Sept 2019 recalls​ A lot of similar questions from other exams, but without obvious answers

(they know what we know, So don't put them in options, huh?)

1. Child with kwashiorkor, hepatomegaly- what deposit in liver? Lipofusin?

2. Pain between 3rd and 4th toes , pain elected by vertical compression on metatarsal
heads. Morton neuroma?
3. Shoulder dislocation - no fracture, AC dislocation Coracoacromial? Coracoclavicular
ligament?
4. Embolization of vessel supplying sigmoid at L3 anterior branch of aorta- IMA
5. Young female pt with blood discharge. answer duct papilloma
6. sickle cell child with osteomyelitis answer salmonella
7. Lady with thyroid swelling with forehead pulsatile swelling. answer follicular carcinoma
8. Features of thyroid cisis - no major symptoms mention - photophobia, somnolence etc
9. Lateral thumb and index dermatome/sensation - c6
10. Supination and pronation of arm- c5
11. Back pain with radicular pain to leg showing MRI pic
12. TM joint - synovial joint?
13. Lower jaw protruding on opening ™ joint?
14. Articular disc in ™ joint
15. Salivary stone impaction scenario
16. Histology of patient with Rheumatoid arthritis joint - what found?
17. Histological features of gout - negative perfringence…..
18. Mediastinal biopsy- Hassal corpuscles - thymoma
19. DVT regarding Homan test - Hallux extension, Hallux flexion, Planterflexion,
inversion,version
20. DVT prophylaxis for patient with IHD and peripheral vascular d/s . a. Stocking,
b.infractionated heparin 1000 unit hrly, c. LMWH, d. LMWH with pneumatic compression
21. DVT prophylaxis regarding patient with antithrombin 3 deficiency - a. warfarin lifelong,
b.wafarin 3 or 6 months, c IVC filter
22. DVT prophylaxis for recurrent PE - IVC filter
23. Injury to shin - wound dirty - split skin graft...etc
24. Burn to leg, wound 7×5 cm exposing tibia - skin grat, free flap,
25. A young woman with breast cyst- aspirated to dry- cytology NAD. No follow up, culture of
aspirated fluid, excision of cyst
26. Middle age woman with breast cyst- Mx - aspirations, Excision.
27. A young woman with 2 cm size right thyroid swelling. Biopsy show papillary with no
metastatis. Tx- Right hemothyriodectomy, subtotal, total
A pregnant woman 6 weeks with Grave disease (palpitations etc)- Tx - propranolol,
thyroidectomy.
28. Lap: Cholecystectomy patient, 1 months later, unremitting jaundice with pale stool, dark
urine - Residual CBD stone, Bile duct injury
29. Acute Cholecystectomy patient with known MRSA carrier - Tx - daily bath, mupirocin to
nose, IV antibiotics
30. Canadian girl with mild jaundice, anaemia, splenomegaly- sickle cells disease,
spherocytosis.
31. Wound healing 2nd phase - Vitamin C
32. A patient with 50% BSA Burn - Fluid requirement in first 24 hrs - 10-13 L, 14-16L, >17L
33. A kid, with Hydrocele fluid in which layer - tunica vaginalist
34. A kid with sudden onset scrotal pain, visible black spot above testes - testicular torsion,
Morgani cyst torsion
35. Inguinal hernia repair, patient lost extension of knee. Which nerve?
36. September 2019 recall
37. Head trauma, depressed fracture, management: a. Refer to neurosurgery ,b. CT head
within one hours,c. CT head within 8 hours

38. Bluish colored flatulent swelling under tongue - Ranula .due to sublingual gland?small
salivary gland tumor? Submental lymph nodes
39. Weak sensation of lat aspect of tongue after sugery.glosso nerve?
40. Q concerned with Cerebral perfusion pressure calculation BP 110/80 ICP18. Ans 72,
92...etc
41. A man with left loin colicky pain. Imaging -Stone impaction at vesicoureteric junction.
Where visible? a. Ischeal tuberosity b. ischial spine c. L2-4 transverse process
42. How to count vertebrae on xray.bifid spinous process?
43. Cori cycle. The following cells depends on Cori cycle for O2 completely.
hepatocyte?osleocyte..etc
44. A lady with persistent creamy dischrge from breast.ductal ectasia
45. A lady with Thyroid swelling and high calcitonin .medullary ca
46. Bp measurement via ordinal/nominal data? A. Paired T test b. Unpaired T test, Man
Whitney test
47. 6yr,short leg,limb pain for 3 months - perthes disease
48. Mass in old age.invasive ca
49. 13yr kid,no internal rotation adduction.externally rotated n limb pain.slipped
femoral/perthes?
50. Scalp laceration with dirt no other lose.a. simple suture b. wound deb with sec intention
healing?
51. Tension haemo-pneumonthorax .chest drain with active suction
52. After trauma.pain on extremes of supination n pronation.injury to radial/post interr?
53. Mixed resp met acidosis scenrio
54. Hypercalcemia.give . initial treatment a. 9% n/saline b. Palmidronate
55. A man hit with some thing - Depressed fracture. A. immediate ct b. CT later within 6 hrs?
56. Ruptured aaa.do ct
57. A case of suspected PE, what investigation . CTPA, VQ perfusion scan
58. Femur fracture dypniac,tachycardiac .rash appear.fat embolism

59. 1/ acase of AAA with 6 cm with distal gangrine. Cause of gangrene Ans arterial
embolism (trash foot)...other atherosclerosis ...thrombus٣...
60. A case of gangrene of the toe On Doppler USG wave form - Ans; monophasic with low
flow velocity...other options triaphasic doppler signal ....biphasic doppler ...monphasic
with high velocity
61. Elderly pt with AAA with knee pain Cause of the aneurysm ....answer : correct
atherosclosis..other marfan ...thrombosis… one autoimmune disease can't recall.
62. A lady with varicose vein clinical examination suggest sapheno femoral junction defect,
Management ....correct answe is dupplex us....other option SP disconnection.
endovenous laser therapy ..CTA
63. A case of intermittent claudication with loss of pulse below knee only. Hip flession pain.
No knee pain. leg with palpable feomral pulse sfa occlusion at the adductor canal
..other options CFA befor bifurcation...external iliac artery ... anterior tibial artery
occlusion
64. A child with Hydrocele - Procesus vaginalis comes from what structure Ans..peritineum.
65. Inguinal hernia surgery, open what layer to explore canal..external ob apo.
66. Ant relation of head of pancreas a..pylorus of stomach. CBD, c.portal vein d portal vein.
67. To get ABG Femoral artery cannulation.where? A.mid point..b mid point of ing ligament
68. Right testicular vein drains into a. IVC b. Rt renal vein
69. Torticolis - spinal accessary nerve
70. A woman with cervical LN, on examination, supra, axilla, inguinal all enlarged Dx -
lymphoma? TB?
71. A woman with a cervical LN. Biopsy reveal Squamous cell metastatis. Aerodigestive
tract - NAD on scopy. What investigation more to detect primary? CT, PET, MRT,
PET-CT scan?
72. A 40-50 yrs old playing football, sudden pain in the calf, can't play anymore. Squeeze on
calf m/s negative planter flexion Dx - archilles rupture? Gastronemius tear, baker cyst
rupture
73. Playing football, tackle to knee, swelling , rest for 4 weeks, play again , happen again
this time…… Dx medial meniscus
74. tear ant cruciate ligament….
75. -a women noticed blood spot in the pants OE - inguinal lymph nodes- Origin vulva,
cervix, uterus
76. - relation of ureter with gonadal vessel, iliac artery..
77. -relation of median nerve with bracheal artery
78. A man with prostatism, On PR, posterolateral ridge on palpation. What structure?
Sacrospinal ligament...puborectalis muscle
79. On VE examination, You feel something infront at the level as cervix- base of bladder,
dome of bladder, POD
80. A man with bp 200/100 potassium 2.1 what you expect to be found in his investigation?
High aldosterone/high cortisol/low ACTH/High urinary VMA/ High urinary
catecholamines.
81. A man with RTA had 10/15 (i dont quite remember) unit blood transfusiin now has low
platelet, normal APTT, low fibrinogen and high PT? Whats the diagnosis? DIC/
Deficiency of antithrombin III/ Thrombin deficiency
82. A man underwent oesophatogasteectomy for ca oesophagus. Post op period he lost
significant weight. Mx should have been a. TPN b. RT feeding c. Intraoperative
jejunostomy
83. A man admited with chest pain .he remembered last night he vomited vigorously. O/E
crepitation in ant chest wall. Ans: oesophagus rupture ( Mallory Weiss tear also in
answer)
84. Barret oesophagus
85. A patient with long term UC, least likly association .Ans. polyarteritis
86. Facial injury - numbness in cheek and upper 3 teeth. Which nerve? Supratrocheler ,
Infraorbital
87. A child with discharge from medial canthus of left eye- ethmoidal sinusitis? Maxillary
sinusitis? Ca ethmoid?
88. Numbness in anterolateral aspect of tongue after molar surgery - lingual, hypoglossal,
facial…
89. Lacrimmation ..which ganglion- Pterygopalatine
90. A young boy with sudden mildly tender swelling in dorsum of wrist- ganglion, cyst
91. A man with Ca prostate. His mother and sister have Ca breast, father healthy, what
genetic association- P53, Ras
92. A mother with Ca breast with family history of ca breast, concerned about her daughter
getting Ca breast, which test? BRCA 1& 2
93. A women with displaced fractured in distal radius, reduced and put on a back slab for 6
wks. After removal of slab, she complaining of pain and limited movement during
supination and pronation. Which structure injured? CPRS, mal union, non union,
compartment syndrome.
94. A patient with cervical lymphadenopathy was investigated and FNAC suggested
squamous cell ca. Clinical examination and upper tract endoscopy normal. What should
be the next line of investigation? CT, MRI, FDG Pet CT, MRI of whole body,
Radio-isotope investigation
95. A patient presented with calf pain on walking 50 meter. Diagnosed as claudication. Block
of which level is responsible? Superficial femoral, popliteal, deep femoral, external illiac,
profunda femoris..
96.
Which level is injured?

97. Features of Thyroid crisis...somnolense, sinus tachycardia, bradycardia, photophobia

98. 26 yr old down syndrome patient who understands everything.. she needs
appendicectomy..who will give consent?
99. Young RTA patient with features of hypovolumic shock, needs operation. Who will give
consent?
100. A man presented after painting of celing with shoulder pain. The pain is mainly
during movements of shoulder between 60-120 degrees. What is most likely
diagnosis?..supraspinatus tendinitis, subacromial bursutis, frozen shoulder.
101. 35 yrs lod female with pruritus ani. Sellotape examination shows egg inn stool. Rx?
Enterovirus vermicularis, Ascariasis
102. Cresent shaped lesion on ct…..acute subdural hematoma
103. Lymphoma associated with coelic disease…….t cell lymphoma
104. Ecg changes in PE….r wave in v6 ,t wave inversion in v1-v3
105. Level of lumbar cistern csf fluid...s2
106. Enterobius vermicularis treatment ….mebendazole
107. Structure divided in esophagectomy to mobalize stomach…...gastrospleenic
ligament Lienorenal ligament ​Lumbar cisterna extends to? S2
108. 1 cm non healing wound at ankle, tactic? punch biopsy, dressing or topical steroids with
antibiotics?
109. Man hits head at door, looses conciousness for 15 sec. Examined, found to be ok.
Management? Discharge home with instructions on head injury, neurosurgeon or hospitalize?
110. Analysis of paired BP of someone recorded 87 times. Paired T-test or wilcoxon.
111. Palpable lymphs in both femoral triangles. Source? Cervix, bladder, uterine body?
112. RTA patient admitted.after observation pt discharges by giving conservative
treatment.10days later came with abdominal discomfort especially after eating. it become
worse....what is the cause. Ans; Diaphragm rupture, phrenic nerve.
113. lateral cutaneous femoral nerve soruce lumbar 2-3 lateral psoas major exit
114. Acute loin pain +afebrile +bl p 100/60 urine analysis normal ? Rupture aortic
aneyrsm or perinephric abcess
115. Prostatic carcinoma his sister died of breast cancer investigation of oncogen ? P53
or kras
116. patient in ICU sudden desaturation after leg movement ?,Slipped endotracheal tube
117. recurrant DVT ?warfaren long term or IVC fliter
118. Patient with IV fluid having Warming device attached during surgery which hormone
secretion decrease? ACTH, Vassopressin
119. torniquet technique ?above systolic blood pressur or mean arterieal pressure
120. Metabolic effect of adrenaline ? Glycolysis, tachycardia
121. bell s palsy
122. Feeling of discomfort at left illiac fossa for 6 wks with increase frequency of
defecation with occasional blood with stool..what is the dx? .. ca sigmoid colon, IBD,
Diverticulitis..
123. Infant with dyspnoea, h/o recurrent chest infection? .. Tracheo-oesophageal fistula,
diaphagmatic hernia..
124. A Neonate with villious vomiting with scaphoid abdomen...duodenal atresia,
volvulus…
125. Position of CBD papilla opening in duodenum in ERCP - anterior & medial, anterior &
lateral, posterior and medial, posterior & lateral.
126. A woman with itchiness around anus, cyst or worms - Tx mebendazole, tinidazole,
metronidazole
127. Shoulder joint - painful arc movement between 60-120 degree, Dx of supraspinatus
was considered. The tendon of affected muscle is Supraspinatus,infra spinatus,
subscapularis, Latissimus dorsi,teres minor
128. Another shoulder joint pain - this time answers options - subacromial
impingement..etc
129. A woman with torticollis , a mass near sternocleidomastoid- accessary nerve,
glossopharyngeal,
130. ECG changes supporting Dx of PE.
131. A middle age man with subcapital femoral neck # with minimal displacement. Mx-
Internal fixation, External fixation etc
132. RTA- grossly dirty & comminuted #femur or tibia Mx external fixation, wound
debridement and internal fixation
133. A question regarding autonomic nervous system
134. A patient with ureteric colic, pain radiates into loin to groin- Why? Which dermatome
135. Hematuria,pain, multiple osteolytic lesion in bone, Lung metastatis - which origin?
136. A thyroid swelling+ HT (BP 200/100 mmhg. Dx-
137. A woman with Increased TSH+ Normal T4 Dx- primary hypothyroidism, grave d/s,
secondary hypothyroidism
138. Diabetic (diet controlled) undergoing sigmoid colectomy- How to mx? Monitoring of
blood sugar hourly? Other insulin stuff
139. Another DM patient
 140. What is not included in enhanced post op recovery program. A. carbohydrate drink 2
hr before. B. intra op antiemitics. C. Preop diazepam. 4.early post op ambulation
141. Patient whi was admitted and received antibiotics, then developed severe diarrhea.
Treatment? = treatment of Clostridium difficile. Po vanco, po flagyl, iv flagyl,...
142. A patient with infection, crepitation
Which Organism- Clostridium perfringens
145. Pfannenstiel's surgery which structure is divided. Rectus abdominis, rectus sheath,
arcuate ligament
146. Jaundice most likely associated with…?... Increase Alkaline Phosphatase..Increase
PT…
147. After ...Operation foot drop..cause...Neuropraxia of common peroneal nerve…
148. After….Operation lateral part of foot sensation loss...Sural Nerve injury…
149. Best biopsy method for breast...Core biopsy..
150. Best way to biopsy thyriod….FNAC
151. Irritibility, muscle twitching after thyroid surgery...Hypocalcaemia…
152. Gradual swelling appearance at lateral aspect of knee….meniscal cyst…
153. Trying to grip knife but failed...posterior cord injury..medial cord injury...lateral cord
injury…
154. Part of MEN I...Pituitary..
155. Unique features of axis vertebrae...bifid spinous process...carotid tubercle…
156. A child with distended abdomen, pain, vomiting, groin swelling...Inguinal hernia…
157. Deep inguinal ring found in...Fascia transversalis...

Another

1. A previously healthy Young male wakes up in the morning sudden SOB with fall in spO2
low Bp and tachycardia...absent breath sounds on the left side. Diagnosis. A.
Pneumothorax B.Pneumonia C.Pleural effusion
2. Mechanism of Analgesic action of I.m Morphine A . Acts on u and k receptors
3. A patient with bee sting - shock. Which first? IM adrenaline, IV hydrocortisone, IV
antihistamine etc
4. Which cell in Lymphoma ? B cells, T cells ,NK cells
5. A farmer with blood tinged darkspot with eschar after injury with fever and severely toxic.
A. Anthrax B. S.pyogenes
6. Main support of uterus. Options a Transverse perineal muscle
7. A patient after colorectal surgery, post-op uneventful. WHat investigation to be done to
rule out anastomotic leak. CT, MRI,Barrium Enema, water soluble double contrast
enema
8. Origin of Rt Coronary artery a. anterior aspect of aorta above valve? Inferiorly below
cursp of aortic valve?
9. A girl had mastoid abscess. Spread of infection Ans: sagital sinus, sigmoid sinus
internal ear
10. Tingling sensation over median nerve sensory supply area... Lunate dislocation ?
11. 25 year down syndrome pt requires surgery for appendicitis .Pt understand the need of
surgery And complications from surgery. A. Pt consent? A. Parents consent
12. RTA patient with obviously internal haemorrhage, unstable - Proceed without consent.
13. A Case of male 20 year , with history of trauma 6 weeks ago in groin , now presented
with irregular hard testicular swelling with fluid around it transilluminated and Lt
supraclavicular lymphadenopathy? 1- hematoma 2 - hydrocele 3- teratoma4-seminoma
14. Patient with hydropneumothorax with fluid level? 1- ICT 2_ICT with suction
15. Pregnant women with clinical hyperthyroid. What treatment to go for:Carbimazole
B.Propylthiouracil C.Propranolol D. Thyroidectomy, E. Radioiodine
16. Patient with HB 9gm%.plan for surgery after 6wk .what is preferred iron therapy
17. Scenario 2
18. A 32-year-old man presented with a 1-month history of shoulder pain especially on lifting
his arm. On examination, he had marked tenderness lateral to the acromion process with
a painful arc of 60–120°.
19. Pregnant women Lower back pain and h/o collapse low BP
20. Tricuspid valve closure occurs in
21. First response after hypovolemia-baroreceptors
22. Gastrin increase by adrenaline, glucagon, calcitonin
23. Early response after injury - mast cells, neutrophils
24. Structure carries oxygenated blood
25.