here are some recalls that I remembered. Please remember me in prayers.

1. Young Man hit to pole and 20 mg morphine given. O2 60, co2 80, ph 7.24. what to do next?
Paralyse intubate and ventilate
Naloxone
Low O2

2. One question of bronchiolitis. Child has runny nose and cough.worsening cough. No expiratory or
inspiratory crackels, generalised wheez. What is next appropriate?
Nasopharyngeal aspirate
O2 saturation
Chest xray

3. Patient with allergic asthma. Takes sulbutamol and not working and now takes extra dose in last
week. And also takes inhaled steroid. What to add.
ipratropium bromide
montelukast
oral corticosteroid
salmeterol inhalation

4. Young man with testicular mass. Usg pic was given. Asked next.
Aspiration
Alfa fetoprotein
Ca125
Reassure
Fnac

5. 3 year old boy had yellow and brown staining on teeth. Mother worried and asks wat to do. All
other findings normal. Next
Reassure that it goes away with time
Dental assessment referral
Use fluoride toothpaste

6. Patient has severe backpain and red eye. Diagnosis

Uveitis
Glaucoma

7. One question where patient had cataract surgery and after 2 days sudden pain in eye and red eye
pic given. There was hypopyon but asked what is it
Hypopyon
Acute iritis
Glaucoma
Endophthalmitis

8. Previous misscariage. Now presents at 8 weeks and asks What to do to prevent miscarriage in this
pregnancy. Next appropriate.
Cervical length
Cervical dilatation
Fibronectin test at 28 weeks
9. 3 abortions done before and now at 8 weeks presents with bleeding and keen to keep this
pregnancy. What is the cause
Ectopic pregnancy
Cervical pregnancy

10. Schizo patient brought by neighbors complain. Poorly dressed & disoriented.long scenario..

Involuntary Admission
Urine drug screen
Refer to psychiatrist

11. 22 weeks preg has her HBA1C 7.8 what is the best management for her?
Obstetrician
Gp share care
Midwife care

12. 7year old came with fever vomiting abdominal pain. Abdomen slightly tender. Tympanic membrane
slightly red. urine dipstick is normal. Next most appropriate
Usg abdomen
Blood culture
Urine culture

13. 6 yrs old boy brought to u with bleeding from nose. alcoholic smell from mother. While waiting in
waiting room mother thrashes her 3year old kid. 6year old complaints that he is scared and tel
father beats her mother every other day. What is the most important to inform child protection
service?
6 year old scared
Your observation of mother thrashing 3 year old
6 year old bleeding from nose
Father beating mother
Alcoholic smell from mother

14. 41 year old with bmi 27 and pregnant. Scandanavian. Asking when to do ogtt.
Ogtt now
Ogtt 24-26 weeks
Ogg 14-20 weeks
Fasting glucose at 18 weeks

15. Patient on clozapine well controlled. Now having involuntary movement of legs and annoyed with
this. What to do
Propanalol
Benztropine
Decrease clozapine dose
Change to other antipsychotic

16. Patient taking sodium valproate and carbamazepine.last seizure 5 years back. Now want to
conceive. What is most appropriate
Stop all drugs
Stop sodium valproate continue carbamazepine
Add lamotrigine
 Do nothing
Start folic acid 5mg

17. Got only one question of stat asking something wants to study my be rheumatic fever cases. What
is least effective study.
Case control
Case series
Systemic review

18. Ecg of vt and nstemi asking to diagnose.

19. Patient recently noticed lesion on forearm. It was 10mm lesion with ulceration. What to do next
Wide excision
Local excision
Wide excision with biopsy

20. Xray abdomen of megacolon given and patient has history of ulcerative colitis. Now having severe
abdominal pain. What is next appropriate.
Observation
Total colectomy
Ct abdomen
Nasojejunal decompression

21. Old lady on multiple drugs for htn and diabetes and acute coronary syndrome. Ecg given where
there was long pause. Looked like asystole. What is next
Pacemaker
Defibrillation
Amiodarone
Atropine

22. Man threatening to jump in front of car N his parents arrived n he was warning of self harm
What will reduce self harm
Hospital admission will reduce self harm
Send him home
Give him antidepressants

23. One more was similar stem where homeless man threatening to jump infront of car if not admitted.
Agitated and shouting. Tells that he Drinks cheap wine and garbage from rubbish since 3 days
Whats immeidate next
give diazepam
admit immediately
mental status check
leave him on street

24. 4 year kid scenario of tic. Raise arm and all. Don’t want to go school because all tease him. What to
do
Habit reversal
Cbt
Family therapy

25. Another 4 year old soiling his pants despite taking 20ml paraffin liquid. What to do next
 Oral senna
Increase paraffin dose
Osmotic laxatives

26. Pregnant at term. Contractions every 3 mins. Fetal head at 2 level. After 3 hr 3cm effaced. What to
do.
Wait for another 4 hours
Start oxytocin
Amniotomy
Cesarian

27. Wife brought new will signed by husband and asks you to witness this wil. Next
Witness the will
Refuse
Cal medical defence
Ask her to go to lawyer

28. high arch feet mother,peri neuropathy,son also developing muscle weakness, difficulty climbing
stairs. Reflexes normal. Ix for confirm
Muscle biopsy
B12 levels
Nerve conduction study
MRI spine

29. 5 yr child,lump just above to umbilicus. Pic given

Umbilical hernia
Epigastric hernia
Lipoma

30. Patient return from Sudan,came with lethargy,body aches ,heamturia,.Just before left the Sudan
malaria rapid test negative.what test next
Malaria rapid test again
Test for Schistosomiasis

31. 6 yr boy everything normal. Normal development. But repetitions of making building and annoyed
when break his orderly placed toys. dx
Autism
Autism spectrum disorder
ADHD
Conductive disorder

32. Child calm and quiet in class but enjoys in sports and plays with friends normally. Also good at
home and in front of relatives.
Selective mutism
Separation anxiety
Autism spectrum disorder

33. 48 yr old Lumbar pain following fall,most important indication for X-ray
Pain radiation to lower limb
tenderness over Lumbar area
 Pain increases on movement
His age
Pain after Work injury

34. 32 weeks premature baby 1.6 kg at birth.consecutive 6 months weights with normal growth
chart .After plot all just below 3rd centile. At 6months 6kg was given
Normal growth
Underweight
Growing slowly but Acceptable growth
need intervention

35. Osophageal rupture scenario didn’t remember stem. Asking Ix

Gastrografin
CT contrast chest
X-ray chest

36. Raised serum calcium. Normal phospahate. Urine calcium normal. Tiredness fatigue. Asked dx
Familial hypocalciuric hypercalcemia
Mets
Primary hyperparathyroidism

37. Lady trying to get pregnant for 6 months now came for check up and bmi 34. apart from weight loss
advice what to do
Ogtt now
start folic acid 5mg
start clomiphene
ivf