MEDICAL BASED

31. A 24 years old man was caught by police trying to get into Palace. He keot saying that he is son of god. He has a lot of plan to improve this country. He was

talkative and irritable. He was tested positive for cannabis, morphine and metamphetamine. Last taken was yesterday.

What would be your provisional diagnosis?

A. Bipolar 1 disorder in mania

B Schizoaffective disorder

c. Metamphetamine induce bipolar disorder

D. Cannabis induce psychotic disorder

32. Best initial oral treatment

A) Haloperidol

B) Lorazepam

C) Methadone

D) Naltrexone

E) Olanzapine

33.Lady u/l mdd but recover for 1 year. For the past 1 month, feel like her brother wants to kill her. She also heard a man kept on telling her that her brother

was planning to kill her. Otherwise, there was no other sound heard. There was no made action, impulse.

What best describe her current condition?

A. Mdd with psychotic feature

B. Delusional disorder

C. Paranoid personality

D. Schizophreniform

E. Schizoaffective

35) A firemen took alcohol to sleep as he had frequent nightmares after failed rescue mission. He had doubt to himself whether he still able to keep his job.

He also cannot felt any positive emotion. He felt like ‘ all my nervous system felt numb'.

what is the most likely diagnosis?

A. GAD

B. Panic disorder

C. OCD

D. PTSD

E. Alcohol induced anxiety

36) Referral from obstetric for post partum lady. Have labile mood and tearful, not been sleeping well for the past 3 days. Ignoring her crying child. Has family

support as her parents are living with her.

A. Initiate community psychiatry

B. Antidepressant

C. Reassurance

D. Benzodiazepam

E. Mood stabilizer

Question 37 and 38

37) a 40-year-old man, with underlying bipolar disorder, was watching television, sawing a lady singer was singing a song and the song was dedicated to him.

She felt the singer was in love with him and that was the reason she sang the song to him. He sent a bouquet of flower to her and he got mad when the singer

rejected his flower.

What would be the sentence “a lady singer was singing a song and the song was dedicated to him”?

A. Delusional perception

B. Delusion of reference

C. Delusion of persecution

D. Delusion of control

38) what would be the sentence “she felt the singer was in love with him..” to be?

A. Delusion of grandiosity

B. Delusion of persecution

C. Delusion of erotomania

D.

Question 39 and 40

39) M, a 10-year-old boy, was brought to the clinic, noted to be always on the go, tend to leave his seat, unable to concentrate in the class. Teacher also

noticed he always write "b" in "d", unable to catch up his friends in his study, unable to recognise words. His parents said, when he wants something, he

would pull their shirt and point on the object and scream. He tends to line up the toys, play with certain toys only, especially car wheel toy.

What is your next best initial step?

A) refer to psychologist for autism spectrum disorder questionnaire

B) refer to dietician for his nutritional aspect

C) refer to speech therapy for his speech delay

D) refer to occupational therapist to teach him in writing skill

E)

40. What is the first step to do?

A) parenting education skills

B) occupational therapy

C) special education school

D) social skill training

E)
SURGICAL BASED

22) Multigravida, 34 weeks POA presented with sudden gush of fluid from vagina 1h prior to admission. On perineal examination, it noted to have loop of

umbilicus vesel outside the coitus.

Choose the most appropriate initial management.

A) immediate went to OT for c-sec

B) fetal viability need to be ascertained

C)Put mother in all 4 position

D) Do VE examination and put the cord manually back to vagina

E) give tocolytics agent

31) A boy playing football, fell with a sudden twisting force. Then had pop sound , pain and knee swelling. Which is the best statement for cruciate ligament

injury?

A. Anterior drawer test positive

B. Positive Lachman's test

C. Reduced range of movement

D. Tenderness at joint line

E.

Question 32 & 33

32. 50 year old lady work as cleaner complained of left shoulder pain upon doing above head activity. On examination, the is limitation of doing above heard

movement but passive all shoulder ROM are normal.

What is your diagnosis

A) acromioclavicular joint arthritis

B) Adhesive capsulitis

C)impingement syndrome

D) osteoarthritis of the shoulder

E)rotator cuff tear

33. What is the best treatment of option

A. Job relocation

B. Decompression surgery

C. Rehabilitation and analgesia

D. Avoid overhead activities

E. painkiller

Question 34 & 35

A girl , had dashboard car injury. Left Leg appeared to be adducted and internally rotated.
34. What is the diagnosis ?

A. Posterior hip dislocation

B. Anterior hip dislocation

C. Neck of femur fracture

D.

E.

35. What is the best investigation.

A. Pelvic X-ray

B. Left hip x Ray

C. MRI hip

D.

E.

36) 65 years old lady diabetic with history of long term traditional medications consumption for joint pain presented with a swelling over right calf with a

central necrotic patch and cellulitis. Generally, she was very ill looking. Intraoperative findings showed sloughy tissue with dish water appearance fluid. What

is the most likely diagnosis?

a) Diabetic foot ulcer

b) Gas gangrene

c) Pyomyositis

d) Calf abscess

e) Necrotizing fasciitis

37. A femal fell on posterior outstretched hand. Post trauma she felt a bulge below her clavicle. What is the most likely diagnosis?

A) Osteoid osteoma

B) Hematoma

C) Dislocation of head of humerus

38. A 20 years old girl fall onto her buttock. She has shooting pain radiate to her right lower limbs. No constitutional symptoms no other problem. Examination

loss of lumbar lordosis.

À. Degenerative spine disorder

B. Spinal stenosis

C. PID

D. Spondylosis

E. Spondylodiscitis

39) 36-year-old gentleman, while playing rugby, was tackled from front when overthrown the ball. He was sustained of left shoulder anterior dislocation.

What structure was the most likely to be injured?

A) axillary artery

B) axillary nerve
C) coracobrachialis muscle

D) cephalic vein

E) subscapularis muscle

40. a 35 yr old lady with underlying SLE came to the clinic with histiry right hip pain for 3 month duration. there was no history of fall or trauma, no

constitutional symptoms.

what is your provisional diagnosis?

a) avascular necrosis

b) hip synovitis

c) femoro acetabular impingement

d) tuberculosis of hip

e) osteoarthritis of hip