Professional Documents
Culture Documents
1 :
A 50-year old man presents to your clinic with erectile dysfunction. He is obese with
BMI 32. He is heavy drinker and smoker. After advice on reducing alcohol intake and
smoking cessation, what is the next most important step?
a. Weight reduction
e. Review in 6 months
a. Alzheimers dementia
c. Fronto-temporal dementia
d. Senile dementia
e. Schizophrenia
a. Phobias
b. Psychosis
c. Depression
d. Insomnia
e. Sleep walking
- Psychosis.
- Phobias.
- Depression.
- Insomnias.
- Eating disorders.
A 20-month-old baby is brought in by his parents with chronic diarrhoea and weight
loss.
On examination,the baby has growth retardation,muscle wasting and distended
abdomen with hyperactive bowel sounds.
Chest examination is clear.
Laboratory investigations show decrease serum iron or folate levels.
Patient has been on lactose free diet for 3 days without resolution of symptoms.
What is most likely diagnosis?
b. Celiac Disease
d. Cystic fibrosis
Vitamin B12 deficiency is associated with all of the following situations except?
a. Metformin therapy
b. Autoimmune gastritis
c. Gastrectomy
e. Pregnancy
Which one of the following is not the differential diagnosis of the lump in posterior
triangle of the neck?
a. Cystic hygroma
b. Branchial cyst
c. Bronchial cyst
d. Pancoast tumour
e. Cervical rib
b. Admission to hospital
e. Notify police
Correct Answer & Detail
b. Spontaneous abortion
e. Termination of pregnancy
-Spontaneous abortion.
-External cephalic version.
-Significant closed intra-abdominal trauma.
-Termination of pregnancy.
-Chorionic Villus Sampling.
-Ectopic pregnancy.
-Threatened abortion after 12 weeks of gestation.
Question No. 9 :
A 29-year-old lady at 32 weeks of gestation presents with regular uterine
contractions.Cardiotocography shows live fetus with regular accelerations.Blood
pressure is 200/120 mmHg. Liver function shows mildly raised serum alkaline
phosphatase.Sterile speculum examination shows foul smelling fluid leaking out of
vagina.
a. Suppression of labour is started by giving oral nifedipine with two further doses if
contractions still persist
b. Intravenous salbutamol should be used as first line drug to stop uterine contractions
d. Further investigations are needed to find whether this patient needs tocolysis or not
e. Continue ramipril
A 6-month-old male is brought to your office by his mother with persistence bouts of
cough for last 2 weeks.There is history of vomiting after coughing episodes. Child
develops cyanosis during coughing.
e. Admission to hospital
Correct Answer & Detail
a. Recurrent depression
A 35-year-old woman returned from an overseas holiday 7 days ago, now presents to
your clinic complaining of fever, periorbital pain, joint pain, lymphadenopathy and
rash over the body.
What is the most likely diagnosis?
a. Leptospirosis
b. Dengue fever
d. Brucellosis
e. Malaria
Differential diagnosis:
Leptospirosis presents with the abrupt onset of fever, rigors,
myalgias and headache in 75 to 100% of patients, after an
incubation period of two to 26 days (average 10 days).
From 25 to 35% of cases have an associated non-productive
cough and approximately 50% experience nausea, vomiting
and diarrhoea.
Which of the following is not used to reduce iron overload in children who require
frequent blood transfusions in patients with sickle cell anaemia?
a. Subcutaneous deferoxamine
b. Splenectomy
d. Erythrocytopheresis
A 35-year old female brought her brother to you for assessment of the acute back
pain.She requested for a medical certificate for her to show her employer as she took
the day off to bring her brother to your clinic.
b. Issue a medical certificate to her brother and ask her to show it to her employer
A 25-year-old female came to your clinic due to a breast lump of her left breast.
Patient claimed the lump is tender on palpation and movable.
You find that these changes are due to hormonal changes.
She is concerned about her risk of having breast cancer.Her mother died of breast
cancer at 45 years old and one of her aunt died of ovarian cancer.
All of the following are the risk indicator of familial breast-ovarian cancer except?
b. Two first-degree or second-degree relatives on one side of the family with ovarian or
breast cancer
c. Individuals with ovarian cancer
6. Jewish ancestry
A 24-year-old woman comes for first antenatal visit at 10 weeks of her gestational
age. Which of the following investigations will change management at this gestational
age?
a. HIV screening
b. Group B streptococcus
d. Varicella antibodies
e. Preeclampsia
A 50-year-old male with past medical history of alcohol abuse developed gross
tremors, agitation and hallucinations.
a. Haloperidol
b. Chlorpromazine
c. Amitriptylin
d. Benzodiazepine
e. Paracetamol
Correct Answer & Detail
A 43-year-old male visits you to discuss his hepatitis B serology report.Report shows
HBcAb and HBsAb are positive while HBsAg is negative.
b. Use a patch to cover the eye and review tomorrow as first patient
d. Call the air ambulance and refer the patient to a tertiary health centre
A 12-year-old male child is brought in hospital by his mother with acute shortness of
breath and wheeze. He has background history of asthma and uses inhalers as
required.
Which of the following is the best bed side measure to assess the severity of asthma?
a. Severity of wheezing
b. Response to inhalers
c. Degree of dyspnoea
A 65-year-old Marcello appears pale and lethargic and her clinical tests done on last
appointment indicate that she is suffering from primary hypothyroidism.
Today her blood tests indicate TSH is 4 (0.4-5 mIU/L) T3, Free T4 low normal
levels.She is currently on levothyroxine 75 microgram daily for last 6 weeks.
What is your best next step in her management?
a. Steroids
e. Consider vitamin K
Correct Answer & Detail
A 20-year-old female in 18th week of her pregnancy presented with right iliac fossa
pain on getting up from a chair and has been coughing and sneezing.On examination
there is no mass palpable and there is no rebound tenderness.
b. Acute appendicitis
c. Allergic reaction
e. Ectopic pregnancy
A 39-year-old woman presented with dizziness after coming from gym. ECG shows
sinus bradycardia with no av-block. What is the most appropriate next step?
a. Transcutaneous pacemaker
b. Atropine
c. Adrenaline
d. Trans-venous pacing
e. Amiodarone
Correct Answer & Detail
Which ONE of the following is the most common cause of acute limb ischemia?
b. Smoking
c. Vasculitis
d. Embolism
e. Thrombosis
Correct Answer & Detail
All other options can increase the risk of acute limb ischemia
however these not very common.
Question No. 28 :
A 32-year-old woman came to see you at your clinic. She has two children previously
and is now planning to start contraceptive pills. She has history of epilepsy and is
stable on two drugs.
Which one of the following anti-epileptic drugs do not affect the efficacy of hormonal
contraceptive pills?
a. Topiramate
b. Carbamazepine
c. Primidone
d. Levetiracetam
e. Phenytoin
- Phenobarbitone.
- Primidone.
- Phenytoin.
- Carbamazepine.
- Oxcarbazepine.
- Topiramate.
You are a locum GP obstetrician at a rural hospital and serving mostly female
population.You are expert in dealing with early diagnosis of endometriosis based on
clinical symptoms.
Which of the following is most common symptom of endometriosis?
a. Dysmenorrhoea
b. Dysuria
c. Infertility
d. Deep dyspareunia
A 34-year-old lady presents with pain and swelling around wrist and hand joints for
last 3 months.Joints are usually stiff in the morning for more than 1 hour.You suspect
she might be suffering from rheumatoid arthritis.
Which of the following statement is correct regarding diagnosis of rheumatoid
arthritis?
a. Anti-CCP antibodies are less specific than rheumatoid factor for the presence of
rheumatoid arthritis
b. Anti-CCP antibodies have better sensitivity as compared to rheumatic factor for
diagnosis of rheumatoid arthritis
c. A positive result for anti-CCP antibodies appears to be a poor predictor of greater disease
severity than a positive result for rheumatoid factor
d. Anti-CCP assay has a sensitivity of 50-60 percent and specificity of 95-98% for the
development of rheumatoid arthritis in young age
e. Anti-CCP assay can be used to screen for rheumatoid arthritis in healthy individuals in
the absence of clinical symptoms
A 45-year-old alcoholic male presents with acute upper abdominal pain which is
steady and is located in right upper quadrant and mid-epigastrium. Patient is also
complaining of nausea and vomiting.He is sitting on bed bending forward.
On examination epigastrium is slightly tender with fever and tachycardia.
a. Acute cholecystitis
b. Acute pancreatitis
c. Acute gastritis
e. Alcohol intoxication
a. Delusions
b. Hallucinations
c. Functional impairment
e. Elevated mood
Which of the following anti-psychotic medication increases the risk of type II diabetes
mellitus,raises the level of triglycerides in blood and has no effect on serum
cholesterol level?
a. Risperidone
b. Quetiapine
c. Amisulpride
d. Haloperidol
e. Olanzapine
You are a ward call resident at night duty.One of the nurses calls you as she has given
a patient an injection of paracetamol twice by mistake.
b. Discuss with your on call consultant and report the matter to chief executive officer
c. Take a blood sample for paracetamol concentration within 30 minutes and contact a
poisons information centre for advice
d. Start the patient acetylcysteine immediately and do serum paracetamol level
a. Lumbar Puncture
a. 10 weeks
b. 15 weeks
c. 20 weeks
d. 28 weeks
An elderly lady visits your office after she has a fracture of her right wrist.She says
that she crashed into a wall and she has lost her peripheral vision which she did not
notice previously.Her pupils are constricted and fundoscopy is difficult.
c. Do an urgent CT scan
This patient has trauma to the wrist while she hit herself to
a wall.Acute loss of peripheral vision with constricted pupils
constitute the possibility of concussion head injury.
A 20-year-old girl is unable to concentrate at work and fears she will lose her job.She
recently has stopped listening songs and she says she becomes tearful and anxious
easily.
Further history reveals that she missed a road-traffic accident and was about to hit a
pole 3 weeks ago.She is happy otherwise with her family life.
Which of the following is the most likely diagnosis?
a. Adjustment disorder
b. Depression
d. Psychosis
A 62-year-old male presented with fever, left flank pain and generally unwell. Urine
microscopy and culture confirms the presence of urinary tract infection. CT scan of
kidney shows acute pyelonephritis and polycystic kidneys.
a. Fluoroquinolones
b. Penicillins
c. Aminoglycoside
d. Macrolides
e. Tetracycline
b. Increase diuretics and wait for the effect for at least 24 hours
A 60-year old male with 30 pack year history smoking presented with history of left
leg pain for last 6 months. Pain is worsened by walking and improves by rest. There is
no pain at rest.
On examination, blood pressure is high, BMI is high and decreased pulsation in the
dorsalis pedis artery of the left. There is no gangrene or ulcer on both legs. Ankle
brachial index is 0.7.
A 29-year-old female presented with blurry vision and swelling of eyelid after being
hit by squash ball into left orbit during play.
The examination shows eyelid swelling, decreased visual acuity and vertical diplopia
of left eye that disappears when right eye is closed.
b. Zygomatic fracture
e. Tripod fracture
The nasal bone forms the medial orbital wall and its fracture
is associated with horizontal diplopia,cerebrospinal fluid
leakage and epistaxis.
A 50-year old farmer sought consult due to a dark mole on his left cheek, which
become enlarged, slightly lumpy and itchy over the last 4 months. What is the most
appropriate initial management in this patients presentation?
b. Serum magnesium
d. MRI abdomen
e. CT abdomen
Which ONE of the following complications of acute diverticulitis carries the highest
mortality rate?
a. Bleeding
b. Abscess
c. Peritonitis
d. Perforation
e. Intestinal obstruction
Children with ADHD are 2.5 times more likely to suffer from
primary nocturnal enuresis.
Question No. 48 :
A 35-year-old man with background history of bipolar disorder, has been stable on
lithium over last 6 months. His serum lithium level is 1.0 mmol/L today.
a. Every 12 months
b. Every 3 months
c. Every 6 months
d. Every week
e. Every 5 years
Correct Answer & Detail
A 30-year-old woman is concerned about breast cancer has her mother was diagnosed
with breast cancer at the age of 48. Clinical examination of the breast is normal.
c. Refer to surgeon
c. Chronic hepatitis C