e.

Plasma osmolality of 335mosmol/kg and urine osmolality of 200mosmol/kg

588. A 75yo man has left-sided earache and discomfort when he swallows. There is ulceration at the
back of his tongue and he has a palpable non-tender cervical mass. What is the single most likely
dx?
a. Acute mastoiditis
b. Dental abscess
c. Herpes zoster infection
d. Oropharyngeal malignancy
e. Tonsillitis
589. A 42yo man has been tired and sleepy for the last few weeks in the morning. His work has starte
getting affected as he feels sleepy in the meetings. His BMI=36. What is the single most likely dx?
a. Idiopathic hypersomnia
b. Narcolepsy
c. Chest hyperventilation syndrome
d. OSAS
e. REM-related sleep disorder
590. A 35yo pregnant woman has been having tingling and numbness of her thumb, index and
middle fingers for a while. She has been treated with local steroids but it hasn’t helped her
much and now she has planned to undergo a surgical procedure. Which of the following
structures will be incised?
a. Flexor digitorum profundus
b. Transverse carpel ligament
c. Palmar aponeurosis
d. Extensor retinaculum
591. A 58yo pt presents with altered bowel habits and bleeding per rectum. Exam and sigmoidoscopy
showed an ulcer. What is the single most likely dx?
a. Colorectal carcinoma
b. Celiac disease
c. Crohns disease
d. UC
e. IBS
592. A mother is concerned that her 18m son has a vocabulary of ten words but can’t form a
sentence. What is the best management strategy?
a. Arrange hearing test
b. Assess developmental milestones
c. Reassurance
d. Refer to speech therapist
e. MRI brain
593. A 55yo man has weight loss, dyspnea and syncope. He smokes 20 cigarettes/day. Inv confirms
squamous cell carcinoma in the left bronchus. What is the single most likely biochemical
abnormality to be a/w the condition?
a. Hypercalcemia
b. Hyperkalemia
c. Hypoernatremia
d. Hypocalcemia
e. Hypomagnesium
594. A 72yo man presents with intermittent difficulty in swallowing with regurgitation of stale food
materials. Sometimes he wakes up at night with a feeling of suffocation. Choose the single most
likely cause of dysphagia?
a. Benign structure
b. Esophageal carcinoma
c. Esophageal spasm
d. Pharyngeal pouch
e. Systemic sclerosis
595. A 9m child is brought to the ED with an irreducible firm swelling which descended into the left
groin when the child has been crying. Exam: both testicles are palpable in the scrotum. What is
the most appropriate management strategy?
a. Reassurance
b. Emergency herniotomy
c. Elective herniotomy
d. Emergency herniotomy + orchidopexy
e. Elective herniotomy + orchidopexy
596. A 37yo woman was admitted for femur fx repair after a RTA. On the 4th post-op day she became
confused and starts picking on her bed sheets and complains of seeing spiders all over. What is
the most likely dx?
a. Delirium tremens
b. Wernickes encephalopathy
c. Korsakoffs psychosis
d. Psychotic depression
597. A 36yo pt came with diarrhea, bleeding, weight loss and fistula. What is the single most likely dx?
a. Celiac disease
b. Crohns disease
c. UC
d. IBS
598. A 72yo woman who is taking look diuretics is suffering from palpitations and muscle weakness.
What is the electrolyte imbalance found?
a. Na+ 130mmol/l, K+ 2.5mmol/l
b. Na+ 130mmol/l, K+ 5.5mmol/l
c. Na+ 140mmol/l, K+ 4.5mmol/l
d. Na+ 150mmol/l, K+ 3.5mmol/l
e. None
599. A 60yo diabetic pt on anti-diabetic medication developed diarrhea. What is the most likely cause
for his diarrhea?
a. Autonomic neuropathy
b. Infective
c. Celiac disease
d. Crohns disease
600. Which artery runs in the anterior inter-ventricular groove?
a. Acute marginal branch
b. Left ant descending artery
c. Septal branches
d. Circumflex artery
e. Right coronary artery