1. A pt with adhd, long face, ear prominent. What problem?

Mutation of FMR1 gene

2. Repeat of FTX gene, ataxia, what more will you see? Heart disease
3. Fetal usg shows cystic hygroma. Why? 45 X0
4. A 17 yr old patient had lone AF. Paroxysmal, lasting 2 mins, not related to exercise, currently ecg
normal. NBS? cardiac event monitors can be used to detect intermittent arrhythmias

Echo, 12 hour ecg, cardiac event monitoring. 24 hour ECG monitoring

5. A patients ecg showing Left heart hypertrophy, patient had failure also. What will be decrease?
Urinary osmo, urinary sodium
6. Picture of folliculitis, but it was very painful and multiple.
Organism? S.aures, HSV
7. Pic of erythema multiforme in a kid. What is it it realted to? Varicella was in option

HSV, Mycoplasma

(very similar to this)

8. Pic of a kid with slapped cheek and rash all over body. NBS? no isolation in B19- droplet precautions for aplastic crisis pt, and
immunocompromised pts
Do nothing, ask the kid to not go for school for a week. (didn’t look like measles to me)
9. A patient had bordtella pertusis. What will he gave leuckocytosis, leucopenia lymphocytic infiltration with leuckocytosis
10. A military man had sevred in South Asia, had seizure, no prv seizure disorder. Organism
associated?
Strongyloides, taenia sagniata
11. A 5 year old kid taken care by grand ma, grandma diagnosed with cavitary pulmonary TB
recently. He had taken BCG at birth, had migrated from india. His PPD showed 6mm. chest xray
normal
NBS?
Isoniazid only
Isoniazid, rifampin, ethanbutol
Repeat ppd in 6 months
12. Patient to b started on Statin. What to check
Cortisol, tsh
13. An x ray of foot, but history had DM, monofilament test positive, loss of sensation. So I put
charcot joint
14. 2-3 questions of IE prophylaxis
15. A 20 year old pt, smoker, had sudden onset left sided chest pain. Breath sounds decreased in
left LOWER lung field. What will confirm dx?
Chest x ray, chest ct, vq scan
 16. Giardia ko pic, how does it cause diarrhea. Long options don’t remember
17. A army woman having pain in lateral foot. Cause?
Stress fracture of cuboid, or metatarsal or navicular Marching: 4th and 5th Metatarsal bone #
4th Metatarsal and tibia # -> repair
18. Patient had thyroid nodule. NBS? USG
19. A neonate had been born in home, no vit k given. Had bleeding, vit K administered. Came 3
weeks later, eth normal, what to supplement
Iron, vit c, vit a, zinc (no vit d, idr if pt was preterm or not)
20. A long vignette, pt had IUCD in place, thread in cervix but pt usg showed hemorrhagic cyst in
adnexa. Nbs?
Give ocp, do cystectomy, remove iucd
21. Pt had blood transfusion for refractive anemia, with 10 mins pt had respiratory distress, no
wheezing present though. b/l crackles.
TRALI, anaphylaxis
22. Pt had blood transfusion, within mins had back pain, pain at insertion site.
Mechanism asked.
23. Pt had PAD, angiography showed severe atherosclerosis of vessels of leg. 2 yrs ago pt had
coronary angio done, there was no atherosclerosis then. Pt had ecg changes from previous ecg,
couldn’t walk even one block, what to do before operation for stenting?
Thallium scan Thalidomide scan, or do nothing
24. Pt had stable angina increasing in frequency. Now angina even at rest since 1 hour. Ecg shows
non-specific t wave flattening, NBS?
Admit in Cardiac care unit, admit and do cardiac monitoring, just admit pt, do immediate
unstable angina lai CCU ma admit garne
coronary angio, discharge with nitroglycerine
25. A lot of interpretation of biostats. Regarding p value, bias, selection method
26. A pt had been taking antacids and famotidine. Asks doc what will be the effect of this
medications
Magnesium causing constipation, calcium carbonate causing milk alkali, famotidine causing
hypocalcemia
27. Pt had urge incontinence. NBS? Urinanalysis, start oxybutynin
28. Tourette syndrome therapy. Primidone, respiridone
29. Pt had serotonin syndrome. What amino acid derivative-tryptopha
30. Pt had IBD, very long vignette, last line biliary dilation and constriction.- sclerosing cholangitis
31. Pt had OCPD. Which area of brain affected? Options with something like wernicke and thalamus,
broca and thalamus, wernicke only. (idr properly)
32. Pic of acnitic keratosis on face nbs? 5 fluorouracil, excision, curettage.
33. Pt says to doc, that his daughter is getting text from a friend saying tht she wants to kill herself.
she says don’t tell it to anyone cause my parents are “jerks” and don’t care. The friend has been
depressed and withdrawn. NBS? Call CPS, tell police to check on friend, do nothing because it
would violate the friends privacy
34. 17 yr old pt had testicular trauma. b/l swelling pt. usg shows normal left testes, soft tissue
swelling present both side. No testes in scortum in rt.
Cryptorchidism, retractile testes (no testicular torsion in option)
35. Pt had recurrent meningococcal infection. What is the cause? Terminal complement deficiency
in option
36. Pt had hepatitis b infection in prv pregnancy. Now at 12 weeks, what will you do
Aminocentesis, hep b antibody, tsh hbsag
37. At 27 week of preganancy what will you do? 1 hour glucose challenge test in option
38. A typical vignette for idiopathic intracranial hypertension: headache, diplopia, nausea, dizziness
in 33 BMI, ocp taking young girl with acne. But lumbar puncture pressure was only 30 mmhg
Migraine, meningitis, idiopathic intracranial hypertension.
39. A woman pt came back from military; she is having nightmares, but can watch tv with war
related news and talk about. She fulfilled criteria for MDD.
PTSD, MDD
40. women had HIV, viral load was low, CD4 was adequate, she wanted vaginal delivery. What
shouldn’t be done. Aminoinfusion, fetal scalp electrode
41. Pt had repeated infdection. IgM, IgE, IgG were severly down, IgA was borderline normal. What
will decrease infection. I chose immunoglobulin twice monthly, don’t remember other options
42. Pt had normal bmi, eth normal but lipid had LDL 200: Atrovastatin was in option
43. An old pt had high bp in right hand, low bp in left hand. Coarctation of aorta, subclavian
atherosclerosis
44. State decides they want to reduce obesity related problems in preadolescents of age less than
15. Nbs?
Regularly check obesity related complication like HTN, hyperlipidemia in kids less than 15
Do counseling to kids and parents of kids about nutrition and eating habits
45. PT had OSA. BMI 30+ (idr exact). Had malocluded teeth and crowding. What is the cause
Upper airway obstruction, decrease movement of chest wall.