011
C-BPH
D-CA Prostate
155. A 50 yr female pt. with mild jaundice is not able to pass urine, she is
confused, tired & has hiccups.
156. A pt. with malignancy develops weakness of both legs with difficulty
in walking. There is urinary retention.
157. A pt. with hesitancy during micturition, nocturia has a large amount
of alcohol & presents with retention of urine.
2011
47-A,
48-F
50-Erysiplelas by D,
51-B/A,
52-C,
53-E
55-g
56-a
57-c
58-b
59-c
60-b/e/f
61-c
63-e,
64-b,
65-c,
66-a,
67-d
75-C,
76- D Septic arthritis [As steroid leads to increased susceptibility to
infections
77-B,
78-A
79-C
80-A/H
81-E
82-?
83-E/G
84-?
86-c
87-c/a
88-b
89-c
90-?
91-g
92-a
93-e
94-?
96-c
97-?
[snip]-d
99-?
100-e/f
101-?
102-g
104-b
105-?
106-?
107108-c
110-b
111-c
112-c/a
113-d
2011
114-b
115-e
116-e
117-d/c
118-a/b
119-?
120121-?
122-c
123-b
124125-c
126-e/a
127-d
128-b/c
129130130- Blood culture
131 Thick & Thin Blood Smear.
132.?
133. Possible infection.
134.. Lactic acidosis.
135. Cardiac rhythm disturbance / T I A / Postural hypotension.
136.. Fluid overload.
137. Digoxin / Heparin / Warfarin.
138.. Chest drain after needle thoracocentesis
139. Next step. Echocardiography.
140.. Duplex ultrasound scanning.
141. C X-ray.
142. Liver function tests / Liver ultrasonogram.
143.. Investigation/RX
144. Gingivostomatitis / Intestinal obstruction.
145146147148149150151-D
152-A/B/C
153-E/F
154-B
155-A
156-C
2011
July 2003
PLAB Part 1 Exam
Theme-1 : Perianal diagnosis:
A. Anal Fissure
B. Hemorrhoids
C. Crohns disease
D. Ulcerative colitis
E. Perianal Haematoma
F. CA Rectum
G. Diverticulosis
H. Proctalgia Fugax
I. Anorectal Abscess
J. Coeliac disease
K. Fistula in ano
L. Hirschsprungs disease
Theme-2: Abdominal pain:

A. Renal Colic
B. Crohns disease
C. Acute Cholecystitis
D. Perforated peptic ulcer
E. Diverticulitis
F. Appendicitis
G. Appendicular mass
H. CA Stomach
I. Cholecystitis
J. Acute pancreatitis
K. Ectopic pregnancy
6. A 19-years-old girl with fever abdominal pain which soon radiates to
right lower quadrant. There is gardening in the right iliac fossa
7. A 20 year old lady presents with, shock & lower abdominal pain &
bleeding. O/E tenderness in left iliac region. She is also having
amenorrhea since 8 weeks.
8. A 32 year old pt presents with severe pain in loin radiating to groin.
9. A middle-aged women with peptic ulcer develops hematemesis. O/E
tender abdomen & she is in shock.
10. A 40 year old woman with upper abdominal pain & vomiting, O/E
diffuse abdominal tenderness was found.
Theme-3: Mechanism of action of contraception:
A. Kills Sperms
B. Post coital contraception
C. Decrease tubal motility
D. Prevents implantation
E. Prevents ovulation
F. Inhibiting transplantation
G. Thickens Cervical mucosa
H. Anti-sperm antibodies
I. Blocks spermatogenesis
2011
1. A young lady gives the h/o fecal shooting with sudden; sever deep
rectal pain lasting for a few minutes at night. Digital rectal exam is
normal.
2. A 25 year old man with constipation & severe anal pain during
defecation. Pain is so severe that cannot even allowed digital rectal
examination.
3. A 32 year old female with very severe anal pain, o/e purple swelling at
anus which is mildly tender. This started 2-months ago after her first child
birth.
4. A 40 year old smoker with diarrhoea abdominal pain, weight loss, rectal
bleeding & barium enema shows colonic strictures
5. A 45 year old man with anal pain on defecation, weight loss & change in
bowel habit. Rigid sigmoidoscopy shows an ulcer 5-cm above the rectum.

POP
IUCD
Mirena
Sponge plus spermicide / spermicidal Jel used in vaginal barriers
COC
Emergency Post coital progesterone alone pill
Depo-Provera
Theme-4: Management of upper GI / H. Pylori:

A. Fundoplication
B. Triple therapy
C. Metronidazole
D. Ranitidine iv
E. Sucrulfate
F. Partial gastrectomy
G. Lansoprazole
H. Misoprostol
I. Pancreatectomy
J. Upper GI endoscopy
K. Send for H. pylori serology
L. Reassurance
18. A pt c/o epigastric discomfort, bloating after meals o/e epigastric
tenderness & in Endoscopy H Pylori was found.
19. A 55 years old male c/o dyspepsia, dysphagia, & weakness. H/o weight
loss. O/E; epigastric mass was found. On UGI Endoscopy shows a tumor in
antrum & beginning of duodenum.
20. A pt with epigastric pains, on esophago-gastro-duodenoscopy was
found to have ulcers in esophagus, gastric mucosa, & duodenum, also
later on ultrasonography a consolidated tumour was found in pancreas. he
has tried other therapy.
21. A severe burn victim with multiple superficial gastric ulcers five days.
22. A pt with joint pain & on NSAIDs for arthritis , now has epigastric pains.
23. An obese pt with complain of regurgitation & otherwise normal. In
upper GI Endoscopy no sign of stricture
24. Long time with peptic ulcer, comes now with epigastric pains,on lab
testing is found negatively spiral organism
Theme-5 :Hypertension:
A- Admit & observe
B- Serum Urea & electrolytes
C-Ultrasound abdomen
D- Aldosterone
E- Serum creatinine
F- Serum Phosphorus
GHI25. 18 yrs old boy is found to have hypertension on routine check up, O/E
there is a murmur maybe there is radio-femoral delay.
2011
11.
12.
13.
14.
15.
16.
17.
Theme-6: Management of Head Injury:

A- Reassure & discharge
B- Admit & observe for 6 hours
C- Discharge with advice
D- Intravenous fluids
E- Intubate & ventilate
F- Elevate the skull fracture
G- Oropharyngeal airway
H- Suction of skull vault,
I- Immediate CT scan
J- Monitor ICP
K- Urgently take to operation room
L- Burr hole
M- CT & observe
N- Lumbar puncture
32. An 8-year-old boy falls off a swing at his school. He is brought to A&E
by one of his teachers. He has a bruise over his scalp but the examination
is otherwise normal. He is fully conscious GCS-14 & with no history of
blackouts since the accident. A skull X-ray is performed, which is normal.
33. A young man involved in fight & hit by baseball bat on the back of his
head. Skull X-ray revels depressed fracture of occipital bone, its not
compound injury, GCS initially was 14 but falls rapidly with in an hour. He
has been intubated but he was getting worse.
34. A pt after RTA comes with depressed occipital fracture & a
haematoma. His GCS was 15, after some time he develops fit
35. Middle aged man fallen & had temporal area lacerations. His GCS-14.
X-Ray Skull shows no fractures.
36. A pt with small skull fracture with GCS-15 & no other neurological
signs.
37. A 36-year old male with the h/o recurrent falls & head trauma presents
with GCS-14, normal neurological signs, & he smells of alcohol.
38. An 18-tear-old girl fell off horse & lost consciousness, CT showed; no
intra cerebral hemorrhage, but she has diffuse cerebral oedema. (she has
bilateral papilloedema)
39. A child, with neck stiffness, consciousness preserved, came to A&E
with fever.
Theme-7: Infectious diseases:
A- Lyme disease,
B- Brucellosis,
2011
26. A person, who was noted to have high blood pressure but after one
week his blood pressure is normal
27. A 25 year old pregnant lady in first trimester with BP- 150/80, on urine
RE: positive proteins, casts, & white cells.
28. A woman have hypertension in third trimester of pregnancy
29. A man having hypertension was normal two weeks ago in his job
30. Prescribing HTN Rx in diabetic pt.
40. A pt coming back from South America (Mexico) presents with night
sweets, fevers, muscle weakness & in CXR there are upper zone
shadowing
41. A pt coming back from holiday in a farm presents with malaise &
fevers & spleenomegaly
42. A pt coming back from Africa complains of recurrent fevers, loss of
appetite & fits D
43. A prisoner with fevers night sweats & malaise & lymphadenopathy
44. A pt with haemoptysis & cough story like TB but chronic without travel
history
45. Women came from Gambia, gives the H/O weight loss, fever,
heamoptysis
Theme-8: Causes of Obesity:
A- Cushings
B- Type-II DM
C- Obstructive Sleep Apnea
D- Type-I DM
E- Alcohol
F- Hypothyroidisim
G- Polycystic Ovary Disease
46. Changing in diet & weight loss may relieve all symptoms & even helps
to stop the medication of this receptor mediated disease
47. All S/S of this disease like obesity will resolve after curative surgery in
woman
48. All symptoms of this disease like sleepiness during days & improve the
family relations (matrimonial harmony) will resolve if obesity is controlled
49. Stop of this would help in weight loss & vitamin deficiency
50. Surgery will help prohibit the sensitivity of certain receptors.
Theme-9: HRT prescribing for menopausal symptoms:

A. Vaginal estrogen cream
B. Cyclical estrogens & progesterone HRT
C. Continuous HRT
D. Clonidine
E. COCP
F. Combined OCP
G. POP
H. Estrogen patch
2011
C- Plasmodium vivax,
D- Plasmodium falciparum,
E- Plasmodium Malaria,
F- Tuberculosis,
G- Lymphoma
H- Bronchial CA

I. Alendronate
J. Bisphosphonate
Theme-10: choice of Investigations:

A- USG / sono
B- Blood sugar
C- CXR
D- Swab of discharges
E- Arthriography
F- Lumbar puncture
G- Serum Electrolytes
H- CT scan
57. A pt with symptoms of Gonococal urethritis
58. A pt with weight loss & polyuria
59. A pt with pulse delay in legs compared to arm
60. A 30 yr old fit lady with a sudden sever headache with no fever or neck
stiffness
61. A 50-year old woman pt with H/O photophobia, neck stiffness,
recurrent hemianopia now came with bilateral headache, No sign of ICP
raising, Eye signs are negative, may had fever too?)
62. A young lady, wants to be thin, vomits by inducing herself, develops
confusion & __
Theme-11: Accidental injuries in children:
A- Congenital
B- Accidental injury
C- Non accidental injury
D- HSP
E- Normal finding
F- ITP
G64. A girl was brought to A&E by her step father with bruises on her
waistline & ankles.
65. A child with pharingitis & purpuras on the back of his thigh & buttock.
66. A child with swelling on wrist after injury.
2011
52. A 48 years old woman with menstrual irregularities, mood swings

flushing since 8-months, needs HRT
53. A 54 years old woman 2 years post monopause with hot flushes needs
HRT
54. A female who has had total hystrectomy & bilateral salpingo
opheractomy, now feels flushes, cant take something orally, what to give
55. A 59 year old woman uncomfortable with pain during intercourse &
vaginal sores
56. An elderly women brought to A&E after a minor trauma at home x-ray
revels fracture of femur, & it noted to have decreases bone density, has
had thromboembolism in past, what to give.

67. A two year old child, father Caucasian & mother is black. He has a
bluish spot on the buttocks back.
68. fell down from cycle , fracture of femur
A- USG-abdomen
BC- Jeogenal biopsy
DE- Barium meal & Follow through
FGH69. A young girl feels pain off & on, but otherwise well
70. A 2-year-old girl with failure to thrive & others symptoms like pain in
abdomen, easy fatigability, aphthous ulcer. (Coeliac disease)
71. A young boy feels pain probably in the right side of abdomen & has
diarrhoea off & on.
72. One young infant has constipation & O/E has found to have hard feces)
Theme-13: Investigation before medication:
A- USG
B- Lumbar puncture
C- Urea
D- Gamma GT
E- Electrolytes
F- Prolactine level
G- Thyroid function tests
HI73. A pt is going to start lithium therapy for bipolar disorder
74. An alcoholic is giving up. He needs lab test to evaluate his addiction
75. Pt using phenothiaines develops galactorrea
Theme-14: Prostate conditions:
A- Trans rectal USG & prostatic biopsy
B- PSA
C- Skeletal survey
D- Alpha blockers
E- Beta blockers
F- Transurethral prostatectomy.
G- TC scan
E- Isotope bone scan
F77. A 55-year-old male with BPH refuses surgery.
78. A 70 year old man with BPH & obstruction.
2011
Theme-12: Abdominal pain in children: Next step
Theme-15: Fractures:
A- Fracture Clavicle
B- Spiral Fracture Of Radius
C- Ulnar fracture
D- Scaphoid fracture
E- Fracture of neck of humerus
F- Spiral fracture of Shaft of humerus
G- Radial head fracture
H- Colles fracture No fracture
I- Supra-condylar humeral fracture
83. 45-year old male injured his right arm after fall on outstretched hand.
He cannot lift up the the wrist from the table
84. A young man injured his wrist while playing football & now has a
painful wrist & cant move the part distal to wrist. There is tender swelling
distal to the radius.
85. A 65 year female falls by shopping bag tripped on road, fell on
outstretched hand & injured her arm. She complains of shoulder pain. O/E,
passive range of movement is restricted terminally, but is pain free.
86. A teenage boy sustains injury to his forearm & presents with painful
forearm with deformity after while fending of a blow while playing.
87. A 6 year old girl falls on her outstretched arm & sustains an injury. She
cant move her forearm. She has tenderness from arm to wrist.
Theme-16: Poisoning in children:

A. Serum oestriol
B. Serum Fe
C. Wait & observe
D. Oestrogen levels
E. Blood sugar
F. Salicylate
G. LFTs.
H. ECG.
I. Serum creatinine.
J. Observe
88. A baby was found playing with aspirin pills some hours ago
89. A baby swallowed some OCPs
90. A baby girl seen playing with red tablets which her mother used as she
was feeling weak, we are unable to contact mother at the moment
2011
79. A 40-year-old man with a family history of prostate cancer asks for a
screening. His per rectal examination was normal.
80. An old aged man with prostatic symptoms & nodule on per rectal
examination, how to diagnose
81. Having prostate cancer a 55-year-old male develops sclerotic bony
lesion in femur.
82. A pt with back pain & obstructive uropathy. ?

91. A baby swallowed some red tablets of his pregnant mother (Fe level)
(measure level)
92. A baby swallowed some TCAs
93. A boy drinks Vodka & is unconsciousness
2011
Theme 17: Investigation in testis swelling:

A- Urine R/E
B- Urethral swab for culture
C- Ultrasonography
D- Urine C/S
E- MSU
F- USG
G- PSA
H- Syphilis serology
I- Immediate Surgical exploration
J- Trans-rectal USG
95. A 30 years old pt has unilateral scrotal swelling from 3yrs,.disabling,
back pain ?
96. A 40 years old pt has a testicular swelling for 3 years / unilateral
scrotal swelling from 10 years, no change?
97. A young man has testicular swelling for 2 months.
98. A young man with sudden severe testicular pain with swelling, shock,
tachycardia.
99. A 35 year old traveler came with scrotal swelling & a h/o unprotected
sex.
Theme-18: Neurological conditions:
A- Multiple Sclerosis
B- SAH
C- MND
D- Alzheimers dementia
E- Plumar wilson syndrom
F- Stroke
G101. A pt with dysarthria & headache & dysphagia?
102. A pt with hoarseness & dysphagia develops paresis of the lower limb
103. A pt that is confined to the wheelchairs & have some neurological
problems develops blurred vision leading to blindness soon
104. A pt is confined to the bed. He got increasingly forgetful within the
last few years
105. A pt with ori creases? & dysphagia.
106. woman previously well, comes with severe headaches,, previously
well
Theme-19: Skin disorders:
107.
108.
109.
110.
A pt with a pigmented lesion with an ulcerated center

An obese pt with neuropathic symptoms develops ulcer on the leg
Skin manifestation of Crohns disease
Pt with diarrhoea & anal ulcers
Theme-20: Gynecological conditions:

AB- CA-Vulva
C- Herpes simplex
D- Candidiasis
E- Atrophic Vaginitis
FGH111. A diabetic woman with white itchy plaques on vagina & white curdy
vaginal discharge.
112. A 70 year old woman developed itching & pruritis vulva with her
vulva is white & shiny
113. An elderly postmenopausal with itchy vulva had an ulcer O/E
114. A woman with itchy vulva & lymphadenopathy
115. 107- One female has dysuria & has vesicles in vaginal area
Theme-21: Diagnosing of Chest pain:
A- Massive pulmonary embolism
B- Myocardial infarction
C- Pneumonia
D- Pneumothorax
E- Pleural effusion
F- Hydropeumothorax
G-Tietz syndrome
H- Broncheictasis
I- Emphysema
117) Pt coming to A&E & had the following findings:
PR: 92
BP: 120/82
TEMP Afebrile, 370C
JVP: Raised
CXR: Normal
ECG: Inverted T-waves in lead III.
118) Pt coming to A&E had following findings:
2011
A- Pyoderma gangronosum
B- Diabetic ulcer
CD- Melanoma
EF-
119) Pt coming to A&E had following findings:

PR: 95
BP: 142/82
TEMP: 39
CXR: Mid zone consolidation.
ECG: Normal.
120) Pt with following findings:
PR: 85
BP: 139/86
TEMP Afebrile
CXR: Absence of vascular markings over the right lung field.
ECG: Normal.
121) I am sorry not able to recall, any way i think it was on pleural effusion
or pneumothorax
PR: __ ?
BP: __ ?
TEMP Afebrile
CXR: Plural effusion.
ECG: Normal ?.
Theme-22: Chest & Abdominal Trauma:

A- Thoracotomy
B- Admit & observe in surgical unit
C- CT scan chest
D- Analgesics
E- Chest strapping
F- Aortagram
G- MRI of thoracic spine
H- Lung function tests
I- Fluid i/v 1-liter in 30 minutes
J- Fluid i/v 2-liter in 30 minutes
K- Laparotomy
L- Refer to surgeon
M- Reassurance & send home
N- No clinical evidence of Fracture
122. A pt with fracture of one rib after a blunt chest injury, features
suggestive of pneumothorax
123. Woman with compressed fracture of thoracic vertebra on x-ray. ?
124. case of RTA wearing seat belt X-ray shows # of sternum, ECG cardiac
functions are normal
125. A pt with blunt trauma to the abdomen after giving 2-liters of iv fluids
was stable but suddenly deteriorates with hypotension & tachycardia.
2011
PR: 72
BP: 132/86
TEMP Afebrile, 370C
CXR: normal
ECG: Q waves in leads V1, V2 & V3
Theme-23: Thyroid:
A- Thyroxine
B- Propranolol
C- Triiodothyronine
D- Carbimazole
E- Radioiodine.
F- Propilthyouracile
G-Steroids
HIJ-
131. A pt with symptoms of palpitation & sweating is planned to have

surgical procedure, needing to releave his
132. A woman with palpitation, sweats & irritability needs treatment to
reduce these symptoms while waiting for the results of thyroid function ?
133. A pt with hyperthyroidism started on some anti thyroid drug is
sensitive to carbimazole, 2 weeks after starting therapy develops rash,
what to give her.
134. A pt have symptoms of
135. An old aged lady brought to A & E, who became unconscious at home
due to hyperthermia, found to have high TSH. What would you give to
increase her basal metabolic rate
Theme-24: Epilepsy:
A- Generalized seizures
B- Petit mal
C- Grand mal
D- Myotonic
E- Vasomotor
F- Tonic colonic
G- Febrile convulsions
H- Vasovagal syncope,
I- Intracerebral hemorrhage,
J- Vertebrobassilar hemmorrage
2011
126. A boy has come with injury by fall on handle of cycle & had got pain
& tenderness in left upper side of abdomen. USG of spleen shows a small
sized haematoma in the splenic capsule.
127. Pt being hit by a ball comes with severe pain in epigastriaum ?
128. Pt was stabbed in a fight & now comes with his omentum outside (or
omentocele) at the umbilical area. His blood pressure is 110/70 & heart
rate 80. ?
129. Pt with RTA has come with tenderness in left side of abdomen & # of
2 right sided ribs. He is in shock ?
Theme-25: Cause of renal stone:

A- Obstruction,
B- UTI,
C- Hypercalciuria
D- Dehydration
E- Idiopathic
F- High serum uric acid
G- Oxalurea
H- Cystine
I145. A marathon man develops severe pain in left loin. His serum urea
was markedly increase ( ) & serum creatinine was normal (0.6)
146. An old man with chronic / recurrent UTI develops stones in kidney.
147. A middle age develops stone without any background.
148. A pt has big stone in renal pelvis other wise normal
149. Middle aged man with stones in ureter.
Theme-26: Foreign body: (Next step)
A. Remove with aural hook
B. Syringe the affected ear
C. Refer to ENT
D. Instill ?% of alcohol
E . Instill soda bi carb
F. Remove under GA
G. Local Antibiotics & Steroids
H. Use crocodile forceps
IJ151. A 15 year old mentally retarded brought to A&E with plastic bead in
the ear which is partially obstructing the meatus
152. A child comes with swelling & carer remembers that she entered a
plastic bead in his ear some days ago
2011
137. A girl has symptoms of epilepsy without lack of consciousness &

always when people are around him
138. boy that miss some sentences during talking at school & then is back
again
139. A girl falls & faints during morning school assembly in the yard & was
pale
140. A pt looks right always when walking.
141. A boy with fits of all limbs involvementand urination during fits
142. A boy with tics ,lasting for few minutes
143. A child with fits, high grade fever & no biting of tongue, just for few
minutes ,
Theme-27: causes of Red Eye:

A. Episcleritis,
B. Scleritis,
C. Corneal ulcers
D. Iritis
E. Conjuntivitis
F. Acute glaucoma
G. Cataract
H. Hypopyon,
I. Retinopathy
J. Sub-conjuctival Hemmorhage
K. Foreign Body in eye
160. A women with redness without pain that is limited to medial side of
the eye visual acuity preserved
161. A pt with headache & blurred vision pupil fixed & dilated
162. A pt with spondylitis develops eye ache & redness
163. A man gets a squash ball hit on his eye. He complains of reduced
vision
164. A man who did welding yesterday. presents with red eye & reduced
vision
165. Diabetic , red eye.
166. Woman, had fortification forming time, now sees hazy.
Theme-28: Preop care:
A- Urea & Electrolytes
B- Hemoglobin
C- Chest X-Ray
D- Spirometery
E- APTT
F- INR
168. A pt using furosemide is going to have surgery
169. A pt with COPD is to have a surgery
170. A pt is going to have surgery is under treatment with warfarin
Theme-29: Avoiding post-operative complication:
A- Stop smoking
2011
153. A middle age man, with difficulty in learning c/o pin in ear. The
attendant says that he might have put peanut in his ear. The ear looks
oedematosus.
154. A child with otitis media
155. A 2-year old boy with complete bead in the ear,, eardrum swollen, &
hyperemic
156. An old man got up from sleep with tinnitus, & something wriggling in
his ear
157. ( insect in ear)
158. Pt with purulent discharge, & red meatus
172. A pt is using stocking suck & is due for surgery

173. A pt is going to have femoral neck replacement & is obese
174. An unstable angina is going to have a surgery
175. A woman needs analgesia for pregnancy termination
176. Pt with incisional hernia, planned of repair & smokes 40 cigarettes
177. Pt with to be operated for thyroid drinks 30 units alcohol
178. A 60-year-old man with BMI 34, who drinks 20-units of alcohol per
day & smokes 20 cigarettes/day for the last 5 years going for a hip
replacement surgery which will last for > then 2 hrs.
Theme-30: Treatment of emergencies:
A- Dopamine
B- Thoracotomy
C- NSAIDs
D- Apomorphine
E- Steroids
F- Antibiotics
G- Adrenalin
H- Foursemide
I- Aortic Aneurysm
J- Cardiac valve
K- Needle thoracocentesis
180. A pt after RTA brought to A&E with breathlessness. He is already with
two chest drains but his PCO2 is is rising & PO2 is falling
181. A pt with severe chest pain radiating to back
182. A pt with breathlessness & have a normal sound in apex
183. Pt with hydro-pneumothorax & surgical empyema)
184. A pt with blue lips & breathless, no lung sounds, median line shifted
to right
185. A pt with breathlessness & shadowing in CXR
186. Pt with , signs of severe pulmonary edema, & basal crepitation.
Theme-31: Asthma in children:
A- Long acting Beta agonist
B- Oral theophiline
C- Short acting beat agonist
D- Oral corticosteroids
E- Nebulized salbutamole
2011
B- Refer to alcohol dependency group

C- Vitamin k
D- Stop Smoking
E- S/C heparin
F- Withdraw some blood Pre-Op,
G- Empty Bowels Pre-op,
H- Total Bed Rest Pre-Op,
I- Antibiotics Pre-Op,
J- Admission to addiction Center,
K- Loose weight
Theme-32: Bleeding disorders: (Dont remember this questions very well)

A- Congenital Deficiency of Coagulation Factors
B- Acquired Deficiency of Coagulation Factors
C- DIC
D- FBC
E- Deficiency of Vit-K
192.
193.
194.
195.
196.
197.
198.
A child with prolonged epistaxis otherwise normal.

A child with hemarthrosis (increased platelet destruction)
A child with symptoms of SCA
A pt with severe bleeding from different organs
A pt on anticoagulation therapy now bleeding
Passing clots in urine
Female child with rashes on shins & abdomen, bleeding problems
Theme-33: Renal problems:

A- CRF
B- IGA nephropathy
C- Ureteric colic
D- Acute tubular necrosis
E- Renal tubular acidosis
F- Sarcoidosis
G- Glomerulonephritis
H- Renal scintiography scan
I200.
201.
202.
203.
204.
205.
206.
A pt with serum creatinine 6. & urea 500

A pt that have renal papilary necrosis
A woman having fullness in loin
A pt who was using NSAID now presents with renal problems
Story like HSP?
Pt had recurrent urinary infection, now anuric
Pt with serum creatinine & urea normal but fever.
Theme-34: Mode of genetic inheritance

A- AD
2011
F- Inhaler corton?
G- Aminophyline.
H- Long acting steroids.
I- Adrenaline.
187. A boy wheezing despite using short acting beta agonists inhaler twice
daily. His parents dont like any steroid preparations
188. A child have dyspnea & wheezing while playing football in winter .
189. A child is not responding to beta agonists
190. A child is in severe attack
191. A child wheezes despite use of short acting steroids & steroids
inhalation.
207. Boy with findings of bleeding disorder ,his father brother & one of the
uncle affected
208. Boy with bleeding disorder his mother & maternal grandfather
affected
209. A 11-years-old boy with clumsy irregular gait progressive, both
parents normal, paternal grand mother & maternal grandfather affected.
one died at 40 years after 5 years of illness, finally restricted to wheel
chair & died. Other is also diseased with same form of muscle disorder.(i
have forgotten who is who.)
210. Age around 10 years.... polyuria, Polydipsia & weight loss
211. A 6 months girl whose dad is checking regularly his Full blood count
& mom receives regularly blood transfusion
Theme-35: Diagnosing of genetical disorders:

A- X link
B- Y link
C- DM
DEFGHI
213. A boy has the disease that was presented in his grandfather & father
214. A 6 months girl whose dad is checking regularly his Full blood count
& mum receives regularly blood transfusion
215. a boy with painful swollen knee after minor trauma
216. A kind of autosomal dominant disorder (dont remember exactly)
217. Multigenic disease
Theme-36: Disease process in heamatological conditions

A. Vasculitic process
B. Platelet aggregation
C. Decrease in platelets
218 henoch .s . purpura
2011
B- AR
C- XD
D- XR
E- Codominant
F- polygenic
GHI-
Theme-37: Investigations in Rheumatology:
220. A pt with migrant polyarthritis & early morning stiffness.

221. A boy with painful swollen knee after minor trauma.
222. A woman, with pains in MCP & DIP joints, on & off since many years
223. An elderly pt with rheumatoid arthritis has hot swollen joint
224. Middle aged man with painful wrist, burning micturation (uretheritis)
& conjunctivitis
Theme-38 : Rheumatology Diagnosis:
A- Multiple sclerosis
B- Multiple myeloma
C- Gout
D- Mixed connective tissue disease
E- Dermatomyocitis
F- Rheumatoid arthritis
G- Ankylosing spondylitis
H- Pseudogout
I- Reiters
J- Osteoarthritis
226. A 70-year-old man with swelling in PIP & knee pain & negatively
birefringent crystals on aspiration of joints.
227. A pt with bone pain & malaise /had renal failure as well?
228. A young man with backache, morning stiffness, & HLA B27 /
straightening of vertebra on x-ray.
229. A middle aged man with swollen, tender knee joint with heat &
swollen painful proximal interphalangeal joints, Rheumatoid factor +ve
(possible ans rheumatoid arthritis + gout + others
Theme-39: Psychological diagnosing:

A- Korsakoffs psychosis,
B- Delirium tremens,
C- Alcoholic confusional state
D- Alcoholic intoxication
E-Schizophrenia
2011
A- Serum uric acid ,

B- Serum Calcium Level
C- Aspiration of joint for positively birefringent crystals
D- Aspiration for infective organism
E- Rheumatoid factor
F- X-ray of the joint
G- Bone survey
H-Chalamydia IgA test
I- Lateral cervical X-ray
231. Man thinks some people have got into his house so wanders in the
street & vows to take revenge.
232. A pt was brought to A&E with some symptoms of Parkinsons,
wandering in the street & claims that some people are in his home & is
afraid of going home
233. A young pt with auditory hallucinations
234. A 25 year old alcoholic patient, doing crazy things
235. A 68 yr old man chronic alcoholic & continues to drink having
confusion
236. An elderly man with increasing confusion was brought to A&E by his
wife.
Theme-40: Treatment of psychological disorders:
A. Cognitive therapy
B. Behavioral therapy
C. Cognitive & behavioral therapy
D. Fluoexetine
E. ECT
F. Amitriptyline
G. Imipramine
H. CBT
I. Imipramine
J. Lithium
K. Psychiatric consultation
L. Beta Blockers
237. A young boy irritable, & brought to shrink for shouting absentees at
school.
238. A nurse that recently washes & cleanness everything more than
usual, like washing hands & so on
239. An old lady with depression having suicidal risk & doesnt eat
240. A women depressed 3-months after parturition & is breast feeding,
telling that some body is trying to kill her baby, not interested in anything
& crying often.
241. Pt with moderate depression has responded to antidepressants &
now has MI & getting treated for CCF
242. Hypertensive pt, with medications of fibrillation now depressed.
Theme-41: cause of suicide / Suicidal risks:
A. Life event;
B. Criminal record;
C. Bad physical health;
D. Unemployment;
E. Isolation
2011
F- Delirium
G- Paranoid delusions
H- Lewy body dementia
I- Depression
J-Drug induced

F. Depression
Theme-42: Incontinence:
A- Intermittent catheter,
B- Life long catheter,
C- Cystoscopy
D- Suprapubic catheter
E- Urinary retention
Mentally retarded recurrent infection , even after putting the catheter
again incontinent.
3---no lung sounds, median line shifted to right..

4- man looks always to his left while walking vertebrobassilar hemmorrage
5. Recurrent infection , even after putting the catheter again incontinent.
ALPHA BLOCKERS (although in theme 44 but answer is not relevant think)
About fractures
a girl falls from a swing, & then has pain going from shoulder to forearm.
(where is this Qs gone)
There was another that a person falls maybe from a ladder & he has pain
around the shoulder region but cant lift his wrist off the table.
5) A young man injures his wrist playing football. There is tenderness
distal o the wrist & little swelling.
Ans. This is a # scaphoid. The area distal to the radius, is the anatomical
snuffbox. This is a small, relatively avascular bone, therefore only a small
hematoma is formed resulting in only a little amount of swelling. GOOD
EXPLAINANTION PUT IT IN ANS SHEET
achalasia
reflux esophagitis
---65 yrs, from many years complains of dysphagia, loss of weight. CA
OSOPHAGUS
--- anal tags, fissures CROHNS
---diarrhoea, with blood & mucous,+ulcers ULCERATIVE coll.
pleural effusion ,pneumothorax, emphysema, bronchiectasis, intubate &
ventillate ,needle
check prolactin levels
check thyroid hormones
---pt with galactorheoa
check prolactin levels
One pt on warfarin, what to do. INR
2011
243. 60- A 28 year old man was sentenced to the prison for the armed
robbery of bank. Now suicides by cutting his wrist veins with piece of glass
in jail. His mother died 3 months ago,
244. 61- A woman with low mood, who sleeps too much & denies to eat
wants to die now cut her veins.
Answers of July 2003 PLAB

1H
2A
3E
4C
5F
6F
7K
8A
9D
10 J
11 G/H
12 D
13 F/D
14 A
15 E
16 D
17 G
18 B
19 F
20 I/G
21 E
22 D/G
23 (oesophagitis is but Rx ?
24 eradication therapy of h.pylori
2011
then a theme on poisoning m/m

1. girl seen playing with red tablets which her mother used as she was
feeling weak , we are unable to contact mother at the moment . S.IRON
LEVELS
2. girl swallowed her mothers oral contraceptive pills SERUM OESTRIOL
PSYCH
behavioural therapy
nutritional deficiency
psychiatric consultation
cognitive therapy
---alcoholic , shows signs of weakness,wt loss nutritional deficiency
---young girl , wants to be thin, vomits by inducing herself.
S.ELECTROLYTES
---computer analyst washes hand again & again. behavioural therapy
--- young boy irritable ,and brought to shrink for shouting obscenities at
school.
GILLES DA LA TOURETTE SYND
PSYCH 2
choices were amytriptalyn , fluoxetin, cbt, imipramine ect, lithium
1. postpartum depression & she is breast feeding . IMIPRAMINE
2. man or woman whose depression was well controlled with
antidepressants has mi ( i think cardiac failure was there too) ?FLOXETINE
ENT .a boy witha plastic bead completely obstucting his ear canal-ans c or
f[not sure]
C
C
B
A
D- difference in the time of the day & position of body
E
C
L
K
B/
M/B
J
N
F/B
B
D
G
H
F
B
A/G
C
E
B
C
H
A
J/d osteoporosis
D
B
C
A
F/h
G
C
D
B
E
D
A
D
Hirschsprungs disease but ?
G
D
F
D
F/G
2011
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
2011
79 B
80 A
81 C
82
83 F
84 D
85 E
86 C
87 I
88 J
89 D
90
91 B
92 H
93 E
94
95
96
97 C
[snip] I
99 B
100
101 F
102 C
103 A
104 D
105 E
106 B
107 D
108 B
109 A
110
111 D
112 E
113 B
114
115 C
116
117 D
118 B
119 C
120 A
121
122
123
124 E/D
125 I
126 B
127
128
129
130
131 B
132
F/G
D
A/C p-818 OHCM
B
E
J
A
D
B
E
A
B
C
G
A
B
J
F
D
H
K
I
A
C
F
E
D
K
A
Aneurysm Aorta
Cardiac valve
Rupture esophagus
K
G
H
2011
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
B
F
E
A
A
D
C
B
A
F
E
B
B
A
A/D
C
E
I
D
H
C
B
G
E
H/J
E
C/A
A
C
E
D
2011
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
220
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240

241 D
242
243 B
244 F
May 2003
PLAB Part 1 Exam
Theme: Post operative Complications
1.Second postoperative day, blood test shows a MCV of 110. What is it due
to?
Theme: Trauma
1. Pt presents to you in A and E with history of trauma .GCS of 10.No focal
neurological signs. What is the next step you do?
Theme: ENT
1.A boy with blow to the ear comes with bleeding per ear. I am not sure if
they had given perforated eardrum in this same patient. What is the next
immediate step you would do?
Theme: Non accidental injuries
1.A baby brought to you whose fundus examination shows retinal
haemorrhages. What investigation do you do?
2.Child with blood from mouth brought to you. On exam, you find frenulum
tear. Again investigation? 3.A child with recurrent multiple fracturesLooked like osteogenesis imperfecta. What investigation?
Theme: Ectopic
1. IVF patient with 2 embryos implanted 8 weeks ago presents to you with
brown vaginal discharge. HCG is positive. What investigation do you do?
Investigations were: Colposcopy, USG, etc, etc.
Theme: Pre operative assessment:
2011

1.A patient with long history of asthma waiting for cholecystectomy.
Investigation you would do.
Theme : Side effects of drugs

1. Pt with sudden opisthotonus, akathesia, etc.-Metoclopramide.
2. Side effects of Lithium-tremors, etc.
Theme: Burns-management
1. An electrician burnt his fingers of dominant hand
2. A baby with about 3% of burns
3. A 40 yr old man with 40% of scalds
4. The guy with the singed nostrils (repeat)
Theme: Fracture-Diagnosis
1. The child with no radial pulse felt (rpt)
2. The POP gets wet and now a fracture earlier none seen (rpt)
3. Baby cries whenever lifted, difficult delivery (rpt)
Theme: what will you do next (something along that line)(rpt)
1. A nurse with needle injury - HIV patient, she is immunized against HEPB, what will u look for in the next months.
2. Similar to the above scenario but here the nurse thinks she might
already be HIV positive. What will u look for?
3. Hepatitis c case scenario- investigation- RNA virus or anti -HCV antibody
4. A needle stick injury from HEP B carrier, how do u find out if he is
infective?
Theme: Hemoptysis
1. A good pasture's findings with renal findings and haemoptysis
2. A RTA case open reduction few days back - fat embolism like picture
3. The repeated sheep farmer ORF, nasal polyp question
Theme: Trauma
1. The past paper question a child fell from 6 metre high
2. The child ran on a door
3. An alcoholic with falls (not sure if this was a question)
Theme: Renal Med
There were more than 1 theme on renal medicine (these questions may be
mixed up)
1. CA of bladder, painless haematuria - familiar question 2.renal cell
carcinoma- triad was given
Theme: Viral infection
2011
Theme: Poisoning
1. A patient with respiratory depression, pin point pupil, etc.
2. Pt presenting with hypotension alone.
3. Pt poisoned with some drug who developed acute liver failure after 4
hours of consumption.
4. Pt with anti cholinergic side effects and arythmias.
5. Arythmia, change in vision and so on.-Digoxin.

This theme was a rpt with roseola infantum, meningitis (with glass test
positive not negative as given in past paper)hand foot and mouth disease.
(The questions were way too familiar but the options were not. It would be
better for the future candidates to read a bit about the past questions
(which will surely be of help) rather than just the options.)
Theme: Renal system
1.A 40 year old man who was investigated with cystoscopy which was
normal, for recurrent haematuria 15 years ago ,now presents with
haematuria and his Bp is found to be 180/110.What do think the etiology
could be?
Options were like membranous nephropathy, Chronic glomerulonephritis,
Accelerated malignant hypertension, and so on.
Theme: Fever with rash.
1. A case with cervical lymphadenopathy, conjunctivitis, and a rash on
hand which started to peel after the fifth day.-I marked this as Kawasaki
disease.
2. Glandular fever was there.-Typical rash after taking ampicillin.
3. Roseola infantum was there. One could recognize easily.
Theme: Conjunctivitis
Viral,
Ophthalmia neonatorum,
2011
The following questions, not sure under what themes they were:
1. A epistaxis with Wegeners picture ( the option was not Wegeners but
systemic vasculitis.
2. The breast CA lady with thirst, and other hypercalcemic findings
option was hypercalcaemia (rpt)
3. Breast cancer lady with hip pain - metastases or bony infiltration
3. In ENT theme a diver with c/o not able to hear or ear pain. the scenario
was like wax impaction.( at least that is what i answered)
4. Parapharyngeal abscess question from past paper was modified and
asked as next step in management. Not sure between options: attend
outpatient review and surgical intervention
5. The abdominal pain with H. pylori management-triple therapy was given
as an option.
6. The past paper question a child with skin or food allergy-RAST was one
of the options. 7. post natal depression scenario from pastpaper
8. a 40 year old man with chest pain for 2 hrs and fever. Pericarditis was
not an option but MI was.
9. Migraine - drug for treatment 10.Migraine - drug for prophylaxis
11. Trigeminal neuralgia-treatment.
12. The past paper question of a guy stabbed in the abdomen BP dropping
but no fluid in USG.-is it mesenteric ischemia?
13. The stems from the theme triple blood test - spina bifida, downs and
previous boy was affected mum wants to know if this child will be affected
too.
14. Under the ENT theme, a lady with dizziness, vertigo and symptoms
subsided after she was prescribed betahisdine-next step in management.
15.A man with ataxia, shuffling gait....
Theme: Prenatal diagnosis.

1. A mother in her midtrimester who has her previous child affected (male
child)by this disease wants to know if her this baby is affected too.Duchennes
2. A mother whose triple blood test shows a low alpha feto protein-Down's
Theme: Scientific basis of Diabetes
absolute deficiency of insulin, Relative deficiency of Insulin, Insulin excess.
1. ketoacidosis,? ABSOLUTE INSULIN DEFCY
2. HONK,
3. Hypoglycemia,
Theme: Injuries
1. A 30 years old man with history of trauma to the left upper abdomen
with lower ribs fractured-Splenic injury
2. A person stabbed with a 10 cm knife in the left upper abdomen was
stable for 20 minutes and then started to collapse. USG shows no free fluid
in the abdomen.-I was stuck here for I was looking for hemothorax which
was not given as an option. Cardiac tamponade, Aortic rupture were there
and few more options but I couldn't choose any.
3. The other questions in this theme was quite easy that anyone can
answer.
Theme: Anaemia
1. Sickle cell anaemia classical picture was there.
2. Hereditary spherocytosis was there-28 year old female with recurrent
history of jaundice in young age now with splenomegaly.
Theme: Investigation of Drug complications
1. Pt on carbamazepine presents with tiredness-Full blood count-as the
comp. is aplastic anaemia
Theme: Diagnosis of Psychiatric cases
1. A patient says that somebody blocks his thoughts -Schizophrenia
2. A patient with yearly presentation of low mood, etc-Seasonal affective
disorder.
3. Bipolar affective disorder was there-a patient with both mania and
depressive features alternating.(Could be even cyclothymia as the less
severe form of Bipolar is cyclothymia. Because cyclothymia was an option
too.)
4. A lady on the 7th postnatal day presents with low mood, not interested
in feeding the child, and sometimes even harmful thoughts towards the
baby-Postnatal depression
5. I believe this case was either major or minor depression because both
options were given for a case which more commonly affects female than
2011
Trachoma,
Chemical,
Allergic.
1. A conjunctivitis case-which responds to sodium cromoglycate
2. Conjunctivitis where both topical and oral tetracycline is advised.
3. Conjunctivitis that responds to topical fusidic acid
4. Conjunctivitis where indomethacin is prescribed

male presenting with symptoms of depression(Reading the case history- it
was clear that it was depression-but one should know the criteria to
differentiate between the major and minor)
Theme: Diagnosis of epistaxis

Nasopharyngeal
Angiofibroma,
Ca maxillary antrum,
Orf,
Coagulopathy,
Hypertension,
Septal perforation
Trauma and so on
1.Man working in a chrome factory presents with a whistling sound on
talking-septal perforation
2.A sheep farmer with a bleeding ployp on anterior part of nasal septumorf
3.Man with prosthetic valve presents with epistaxis-coagulopathy.
4.An 80 year old man with epistaxis since 2 hrs-I went for HT(not sure)
5.Man involved in furniture making presents with epistaxis and anesthesia
of rt. cheek.-Ca maxillary antrum
Theme: Investigations for abdominal conditions
Plain x-ray abdomen,
Barium enema,
Upper GI endoscopy,
Sigmoidoscopy,
Colonoscopy,
Small bowel enema and so on
1.A patient presents with increasing constipation, passes stools which is
ribbon like. Otherwise he is well.
2.Pt with abdominal pain and vomiting-to me it looked like intestinal
obstruction.
3.A pt with history of epigastric pain after food(i vaguely remember as
long standing history),and tarry stools.
2011
Theme: Management of psychiatric cases

Family therapy,
Occupational therapy,
Genuine mourning,
Antidepressants, and so on.
1.A young girl brings her mother who is low in mood for the past 6 months
after the death of her father. It is worse in the past 3 months and she is
incontinent with few more somatic symptoms How would you help her?
2011
March 2003
Theme 1: Mg. Of Ophthalmologic conditions.
A. Intraocular steroids.
B. I/V steroids.
C. Oral steroids.
D. Eye surgery.
E. B-blockers.
F. Laser treatment.
G. Systemic Anti-biotics.
H. No treatment.
1. A pt. With sudden loss of vision. & h/o temporal arteritis.
2. A pt. With decreased Vision. On watching TV, gives h/o tunnel vision. On
examination cupping of disc is seen.
3. Pt. With h/o of SLE develops lens opacities.
4. A diabetic pt. Develops proliferative diabetic retinopathy.
5. A 80 year man with marked loss of Vision. On fundoscopy bilateral.
Macular degeneration & pigmentation.
Theme 2: Side Effects of Drugs.
6. A child who takes a large amount of paracetamol.

7. A pt. on chronic use of Aspirin.
8. A pt. Taking carbamazepine for some painful problem.
9. A pt. With some psychiatric problem on TCA.
10. A pt. on chronic use of Ibuprofen.
Theme 3: Involvement Of Cranial Nerve.

A. Nerve I
B. II
C. III
D. IV
E. V
F. VI
G. VII
H. no cranial verve
I. VIII
J. IX
K. X
L. XI
M. XII
11. A. Pt. Involved in RTA. Has MRI done which shows longitudinal # of
temporal petrosal bone of skull & now is unable to perceive smell.
12. A 19 yr. Old pt. Sustained # of base of skull, presents with ptosis, loss
of pupillary reflex associated with lat nystagmus.
13. Pt had trauma to back of skull & since cannot shrug his shoulders.
14. A pt cannot move his lower facial muscles but sparing of the forehead
muscles.
15. Pt. had a stroke & has lost the ability to feel taste in the anterior 2/3 of
the tongue.
Theme 4: Diagnosis Of Anemia.
A. Pernicious anemia.
B. Aplastic anemia.
C. Iron deficiency anemia.
D. Coeliac disease.
E. Anemia due to Iron malabsorption.
F. Anemia due to folate malabsorption.
G. Folate deficiency anemia.
2011
A. Liver Failure.
B. Bronchiolitis.
C. Rash
D. Reye's syndrome.
E. Dry Mouth.
F. Drowsiness.
G. Gastric erosion.
H. Dilated pupil.
Theme 5: Vaginal Conditions In Female child.

A. E. Vermicularis.
B. Examine under GA.
C. Local hygiene.
D. Take high Vag. Swab.
E. Culture & investigate for Chlamydia.
F. Local Nystatin.
G. Candidiasis.
H.
20.
21.
22.
23.
24.
A child with itching in vulva mostly at night.

A child with excoriation & ulceration in vulval region.
Rash is noted in vulva in a diabetic child.
A child with some kind of vaginal discharge.
Rash in a normal child when nappy removed.
Theme 6: Diagnosis Of Confusion.

A. Delirium
B. Subdural Haem.
C. Extradural Haem.
D. Subarachnoid haem.
E. Wernicke Encephalopathy.
F. Drug overdose.
G.
25. Pt admitted in hospital with some ailment then becomes confused &
irritated.
26. A pt is operated, on gaining consciousness becomes confused &
disoriented.
27. An alcoholic with h/o of recurrent falls is confused.
28. A rugby player hit by a ball on head loses consciousness & then
become normal now is brought in hospital with detorriating consciousness.
Theme 7: Prevention Of Heart Disease.
A. Statin
B. Reduce Wt.
C. Stop Alcohol & Cigar.
D. Aspirin
E. Warfarin
F
29. A pt. With hyperlipidaemia develops cardiac problems.
2011
16. A man on Rx with cyclophosphamide for lung alveolitis develops

anemia.
17. A man with h/o of gastric erosion develops anemia.
18. A strict vegetarian develops malnuturion & anemia.
19. A pt. With coeliac disease develops anemia.

30. A smoker & alcoholic develops cardiac problem.
31. An obese develops cardiac problems.
A. FNAC.
B. MRI
C. USG.
D. Mammography.
E. Stereotactic Biopsy.
F. Stereotactic Fine needle biopsy.
G. Excisional biopsy.
H. Lumpectomy.
I.
32.
33.
34.
35.
A
A
A
A
pt. With fibrocystic disease with symptoms related with menses.

pt. With breast lump but has morbid fear of needles.
pt with no obvious palpable lump but with axillary lymph nodes.
pt with retraction of nipple.
Theme 9: Investigations & treatment in convulsions.

A. EEG.
B. CT Scan.
C. MRI
D. ECG
E. No Investigation.
F. valproate sodium.
G. Phenytoin.
H. Diazepam.
36. Mother brings child who had some febrile condition, the child was
wrapped in multiple blankets, he had convulsions, when the blanket was
removed he was alright & playing happily.
37. A boy with h/o of convulsions starting with tingling in Thumb of one
hand.(Jacksonian)
38. A pt. With convulsions & an EEG was done, which showed firing
impulses in temporal area.
39. A pt had generalized tonic clonic convulsions.
Theme 10: Diagnosis In Dementia.
A. Alzheimers
B. Schizophrenia.
C. Pseudodementia.
D. Senile dementia
E. Multi infarct dementia.
F. Lewy body dementia.
G. Frontal lobe dementia
2011
Theme 8: Investigations In Breast Lumps.

H. Huntingtons dementia.
A pt had some psychiatric problems with thought insertion.
Commonest dementia in UK
Dementia which has neurofibrillary tangles.
Pt. With cognitive impairment.
A hypertensive with dementia.
Dementia treated with anti depressants.
Theme 11: Diagnosis Of Hearing Loss.

A. Menires Disease.
B. Wax Impaction
C. Acoustic Neuroma
D. Acute Otitis Media.
E. Presbyacusis.
F. Otosclerosis.
G. Viral Involvement of nerve.
H. Otitis Externa.
46. A
47. A
loss.
48. A
49. A
50. A
pt. With intermittent tinnitus, giddiness, & vertigo.

50 yr. Old man with bilateral deafness, his father also had hearing
brown mass obliterates the tympanic membrane.
woman with unilateral conductive hearing loss.
pt. With tinnitus, vertigo & tingling on one side of face, & numbness.
Theme 12: Diagnosis In Rheumatology.

A. Chondromalecia patella.
B. Rheumatoid arthritis.
C. Gout.
D. Psoriatic arthritis.
E. Enteropathic arthritis.
F. Ankylosing spondylitis.
G. Septic arthritis.
H. Reactive arthritis.
I. Pseudo gout.
J. Gonococcal arthritis.
51. A 65 yrs old man has a swollen left knee jt. For ten yrs. With
associated swelling but no skin changes, he had no other problems.
52. 35 yr. Old woman with left knee pain & associated problems, & with
nail pitting & discoloration.
53. A 45 yr. Old man on anti hypertensive treatment, presents with lt knee
pain which is swollen & hot to touch.
54. Pt. Returned from Thailand develops painful swelling & warm rt. Knee.
55. A female with symmetrical & crippling arthropathy.
Theme 13: Diagnosis Of Ulcerative Colitis.
2011
40.
41.
42.
43.
44.
45.
Theme 14: Investigation In Lung conditions.

A. CT
B. MRI
C. Sputum cytology.
D. Sputum culture.
E. Lung biopsy.
60. Elderly man has lower lobe consolidation & fever, he was Rx with
antibiotic, which resolved the fever but the consolidation persisted after 4
wks.
61. A pt with lung affected due to asbestos exposure.
Theme 15: Investigation In Haematology.
A. Bleeding time
B. Clotting time
C. Platelet count
D. Von willebrand
E. INR
F. PTT
G. TT
62. A pt. is taking warfarin develops bleeding problems.
63. A female pt with rash & other symptoms of purpura develops
hemorrhage.
65. A 16 yr. Old girl is pale. Weak presents with menorrhagia & epistaxis,
mother also had similar problems.
66. I think another question on Von Willebrand.
Theme 16: Diagnosis of Meningitis.
A. Streptococcal Meningitis.
B. Meningococcal.
C. Viral.
D. Tubercular.
E. Leukaemic Infiltration.
F.
67. A 3 yr. Old boy developed URTI & also had recent h/o ear discharge,
now presents with neck stiffness.
2011
A. Ulcerative Colitis.
B. Pseudo membranous colitis.
C. Haemorrhoids.
D. Anal fissure.
E. Crhon.s disease.
56. A pt taking iv antibiotic treatment for some disease develops diarrhea
& bowel changes.
57. A pt has bleeding mixed with stool & also bleeding after passing stool.
58. non-smoker with fever c/o abdominal pain which was gradual on onset
with diarrhoea & mucus. O/E clubbing, aphthous oral ulcers &
conjunctivitis.
59. Patient passes stool with blood streaked on it.
Theme 17: Management of Thyroid Problems.

A. Propanalol
B. Carbimazole.
C. Radioiodine.
D. Thyroidectomy.
E. Observation
F. Thyroxin
G. FNAC
H. Auto anti body.
I. Thyroid ultrasound.
J. MRI
K
71. A female pt. Presents with wt. Loss, palpitations & diarrhea.
72. A female pt. Having previous h/o of asthma is now c/o wt. Loss &
diarrhea.
73. A pt with diffuse thyroid enlargement but otherwise well &
asymptomatic.
74. A pt. With a solitary thyroid nodule of about 3 cm in size.
75. A woman presents with features of hypothyroidism & a tender thyroid.
Theme 18: Management. Of Trauma In Children.
A. I/V morphine.
B. Endotracheal intubation.
C. Intraosseous line.
D. CV line
E. Oropharyngeal airway.
F. Nasopharyngeal airaway.
G. Dobutamide.
76.
77.
78.
79.
80.
A 4 yr. Old child with 10 % scalds on chest.

6 yr. Old, intubated after RTA, BP low, pulse high.
2 yr. Old with hypovolemic shock, unable to get iv access.
5 yr. Old with soot in nostril.
13 yr. Old in shock, unable to get iv access.
Theme 19: Management. Of Varicella.

A. Oral Acyclovir
B. Iv acyclovir.
C. No treatment required at present.
D. Varicella Ig.
2011
68. A child is diagnosed with meningitis his CSF examination shows 10

blood cells with 1-2 lymphocytes, & the glucose level is not too reduced.
69. A child with meningitis, his CSF examination shows presence of
gram .ve encapsulated diplococci.
70. A child with signs of meningism & presence of abnormal blood cells in
CSF.

E. Barrier nursing.
F. Quarantine.
G. Check immune status.
Theme 20: Diagnosis Of Acid-Base Disturbances.

A. Metabolic Acidosis.
B. Metabolic Alkalosis.
C. Respiratory Acidosis.
D. Respiratory Alkalosis.
E. Hypokalaemia.
F. Renal Failure.
G. Dehydration.
H. Fluid overload.
I
88. A man having projectile vomiting due to pyloric stenosis with
hypokalaemia & base excess.
89. A man with villous adenoma of rectum with diarrhea.
90. A man with pulmonary embolism, with tachycardia, hypotension &
breathlessness.
91. A man with pallor, dry skin, & anuria.
92. A pt. With post operative breathlessness, & peripheral oedema.
Theme 21: Psychiatry Next Step.
A. Chlorpromazine.
B. Clozapine.
C. ECT
D. Benzhexol.
E. Continue the same drug orally.
F. Stop the treatment.
G. Hyoscine.
H
93. A pt. After treatment with antipsychotic, he develops hyper salivation.
94. A pt. After treatment with haloperidol, a man develops stiffness of
limbs.
95. A pt. stabbed his father in acute psychosis, & then was treated with
anti psychotic, now believes himself to have recovered from the illness.
96. A pt who has recurrent hiccups, due to anti psychotic treatment.
2011
81. A pregnant woman who is in her last trimester of pregnancy, & her
husband is infected with varicella.
82. A boy who is taking steroids for asthma gets chicken pox.
83. A child having lymphoma/leukemia, his father has shingles.
84. A boy whose sister has just had renal transplant & is returning from
hospital.
85. 80 year old man develops ophthalmic shingles.
86. A boy has developed vesicles all over the body & also has high fever.
87. A woman with vesicles on small part of the chest.
Theme 22: Investigation In Renal stones.
97. A 25 year old man presented with recurrent loin pain & stone in the
ureter.
[snip]. A 35 year old man presented with loin pain all serum biochemical
investigations were done & are non conclusive.
99. A man with gouty skin changes of the ear pinna.
100. A man with stone in the kidney which is radio luscent.
Theme 23: Management. Of Trauma In Children

A. CT Scan
B. Barium Swallow.
C. MRI.
D. X- Ray abdomen.
E. Peritonial Analysis.
101. A child with stab wound of abdomen, & signs of peritonism & shock.
102. A child involved in RTA was seated in back seat, with seat belt on,
presents with pain in Lt. Hypochondrium, pallor, low BP, tachycardia.
Theme 24: Investigations In Diabetes.

A. Random Blood Sugar.
B. Fasting Blood Sugar.
C. Oral Glucose Tolerance Test.
D. Insulin Level.
E. Urine Sugar.
F. Blood Sugar.
G. Post prandial blood Sugar.
103. A 25 yr. Old male who is conscious & wants to know weather he is
diabetic.
104. A 65 yr. Old male with h/o of polyurea wants to know abt. His
diabetes.
2011
A. Serum Ca Level.
B. Plasma Urate level.
C. Serum Alk. Phosphatase, Calcium, & phosphate level.
D. Dietary conditions.
E. Urea & Electrolytes.
F. Urinary Calcium.
G. USG.

105. A 20 yr. Old girl presented to you with history of attacks of
hypoglycemia when ever she misses her meal.
106. Mother brings in a child she is worried if he is diabetic.
2011
Theme 25: Management. Of Ectopic Pregnancy

A. Laparotomy.
B. Diagnostic laparoscopy.
C. USG.
D. 24 Hr. B HCG.
107. A 25 yr old with 8 weeks amenorrhoea presents with BP 70/50 &

pulse-140.
108. A 35 year old woman with bleeding per vagina & USG shows empty
uterus.
109. An 28 year old woman presents with 5 weeks amenorrhoea & has h/o
vaginal bleeding her B HCG is 5000.
Theme 26: Control Of Hypertension.
A. Beta blockers.
B. Ace-inhibitors.
C. Diet Control.
D. Stop Smoking.
E. Exercise.
F. I/V Anti Hypertensive.
G. Fish Oil.
110. 30 year old lady with a BP of 160/100 recorded on 3 times
consecutively BMI-27 & drinks 7 units of alcohol & smokes 1 pac cigarette.
111. 35 year old lady with BMI is 33 & drinks 3 units of alcohol/week. & BP
recorded 160/100 3 times in a row.
113. A 50 year. Old with h/o HTN. Not relieved by diuretics.
114. A pt with family history of cardiovascular disorders.
Theme 27: Next Step In treatment Of Psychiatric Pateints.

A. Oral anti psychiatric drug.
B. IV anti psych.

C. Stop Rx.
D. Continue same treatment.
E. Review after 3 months.
F. Regular visits to Doctor.
Theme 28: Cervical Pathology

A. CIN.
B. Cervical Ectropion.
C. Endometrial Carcinoma.
D. Cervical Cancer.
E. Vaginal Cancer.
F. Vaginal Trauma.
G. Chlamydial Infection.
H. Cervical Smear.
117. A female presents with a cervical lesion, which bleeds to touch, she
gives h/o multiple sexual partners recently.
118. A female with bleeding on oral contraceptive pills.
119. A woman with post menopausal bleeding & with Endometrial
thickening.
120. A woman, who has got unpleasant vaginal discharge.
121. An post menopausal old lady presents with post coital bleeding after
having sex for the first time in her life!!.
Theme 29: Respiratory Pathology .

A. Chloride Channel Defect.
B. Surfactant Deficiency.
C. Alpha 1 antitrypsin deficiency.
D. Asthma.
122. A baby who has recurrent pneumonitis.
123. A baby with RDS.
124. Woman has h/o of recurrent jaundice as a child ,now develops
emphysema.
125. A child who develops cough & difficulty in breathing during winter.
Theme 30: Investigations In Acid Peptic Disease.
A. H. Pylori Serology.
B. Oesophageal Manometry.
C. Endoscopy.
D. Faecal Occult Blood.
E. 24-hr. ambulatory Ph monitoring.
2011
115. 30 year old with psychiatric problem on oral anti psychotics.

116. Pt who is doing well on anti psych. on his regular visit to GP after 3
months.

F. Barium meal.
G. Do nothing.
Theme 31: Treatment For Upper GI conditions.

A. Give antacid.
B. Give H2 blockers.
C. Esophageal dilatation.
D. Esophageal Excision.
E. Celestin Tube.
F. Radiotherapy.
G. Chemotherapy.
H. Endoscopic Biopsy.
130.
131.
132.
133.
134.
A pregnant woman with dyspeptic symptoms since past 4 days.

A pt. With chronic dyspepsia has developed Barretts esophagus.
A pt with esophageal stricture.
A pt with a localized esophageal tumor with no signs of metastasis.
Pt with CA-oesophageus & mets.
Theme 32: Mx Of Injury to Upper Limb.

A. Manipulation.
B. Physiotherapy.
C. Sling.
D. Apply plaster cast.
E. Admit for further Investigations.
F. No treatment required.
135. A child with pulled elbow first presents to A&E.
136. A child with h/o fall, tenderness & pain below the thumb, X-ray is
normal.
137. A child presents with torticollis she has no h/o trauma.
138. Child presents to A&E with limping & pain on rotation after playing
football.
Theme 33: Mx of Ischaemic limb.
A. Incise the fascia.
B. Embolectomy.
C. Amputate.
D. Arteriovenous grafting.
2011
126. A 50 yr. Old obese woman with h/o pain in epigastrium which is
present specially at night & after meals, also has water brash.
127. A woman with h/o pain in stomach after a fundoplication operation.
128. Woman with long h/o peptic ulcer disease with positive H. Pylori
serology comes for re-examination after 4 yrs.
129. A 36 yr. Old man has been treating himself for dyspeptic symptoms
for many years.
Theme 34: Mx Of Osteoporosis.

A. HRT.
B. Raloxifen.
C. Reduce Wt.
D. Wt. Bearing Exercise.
E. Calcium Supplement.
143. A woman with high BMI.
144. A 40 year old lady with family history of osteoporosis, comes for
advice.
145. A pt who needed dietary calcium.
Theme 35: Head Injury.
A. Mild Injury
B. Moderate Injury.
C. Sever Injury.
D. Fracture Skull.
E. Fracture Base of Skull.
146. 45 year old alcoholic with h/o recurrent falls was brought to A&E by
his wife in a Confused state, his GCS is 12.
147. 7 year old boy with h/o fall from cycle, lost consciousness initially but
alert, oriented now. examination reveals no abnormality.
148. A man with head injury who also has hemotympanum.
149. 23 year old footballer brought to the A&E was talking to the
paramedics well after injury but subsequently lost consciousness.
150. 42 year old man fell down .GCS-13.
Theme 36: Management Of drug abuse:
A. Opiate abuse.
B. Opiate withdrawal.
C. Alcohol withdrawal.
151. A female pt comes to A&E demanding pain relief.
152. A pt with h/o of alcohol abuse with signs of alcohol withdrawal.
Theme 37: Analgesia In terminaly Sick.
A. Pt controlled analgesia.
B. NSAID.
C. Paracetamol.
D. Radiotherapy.
2011
139. A pt with h/o atrial fibrillation presents with a pale, cold, pulse less,
leg which he can barely move, & has very little perception of touch.
140. A pt with bilateral diabetic lesions on the feet, presents with a foot
with multiple malodorous gangrenous lesions on one foot.
141. A pt. With trauma to leg presents with # of both the bones, sever
pain & a lot of swelling.
142. A diabetic pt with a unilateral ulcer on foot, which has absent pulse
arteriography shows lack of blood supply.

E. Palliative X-Ray.
F. Dihydrocodiene.
G. I/V opioid
Theme 38: Management Of cardiac Conditions.

A. Verapamil.
B. Heparin.
C. Amiodarone.
D. B blocker.
E. DC Cardioversion.
F. Captopril.
G. Thiazide diuretic
157. A pregnant female with tachycardia of 160/min. she shows no
response to adenosine.
158. A pt with refractory pulmonary edema & cardiac failure, was
prescribed fursemide, but pt. still continues to detoriate in spite of
fursemide therapy.
159. A diabetic pt who develops hypertension.
160. A pt with family history of sudden death, & signs of HOCM.
Theme 39: Respiratory Disorders.
A. Bronchiolitis.
B. Pericarditis.
C. Pneumonia.
D. Coarctation Of Aorta.
E. Pneumothorax.
F. Sleep apnea.
161. An obese male who is tired lethargic, gives h/o repeated awakening
during sleep with sweating, palpitations, & tachypnea.
162. A pt with COPD develops sudden breathlessness & absent respiratory
sounds on one side of chest, X-ray shows absent lung shadow.
163. A tall male develops sudden central chest pain, becomes pale, &
tachycardic with difference in pulse.
164. A teenager with fever & cough & pain in lt lower side of chest on
breathing.
165. A pt with pain in central chest, which is relieved by bending forward,
also raised JVP & pericardial rub.
166. A child with bronchiolitis.
2011
153. A pt with bladder carcinoma, now presents with metastasis to the

spine presents with severe pain in the back.
154. A pt with carcinoma colon has sigmoidectomy done.
155. A woman who has had breast surgery done.
156. A pt. With carcinoma rectum.
Theme 40: Diagnosis Of Urinary Retention.
167. A child is brought by mother who says he is sometimes faecaly &

urinary incontinent.
168. An old pt. who has been incontinent for a long long time now
develops signs of dysuria.
169. A pt. with carcinoma of prostate, & urinary symptoms, has
haematuria & then sudden retention of urine.
170. A pt with history of urinary hesitancy, has a large amount of alcohol,
& then presents with sudden retention of urine.
171. A pt. with huge enlargement of prostate, it is even palpable
suprapubically, presents with weakness of feet & retention of urine.
172. A pt with H/O recurrent numbness of feet & recurrent focal
neurological signs, & retention of urine.
Theme 41: Pre Operative Investigations.
A. Exercise ECG.
B. Arteriography.
C. Spirometry.
173. A pt with respiratory problem due for operation.
174. A female on chronic use of OC pills.
175. A pt with h/o angina on exertion.
Some Miscellaneous Questions:

176. An old pt with his dentures missing.
Answers of March 2003 paper from rxpgonline.com forum

1. C
2. E ?
2011
A. Clot Retention.
B. BPH.
C. UTI
D. Systemic Sclerosis.
E. Compression Of Spinal Cord.
F. Incontinence Pants.
2011
3. D
4. F
5. H
6. A
7. D
8. C
9. E
10. G
11. A
12. C
13. L
14. G
15. G
16. B
17. C
18. A
19. G
20. A ?
21. B
22. G
23. E
24. C
25. A
26. A
27. B
28. C
29. A
30. C
31. B
32. C
33. D
34. F
35. G
36. E
37. F
38. G
39. F
40. B
41. A
42. A
43. G
44. E
45. C
46. A
47. F
48. B
49.
50. C also think about G
51. I
52. D
53. C or G
54. J
55. B
56. B

C
A
D
E
A
E
C
65. D factor viii deficiency

66.
67. A
68. C
69. menningococci
70. E
71. A
72. B
73. E
74. G
75. H
76. iv fluids
77. G
78. C
79. B
80. D
81. D
82. A
83. E
84. F
85. B
86. B
87. Topical acyclovir
88. B
89. E
90. C
91. F
92. H
93. G
94. F
95. E
96. HALOPERIDOL.
97. C
[snip]. D
99. B
100. C
101. A
102. A
103. A.
104. E
105. G.
106. A
107. A.
108. D
109. B
110. A
2011
57.
58.
59.
60.
61.
62.
63.
2011
111. E
112. 113. A
114. C
115. F
116. E
117. A
118. B
119. C
120. G
121. ATROPHIC VAGINITIS ( it said women has sex first time after 20 years
at age 60 odd)
122. A
123. B
124. C
125. D
126. C
127. E
128. A
129. A.
130. A
131. H
132. C
133. D
134. G
135. A
136. D (fracture scaphoib bone)
137. E
138. B
139. B
140. C
141. A
142. D
143. C
144. D
145. E
146. B
147. A
148. E
149. Extradural (was there in the options)
150. A
151. B
152. C
153. E
154. A.
155. DIMORPHINE.
156. G.
157. E
158. DIGOXIN (this what I wrote???)
159. F
160. D
161. F
162. E
163. D

C
B
A
F
C
A
B
E
MULTIPLE SCLEROSIS.
C
B
A
X-RAY CHEST
ALZ. DEMENTIA
METRO GEL
2011
164.
165.
166.
167.
168.
169.
170.
171.
172.
173.
174.
175.
176.
177.
178.
2011
Jan. 2003
Theme 1. Shock
A. Septic-gram -ve septicemia
B. Cardiogenic
C. Hypovolemic
D. Anaphylaxis
E
1. A young boy after eating peanuts suddenly develop difficulty of
breathing with red oedematous lips.
2. Pt had an accident & fracture of pelvis & femur ,B.P-100/70, Pulse-90
3. Pt had an M.I. & then is in shock now
4. A middle aged man has been operated for a perforated gall bladder. He
becomes progressively drowsy with warm peripheries. BP 90/60, PR 110
Theme 2. Epistaxis
A. Anterior nasal packing
B. Post nasal packing
C. Neomycin cream
D. Pinching of the nose
E. Reassurance
F. Vit k
G. FFP
H. Ice pack on the nose
5. Pt on warfarin , comes with you with nose bleeds INR is 0.9
6. Boy has come with slight bleeding from nose 2 days ago. On
examination of the nose showed redness & crusting.
7. Pt came with BP-230/110, bleeding from nose, his circulatory system
has been stabilized, nose ant. packing done ? but he continues to bleed
8. Girl has come with slight bleeding from ant part of nose . by the time
she reaches a-e bleeding has stopped
Theme 3. Fractures Of Wrist Joint

A. X -ray of wrist scaphoid view

B. Refer to orthopaedics doctor immediately
C. Bandage & discharge
D. Isotope scan
E
Theme 4. Relation To Obesity

A. Obstructive sleep apnoea
B. Type 1 DM
C. Type 2 DM
D. Alcohol
E. Cushings
F. Hypothyroidism
G. Polycystic Ovary Disease
13. Wt loss would help night sleep & this condition & improve family
relations
14. Wt loss would even help to stop the medications
15. Stop of this would help in wt loss & vitamin deficiency
16. Surgery in this condition in a female would help in wt loss & improve
this condition
Theme 5. Delayed Milestone

A. Fragile x syndrome
B. Tay-sachs disease
C. Bacterial meningitis
D. Hypothyroidim
E. Prematurity
F. Duchennes muscular atrophy
G. Fetus alcohol syndrome
17. A 4 yrs old boy can write his name & draw a circle & square; he walks
with a lordosis & he cannot run.
18. 3 yrs boy, has delayed milestones his uncle & & brother also have this
condition
19. Girl can sort out cube 4 9 & is 97 percentile for her weight, but her
head circumference is lower than normal
20. A six months old child, can smile, but has head lag.
2011
9. Boy fell from tree now has come with painful wrist x- ray taken was
normal
10. Pt had a fall x- ray shows perilunate fracture .
11. Pt had a fall x ray normal , tenderness in anatomical snuff box
12. Pt had a fall, X-ray showed displacement of the radius

21. Child was normal but then delayed milestones after a fever
Theme 6. Psychiatric Management How Can You Help These Pts
22. A girl has oral numbness & limb paraesthesias after an argument with
her friend
23. Pt a heroin addict - now in ward in withdrawal wants u to help him
24. An alcoholic now has been detoxified feel that he wants to remain off it
but is scare he may relapse
25. Female with s-s of pain in chest; tightness, feeling like dying & sinking
feeling, wants some medication for her condition.
26. Pt has to go for an interview has sweaty palms & palpitations asks for
your help.
27. Pt having restlessness, pacing up & down after death of her husband
with difficulty in falling asleep .
Theme 7. Diagnosis Of Psychiatric Disease
A. Post-traumatic disorder
B. Post natal-psychosis
C. Though -broadcasting ,
D. Insertion ,
E. Echo
F. Hallucination
G. Illusion
H. Paranoid delusions
I. Judgment
J. Insight
K. Low mood
L. Flight of ideas
28. Pt keeps on talking to you non stop & jumps from one topic to another
29. Pt after the birth of her child feels sad & does not want to feed the
baby
30. Pt has the believe that his neighbor is planning an attack
31. A old woman has been admitted & feels that the staff of the hospital
knows what she is thinking all the time.
32. Pt who lost her husband is sad now & avoids eye contact
33. A man has psychiatric problem & he knows that he need a treatment
Theme 8 Vomitting In Pregnancy
A. Hyperemesis gravidum
B. Hydatid form mole
C. Cholecystitis
D. Chloecystic pregancy
E. Brain tumour
2011
A. Methadone
B. Propanolol
C. Diazepam
D. Acomprosate
E. Zopiclone
F. Risperidone
G. Amitryptilline
Theme 9. Nerve Injury

A. Axillary
B. Musculocutaneous
C. Radial
D. Ulnar
E. Common peroneal nerve
F. Sciatic
38. Pt has history of fracture shoulder now has decreased sensation on the
lateral aspect of the deltoid muscle
39. Pt had fracture of fibula or at level of fibula & now lost his dorsiflex &
sensation loss on the lateral side of his low leg.
40. Pt had fracture of medial epicondyle & now come with decreased
sensation of 5th & 4th finger
41. Pt has some fracture of humerus & comes with s/s/ of wrist drop
42. Old man had a fall & fracture or dislocation of hip now has weakness in
his hamstring.
Theme 10. Pain relief
A. Allopurinol
B. Radio therapy
C. TENS
D. I/m diamorphine
E. Oral NSAIDs
F. Paracetamol
G. Prednisolone
H. Physiotherapy
I. Home exercise
J. I/M steroids in joint
43. Pt with CA-prostate & now has 2 aries to back with severe pain, no
NSAIDs, morphine has helped? wants to continue his work.
44. Pt with ca lung with 2 aries now has come with an unilateral swollen
arm , all other medications have failed ( i.e nsaids & morphine )
45. 50 yr old woman has come with painful shoulder joint & hip joint
46. 30 yr old busy executive has got pain on lateral aspect of thigh . he
shows no improvement with nsaids . x ray taken was normal
47. A man is on Fresmide & got pain in his joint
2011
F. pre eclampsia
G. migraine
34. 12 weeks pregnant woman has been continuously vomiting , comes
with a furred tongue & signs of dehydration & uremia.
35. A 14 weeks pregnant woman comes to you with severe vomiting , u.s
of uterus shows absence of f.h.s. & the uterine is 18 weeks to date.
36. Pt comes to u with severe vomitting ,diziness & photohobia. She is in
the 34 week ,she tells you that she had these symptoms since 14 weeks &
o/e her pulse rate is 60 /min
37. A pregnant woman had a nauseous & vomit since week 18 & these
symptoms have got worse since two weeks & she is anorexic, vomiting &
slightly jaundice.

Theme 11. MECHANISM OF ABORTION
48. Pt having 6 abortions in mid trimester

49. Pt having some problem with the deformed child (She married her
cousin)
50. Pt has recurrent abortions, is obese & hirsutism.
Theme 12. Investigation Of Leg Ulcers

A. Pyoderma gangrenosum
B. Bowens disease
C. Venous stasis
D. Arteriography
E. Melanoma biopsy
F
51. Pt having pain on walking. His leg & foot are pale & with the 4th & 5th
digit blackened
52. Pt with diarrhea. abdominal pain had a small round (with central
necrotic tissue)
53. Female fat obese & having edema of leg now has a small ulcer on
medial aspect of her ankle.
54. 60 Yrs old man with a pigmented skin lesion on his shin.
Theme 13. Head Pathology
A. Intra-cerebral hematoma
B. Brain stem injury
C. Extradural hematoma
D. Subdural hematoma (SDH)
E. Acute SDH
F. Chronic SDH
G. Vertebrobasilar ischaemia
H. Migraine
I. Depressed fracture of skull
J. Subarachnoid Hemorrhage
55. Motor cyclist with accident is brought to A&E with head injury. GCS-3 &
his BP-180/100 & Pulse-56/min & his pupil is dilated & sluggish to light, no
neurological sign except his plantars are going up.
56. Young male 27 after a heavy bout of alcohol fell down on the road &
then got up n walked home. His wife found him on the floor & cannot
rouse & has fluctuating consciousness.
57. 67 yrs old man had recent falls, became agitated & confused.
2011
a. Immunological
b. Genetic
c. Anatomical
d. Endocrine
e. Drug-induced
f

58.
59.
60.
61.
A old lady has dizziness & vertigo & walking reeling to one side.
Female at A&E with vomiting & severe pain in the back of the head
Pt hit on the head with a hammer, now comes with vomiting
Young man fell over & there is injury on his temple scalp (he is alert)
Theme 15. Management Of Injuries

A. Laparotomy
B. Refer to surgeon
C. Admit & observe
D. Give iv fluids 1 litre in 30 mins
E. IV fluids 2 litters in 30 mins
F. Reassurance & send home
66. Boy has come with injury by fall on handle of cycle & had got pain &
tenderness in left upper side of abdomen. U/S of spleen shows a small
sized haematoma or infarct in the splenic capsule
67. Pt with being hit by a ball comes with severe pain in epigastrium
68. Pt was stabbed in a fight & now comes with his omentum (or
omentocele outside in the umbilical area). His BP is 110/70 & heart rate
80.
69. Pt with h/o fall has come with tenderness in left side of abdomen &
fracture of 2 right-sided ribs. Pt in shock
70. Pt had (some sort of injury), after 2-L IV fluid, his BP is low & HR
higher.
Theme 16. Management investigation of seizures
A. Start anti-convulsants
B. Reassurance
C. Anxiolytic treatment
D. Vulvar surgery
E. EEG.
F. ECG
G. I.V. glucose
71. A 50 yrs old man had hemoptysis & cough for some time & now come
with a first fit.
72. 8 year girl falls down in the assembly. She is pale & loss consciousness
for 1 min. She often falls in dentist visit.
73. Boy has period of breath holding spells where he becomes blue & loss
consciousness. This happens when he is separating from his parents.
2011
Theme 14. Diagnostic tests on loss of vison

A. MRI temporal lobe
B. MRI pituitary
C. MRI occipital lobe
D. Doppler carotid artery
E. ESR
F. MRI parietal lobe
62. Pt comes with repeated h/o loss of vision in one eye & it improves after
a few hours
63. Pt with bitemporal hemianopia & increase in shoe size.
64. Pt has come with vomiting & upper quadranopia (not sure of the full
question )
65. Pt having pain while brushing her hair & now comes with loss of vision
in one eye
Theme 17. Haemetemesis

A. Mallory Weiss tear
B. Alcoholic cirrhosis
C. Gastric erosion
D. Peptic ulcer
E. Duodenal ulcer
F. Diverticulosis
G. Benign gastric ulcer
78. 55-yrs alcoholic drinking 15-units/day now came with massive
hematemesis
79. Pt comes with massive hematemesis after eating a lot & a bout of
alcohol
80. Pt suffering from RA comes with vomiting with streaks of blood
81. A 50 years old manager had epigastric discomfort for some time & his
stool is tarry. He is otherwise normal.
Theme 18. Management Of Drug Side-Effects

A. Drug serum levels
B. Thyroid function tests
C. Liver function tests
D. S Prolactin levels
E. Urea & electrolytes
F. Increase / decrease levels of insulin
82. Pt on lithium now comes to you with tremors of hand
83. Pt on lithium now comes with wt gain, slow down
84. Pt on phenytoin for epilepsy now came with dizziness, blurred vision &
ataxia
85. Male Pt on phenothiazines now comes with a painful or lactating
breasts?
86. A man take overdose of his Aspirin. Conscious (did not mention how
much & when)
Theme 19. Hearing Problem
A. Ototoxicity
2011
74. A 30 year female has 2-3 episodes of falling down, she also has got a
loud murmur in inspiration
75. A 50 yrs woman has episodes of unconsciousness starting in the left
thumb & then going to whole body. she loses consciousness
76. A 10 yrs boy behaves strangely (cannot remember exactly), & his
teacher says that he is not concentrating at the moment.
77. A young man has some kind of fit, his heart rate drop down to 50/min
78. A young boy has fit, he is a DM , his blood glucose is 2mmol.
87. Pt on gentamycin comes with ringing of ears

88. Pt with some Pathology of ear comes with tinnitus & it worsens
withmovement. the test for it is by lowering the Pt
89. Pt took some treatment for his should pain or headache? & now comes
with tininitus
90. A boy was hit & fell & hit somewhere behind his ear & now comes with
difficulty in hearing & tinnitus
91. Vagrant comes to A&E with diminished hearing particularly after a
shower.
92. A Pt who is anesthetic to his cornea reflex has a diminished hearing.
CT showed a widened ear canal.
Theme 20. How Would You Help This Lady
A. Home redecoration
B. Advice on posture
C. Neck collar
D. Review the dose of anti hypertension
E. Review the dose of anti diabetics
F. Rearrange home
G. Eye sight test
93. Lady on Asprin, end of loridazole 7.5 mg comes to you with repeated
falls while trying to get out of bed
94. Lady on various medication one of them which is glibenclamide come
to you with sweating & altered consciousness
95. Lady 85 year old lives alone fell down while trying to put up her
curtains. This has occurred on another same occasion.
Theme 21. Anal Conditions
A) Anal hematoma
B) Ischaemic colitis
C) Proctalis fugalis
D) CA rectum
E) Sq cell ca of anus
F) Chorons
G) Ulcerative colitis
H) Anal fissure
96. Pt comes to you a young woman with electric pain in the rectum
97. Young girl with h/o/ constipation cannot pass stools. PR is impossible
because of the pain.
2011
B. Tilt test (BPV)

C. Salicylate levels
D. Fracture petrous temporal bone
E. Wax in ears
F. Acoustic neuroma
G. Blast injury
H. Syringing

[snip]. A young woman has constipation & painless fresh blood after
defecation
99. A woman of 29 of age has diarrhea & colic abdominal pain with tags in
her anal exam
2011
Theme 22. Diagnosis Of Rectal Conditions

A) Rectal hematoma
B) Carcinoma of rectum
C) Ischaemia colitis
D) Ulcerative colitis
E) Crohns disease
100. 50 year old Pt with diarrhea & pain in abdomen
101. On proctosigmoidoscopy an ulcer is found 10 cm from the rectum
102. Pt has come with pain while defecating. o/e anal cushions are found
which are purple in color
103. Pt comes with h/o/ fever & diarrhea on biopsy granuloma found
Theme 23 Contraception
A) Abstinence
B) Mirena coil
C) 9 nothistone
D) OCPs
E) Progesterone only pills
F) IUCD
G) Depot preparations depot vera
H) Tubal ligation
I) Vasectomy
J) Rhythm method
K) Withdrawal
L) Ovulation testing
M) Condom
N) Diaphragm
104. A 47 year old woman with 9 month h/o amenorrhea now comes
wanting to have contraception. She says that her husband is not reliable
with condoms & she doesnt want chemicals in her body
105. A 26 yrs old lady with irregular periods of 24 to 40 day variations, she
does not want children for the next two years. She comes to you saying
she wants a natural method of contraception
106. 37 yrs old lady with 2 children & a hectic life style comes to you for
contraception. She wants reliable method since she was pregnant when
she was on the oral combined contraceptive last time.
107. Lady 26 year old .2 kids the youngest 6 months says she wants to be
sterilized. She has separated from her husband & she does not want to put
weight on since the oral combined contraception did before.
Theme 24. Investigations for fever
A) Plasmodium vivax
B) Falciparum ovale
Theme 25. Management of post-operation

A) Catecholamine
B) Dopamine
C) Laparotomy
D) Antibiotics
E) Wide excision of affected tissue
F) Percutaneous drainage
G) Insert stent
H) Excision of the dead tissue
113. A middle aged woman had operation on the perforated. She has been
unwell since the operation. She has difficulties in breathing. Despite of the
full support from the high independent unit, her PO2 is 6.
114. Pt post acute pancreatic attack has on CT-scan have non-enhanced
.behind the tail of pancreas.
115. Girl post chicken-pox gets blue discoloration of skin after scratching
,it is spreading at the moment .
Theme 25. NATURE OF ANAEMIA

A. Folate deficiency
B. B12
C. Iron deficiency
D. Sickle cell
E. B-thalassemia trait
F. G-6-PD
G. Hereditary spherocytosis
116. A boy brought Hb 8, unconjugate bilirubin 120 mother says that
anemia is hereditary in the family
117. A Greek boy brought by mother says that he looks pale inspite of
being normal
118. Pt with severe menorrhagia & tired
119. A four year old boy has been having funny dietary pattern. He likes
cheese & drinks 2 litters of milk a day. He looks pale & otherwise normal.
Theme 26. Dysphagia
A. Achalasia
2011
C) Lumbar puncture
D) Lymes serology
E) Brucellosis
108. Pt returned from Zambia now has fever with rigors & fits
109. Young girl with fever, ash & neck stiffness
110. 18 yr old boy has come back from Mexico after working in a farm
there & now has fever with splenomegaly.
111. Girl went out in the forest for walk now has a tick bite & has fever at
the moment
112. Surgical conditions what is the rx
Theme 27. Cervical Pathology

A. Cervical smear
B. Cervical biopsy
C. Colposcopy
125. Young Pt gets post coital bleeding. Speculum shows cervical ectopic
126. Pt attend clinic because of CIN 1
127. Pt with CIN-2 what will you do now
THEME 28. RESPIRATORY DISESE
this was given in an value form EMQ with clinical findings ? ECG & chest XRay & temp given in serial order.
A. Pneumonia
B. Pulmonary embolism.
C. Pulmonary edema
D. Rupture of esophagus
E. MI
F. Pneumothorax
128. Pt with fever? basal consolidation & ECG normal
129. Pt with surgical emphysema (cant remember the rest --)
130. Pt with breathlessness & absent markings on chest x ray
131. Pt with severe pin in chest & q waves in v 3
132. Pt with severe pain in chest & q waves in v 1 to v3
Theme 28. Diagnosis Of Chest Pain
A. Occupational asthma
B. Pneumothorax
C. Aortic dissection
D. Interstitial ~{~}
E. Pulmonary embolism
133. A carpenter has chronic breathlessness, he does not smoke. He
becomes normal when he goes away for holidays.
134. A woman has cough. On examination she has crept on her lung base.
(not exactly)
135. 50 year old Pt comes with severe pain in chest & now has
breathlessness & difficult in breathing ECG shows gallop rhythm
2011
B. Pill Stricture
C. Barretts
D. CA esophagus
E. Post cricoid cancer
F. Phar Pouch
G. GORD
120. A 34 yrs aged plump woman has difficult in swallowing food,
particularly after drinking alcohol & in the night.
121. A young girl (cannot remember this Q)
122. 45 yrs old man, he has difficulties in swallowing the food to start with,
but the rest of the swallow is normal. He does not have regurgitation.
123. This Q is about a man has difficult in swallowing, & there is lump in
his throat.
124. Pt having difficulty in swallowing specially liquids (did not mention
about weight loss)

136. A 50 yrs old man had severe chest pain under the sternal. He late
had hemiparesis.
2011
Theme 29. Asthma in children

A. Peak flow diary
B. Spirometry
C. Exercise test
D. No need investigation
E. CXR
137. A young girl has 2 episodes of breathless so far & she is on short
acting bronchodilator & now she is fine. Mother had eczema.
138. Boy comes with sudden breathless & trachea deviated to the left
-pneumothorax
139. A girl in the A&E, she is too breathless to have her peak flow
checked.
140. A boy has asthma, & he is given some short acting dilator inhaler. His
parents dont know when he should use it.
Theme 30. Anatomy Of Renal Failure
A. Bladder
B. Prostate
C. Parpilla
D. Medullary
E. Interstitium
F. Ureter
G. Renal artery
H. Cortex
141. A woman has not pass her urine for many hours (not exactly), on
examination there is mass on super pubic
142. A old man has difficult in passing urine & dribbling for long time
143. A woman of sickle cell disease has not passed urine for many hours
144. A woman has protein urine & edema
145. Pt with hypertension & small kidney on one side
Theme 31. Investigation Of Hematuria

A. Ultra sound
B. Microscopy & sedimentation
C. Anti-strep. Trite
D. Creatinine
E. IVU
F. Urine osmolarity
Theme 32 Diagnosis Of Hematuria

A. Bladder cancer
B. HSP
C. SLE
D. Polycystic kidney
150. A smoker with painless Haematuria
151. A 40 yrs old woman has Haematuria. She has got non-blanching
purpura on her legs & back. (it is obviously HSP, but never come cross
with somebody who is 40!)
152. A man with Haematuria, his father or somebody has got it.
Theme 33. Management of cardiac pts
A. Nitrates
B. B-blockers
C. AEC
D. Surgical intervention
E. Valve replacement
153. A Pt has angina & he is on nitrates. He is having pains once a week
although he has been taking his medication
154. A old woman has pains in her chest, angiograph shows three severe
antero-sclerotic lesions.
155. 65 old woman, has murmur & palpitation {~}..(cannot remember)
Theme 34. Investigations for breast lump
A. FNA
B. Ultra sound
C. Mammograph
D. Discharge cytosis
E. CT scan of the spine
F. X-ray of the spine
G. Duct-graphy
156. A young 24 yrs old woman with a breast lump. She has other lumps
in the out quarter of her breast.
157. A young lady with a breast lump that varies in size according to her
menses
158. 56 yrs old woman has blood stained nipple discharge. The discharge
is from a solitary duct. Ultra sound & mammography show normal
159).48 yrs old woman has a breast lump in the upper out quarter of her
breast. Mammograph showed a solid lump.
160. A old woman had breast cancer which was operated a few years ago,
now she has numbness on her chest.
Theme 35. Diagnosis of gastroenterology findings
2011
146. A man came with Haematuria, he says this runs in the family
147. A boy has fever, oliguria and edema.
148. A 56 yrs old woman had operation on her uterine cancer years ago
now comes with Haematuria
149. A man has been unwell for long time, came with hypertension &
hematuria (cannot remember exactly, but sounded like he has got DM to
me)
161. A young boy has fever, nausea & vomiting for 24 hours
162. A pregnant teacher has diarrhea & vomiting. The children with her all
had same symptoms
163. A young boy has bloody diarrhea & vomiting for one day
Theme 36. Preparation for pre-operation
A. ECG
B. CXR
C. FBC
D. Blood glucose
E. Angiography
F. CT
164. A old Pt is due for his {~}. Operation. He has palpitation {~}..
165. A woman due for her operation, she is amenarrhgic & tired
Theme 37. Bites & Stings
A. Thick & thin blood film
B. Lyme disease serology
C. Leptospirosis serology
D. Hep a serology
E. Hep b serology
F. Skin swab test
G. Skin prick test
165. 28 yrs old policeman is brought to A&E after bitten by a drug addict
while the f catch. There is a deep wound at his right hand.
166. 16 yo girl after forest walking, she had to remove an insect form her
leg, now present with red raised ulcer.
167. 52 yo businessman present with fever & rigor after coming back form
10 days meeting at Zambia
Answers
01-D02-C03-B04-A05-D06-C07-B08-A09-A10-B11-A12-B13-A14-C15-D16E17-F18-A19-G20-B21-C22-B23-A24-D25-C26-B27-C28-L29-K?30-H31-C3233-J34-A35-B36-G37-D38-A39-E40-D41-C42-F43-B44-G/B?45-F46-H 47E48-C49-B50-D51-D52-A53-C54-B55-C/A56-D57-F58-G59-J60-C61-I62-6364-65-66-C67-C68-A69-E70-B71-E72-C73-B74-D75-A.76-E77-F78-G79-A80C81-D82-A83-B84-A85-D86-E87-A88-B89-C90-D91-H/E92-F 93-D94-E95-
2011
A. Crampy diarrhea
B. Gastroenteritis
C. UTI
D. Carcinoma Colon
E. Acute appendicitis
F. Salmonella infection
November 2002
PLAB Part-I Exam
Theme- 1 :Investigation of choice

A. 24 hr urinary free cortisole
B. Serum cortisole
C. Serum aldosterone
D. U/ s abdomen
E. U/ s pelvic
1. A 40 year old obese woman with hirsutism and stria on abdomen
presents to A E with raised B.P.
2011
C96-C97-H98-G99-F100-E101-D102-A103E104-F105-K106-G107-H108B/A109-C110-E111-D112-113-C?114-F115-E116-G117-E118-C119-A120-G?
121-122-E?123-F124-A125-A/C126-B127-A128-129-D130-F131-E132-E133A134-135-E136-C137-D138-E 139-E140-A141-A142-B143-C144-H145G146-A147-C148-E149-D150-A151-B152-D153-B154-D155-E156-A/B157B158-D159-A160-E161-E162-B163-A164-A165-C165-F166-B167-A168-169170-171-172-173-174-175-176-177-178-179-180-181-182-
2. A patient with a B.P of 210/100 and having hypertensive changes on

fundoscopy with a raised K level and having no other abnormalities.
Theme- 2 Management of thyroid diseases.

A. Propranolol
B. Carbimazole
C. Radio iodine
D. Tyroidectomy
E. Observation
F. Tyroxine
G. Fnac
H. Autoantibody
4. A female patient presents with wt loss; palpitations and diarrhea.
5. A female patient having a previous history of asthma is now
complaining of wt loss and diarrehoea
6. A female patient has got a diffuse goiter but she is asymptomatic
7. A patient presents with a solitary thyroid nodule about 3cm in size.
8. A woman presents with features of hypothyroidism and a tender
thyroid.
Theme- 3; Ear Ache In Children

A. Removal of foregion body with the forceps
B. Removal of foregion body by syringing under ga
C. Amoxicillin
D. Amoxicillin with clavulinic acid
E. Syringing
9. A 3 year old child presents to the A E with the complaint of ear ache. on
otoscopy the external ear was found to have wax in the right ear.
10. A women carries her 3 year old child with the complaint of severe ear
ache .on examination he was having a red bulging tympainic membrane.
11. A 4 year old child was carried by her mother who says that a green
bead has been introduced in to the childs ear and now complain of severe
ear ache.
2011
3. Women with bilateral palpable kidneys presents to A E with a reaised

B.P.

12. A 3 year old presets to the A E with severe ear ache .on otoscopy he
was having a pink scared tympanic membrane.
A. Breast milk jaundice

B. Congenital viral infection
C. Sickle cell anemia
D. Tahalassemia trait
E. Hepatitis A
12. A neonate present with jaundice and straw color urine.
13. A new born baby was having jaundice and hepatomegaly and a rash
on the body.
14. A child was found to have pale stool and dark urine .
15. A child developed mild icterus while she was still breast feed by her
mother.
16. A child accompanying a Siri Lankan mother was found to have an Hb
of 10 gm/dl and having mild jaundice.
17. African women presents to the A E with a jaundiced child .the baby has
several previous episodes of chest and joint pains.
18. A child presents with fever and jaundice for few days .on examination
he was found to have hepatomegaly.
Theme-5 ; Fever With Rash
A. Auto antibody
B. Blood culture
C. L.P
19. A 15 YEAR old presents to A E with joint pains and a rash on both
cheeks.
20. A 5 year old presents to A E with vomiting ; fever; and a nonblanching rash.
Theme-6; Relief Of Pain
A. Paracetamol
B. NSAIDS oral
C. NSAIDS i/v
D. Pethidine i /v
E. Morphine
20. A 12 year old child presents with a minor bruise on the temporal
region. he is otherwise normal.
21. A patient in terminal illness from a malignancy wants to have a relief
of pain.
2011
Theme- 4;Diagnosis Of Jaundice In Children
Theme-7;Paeds Diagnosis
22. Women in the hospital phone to A E that one of her sons best friend is
having meningo-encephalitis.
23. A child presents with chicken pox to A E but his sister has been
recently sent to home after renal transplantation.
24. A child presents with wt loss ,diarrhea and endomyseal antibodies.
25. A child presents with recurrant chest infections and diarrhea.sweat
test is positive.
26. A one year old presents with drowsiness and confusion prior to this he
was complaining of increased thirst and wt loss. (serum blood glucose
level.)
27. A child vomit after every feed and is now looking lethargic and
dehydrated. The diagnoses was made on abdominal U/S.
28. A child brought to A E by her parents with sudden onset of swelling of
the lips; wheeze and swelling of the palms etc.
Theme- 8; diagnosis of falls

A. Adjust anti-hypertensives
B. Adjust anti-diabetics
29. Women on bendrufluazide for hypertension is now having several falls
especiallyafter . waking in the morning.
30. Women on aspirin , bendrufluazide usually found to have confusion.
31. Women on glibenclamide for a long time presents with sever confusion
and is sweaty on examination. she previously was found several times to
be unconscious in her home.
Theme- 9; diagnosis of bleeding diathesis.
A. PT
B. APTT
C. B.T
D. Factor 8 level
E. Factor 8 antigen
F. Platelets count
G. Platelets function
H. Vit k
31. A child presents to A E after several episodes of bleeding in to joints.
32. A child presents to A E with purpras. platelts count or B.T? and clotting
time normal
2011
A. Acyclovir oral
B. Acyclovir i v
C. Quarantine
D. Barrier nursing
E. RAST
33. A chronic alcoholic presents with mild jaundice and bleeding.

34. A 13 year old complains of mennorrhagia.
A. Motor neuron disease

B. Multiple sclerosis
C. Cerebellar degeneration
D. Parkinsons
35. A woman of 40 years complains of numbness in her right leg.
previously she was having episodes of visual loss with out permanent
damage.
36. A man complains of dysphagia ,chocking on food and weakeness of
leg.
37. A man presents with tremor , nystagmus,and ataxia.
Theme- 11; Constipation
A. Sigmoidoscopy
B. Stimulant laxative
C. Bulk laxative
38. A woman with diffuse abdominal pain alternating with bowl habits.
Previoulsly constipated and now complains of diarrhea.
Theme- 12; diagnosis of arthritis
A. Septic arthritis
B. Enteropathic arthritis
C. Sjoggeren disease
D. Rehmatoid arthritis
E. Osteoarthritis
39. A 15 year old female with long standing bloody diarrhea and swelling
of right knee.
40. A patient of 40 years with symmetrical arthritis. Shirmers test is
positive.
41. A 15 year old boy with bloody diarrhea and having unilateral knee
swelling.
42. A 25 year old male who is single return after a visit to India and is now
complaining of swelling of right knee.
Theme- 13; diagnosis of confusion
A. Multivitamins
B. Post ictal confusion
C. Parkinsons disease
D. Post natal depression
E. Post natal psychosis
2011
Theme-;10 Diagnosis Of Neurological Condititons

F. Schizophrenia
G. Subdural heamatoma
Theme-14; diagnosis of chest pain.

A. CT
B. V/Q Scan
C. Pulmonary oedema
D. Aspirin
E. Cardiac enzymes
F. Wegeners granulomatosis
G. Streptokinase
H. T(pa)
I. COPD
J. Bronchiectesis
K. Ca bronchus
48. A businessman fly from u.s to u.k now presents with sudden onset of
breathlessness and chest pain.
49. A tall man of 24 years presents with sudden chest pain radiating to left
shoulder while cycling and is breatheless.
50. A women with past history of mitral stenosis and atrial fibrillation is
now coughing up sputum mixed with blood and is breathless.
51. A patient presents with pain lasting for an hour.he is now stable but
the ECG shows Q wave in leads 2,3.and avf.
52. A patient present with chest pain radiating to left shoulder.CXR and
ECG is normal.
53. A patient presents with heamaturia, proteinuria, and heamoptysis.
54. A man with chest pain still complaining of pain .ECG shows ST
elevation in leads 2,3 and AVF.
55. A man with chest pain previously received streptokinase.
56. A chronic smoker presents with cough with sputum and wt loss.?
2011
42. A chronic alcoholic lying un-consiouss in his home is now complaining

of headache.
43. A chronic alcoholic presents with increasing forgetfulness despite
multivitamins and not improving.
44. A man with increasing forgetfulness and slow to start walking.
45. A film maker is filling gaps in his memory. he is now frustrated that he
cannot remember any thing.
46. Women with decreased mood , loss of appetite, thoughts of harming
the baby.
47. A man presents to A E with the complaint that some one is taking
thoughts from my head.
57. A man with cough, fever (39C )and decreased breath sounds.in the
right lower base.
A. EBV virus
B. Mesothelioma
C. Sarcoidosis
D. Tuberculosis
E. Sore throat
F. Thyroid ca
58. A female with wt loss, night sweats and cervical lymphadenopathy
which on histology shows the granulomatous inflammation.
59. A shipyard worker presents with breathlessness. CXR Shows bilateral
pulmonary fibrosis and minimal pleural effusion and having supraclavicular lymph nodes.
60. Thyroid mass which is now invading the sternomastioid and is moving
upward with protrusion of the tongue.
61. A child with sore throat and cervical lymphedenopathy, rash appear
after amoxicillin.
Theme- 16; diagnosis of trauma
A. Splint the femur
B. Take to theter
C. Rupture of spleen
D. Renale contusion
E. Renale pedicle avulsion
62. A motorist with left sided trauma and with LUQ pain.
63. A motorist after having an accident is stable but becomes breathless
on sitting up in bed.
64. A motorist with LUQ trauma. B.P is 90/50.
65. A motorist which has been resussicitated is stable but has got a
deformed thigh.
66. A motorist after a road traffic accident received right sided trauma.
How- ever the IVU on the right side does not show any excretion of the
dye.
67. A motorist after a road traffic accident has been paralysed, intubated,
and ventilated with a GCS of 9 and having a deformed thigh.
2011
Theme- 15; diagnosis of cervical lymphadenopathy.
Theme- 17; pre-natal diagnosis.
68. The condition for which a patient needs folic acid before and after
pregnancy.
69. A pregnant lady has got high HCG and a low AFP.
70. A woman in 16 weeks of pregnancy want to know about the condition
of his son in utero for a condition which affected her last son.
71. A women with high AFP level
Theme- 18 treatement of incontinence of urine

A. Intermittent self catheterization
B. Incontinence pants
C. Vaginal estrogens
D. Pelvic floor exercises
E. Bladder neck surgery
72. A 3 year old boy was brought by his mother. the child is occasionally
urinary and feacally incontinent.
73. Child with meningo-myelocele and is incontinent.
74. A 80 year old women with mild enterocele and cystocele and has
stress incontinence.
Theme- 19; scientific basis of diagnosis
A. Spontaneous stone passer
B. Open removal of stone
C. No further problems
D. Recurrent renal colic
E. Progressive renal failure
F. Infective
G. Hormonal
H. Inherited
I. Congenital
2011
A. Spina bifida
B. Duchann muscular dystrophy
C. Downs syndrome
D. Edward syndrome
E. IUD
Theme- 20; diagnosis of skin diseases

A. Squamous cell carcinoma
B. Basal cell ca
C. Bowens disease
D. Kerato-acanthoma
E. Malignant melanoma
F. Neurofibromatosis
G. Lipoma
82. A patient presents with and ulcer having rolled edges with a central
horny ball.
83. A patient presents with a Pearly shaped ulcer having rolled edges on
cheek.
84. A patient presents with a lesion having different colors and having
typical satellite lesions.
85. A patient presents with a raised scaly lesion on the shin which is slowly
growing .
86. A patient presents with multiple caf au lait spots and subcutaneous
nodules. After 16 years the lesions are increasing in no.
87. A patient presents with a slowly growing mass in the thigh .its is soft in
consistency.
Theme-21 data Interpretation In Renale Failure.
A. Captopril use
B. Uretheral catheterixation
C. Dialysis
88. A patient who is known diabetic and hypertensive for the last decade
has a blood tests ; Na=142 mmole K=6.7 mmole Urea=18 mmole
Creatinine=300 mmole
89. A patient with a chronic renale failure have the following blood values.
the ultra sound shows the dialated ureter and the bladder. Na= K=
UREA=16 mmole CREATININE=250 mmole
Theme- 22; Diagnosis of GI conditions.
A. Gastric ca
2011
75. A patient pass stone per urethra

76. A stag horn stone is removed by open surgery. follow up tests shows
no further abnormality.
77. A patient presents with severe renal colic .he has a past history of
similar episodes of colic several times.
78. A patient has a ureteric stone for some time and now have creatinine
of 200 mmole
79. A patient having history of rehumatic fever, mitral stenosis, clubbing
and splinter hemorrhages.
80. A patient with history of rehumatic fever and a changing murmur,
spleenomegaly and a new murmur.
81. A child is having bicuspid aortic valve.
90. A patient with primary hyperparathyroidism presents with severe

peptic ulcer which does not respond to omeprazole.
91. An obese women with a history of indigestion especially at night.
92. A japeness bisunessman is complaining of wt loss and is having a
supraclavicular lymph node.
93. A patient presents with wt loss and pain which radiates to back.
94. A patient presents with a pulsatile mass in the abdomen.
Theme- 23;diagnosis of ammenorreaha
A. Turner syndrome,
B. Gonadotrophin levels
C. Prolactin level
D. TFTs
95. A girl presents with a webbed neck, cubitus valgus,and no
menstruation.
96. A 10 year old whose secondary sexual characteristics are well
developed is having no menstruations.
97. A woman who is breast feeding her baby has not menstruated since 18
months.
[snip]. A patient presents with oligomenorrhea, wt gain, and constipation.
Theme- 24 drugs and their effects
A. Metoclopramide
B. Diazepam
C. Haloperidol
D. No Rx required
99. A patient presents with dyskinesia, tremor, and opisthotonus.
Theme- 25; management of vericose veins
A. Injection sclerotherapy
B. Graded compression stockings
C. Operation for varicose veins
D. Reduce wt
2011
B. Peptic ulcer
C. Gastrinoma
D. Pernicious anemia
E. Gastric esophageal reflux disease
F. Abdominal u/s
Theme- 26 management of incontinence repeat

A. Intermittent self catheterization
B. Incontinence paints
C. Pelvic floor exercises
D. Desmoprisin
E. Bladder neck surgery
F. Vaginal estrogens
104. A 12 year old boy who is wheel chair bound with minigo-myelocele is
found to have incontinence of urine.urine culture is sterile.
105. A 30 year old female is mother of 3 .cyto- urometery proves genuine
stress incontinence. 14/12/2/0
106. A 80 year old female is found to have mild cystocele and mild
rectocele.
107. A child is having history of occasional enuresis and occasional feacal
incontinence.
Theme- 27; diagnosis of gyenocological diseases
A. Endometriosis
B. Dermoid cyst
C. Ovarian ca
D. Tubo ovarian abcess
E. PID
F. Endometrial ca
G. Ectopic pregnancy
H. UTI
108. A 50 year old woman presents with lower abdominal mass more to
the left side .USG shows solid and cystic areas and fluid in the pouch of
douglas.
109. A pregnant lady is found to have a mass with complex solid and
cystic echo patterns during a routine USG at 16 weeks.
110. A laky presents with history of dysmenorrhea. on examination there
is tenderness in pouch of douglas .USG shows cystic lesion with numerous
echogenic substances.
111. A 35 year old woman is being treated for PID and seems to be
recovering .after a few days develops high temperature.USG shows a
cystic mass.
Theme- 28 ; diagnosis of fractures in children
2011
100. A female with bilateral varicose veins, lipodermatosclerosis presents

with painful legs .she is using compression stockings .despite this there is
an increase in itching and eczema. Her BMI is 27
101. A 75 year old underwent 2 operations for varicose veins presents
with painful legs has h/ o of heart failure. on examination there are
bilateral gross varicose veins, lipodermatoclerosis and no ulcers.
102. Female with BMI of 33 comes with the complaints of varicose veins
and eczema
103. Man with varicose veins has to fly for 20 hrs. his father has a h/ o of
pulmonary embolism after flying.
112. a 7/7 baby cries whenever lifted. labour was difficult.

113. Young girl tripped while holding her mothers hand .now cant use
arm at all.
114. Young boy fell off horse on to his hand. now c/o mild tenderness but
there is no deformity on examination of the fore-arm.
115. Young patient fell on outstretched hand and now has absent radial
pulse.
116. A child fell on hand .plaster cast was applied to the forearm. child
makes it wet, re- examined and x- ray reveals a fracture. patient gives
history that previous x-ray was normal.
117. Mother carries a child and says that the baby rolled of bed and now
has got multiple bruises.
Theme- 29; alcohol and drug abuse

A. Benzodiazepines
B. Admit and benzodiazepines
C. Methadone
D. Naltrexone
118. Heroin addict want to quite.
119. A chronic alcoholic presents to A & E .He is accompanied by a non.
Alcoholic supporter, he intend to quite alcohol.
120. A chronic alcoholic presents to A E. he is complaining of some insects
crawling on his body. doubling at 3 sites.42;19;8.
Theme- 30: dignosis of htn in pregnency

A. Period of observation
B. Immediate c/s
C. Induction of labour
D. I.v deazepam
2011
A. Fracture of the scaphoid

B. # shaft of radius and ulna
C. # shaft of the humerus
D. # neck of humerus
E. Supra-condylar fracture of humerus
F. Spiral fracture of the forearm
G. Pulled elbow
H. Non accidental injury
I. Fracture of the clavicle

E. I.v anti hypertensive
F. Oral diuretics
G. Oral anti hypertensive
122. A 24 year old has an uneventful Ist pregnancy to 30 wks .she is then
admitted as an emergency .during the ist 2 hours her Blood pressure rise
from 150/105 to 170/120.kshe has 3+ protinuria.
123. At anti natal clinic visit at 38 wks a multiparous woman has a b.p of
140/90 she has no protienuria.
124. At 32 wks a 22yr old is found to have a b.p of 145/100. At her ist visit
at 12 wks the was 1456//90 she no protenuria but she is found to have
edema to her knees.
November 2002 Answers by Dr. Junaid

01-A02-D03-D04-A05-B06-F07-G08-H09-E10-C11-B12-C*12-A13-B14-F15E16-D17-C18-E19-A20-C*20-A21-E22-F23-C24-G25-H26-27-28-29-30-31D/B32-33-A34-C/B35-B36-A37-C38- 39-B40-C41-A42-A*42-G43-G44-C 45A46-E 47-F48-B49-L50-C51-G52-E53-F54-G55-E/R/G?56-K57-58-D59-C60F61-A62-D63-64-C65-A66-E67-A68-A69-C70-C71-A72-B73-A74-B75-C76-F
77-D78-79-F80-F81-I82-B83-B84-E85-C86-F87-G88-A89-B90-C91-E 92-A
93-F94-F95-A96-B97-C98-D99-A100-C101-A102-D103-B104-A105-E106B107-D108-C109-G110-A111-D112-I113-G114-A 115-E116-A117-H118C119-A120-B121-G122-E123-A124-A
2011
121. A patient in her third pregnancy presents JTH her G.P at 12 wks
gestation she was mildly hypertensive in both of her pregnancies .her B.P
is 150/100 .2 wks later at the hospital anti natal clinic her B.P is 150/100.
2011
Others
Scientific basis of the disease

1. a person got stabbed on the right side of the neck. Later when asked to
protrude the tongue it was deviated to right.
2. a person was not able to close the eye and some difficulty with mouth
movement
3. a persin with left sided upper and lower limb weakness and left sided
facial weakness.
4. a patient comes after a week after thyroidectomy complains of difficulty
with the speech.
5. a patient gets up in the morning and finds difficulty in speaking. He has
an incoherent speech but comprehension was normal.
Options.
a. hypoglossal nerve
b. trigeminal nerve
c. facial nerve
d. recurrent laryngeal nerve
f. internal capsule
g. cerebellum
h. cerebral cortex
i. brocas area
j. wernickes area
1 . a man presents with knee injury while skiing. On examination there is
pain on valgus stressing. Diagnosis?
Options;
a. medial collateral ligament
b. lateral collateral ligament
c. ant cruciate ligament
b. post cruciate ligament
what`s the next management for these patientrs ,

1- a child is brought to A &E for severe attack asthma , he didn` t respond
to nebulised Beta2 agonists at home
2- a child present with eczema and wheeze , he didn`t respond to inhaled
beta2 agonists
1 . a woman 16 weeks pregnant is worried about abnormal chromosome
anomaly in her child
what`s the defintive investigation at this stage ?
options :
a- amniocentesis
b- chorionic villous sampling
c- parents karyotyping
d- coomb`s test
. a woman 16 weeks pregnant is worried about abnormal chromosome
anomaly in her child
what`s the defintive investigation at this stage ?
options :
a- amniocentesis
b- chorionic villous sampling
c- parents karyotyping
d- coomb`s test
diagnosis of psychiatric symptoms
1 . pt has many ideas and jumps from one topic to another
2 . pt speaks continously and does not get distracted ffrom interventions
3 . pt knows about his psychiatric problem
4 .pt in ward claims that nurse knows what she is hinking
5 . pt having difficulty falling asleep, early morning waking and avoiding
eye contact
2011
THEME : ASTHMA MANAGEMENT

options :
A-budesonide ( inhaled )
B- leukotriene
C- oral steroids
D- IV salbutamol
E- inhaled salbutamol
F- inhaled salmeterol
G- reassure
H- IV aminophylline

8. A mother who gave birth a couple of weeks ago feels as though she
doesn't like the baby and doesn't want to feed it. Those thoughts keep
coming back to her very often and she does not like these thoughts. How
will the doctor explain her symptoms to her? C
A. Delusions
B. Hallucinations
C. Obsessions
D. Illusions
E. Psychosis
12. During the past three to four years a middle aged man has had two
episodes of mania and three of depression with several hospital
admissions. What is the best management in this case?
A. Flupentixol
B. Chlorpromazine.
C. Lithium
D. ECT
E. Haloperidol
The average age of patients presenting with schizophrenia is
a)20-30 years
b) 30-40 years
c) 40-60 years
d) over 60 years
ans 20 -30 years
297.Theme: Psychiatric disorders in pregnancy and the puerperium
A. 'baby blues'
B. Chronic schizophrenia
C. Depressive illness
D. Munchausen's disease
E. Neurotic Disorder
F. Personality disorder
G. Phobic disorder
H. Postnatal depression
2011
options;
low mood
thought insertion
thought broadcasting
insight
flight of ideas
pressure of speech
concentraction

drug side effects:
1==A pt receiving treatment for bipolar affective disorder his tsh level is
increased and t3 and t4 levels are reduced.
Ans: lithium.
-2== Pt: having extrapyramidal effects complains of reduced sexual libido
and erectile impotence his prolactin is raised.
3==A pt on treatment for depression complains of dry mouth, blurred
vision, constipation and tremors.
Ans: Amitriptyline.
-4== Pt: with h/o of schizophrenia receiving an antipsychotic agent
becomes physically unwell and is found to have an elevated body temp:
unstable blood pressure excessive sweating and a raised white blood cell
count and raised cpk.
2011
I. Postpartum thyroiditis
J. Puerperal psychosis
K. Sheehan's syndrome
1. A 19 year old living alone, 2 weeks following the delivery of her first
child
complains of difficulty sleeping, tearfulness and anxiety that she is
incapable
of looking after her baby
2. A 36 year old solicitor, 3 days after an emergency Caeserean Section for
fetal distress, suddenly becomes aggressive and abusive to staff and her
partner. She threatens to strangle her baby
3. A 36 year old solicitor, 3 days after an emergency Caeserean Section for
fetal distress, suddenly becomes aggressive and abusive to staff and her
partner. She threatens to strangle her baby
4. A 32 year old 6 weeks following the vaginal delivery of her 5th child,
which
was complicated by a large postpartum haemorrhage, presents to her
general practitioner complaining of lethargy, loss of libido and difficulty in
bonding with her new baby. She looks extremely pale although her
haemoglobin is normal.
5. A socially withdrawn 42 year old, living alone presents to the antenatal
clinic
at 26 weeks with dishevelled appearance and exhibiting poor personal
hygiene. Prior to this visit, she has not attended for antenatal care and is
unresponsive throughout the interview, failing to make any eye contact.
HJAKB

woman after pregnanacy becomes very fearful and sleepless and avoids
going out.has frequent emotional outbursts,sleeeplessness and clings to
her child claiming inadequate bonding etc.
2.normal reaction
3.depression
4.acute stress reaction
Theme 16 Psychiatry
a) Acute confusional state
b) PTSD
c) drug induced psychosis
d) Mania
e) schizophrenia
65) A Pt undergone surgery for some condition and is receiving medicines
for pain relief. On 3rd postop day he has features of delirium tremens.
66) A kosovian who gets startled easily when he hears any loud noises etc
67) A person who is being stopped by the police and goes on talking
jumping from one topic to another.
68) Something about a man running to the police station and saying that
his house is not safe, but on checking thats not the case.
A.bitemporal heminopia
B. left homonymous heminopia
C. tunnel vision
D. increased size of blind spot
E. right homonymous heminopia
F. cortical blindness
G. hysteria
H. central scotoma
I. amaurosis fugax
J. uniocular visual loss
K. night glare
1. A 70 year old man presents with a sudden onset of mild right sided
weakness, and has noticed that he has been bumping into things
2. A 65 year old woman is blind on testing but denies that there is a
problem
with her eye sight
3. A 27 year old woman complains of visual problems and weakness of
both
legs. She had weakness in her left arm 3 months ago, which resolved.
Fundoscopy reveals optic atrophy.
2011
1postpartum psychoses
2011
4. A 54 year old woman complains of coarsening of her facial features,

sweats
and headaches. She also has a visual deficit.
5. A 75 year old woman presents with deterioration eyesight. She has
been on

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PLAB 1 past papers 2002-2007

Jan 2007 Plab

Theme on x-ray features of diff. diseases:

1.pt with SVC Obs

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

Theme on diagnosis of Upper GI diseases

24. Myocardial infarction with murmur

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

theme on electrolyte imbalance

60. A person with symmetrical unilateral swelling behind angle of jaw,

PLAB 1 past papers 2002-2007

72. A man after prostatectomy, requires D.V.T prophylaxsis, what would

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Theme on investigation of breast lump (little bit twisted)

pt. With fibrocystic disease with symptoms related with menses.

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PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

101. A person suffering from some pneumonia like s/s

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PLAB 1 past papers 2002-2007

116. A 70-year-old heavy alcoholic presents with hepatic encephalopathy,

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PLAB 1 past papers 2002-2007

150. Child brought with 8 hr Hx of sorethroat, saliva dribbling, what to do

theme on midline neck swellings

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

26.man with cervical spondylosis,has a painful eye,intraocular pressure is

PLAB 1 past papers 2002-2007

THEME: MANAGEMENT OF DEVELOPMENTAL DELAY

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

53. A 3 month old baby needs to be ressuscitated CPR.

PLAB 1 past papers 2002-2007

66.A woman with symptoms of polidypsia, constipation and confusion after

Complication of breast cancer malignancies

PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

90- A woman or a man with hearing impairment and no corneal reflex.

92- (SBA) a woman after 1 or two years post or premenoupausal with a

91- Theme: Management of cardiac arrhythmias with 5 stems.

PLAB 1 past papers 2002-2007

What is the most likely diagnosis?

102-A middle age man presents with with splenomegaly and

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July 2006 PLAB 1

2-Prevalance population in one area is 500000.no.of pts reporting to gp

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5 Theme--Treatment of varicella infections

4--theme -Prenatal screening

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PLAB 1 past papers 2002-2007

PLAB 1 past papers 2002-2007

22 theme-A/ Allow out of bed to go to Toilet.

PLAB 1 past papers 2002-2007

2/ A 66 year old man undergoes abdominal aneurysm repair. Over the