FEB 2019 - MplusX QBank

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21 yr old girl with BMI 15 , came with ammenorhea and infertility . progesteron test neg. wat will help her to
coceive?
A- correct her bmi will lead to conception
/
b- IVF
m
C- ICSI
A, hormonal imbalance sec to poor nutrion
co
-Reza Khan Kochai recall 17 June 2015
Dermatofibroma, after insect bit.
Hyperkalemia ecg, poly pharmacy patien,on amidarone, amilodipine, fruesmide, aspirin.
x.
us
pl
a.aspirin+amidaron
b.frusimide+ amidaron
r.m
c.frusimide+amilodipne
d.amidaron+amlodipine
Ankylosing spondlytics, xray was given,.. but patient was having some tomach problem, and also 57 year
be
old.and mild pain from 20 years.

a.paracetmol
b.naproxen
**Etocoxirib
em
Crisis management .Hb question 3.331
Pts on olanzapine 440 mg something like that. Now complaint of excessive sleep. 15 hours for a day. Whats
//m
next.
a.dec dose
b.inc dose
c.change to resp
d.refer to drug rehab center
s:
Pts collapsed at work site, was having some spiritual belifs that God tell him if he fast for 40 days he will finish
war in worl, bmi 13. Temp 36.5… in ER but now not letting you examine himself, after giving iv fluids, thiamine,
tp
what next.
a.start clonazepam
b.start olanzapine,***helps for wt gain as his BMI 13
ht
c.resperidine consta
For a good screening test … a) good sensitivity B) good specificity

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Patient on venflexin well controlled now developed pressure speech, euphoria. What to do.
a.add Na volporate.
b.add olanzapine.
/
c.add chlorpromazine
m
Depressed pt on venlafaxine, difficulty falling asleep, mx?
a) Olanzapine
co
b) Resperidone
c) Sodium valproate
d) Diazepam
.
x.
Gp 484
A very clear ecg of second degree / type 1, heart block, pt on poly pharmacy, acei, frusimide, digoxin, what to
us
do next. No option for temp pace,
Stop dig
Stop acei
Stop frusimde
pl
Permanent pace maker
Pts 41 yr old, was trying to conceive form last 2 year, after getting pregnant, there was spontaneous abortion
at 12 week. Now whats next.
r.m
a.. tell her to conceive as soon as possible
b.. ivf
c.egg donation
be
After reading this topic allooot i think ill go with option C.

The advanved maternal age will not be able to giv healthy ovum for conception and will reault in miscarriage
em
even in an ivf.
I think she needs donor eggs
Changing my answer to C Since she concieved after two years and that ended up in a misscarriage. Due to
advanced maternal age, conception and retaining the fetus gets tougher due to the quality of oocytes.
//m
I think eveb if ivf is done with hr own egg it night result in the same problem. Probably a donated egg is the
answer to a successful conception.
s:
Lbbb ecg, which drug to stop,

tp
ht
stop frusemide
Trichotillomania senerio, 12 yr old child, remain depress, when in tension pull hairs. And always remain inside
the room playing games on pc.
/
a..family therapy
m
b.cbt
c.some other therapies
co
Rx- CBT, then to decrease anxiety SSRI, anticonvulsant, antipsychotic
1 yr old Child with seizures Na (125).

10ml/kg NS
x.
5ml/kg 3% saline
us
Dissociative fugue scenario…
Cause of agitation in a pt except
Pt with mmse 26/30
Pts with femur fx.
pl
Alcoholic pt
Pts with eyes problems( total blind)
r.m
85 year old man with MMSE 10/30 rectal bleeding for almost 500 ML no ability to talk or decide for himself. His
family is insist of full healthcare for him .what is your next action?
a. immediate transport to nearest hospital with ambulance
b.suggest them to take him to the nearest hospital
be
c. arrange transport to a tertiary hospital

d. consult the family for the end life support
em
Pt with renal functions impaired, v/Q scan was done, showed some thing in rt lung, like positive finding for PE
whats next.
a.Warfarin
b.Iv heprin
c.s/c enoxaparin
//m
d.LMWH
Doppler showing plaque from tibial to popiliteal vein, patient RFts were very dearranged.
a.Warfarin
s:
b.Iv heprin
c.s/c enoxaparin
d.LMWH
tp
male with sperm count 19 million, 40 motility and 65% abnormal sperm.
ht
Spontaneous pregnancy is not unlikely.

No chances for pregnancy.
Hormone therapy to male cane help.
Volume>2ml
Sperm concentration>20miilion/ml
Total sperm 40 million

Motility 60 min after ejaculation >50 % with normal progression
morphology > 30% with normal morphology
/
m
87 yr old nrsing home resident, diarrhea form 4 days, now fecal inconrinance.next?
a.stool c/s
co
b.stool for c.difcalis
c.abd xray.
D. abd ct
DRE...first....then....x.ray ..from these options
x.
Pts at 8 week gestation, mother have h/o of GDM, then developed DM.. when to do GDM testing. No option for
us
now.
Ogct at 26
Ogtt at 26
Ogtt at 20
pl
Fasting insulin level at now r.m
Warts in 2 years old girl… sexual abuse
Hypopyon pic.
be
Abd trauma no option for fast and dpl….

a.ct abd
b.xray abd
em
c.laprotomy
Old lady senerio , nothing was given just cardiac issue, she was pallor, so whats next.
a.fbot
b.parentral fe
//m
c.paked cells
d. colposcopy
In my recall, similar to this one, the lady had dyspnea on exertion, chest tightness and Hb was given as 7,2. I
s:
went for C.
Young patient presented with pallor and lethargy. Investigation shows Hypo chromic microcytic anemia, low
calcium & increased INR. What investigation you will do next? A. CT abdomen B. USG C. Stool C/S D. Anti gliden
tp
antibodies E. Blood C/S

u r intern in psychiatric word , brother of pt told u that his brother plan to suicide tomorrow, and asked u not to
ht
tel his brother that I inform u, wt u will do

inform police
b- let him do wt does he plan as he wish that
request him to ask sister for you about any plan for that
engineer man in coal mine present with nocturnal cough, pt heavy smoker , on examination every thing normal
chest clear and normal cxr, wt to do next
a- endoscop
/
b- ct chest
m
c- repeat cxr after 6 month
d- mri
co
Investigation of patients with respiratory problems should include spirometry and a chest X-ray, which is
available to most general practitioners. These preliminary tests will not rule out many conditions and more
specialised investigations such as bronchial provocation testing or a chest computed tomography (CT) scan may
x.
be necessary. Referral to a respiratory physician will assist in the performance of appropriate further
investigations and establishing a diagnosis. If the condition is work related, then involvement of a respiratory or
us
occupational physician is needed to consider factors such as the effect of the causative exposure on other
workers, how to control the exposure at the workplace and appropriate use of personal protective equipment.
The role of pre-employment screening is controversial and therefore an experienced clinician should supervise
these assessments.
pl
r.m
business man got bankrupt , many financial problem, complain of late insomnia, lack of pleasure , loss 15 kg
from his wt through 3 months, any many other symptoms of depression, his family concern abt him and the pt
refused to take any medication as he doesn’t believe he is sick, he admit he is tired and exhausted but not
depreesed,, wt this called
be
a-denail
b-reaction formation
c-deperssonalisation
em
d-rationalisation
young adult prepared for kidney donation , dr says he will be alright after operation .
a-altrusm
//m
regression
----incomplete ques....
pt 4 days after parathioroid sx for parathyroid adenoma, develop finger and perioral numbness ca level 2 days
back at time of discharge was 2.02 (it was low then the normal limits given) was low wt to give
s:
a-ca carbonate
b- ca carbonate and vit d3
c.calcitrol
tp
calcium iv
ht
boy recently complain of headache, abd pain , nausea vomiting, refuse to down out car wn see his friends and
reluctant to go for school parties and peer group, wt is important to ask
a- family hx of irritable bowel
b- ongoinic academic deterioration
its separation anxiety which if present with somatic symptoms is a sign of depression in children. and school
performance seems more suitable answer.
/
m
co
bells palsy senerio, what next.
Good eye care aids
Steroids.
Acyclovir
x.
presented with frsh blood during diffication has hx of ca prostate treated by radiation 4 yr ago wt the cause of
us
blood per rectum
a- radiation proctatitis
b- ca rectum
c- diverticular dis
pl
d.ca colon
There is both an acute and chronic radiation proctitis.. acute radiation proctitis presents as diarrhea, tenesmus
r.m
within 6weeks of radiation exposure. Chronic radiation proctitis can occur years after exposure and mainly
presents as bleeding..
pt wth mass infront tragus with saliva drippling next

a-ct head and neck
be
b- fnac
em
//m
35 yr women feel discomfort down below , condition developed after twice intercourse with new partner now
condition resolve wn her partner go away last pap smear 18 ago was normal wt to do next
s:
a- repeat pap
b- check chlamydia pcr in urine
tp
c- cervical smear for HPV
malingerer ask for certificate cause she did exam and she was not good in exam , certificate will help her
ht
a- refer her to university medical section

b- give her certificate
c- refuse to give her certificate
3 year old child came with asthma attack every month for last 12 mo, he takes inhaled salbutamol. What to use
/
for prevention
m
Inhaled salbutamol
Inhaled fluticasone
co
Inhaled salbutamol/fluticasone
SCG
asthma handbook didn't recommend scg for children 2-5 yrs...for frequent intermittent asthma, 4mg
montelukast initially..if not controlled, ICS.... http://www.asthmahandbook.org.au/table/show/20
x.
Cv disease risk calculation 5 year , 54 age, smoker, bp 142/90, total cholesterol 6.2, Hdl 1…
us
16-19%
20-23%
jm 1300
Child wake up at night many times and sleep by drinking few sips of juice, whats to see in him.
pl
a.iron def anemia
b.obesity.
c.high sugar
r.m
d.dental carries
Child 15 month old, cry at night, pale looking, drink just bottle milk, what to next.
a.check bsr
b.inc solid food in diet
be
c.gave cow milk only
Young age boy with diarrhea, stool feel greasy, anemia was given , anti glidin and others were normal, what
em
next invest ( sorry confused btw 2 mcq).

a.ctabd
b. small bowel biopsy
Ct headm heam strok, quite big one, ventricle was unable to see.. gcs 11, bp as usal 180/110.. all exam was
//m
normal..
a.low bp.
b.do nothing observe.
c. pass ng
s:
borderline personality for management ???

a.CBT
tp
b.Dialectical therapy
c.Exposure therapy
ht
pts hear a poping sound in hear, before that mild vertigo, the nystigms, and then fall down, now have rt ear
total sNHL, rt horner syd, and nystigmas what is the cause.
Basilar infract
Meningioma.
Acoustic neuroma
Acute labryinthitis.
/
scenario of nerve injury after lithotomy …which muscle is affected ???
m
Extensor Hallicus longus
co
Fundoscopy was done. Patient has DM, Hypertension. Now come for vision loss painless for 3 hours. CRAO
conirmed
a.Ocular message
x.
b.IV acetazolamide
c.Topical pilocarpine
us
Scenario of 11 month old. The baby was born at 31 weeks gestation. Child could not sit with support(or without
support?) Neonatal history of 2week hospitalization after birth. What is the cause?
a.Delay motor due to prematurity
pl
b.Cerebral palsy
c.duchen muscular dyst
r.m
40wk-31wk=9wk pt
Then 11 mnth-9wk=9mnth
So,this child shud sit wth or wthout support
Patient had sex with HIV positive person, comes for a test with the symptom of rash ,NO lymphadenopathy in
be
stem, splenomegaly.
a.Western blot and Elisa negative, what would you do next for diagnosis?
b.EBV test
em
c.CMV test
d.Repeat HIV
Nursing home pt, for dementioa tx, fall from bed, now abd distention. Cx
a.LBO
//m
b.SBO
c.pseudobst (xray was given)
Csf protein and glu was normal, but lymp was 290*10 to power 6, and normal values were mentioned below 2 I
s:
think, and neutrophil was high too. Next

a.obsever and supportive (JM 272)
b.acyclovir
tp
c.iv ceftriaxone
ht
Cellulitis on thigh cx asked. Rest everything was normal.

a.strp aurus
b.st pyogene…jm 755
MMR vaccine with mother come into clinic. She said baby is egg allergy. What to do?
MMR is not related to egg and give vaccine now.
/
MMR should not be given as baby is egg allergy.
m
co
Lady at nursing home who said not to transfer to hospital when she is severely ill. Now fracture femur and
morphine given for pain?. Patient drowsy and ill. What to do next?
Admit to ED
Refer to palliative specialist…….
x.
Decrease morphine dose.
us
pl
r.m
be
em
//m
3
s:
3wks after snow skiing develop this condition .most important management?
a.remove the full nail?????
tp
b.its a result of froz bite so will resolve spontaneously

c.anti fungal
2.12ymnths old child what taken as development defect?
ht
a.cant say no
b.cant stand with support
c.cant drink from spone
3.4 year old chilwhats taken as development defect?
a.cant ride a bicycle???

b.cant dress alone
c.cantdrow a man
/
4.31 year old lady come with 6 month unpredictable heavy bleeding she had a history of irregular bleeding for 3
m
years. What is the most appropriate investigation?
CBC-initial
co
TVS
Serum BHCG
TSH-best
(Benign (noncancerous) causes of menorrhagia include:
x.
• uterine fibroids
• endometrial polyps
us
• adenomyosis
• intrauterine devices (IUD's),
• underactive thyroid function (hypothyroidism),
• an autoimmune disorder systemic lupus erythematosus,
pl
• blood clotting disorders such as inherited bleeding disorders, and
• certain medications, especially those that interfere with blood clotting.)
r.m
5. A mother brings her two year old child who has genital warts. The mother had CIN 1 lesion 3 years ago. What
could be a possible cause for the warts in the child now:
A. Swimming in the river
be
B. Sexual abuse
C. Acquired during birth through infected birth canal
6.A 2 yr boy was stung by bee and developed sever urticarial rash and swelling of the leg .but no
breathlessness or any breathing difficulty .what is the management
em
a.adrenaline IM
b oral.promethazine
c.coticosteroids
7.pasthx of post partumdepression.worried about recurrenc in this preg.now at 12wks .whats the next best
//m
advice?
a.hold the tx till delivery
b.givefluoxatin now
c.discuss with a phycologist
s:
8.samequez with different options.
a.have a discussion with the preg lady with her husband at the late pregnancy
tp
b.hold the tx till end of pregnancy
9.prg lady found with parvo virus Ig M amd Ig G positive.wts next?

ht
a.fetal blood hg % check

b.uss
c.top
.d.repeat 2 weeks later
10.lady with the GAD long scenario asking for medical management?
a.mitazapin
b.chlordiazepoxid
/
c.diazipam?
m
d.clozapin.
e.risperidone
co
GAD>>>>SSRI>>>SNRI>>>BENZO(chlordiazepoxide-lorazepam-diazepam)>>>>>>no role for MIRTAZAPINE at all
11.31 yr old man travel to Thailand and came back now 1 wek .fever
,malais,pharyngealexsudates,splenomegaly.atypicallymphocytes,cervicalLN.malaria prophylaxis taken thru out
still taking.had sex with so many prostitutes.
x.
Monospot test –negative dx?
a.hiv
us
b.ebv
c.malaria
Atypical lymphocytes are indicative of EBV infection ( infectious mononucleosis )
pl
r.m
be
12.
.hyperkalemiaecg strip only dis much given asking for the drug combo which cause it?
a.amioderone + frusamide
b.aspirin + amioderone
em
//m
s:
tp
13.
75 yr old had a sudden clonic tonic genaralized seizure attack.he had a traumatic fall 3 weeks back.now have
ht
headache for 3 weeks. dx?

a.SDH
b.cerebralischimicstrok
c.EDH
14.OCD scenario.gettng late ro go to work because he have become so concern about security.so check all the
locks so many times .already done relaxation methods whats next mx?
a.citalopram
/
b.diazipam
m
c.exposure and respons prevention.
15.48 yr old woman .worry about breast cancer as her friend have breast cancer . breast examination and
co
mammogram done.what to do?
a.register her for breast cancer screening program 2 yearly mamo from 50 yr
b.anual breast examination
c.reasure
x.
16.42 year old woman worry about breast cancer as her cusin got from 58 yr .exam amd mammogram
normal.what to do next?
us
a.two yearly mamo from 50 yrs
b yearly mamo from now
c.yearlymamo form 50 yrs
pl
17.35 yr old woman with irregular menses can with 6 weeks amenorrhea .fsh ,tsh, oestradiol with in normal
levels .progesteronchallang test dosntcouse bleeding .whats the IOC?
a.pitiutarymri
r.m
b.vaginal uss
18.83yr old nursing home man.fall from bed. 3 days worsening abdominal pain and distaension .abdominal pain
on and off ,bowel sounds reduse.dx?(very unclear AXR)
be
a. sigmoid volvules
b.pudo obstruction
em
19.recall of child with ketotic hypoglycaemia

//m
s:
20.
tp
35yr old pt with FBS 5.8 ,2 standerd drinks of wine per day.smoking,now have this .how to confrm?
a.OGTT
b.hand uss
ht
c.LFT
21.soldier with acidently health check with urin protin + .whats next?
a.24 hur protin check or ACR
22.soldier with rutine health check high bp.creatinine and urea increas.with a family renal diseas.dr?
a.Alport syndrome
b.pkd ,if not then ckd
c.renal artery stenosis
/
CKD due to Alport syndrome(It is a progressive disease that ultimately leads to chronic kidney disease, .X-linked
m
dominant - approximately 85% and early presentation is Progressive haematuric nephritis: microscopic
haematuria is reported in almost 100% of patients with AS. Proteinuria is found in 85-95% of patients).... as
co
family heredity Present,high BP,high creatinine,urea-it indicates CKD-progressive stage of alport)… Here CKD
developed (which is a progressive stage of alport).....alport presents mainly with hematuria and proteinuria at
early stage.....here,creatinine ,urea raised,high BP that indicates ckd already developed
1.soldier with routine health check high bp.creatinine and urea increased. With a family renal diseas.dr?
x.
a.Alport syndrome
b.pkd
us
c.renal artery stenosis
2.2 yr old with hematuria and hypertension. History of recurrent nephrotic syndrome (thrice in the last 18
months). Symptoms unresponsive to steroids. Diagnosis?
pl
A) Iga nephropathy
PSGN
r.m
C)vesicoureteric reflux
D) Family history of kidney disease-or focal segmental glomerular sclerosis
E) flank non tender mass
be
3.4 years old boy with hematuria, proteinuria and hypertension now symptoms not responding to steroids. who
initially responded to steroids. Diagnosis?
A- PSGN
B- Minimal change disease
em
C- FSGN
D- Anti GBM disease
23.PSGN pt senario with penicillin given .whats next?
a.reduse salt,high cho,reduse prot diet
//m
b.reduse salt ,water .high prot

c.steroid
Low salt ,low protein,high carbohydrate ,fluid restriction.jm 812
25.cardiac risk rate assesment .chart was given .just to check the range
s:
tp
ht
/
m
co
x.
us
pl
26.aborgin with anal fissure –anal abses
r.m
be
em
27.
Pt with RA ,now this .dx test?
a.anca
b.ana
//m
28.7 yr old harsh dry cough for 2 weeks. Ioc?

a.Np aspirate
b.serology
c.blood culture
s:
29.venalafaxine with insomnia –reduse dose or olanzapine?

30.setralin with agitation
a.reduse dose
tp
b.start other ssri

31.opst op D3 thyroidectomy numbness n tingling arounf mouth –ca infusion
ht
32.CRAO 3hrs .painless LOV.pic given-iv acetazolamide..ocular massage

33.12yr old boy BMI 20(btw 90th -95th centile).parents worried as all are fat in the family.what advice?
a.tell according to family its normal
b.excersice n diet
c.tell he will be normal by puberty
8 year old boy BMI between 90th -95th centile. Parents are worried as all are fat in the family. What advice?
a. tell according to family its normal
/
b. Strict diet and exercise
m
c. tell he will be normal by puberty
co
d. Structured exercise program.
34 .35 wks POA.membrain ruptured.CTG with base line 140,no decelerations ,acceleration present,veriability
5bpm .
x.
Maconiym stain liqur .intrapritation?
a.normal CTG
us
b.normal CTG but baby is in distress
c.abnormal CTG need c/s
Managemnt of meconium stained amniotic fluid bfor brth>>continuous electronic fetal HR monitoring is
required & if CTG shows abnormality then we need fetal sampling,otherwise its normal CTG so far...
pl
35.Brode ligament Hematoa old recall
36.rectus sheeth hematoma old recall
r.m
be
em
//m
37.5 days aftre femour fracture management .PE fetures .renal failure features present .what IOC?
a.ventilation perfution
b.duplex uss
s:
c.ct pulm.angiogram
• 38.scv obstruction senario with face flushing,arm swelling ,wt s the ix to do? (
tp
a.cxr b.mri of cervical spine . c.ct with contrast

• (basic coz Breast cancer.
• Lymphoma.
ht
• Metastatic lung cancer (lung cancer that spreads)

• Testicular cancer.
• Thyroid cancer.
• Thymus tumors).
39.in assessment of a living kidny donor which of the following you need to exclude ?
a.altruism
/
b.reaction formation
m
c.regression
Many ques are from recalls with little twist or new options.two or three hand book direct quez so do the hand
co
book and recalls well.All the best guys
ARMANIOUS PAULA RECALLS JUNE 2015

3. ECG of Bradycardia he is sure about it .. patient on polypharmacy what combination causes all -
x.
1-amiodaron frusemid ...(decrease K n Mg)
2-amiodarone amlodipine ..
us
3- digoxin and other drug
7.which of the following is LEAST likely to be reliefed on HRT A) depression😎 insomnia C) hotflushes D)vaginal
dryness E)urinary frequency
pl
middle age man with history of smoking and PPI usage for years .. present with cough that wakes him at night
which of the following will help you to reach diagnosis A) endoscopy😎 barium meal
Post menopause by 4 years yellowish green vainal discharge no sexual intercourse asking about the cause
r.m
candida Chlamydia
Endometrial cancer
Cervicitis
(E. cancer-bleeding+obesity/DM/HTN. Ix-endometrial sampling, hysteroscopy, USG, Mx- stage-I,II,III,IV

be
TAH+BSO+lymph node dissection, S-II-radiotherapy, S-III+IV-radio+chemo)

11 mounth post menopause 3 days bleedin asking about the cause Atrophic vaginitis Cervical cancer Follicular
acctvation Endometrial cancer
em
Child if any body cough in the home he goes and take a shower rx parents tried all measure without any
benefits FluoxetineParoxetine Fluvoxamine
A 55 year old builder came with weakness of his left hand and leg not lasting for 12 minutes, same complaints
couple of weeks back. he is taking only Aspirin, no other drug, what will you advice him other than usual Mx
//m
(October 16 recalls) a)Do not do strenuous exercise b) Do not drive for 6 months c) Add warfarin d) Add more
anti coagulation e)don’t go 2 work unless allowed by ur gp
acute MI, PE-6week,
h
s:
chronic
epi-2yrs
tp
scenario of peritonsilar abscess with uvula devited suddenly in the er get severly distressded with severe stridor
ht
management
intubation
incion and drainage of abcess
young female with mild lower abdomen discomfort , u/s shows 6 cm lesion on side of the uterine wall, Dx ?
A. mucocinous cystadenoma****teratoma
/
B. endometrioma
m
C. corpus luteum cyst
co
x.
us
pl
r.m
Cause of puerperal fever young female with mild lower abdomen discomfort .she is sexually active. u/s shows 6
cm lesion on side of the uterine wall, Dx ?
A. mucocinous cystadenoma
B. endometrioma
be

depressed patient on venlafaxine for depression now came with euphoria and elevated mood ask mx
A. Add olanzapine
B. Increase venlafaxine
em
post parathroidectomy. discharged on day 4. levels of calcium normal that time. now after 2 days
present with feature of hypocalcemia. what to give
calcium carbonate
calcium carbonate plus vit. d3
//m
calcitriol iv
post parathroidectomy. discharged on day 4. levels of calcium normal that time. now after 2 days
present with feature of hypocalcemia. what to give
A) calcium carbonate
B) calcium carbonate plus vit. d3
s:
C) calcitriol
57. Pt. had perioral numbness after parathyroidectomy what is the next?
tp
A) calcitriol
B) Vit. D3
C) calcium chloride IV
ht
D) calcium supplement oral
Danijela Stojkovski Keyvan Samimi Ehsan Edalat plz

Patient with ischemic heart disease , treated. on aspirin and other medication ,well contrtrolled HTN.
cholesterol 4.5 what mx
Start statin
/
Life style modification
m
cease Aspirin
.husband worried about his wife after conflict with her 8 yrs daughter,she worried about his injury in shoulder
co
and finacncial stuff ,, she denied depression but she feel that she lost intersist of her hobbies
ask for dx
Depression
Adjustment
x.
Generalized anaxiety
.Exact same question :D preg lady g2 p1 previously had abruptio 34weeks. now had twin pregnancy what after
us
antenatal things is ur next appropriate managment
a. ctg from 34 weeks onwards
b.admit after 34weeks
c iron n folic acid
pl
d inc vitamins
Fenale 24 yrs with 2ry amenorrheamen for 2 yrs all investigation normalFsh ,lh , prolactin , tsh , us show 3 -4
cysts ask dx :
r.m
Hyopthyroidm
Pco
Idiopathic hypothalamic dysfuncion
Pitutary adenoma
be
children with runny nose from 2 days and many children in his class absent because of infection with influenza
what will you do?
a…confirm influenza infection
em
b..give oseltamivir
c..give influenza vaccine
d..exclusion from school for 7 days
13.Stab wound in chest with knife.what u do for management

//m
A. remove under G/A

b. remove under L/A
C remove under G/A with cheast drain
d. Remove in E/R
s:
.mother present with her boy complaining persistant bleeding after tripping with a coffee table..what is the
treatmnet of this condition?
a)steroid
tp
b)IgG
C)platelate
ht
. desmopressin acetate is best here.....but if not in option then platelet transfusion...

16) mother present with her boy complaining persistant bleeding after tripping with a coffee table..what is the
likely cause?
a)VWD disea
b) ITP
17)similar stem as before. Appropriate ix asked.

A) factor 8 deficiency
b) serum platelet count and platelet morphology
/
m
next or initial >>>aPTT , Appropriate ( diagnostic ) >>> factor 8
co
long term treatment of patient of DVT on discharge
A)LMWH
x.
B)Warfarin
19.Pt from Iraq. Dry cough.no fever or hemoptysis history. You notice pan-systolic murmur on apex. Chest x-ray
given
us
A) TB
B) Mycoplasma pneumonia ( if xray-opacity )
C) rheumatic fever (if xray normal)
pl
D) Ca Bronchus
Old 50 year lady her daughter is going to be pregnant. Vaccination for that old lady
a)Variceela
r.m
b)Pertusis tetanus diphtheria
c)Influenz
d)Pneumecocal
e)Hiv
be
25.Meningococcal rash senario asked next

a)im penicilline(benzyl penicillin)
b)blood culture
em
Man coming back after short trip from endemic area for only 5 days with severe Jaundice ..fever ..on
examination you find tender liver and enlarged 5 cm under costal margin ..you do investigations
Found Very high ALT , AST , GGT,ALP
//m
Diagnosis-
a) Active viral hepatitis A (ncrease ast, alt) ans
b) Active viral hepatitis B
c) Malaria( bilirubin, AST, ALT, ALP-increase)
d) INFECTIOUS mononucleosis
s:
34.16 weeks pregnant woman found to be HCV +what next

a)HIV testing
tp
b)gonorhea pcr
c)chlamydia pcr
d)HCV pcr
ht
13 year old girl come to u asking for abortion . she left her house 4 month ago and the pregnancy was the
result unwanted sex, 3 weeks ago in a univerity party.what is the next step in management :
a)Inform the sexual assault service
b)Tell the parents
c)Tell the police
6.patient with history of mi last month comes with cholecystitis pain not responsive to iv antibiotics what is
/
next
m
a)change antibiotic
b)percutaneous cholecystectomy
co
c)ercp and extraction
d)surgery
man came with fever and other symptoms and his HIV test were ELISA positive wetern blot negative now after
2 weeks is fine no fever what is the cause
x.
a)acute HIV
b)Chronic HIV
us
c)false positive
a man coming for his testing and now test results after one week are Elisa neg Western blot negative He was
having partner with hiv but once he comes back for receiving results then he was having diffuse pharyngitis
rash no lympahdenopathy and splenomegaly what will u test now
pl
a-HIV
b- EBV
r.m c-Influenza
Final plz
Why not EBV now??
48. farmer had arm swelling and pain after long day of working with saw
a-subclavian vein thrombosis
be
b-cellulitis
Diabetic Pt with skin infections, staphylococcus detected.pt is on insulin, perindopril and combined ocp. going
to start rifampicin for 10 days. what to do
em
Increase insulin
Increase perindopril
Use alternate contraception
. s.bovis on culture, what investigation next?
a)colonoscopy
//m
26. after ca colon treatment? After CEA, what next?

a)colonoscopy (thn CT)
b)ct scan
c) usg abd
s:
traumatic fat necrosis, breast scenario, mammography given, what next?

a. percutaneous core biopsy
b. repeat mammography
tp
C . excision
Haematuria and 3 cm mass in CT what to do
ht
Nephrectomy
Repeat ct after 6 month
-An old patient who recently had MI and stent placement and using aspirin and clopidogrel comes
with haematuria on CT scan 1 cm mass inkidney is found which is strongly being suspected to be renal cell
carcinoma. What you will do?

A- Nephrectomy-Abdullah Al jaseem
B- Hemi nephrectomy
/
C- repeat CT scan after 12 months..
m
D-Biopsy
he is using CLOPID+ASPIRIN post MI >>>contraindicated for renal biopsy Surgical Treatment
co
Surgical resection remains the only known effective treatment for localized renal cell carcinoma, and it also is
used for palliation in metastatic disease. Partial or radical nephrectomy may be used, depending on tumor and
patient characteristics. Open, laparoscopic, or robotic surgical techniques may be used.
the vast majority of solid renal masses in pt with Hx of haematuria is >>>> primary Renal Cell Carcinoma.
x.
Due to this cancer is unresponsive to chemotherapy & Radiotherapy , probably the best action is Resction of
ablation >>>> after confirming by CT or MRI >>>> go for NEPHRECTOMY in primary stages-AAJ.
us
pl
r.m
be
em
//m
pneumothorax 25% Mx
s:
A. water seal drain

B needle aspiration-if symptomatic
tp
1. Best study for causal relationship between HTN and MI

A. cohort
ht
B.Case control
C. RCT
11 month cant seat unsupported born at 32 wk advice

A.it happens due to prematurity

B. its gross motor delay
/
.A man from thiland trip history of multiple exposue now with arthralgia,rash generalised lymphadenopath,mild
m
sore throat,monospot negative, no atypical lymphocyte Dx
A.HIV
co
B.EBV
C CMV
Patient comes back from Thailand with hx of having sex with multiple prostitutes. After one week presents with
lymphadenopathy, mild pharyngeal erythema, splenomegaly, sore throat Atypical lymphocytes present.
x.
Monospot test negative. What is the diagnosis?
us
a) HIV
b) EBV
c) CMV
17. old man with tiredness and microcytic hypochromic anaemia next
pl
A.FOBT
B. Electrophorosis
r.m
.Xray of megacolon asking Mx
A. hemicolectomy
B.NG decompression
C.iV fluid and NG
be
21. Sterile pyouria with wt loss and hematuria Dx

A. renal tb
em
B RCC if not bladder CA
24. ptnt brought by police complaining of hallucination what next

A. Collateral history from police
B psychiatric assessment
//m
C.call his wife
Scenerio Of inferior MI within 2 hour what to do next ( percutaneous angioplasty

A. RTpa
s:
B.angigraphy
C. nitroglycerine
6 yr old moderate asthma now exacerbation 6 puff salbutamol given not improved what next
tp
A.oral steroid
B ICS
ht
C. 12 puff salbutamol
D.ipratropium
old man fall from height severe pain no # on Xray next

A. bonescan
B.PCM
mother of a 2 month child has recurrent thought of harming baby, she said her husband not to leave her alone
with the baby she is anxious about handling the baby
/
Her thoughts are result of
m
A.Obsession
BPPD
co
C.PPP
31.old lady was found lying on the ground by her neighbours….she was drowsy and dehydrated…noticed dark
urine when urinary catheter inserted ,hematoma on thigh ….weight 42kg
Blood investigations given CK was elevated 11000
x.
What is the next step of management?
a) Normal saline with urinary output 2ml/kg/hr
us
b) Dextrose 1/5 saline with urinary output 1ml/kg/hr
c) 5% dextrose with urinary output 2ml/kg/hr
d) Normal saline with urinary output 1ml/kg/hr
Dx-Rhabdomyolysis
pl
r.m
Neonate 4 days with jaundice with full breast feeding ,total bilirubin 240 and indirect 120 dx
breast milk jaundice
sepsis
biliary atresiahttp://emedicine.medscape.com/article/927029-clinical#b4
hypothyroidism (unconjugated hyperbilirubinemia)
be
postmenopausal women with purulent green brown discharge she is sexually active with her husband ask dx
Endometrial ca
Chlamydia
em
Cervical ca
female with subclavian catherizationafter time she got facial swelling ..ask investigation to dx
Ct with contrast
//m
Which one of the following is not a cause of IUGR ?

a) thalassemiaminor with HB 8
b)hypertension with methyldopa
c) infection
s:
football player has an injury while playing after that there was effusion and some times he feels his leg is giving
away and some other times his knee is locked DX
tp
A)antcruiciatelig injury
b)medmensciallig
ht
c)medmenscial +ligamentous lesion
( unhappy triad (or terrible triad, "horrible triangle", O'Donoghue's triad[1] or a "blown knee") is an injury to
the anterior cruciate ligament, medial collateral ligament, and theMedial meniscus.d)fracture patella
(he medial meniscus is a fibrocartilage semicircular band that spans the knee joint medially, located between
the medial condyle of the femur and the medial condyle of the tibia.
Acute injury to the medial meniscus frequently accompanies an injury to the ACL (anterior cruciate ligament) or
/
MCL (medial collateral ligament).
m
Healing of the medial meniscus is generally not possible unless the patient is very young, usually <15 years old.
Damage to the outer third of the meniscus has the best healing potential because of the blood supply, but the
co
inner two thirds of the medial meniscus has a limited blood supply and thus limited healing ability.)
1.Old age pt. with drug elution stent after MI since 6 mo. on clopidogrel had uncomplicated varicose veins ,
x.
management ?
A) postpone surgery for 12mn then stop clopidogrel for 2wks
us
B) continue clopidogrel& do surgery now
C) stop clopidogrel , give ffp& op. now
D) stop clopidogrel 7 days then do op.
E) continue clopidogrel , give ffp& op. now
pl
lady with with history of diverteculitis presented with urine frequance and urgency that looks turbid and cloudy
r.m
with a very bad smell (didn't say air bubless) on Xray you see a very large round lesion with air fluid level , there
is minimal fever 37.5 which of the following is diagnosis
A-pericolic abscess (i choose this but apparently wrong :/ )
B-pelvic abscess
C-colovescular fistula
be
young male who fall suddenly in the field of a match , without being touched , after a few seconds/minutes he
stood without any intervention and continued playing what is the case
em
a)vasovagal attack
B)Jacksonian seizures
A patient with rheumatoid arthritis got a flare up and doctor wants to administer azathioprine. which screening
test should be done before starting this drug? • Tb Gold test • Thiopurinemethyltransferase genotype
//m
screening • Thiopurinemethyltransferase phenotype screening
q2.) 57 year old woman, suffering from chronic rheumatoid arthritis, recently develop hypertension came for
the treatment? She describe past history of asthma and pylonephritic syndrome. a.) Amilodipine b.) Ramipril c.)
s:
Lorsatan d.) Metopropanol
3.) The damage to the trigeminal nerve can cause ? a.) Forhead wrinkling b.) Vision loss c.) Squint or double
tp
vision d.) Loss of taste e.) Difficulty in opening a jaw q.

ht
4.) Hyperkalemia Tall T- wave from the HB asking for the treatment Ans) Calcium gluconate
Q.5.) Among all which drug is hepatotoxic drug require liver function test. a.) Venaflaxine b.)
Hydrocholorothiazide c.) Furesimide d.) Gentamycin Q A>>>>>>>VENLAFAXINE >>>require>>>LFT- BP
MEASUREMEMNT -NA monitoring(sodium levels)
6.) 32.young female with mild lower abdomen discomfort , u/s shows 6 cm lesion on side of the uterine wall, Dx
A. mucocinouscystadenoma
/
B. endometrioma
m
D. Germ cell tumour
co
42 years old olive skin man came to your gp practice he came to u becoz of Tv advertisement of melanoma,no
family history,no symptom.you reassured him,patient said if he feel any symptom he ll come for check up but
instead of that what u ll recommened him for follow up???
x.
A.every 6 month
B.2 yearly
us
C.5 yearly ???
D.put him on regular medication
Table 1. Assessment of skin cancer risk
High risk (3 monthly self examination and 12 monthly skin check with doctor)
pl
Red hair
Type 1 skin and age more than 45 years
r.m Type 2 skin and age more than 65 years
Family history of melanoma in a first degree relative in patients aged more than 15 years
More than 100 naevi (more than 10 atypical naevi)
Past history of melanoma
Past history of nonmelanoma skin cancer or more than 20 solar keratosis
be
Medium risk (3–6 monthly self check and 2–5 yearly skin check with doctor)
Blue eyes
Type 1 skin and age 25–45 years
em
Type 2 skin and age 45–65 years

Type 3 skin and age more than 65 years
Family history of NMSC
Past history of solar keratosis
Multiple previous episodes of sunburn
//m
Low risk (annual self check and one-off skin check with doctor for assessment of risk and advice regarding skin
care)
Type 1 skin and age less than 25 years
s:

Type 4 and 5 skin
20. Under which condition would you suggest couple to go for IVF a. Bilateral blocked tube b. endometriosis c.
tp
unable to conceive 2 years d. sperm motility

ht
7. ) Definition of prevalence Number people suffering from disease Number of new cases Data collected from
different area
Incidence. Number of new cases occuring in defined population within specified period of time
Prevelence. Refer to total number of individuals who have disease at a particular time in a population.
8. ) Med/Surg-6. A 65 year old woman is a known case of presents with flickering movement on his mouth and
tremor history. What will you do? a) Add Benhexol b) Add Benztropin c) Propranolol d) Levodopa/ carbidopa
/
m
06/14-79. MOST TERATOGENIC..............MARIGUANA/COCAINE/ECSTASY
(Cocaine-IUGR, placental abruption,stillbirth,PROM n delivery, need for neonatal resuscitation, IVH, dev delay)
co
Amphetamine- cleft palate, IUGR, preterm delivery, eclam/preeclm)
-primigravid ,in labour,cervix fully effacement,cephalic position ,5cm dilation after 4 hours again in this
situation but fetus is ok and there is no sign of distress again no progress but fetus is ok and no progress a-
x.
normal labour b-obstructive labour c-require ctg d. require CS
Primipara woman in spontaneous labour. Membrane ruptured 1 hr ago. Head 2 cm above ischial spine, vagina
us
4cm dilated and fully effaced. 4 hrs later head is 1 hour above ischial spine and 5cm dilated. What is the best
next management? - Do another vag exam in 4 hours - Start oxytocin - C/S - Start lumbar epidural - Don’t
remember other
preproliferative diabetic retinopathy picture & patient stop taking insulin or diabetic drugs. Now complain of
pl
vision disturbance, wof you need to add in prescription a.) propanolol b.) ACEI c.)
Continue insulin d.) Pilocaprine e.) IV acetazolamide
r.m
Three questions on sigmoid volvulus One to identify what shown on image Second what next – CT scan with
barium Third – surgery to fix volvulus
A caecal diameter of greater than 11 cm or small bowel dilatation should initiate urgent surgical referral as it
indicates complete obstruction and the risk of perforation is high.
be
A 17 years old boy parents come to you complaining that he listen to loud music, spend more time watching TV,
get up late afternoon, do noy attend school regularly and eat lot of junk food, what would you advise to
em
parents? a.) Prodomal schoprenia b.) Depression c.) Normal teenager d.) Adhd e.) Asperger syndrome
10/14-88. 12 yr old boy with bmi 20,has all the family members obese.wats the best advice a) Tell the parents
that he is normal according to wt of family b) Refer him to exercise and diet c) Tell the parents that he will be
normal by puberty d) There was no option for faily therapy
//m
Mother came with her little son. His BMI was given 18 (95 percentile). You have seen all family members are
obese. What`s your advice a. Consult all family members b. Tell his mother he will be well as he grows c.
Consult with her mother d. Healthy diet oppose to increase activity e. Advise to replace soft drink with fruit
drink
s:
One ques from data collection with or without variability change

young girl BMI 32 & all family members are obese: A.Reduce exercise B.Increase soft drinks C.Strict dieting plan
D.Family counselling for obesity
tp
20th june Recalls (PERTH AUS)

(Durain Baloch)
ht
1 same HB q 3.337
2 otitis media asking about treatment
3) Cluster headache
4 acute tubule necrosis was asking about diagnosis (weird question)

5) MVA vey weird q asking about haemopneumothorax
6) Sub-arachnoid hemorrhage was new question to me)
/
7) Old recall alcohol teratogenic effect (one recall that i got in my exam.)
m
8 morning pill new question)
9) 3 questions on ocps but very tricky)
co
10) Many xrays very weird xray)
11 HOCM 2 question new twisted q asking about how to diagnosis...
12) Hemolytic anemia
13) Many diabetes questions with polypharmacy)
x.
14) Migraine question
15) Rectum cancer
us
16) Few question on antenatal checkup difficult to choose)
17 few murmurs with very weird presentation one was pulmonary stenosis
18) Few pics difficult to diagnosis one drug reaction that asking about which test u do
19) Femoral hernia i think same in HB (didn’t checked i m scared)
pl
20) Prevalence asking for definition
21) Mammography question
r.m
22) I think old recall ankle strain asking what to me picked bp
23) Breast papilledema q asking for investigation
24) One cellulitis question vary with many polypharmcy
25) Pneumonia q with xray
26) HB 3.216)
be
27) One fluid q I think pre-operative management I think (sorry guys i got all lengthy questions so didn’t
remembered anything)
28) One q was bilateral milky discharge patient was taking respirdone throxine and ocp)
em
29) One ecg of pericarditis with many polypharmacy

31) One case of generalized anxiety disorder
32) One paranoid type question
33) Two u/s question honestly speaking didn’t recognized (just mark tooka)
34) Few q on metoclopramide asking for reactions hb related q
//m
35) One sexual abuse 8 year old girl sex in playground with very weird stem
36) HIV q very new question couple ELISA positive...
37) HB 3.186
38) Dengue prevention
s:
39) Implanon asking to gp for insertion

ALL TYPICAL Q
40) Epilepsy with carbazampine but not controlled 3episode within one week
tp
41) Agitated patients came to ask gp see immediately what gp will do

ht
I got 11 ecgs , complete HB , Svt , Inferior MI , digoxin effect , hyperkalemia , those are the ones I remember
Stastics question about best study for influenza and vitamin C… randomization , random selection , case
control , csigmoid volvulusohort ………………. Twice ☺
which of the following is LEAST likely to be reliefed on HRT A) depression😎 insomnia C) hotflushes D)vaginal
dryness E)urinary frequency
female 65 with really atrophied vaginal epithelium comes to you with brownish discharge for 2 month ,
/
Diagnosis
m
a – vaginal atrophy
b – endometrium cancer
co
c- caner cervix
5. Post menopause by 4 years yellowish green vainal discharge no sexual intercourse asking about the cause
candida Chlamydia Endometrial cancer Cervicitis
6- A 55 year old builder came with weakness of his left hand and leg not lasting for 12 minutes, same
x.
complaints couple of weeks back. he is taking only Aspirin, no other drug, what will you advice him other than
usual Mx (October 16 recalls) a)Do not do strenuous exercise b) Do not drive for 6 months c) Add warfarin d)
us
Add more anti coagulation e)don’t go 2 work unless allowed by ur gp
pl
r.m
be
em
//m
s:
tp
ht
7- The most common finding in us of acute cholicystities Thick wall and pericyst fluid Stones
/
m
co
x.
us
pl
r.m
be
em
//m
8 - Parotid sweliing with drippling of saliva progressive inx intially

A - Ct
s:
B - Fna
C - Biobsy
D - Surgical excision
tp
E - Antibiotics
9-scenario of peritonsilar abscess with uvula devited suddenly in the er get severly distressded with severe
ht
stridor management
A - intubation
B - incision and drainage of abcess
10 -young female with mild lower abdomen discomfort , u/s shows 6 cm lesion on side of the uterine wall, Dx ?
A. mucocinous cystadenoma
B. endometrioma
teratoma
/
11- female with vaginal bleeding , husband away on 6 month trip and she doesn’t want to conceive anymore ,
m
asking about contraception
ocp
co
mirena
pop
12 - post parathroidectomy. discharged on day 4. levels of calcium normal that time. now after 2 days present
with feature of hypocalcemia. what to give
x.
A - calcium carbonate
B - calcium carbonate plus vit. d3
us
C - calcitriol
13 - 40 yrs female , history of migraine , polycystic kidney ,sudden occipital headache , no neck stiffeness nor
photophopia , ct normal and 2 LP unsuccessful , next appropriate inv. ?
pl
-repeat ct
-MRI
-cerebral angiography
r.m
Repeat lp
14 - scenario of marijuana and antipsychotic use with akasethia , next appropriate
-stop marijuana
-reduce marijuana
be
-advice to be back to normal smoking

-benzotropine
em
15 – xrays very bad quality , 3 for abdomen asking for diagnosis

16 – 2 capsule endoscopy questions
17 – wedge resection for nail picture
18 – xray chest A-p and lat. View showing increased Bv markings and basal lung patch , pt with haemoptysis
asking cause ….
//m
Bronchiectasis
Cancer lung
Pneumonia
19 - old age female , had will of no transfer when seriously ill , fracture neck femur and so dehydrated after
s:
morphine :
-ED
-admission
tp
-change to normal analgesic

- family meeting
ht
20 - 3 days oliguria , after knee surgery , appropriate next :

-US
-CT
-IVP
21 - A young woman with H/O blurring of vision for 2 days.O/E 6/12 on right eye 6/36 left eye.whats the
appropriate next
/
-visual evoked potential
m
-LP
-CT
co
22 - sleep apnea typical , next appropriate :
-surgery
-CPAP
x.
-weight reduction
23 - multiple medications use , low mcv , cause :
us
-asprin
-diclophinac
-chloriquene
pl
24 – very weired question about pt with low MCV and anaemia 8.6 , had fever for 3 days 2 weeks before
presentation that subsided spontaneously , now presents with anaemia investigation asked , no bilirubin given
Autoimmune haemolytic anaemia(coomb’s test)
r.m
Malaria (thick and thin film)
25- why we do chlamydia screening:
-asymptomatic in girls
-asymptomatic in partner HB-3.390
be
-it causes infertility

STIs are frequently seen in general practice, especially chlamydia, which is typically asymptomatic. It is
important to detect it early in order to minimise potential complications, such as infertility, and to prevent
em
transmission to others.
racgp.org.au
Scenario of young female with pallor and tinge jaundice. On examination, there is splenomegaly and Coomb’s
test is positive. Blood film show numerous spherocytes. What is your Dx? A. Hereditary spherocytosis B.
Autoimmune hemolytic anaemia C. Thalassaemia
//m
B,coombs test is done to detect antibody or complement present on red cell surface.Indication of Coombs test
incase of:1:Auto immune haemolytic anaemia.2.Drug induce haemolytic anae mia,3haemolytic disease of
newborn.4.Haemolytic transfution reaction.
13. Autoimmune hemolytic anemia is asso.with malignancy of which lineage? A. T cell B. B cell C. Pre T cell D.
s:
Pre B cell
26 - limp ischemia scenario , what management : -
A - iv heparin
tp
B - enoxaparin
c - warfarin
ht
27 - influenza case 4 yo , rhinorrhea , influenza outbreak :

-vaccine
-swab
-exclude from school
-oseltamivir
28 - hemothorax scenario : water underseal drainage

29 – 1 really weired statistics question that peter sabry got on 16th june about HBV , didn’t know the answer
and cant remember the details you can find it on peter sabry recalls
/
You are a doctor in a remote area where a study is conducted to determine the prevalence of Hep B the study
m
included 200 patients and showed the following results
2008 2009
co
Patients with Hep B Ag +ve only 10 12
Patients with +ve Hep B core antibody and Hep B Ag 50 52
Patients with Hep B core antibody +ve only 20 30
Calculate the incidence in 2010 in 1000 patients from this population? ( new pt/ pple no)* 1000
x.
A. 25 B. 50 C. 75 D. 300 E. 325
us
pl
here,+ve HBsAg(infectious but not diseased)=12......,+ve HBcAb(resolving)=30..... +ve HBc Ab +
HBsAg(chronically infected) =52,......So,new cases are=(52-12)-30=10...so,incidence rate in
r.m
2010=(10/200)x1000=50
30 - 8 yr old girl with recent URTI hematuria noticed in routine UA , what is the next step
be
A) renal biopsy
B) u/s
C) start treatment with steroid
D) repeat UA after getting healthy from URTI
em
31 - Mother comes for 5th time in 2 weeks, with 10 weeks baby says he cries all the time. Successfully breast
feed and baby goes back to sleep. On examination baby is okay. What you will look in mother’s history?
A - Her mood
//m
B - Her post partum weight loss history
32 - Women 24 years old, on all possible drugs available!!Which one is most teratogenic?
Heroin
Cocain
s:
Marijuana
Smoking
tp
Alcohol....amphetamine ...mdma.....cocaine ...benzo...smoking
33- Aspergens boy 13 years old, had multiple phobias. Given sertraline, he improves and parents are happy that
ht
he is confident and doing well now. Lately became aggressive and irritated. Reason?
a.Puberty realted mood change
B - Sertaline induced((ssri side effects including NVD))
C - Aspergens turning to ADHD
D - Relapse of Aspergens
34 - Hereditory spherocytosis question, girl brought by parents with Hb 4.6 (very low) asking for cause? She was
/
stared on a medicine recently, like naphthone
m
36. Jaundice on 10th day. How do you manage?
A - Stop breast feeding
co
B - Check baby direct and indirect bilurubin
35 - Pregnant present on term for delivery uterine contraction start membrane ruptured and cervix 5 cm in
diameter , LOT, head just above ischial spine ,CTG 144/m, 5bpm variation, acceleration nothing significant,
x.
deceleration no variable , wt CTG indicate
1. fetal distress
us
2. incordination
3.normal ctg
36 - 26 Yr old woman presented with slight lower abdominal pain on day 6 of her menstrual cycle.on
examination other than cervical excitation there is no adnexal mass.what is your next inv to dx the condition?
pl
a) 1.TVS r.m
b) 2.Cervical swab
c) 3.Urine RE
d) 4.TSH
be
***PID
37 - salmonella case in your gp practice in the last week.what study will you do to find out the cause?
a) compare food source between infected group and non infected group
em
b)consider about the take way condition of food store

c) consider only infected people food source
d) consider only non infected people food source
38 - An old man of nursing home resident came with new onset 3days diarrhea now complainting of faecal
incontinence.What will be next?
//m
a. Stool e microscopy culture

b. DRE
c. Colonoscopy
d. Sigmoidoscopy
s:
39 - Recent coming from india, with bloody diarrhea and abd pain. On hx, he said he is suffering with this for
last 3 years. what's the cause?
a) E.Coli
tp
b)Amoeba
c)Ulcerative colitis
ht
40 – pt 28 weeks with pprom

Send her to local hospital
2ry hospital 50 km away
Tertiary hospital 150 km away
41 - pt admitted in psychiartric ward for 10 days.he is treated with some antipsychotic n diazepam good now bt
for the last 4 days he become agitated n go to other ward n mess all the things with some urinary
/
incontinence.no other urinary symptoms.what is the dx?
m
a.benzo toxicity ???
b.relapse of pyschosis
co
c.UTI
42 -scenario of woman travelling to china in 5 stars hotel asking about vaccine-influenza

43 - adrenal mass 5cm find on CT scan other physical examination normal , what is management
x.
(adrenelectomy if tumor >3-5cm)
A - Surgery
us
B - Review after 6 month
Those are all i can remember guys sorry , if i remember anymore i will post them , please keep me in your
prayers i really need it 
pl
recalls 18/6
r.m
1. Two que regarding haematoma on thigh, it was clearly written circumferential increase, so no issue in
identifying that its not celulitis, one que asking diagnosis and other asking Ix: INR
2. GYNECOMASTIA pic: normal adlocescentchange(in footballer on inhaled fluticasone)
3. Cervical spine injury bp 80/55, HR 50 (sure), what is the most NEXT most appropriate step: atropine , iv
colloids , trendelenburg
be
em
//m
4. Cerebral tumourhbque
5. Pnemunia in 4 yr old kid wid 85% spo2,: iv penicillin, iv fluclox
6. One more pneumonia que, can easily be attempted
7. Malaria in returned traveler
8. Dengue in returned traveler
s:
9. Nurse needle stick with hivpt, wat to do: samples sent already: start antiretro
10. Mom not want to vaccinate child, : respect her wish, persuade her
tp
11. Delay in hearing and development in kid due to prematurity

12. Confusing scenario b/w GAD AND DEPRESSION, duration was 6 wks, old recall lady worries abt her husband
shoulder in jury, fights wid daughter, loses intersrt in everytiong,loss of sleep and anhedonia
ht
13. OCD scenario, citalopram or exposure and response prevention, already they have started relaxation
therapy,
14. Old recalls pt 45 yr, father CRC AT 57 AND MATERANL AUNT AT 68:fobt 2yrly
15. Recent recall of Chlamydia causing infertility
16. Infrequent breast feeding is an issue in poor feeding

17. Thank GOD no ctg and murmur que
18. 15km run, no previous ailment, ecg given AFIB, VT, ATRAIL FLUTTER,V FIB nd ONE MORE, NO CLUE IN QUE
/
THAT pt is having regular or irregular heart beat, I AM SURE THER WAS NO PSVT
m
19. 4 yrchild , with wide cimplex tachy, : iv adenosine
20. Ecg given asking wat is in ecg, : a fib, frequent pvc,U waves, a flutter and one more chice
co
21. Aboriginal man smoker drinker: environmental issue, other choices didn’t fit in
22. Mother calls asks fr Chlamydia result of daughter: u cannot discuss with mothter
23. 51yrs female post menopausal 11 months, 3 day bleed: ovarian follicular activity
24. Hyperkalemia ecg given , not full ecg , just 4 beats asked to identify which drug combo causes it: aspirin and
x.
amiodaronre
25. Old lady widabd distension and drenormal,nursing home pt, asking diagnosis, obstipation : sigmoid volvulus
us
, crc
26. Recall of child widketotic hypoglycemia, ketones in urine , now confused
27. One poor progress of labour very long stem, don’t remember exactly. Que was when to do cs
28. Premature New born wid hyaline memb ds, now requiring more oxygen, : pneumothorax
pl
http://www.health.vic.gov.au/neonatalhandbook/conditions/respiratory-distress-syndrome.htm
r.m
29. 16 yr old wat to do opportunistically: bp JM 68
30. Postmenopausal lady wid brownish green diacharge, actve wid husband, wat most likely diagnosis,:
chlamydia , atrophic vaginitis, ca endometrium
31. One que based on cin chart given at end of cervical cancer que: repeat pap after 1 yr
32. Retracted tm aboriginal discharge wid pus from ear :amoxy , ear toilet
be
33. Inr 5.3 bladder hematoma ct given: wat to do, drain ,injvit k, decompress bladder
34. Epidrmoid cyst pic givn asking diagnosis
35. Ct brain hemorrhage widbp 180/100: same old options, I cudnt see any midline shift, gcs 11
em
36. Scv thrombosis, arm swelling old one

37. Child wid systolic mrmr: refer to peds, immediately refer to hosp in ambulance, do nothing coz systolic
mrmr is good and heart is normal
38. Mentally retarted mneorrhagia: depoprovrea, implanon, mirena
39. Old recall OA : hold stick in opposite hand and walk wid affetcetd side first
//m
40. OA hip, loss of sensation in lateral side of leg, wat u find in examination: LOSS OF sensation in same ear
41. INFLUENZA epidemic child comes widrhinorhoea, wat to do; isolate, lp , treat, exclude from school for 7
days
42. Venlafaxine side effect of insomnia ,pt having in somnia on venla,: DECREASE DOSE
s:
43. Cauda equine syn, wid bladder sensation loss

44. Psychotic pt admitted and fine but suddenlt start behaving aggressively, and yrineincontinenece on
antipsychotic and benzos: relapse of psychosis, uti, benzotoxixicty, antipsychotic toxicity
tp
45. Man with normal lfts and elevated ggt falls and hits head, followed by lowering of MMSE, ASKIMG
DIAGNOSIS: alcoHOL RELATED DEMENTIA, SDH, SORRY I donrt remember more
ht
46. 12mm endo complete abortion recal

47. Uterus deviated after delivery, and pph :broadligament hematoma recal
48. Sleep apnea scenario, wats immediate Mx: cpap, wt reduction
49. Low risk exposure to asbestos wile house renovation : x ary now and then 5 yrly, other weird options
50. On x ray pleural plaques seen, wat to do to arrive at diagnosis: ct scan ,pleural biopsy
51. Hemopnumothorax scenario, dull on percussion ,wat to do next, : x ary chest, needle asiparoin , underwater
seal drain
52. 2 que on testes mass, on one usg was done and mass was clearly cystic and very normal findings of
/
epididymal cyst on physical exam: wat to do next: same optionsand in other normal physical exam ,usg not
m
done wat to do next was asked
53. One scenario on depression don’t remember, read depression well, but the que a surprise
co
54. 2nd day post op, agitated not controlled by security: same options widim halo
55. Chinese lady having exams n ibs: start ssri
56. Child fall from table bleeds since yesyerday, no petechie, no lymph nnode, no hepatosplenomeagly: vvd ,itp
57. Scfe scenario: asking M x: pinning was
x.
58. Lets solve dat controversy of intubating or giving oxygen first as ans to persinwid singing of facial hair ,
eyebrowsand laryngeal oeedma, it was clearly given dat OXYGEN VIA NASAL PRONGS or INTUBATE, so I think its
us
intubate here I think, no confusion with preoxygenation which we were confused for ages
59. 2 or 3 que directly from HB, SO read it well
60. Stastics question about best study for influenza and vitamin C… randomization , random selection , case
control ,sigmoid,
pl
61. Old man wid esr100, calcium 2.4(2.7 was upper limit given), platelets normal, spinal fracture, hb was around
10,wat will u help to arrive at diagnosis: bone marrow , PSA… M SURE OF VALUES GIVEN
r.m
62. Pt wid TIA and cholesterol 7.5 and bp 180/110, wats next: perindopril, metoprolol, atorvas, one more
antihypertensive in options
63. Crao 3 hrs : iv acetalozalmide, pic given
be
1-Mother brought her child complaining that the child doesn’t want to go to school. When you examined the
child you found that he talk like “ I am cl.. cl.. cl.. clever” “ I like fo.. fo.. foo.. football”.. He told you that he does
em
not like to go to school because children bother him but he has only one friend who loves him. What is Dx
Asperger Syndrome.
Autism
expressive dysphasia
//m
2- (weird x ray of ant oblique position of abdomen with air fluid level of bladder) bed ridden woman has abd
pain and dysuria with bad smell urine ( didn’t mention air bubbles). Pt had history of diverticular disease
s:
colovescular fistula
UTI
tp
3- Mother asking about her daughter case

Tell her come with her daughter
ht
Cant ask about any other pt

tell her daughter condition
4- A patient gives u a gold watch as a gift after you treat him/her successfully
accept it.
say its an expensive gift u can't get it
.refuse it
Give it to another friend
5- a girl did her exam... came to your office 2 days after asking for certification of her retrospective illness. She
/
is currently asymptomatic. What is the personality disorder
m
Narcissistic Personality Disorder
Borderline Personality
co
Malingering
6- man had marked anxiety. Isolated, poor hygiene, leave school, nevere work.what will help u to reach dx
eccentric attair
perplexity
x.
depressed affect
auditory hallucination
us
7- a woman on dialysis. Nurses loves her and used to walk with her. She suddenly is upset and shouting. She
didn’t want to continue the dialysis
depression
disorientation
pl
blunted affect
8- heavy drinker with s/s heart failure... need Dx...alcoholicx cardiomyopathy
r.m
9- 15 month old baby,having diarhea at the start of weaning,and buttock wasting,not gaining weight..inv
needed for Dx
Sweat chloride test
duednal biopsy
Stool for reducing substances
be
10- lactose intolerance scenario with same options-stool for reducing substance
11- a girl complaining of wt loss 3 mon after her father death.she denied any symp of depression.on
examination she is in good mood. She occasionly vomits after meals. What is Dx
em
Normal grief
Depression
Bulimia
Anorexia
12- old man with DM type 2. Has an ulcer on the medial malleolus. It started 2 mon ago after a scratch at the
//m
same site.what is the Dx

Diabetic ulcer
Ischemic ulcer
Venous ulcer
s:
13- 2 hours postpartum, the woman developed an 8 cm hematoma extended from the cx to the labium majus.
What is the next step
IV antibiotic
tp
Evacuate
Aspirate
ht
14- primigravida woman in delivery. she asked a minimal intervention in the delivery. The cx was 2cm but after
4 h its fully effaced with 9 cm. Intact membrane with the head of fetus at the stage -1.what is the Mx
Oxytocins injection
Artificial rupture of membrane
Ergotamine injection ( no option for doing nothing)
15- medical student had needle stick injury with a pt known HBV positive. The student was tested positively for
HBS Ag. What is the MX
Give immunoglobulin and vaccination
/
immunoglobulins only
m
Vaccination only
No action required
co
16- middle aged man with solid testicular tumour. What is next to do
US
FNAC
Excision ( no option of tumour markers)
x.
17- epididymal cyst scenario what is the next Mx
FNAC
us
Tumour markersu7
Review after 3 mon…
excision per scrotum
epididymal cyst asking most app management he did u/s and it was simple unilocular cyst and the vas felt
pl
separately from the testis
inguinal surgery - scrotal surgery - review after 3 month - tumour markers
r.m
#GENI 3. Man with swelling 1.5 cm in scrotum testes & cord palpated normally , no pain or urinary symptoms ,
whats is the definitive treatment ?epididymal cyst
A)trans scrotal surgery
B)aspiration by needle
C)Reassure now & check it after 3 mo.
be
D)trans inguinal surgery

18- old man with MI 2 mon ago. Has RUQ pain with J and fever. He took AB infusion for 2 days without
improvement. What is the MX
em
Open Cholecystectomy
Perc cholecystostomy
Continue AB
19- pt with cholecystitis. US shows thick wall of gall bladder with stone in it. What is the Mx
Remove the stone
//m
Cholicystectomy... ( sorry cant remember the exact scenario and answers)

20- pic of varicocele. Pt has scrotal swelling which subsides with lying down.what is the most imp inv.(HB 2.075)
ct abd
xray
s:
us groin
urinalysis and cytology
21- most teratogenic substance
tp
alcohol
marijuana
ht
cocaine
22- ureteric stone high in position making pain.. it is 2 cm but doesn’t block the passage of urine.what is the mx
lithotomy
some substance that dissolve the stone
ESWEL
Ureteroscopy with basket removal of stone

23- pregnant teacher exposed to a child who has rubella. She took rubella vaccine when she was 12 years
old.what is next
/
IgM and IgG titres of teacher
m
Check rubella in child with lab investigation
Terminate the preg
co
24- patient has rheumatoid arthritis had history of DVT. Now he came with black fingers.what is the inv
ANCA
Anticardiolipin
ANA
x.
Anti ds DNA
25- You are a doctor in a remote area where a study is conducted to determine the prevalence of Hep B the
us
study included 200 patients and showed the following results
2008 2009
Patients with Hep B Ag +ve only 10 12
Patients with +ve Hep Bcore antibody and Hep B Ag 50 52
pl
Patients with Hep B core antibody +ve only 20 30
Calculate the incidence in 2010 in 1000 patients from this population
25
r.m
50
300
325
26- scenario and x ray of AS.what is the next treatment for pain
be
Sulfasalazine
Infliximab
Methotrexate
em
Paracetamol
Indomethacin
27- what is the study for the effect of vit C on influenza
Cohort
Cross sectional
//m
Case control
RCT
28- X ray of pleural effusion.Mx
29- pt with spasticity of lower limb. Tingling and numbness in upper limb. Dx
s:
Guiilian barre
Cord compression
Syringomyilia
tp
30- old pt has LL pain when he runs > 200 m and relieved with rest. On examination his peripheral pulse is not
felt. What is Mx-gradual walking programme
ht
31- pt has DVT. Not compliant with drugs.what is Mx

Clopidogril
LMWH
Vena cava filter
32- carotid stenosis 75% with past hx of 2 TIA. Now he is ok. Mx-CEA
33- Incidence of schizophrenia in dizygotic twin

10%
15%
/
20%
m
40%
34- scenario of dengue fever.asking Dx
co
35- pt with bleeding per rectum with back pain. Asking Dx
external hmrds
internal haemorrhoids
ulerating cancer rectum
x.
36- old patient having fresh rectal bleeding & blood not mixed with stool.He was treated for prostrate cancer
given chemotherapy. Cause of bleeding
us
Diverticular disease of colon
Ulcerative colitis
Ca rectum
radiation proctitis
pl
37- old recall with 3 murmurs-AR
38- screening test to be accurate
r.m
high positive predictive value
low negative predictive value
high sensitivity
high specificity
be
39- woman with bilateral milk discharge ( I think with not very high prolactin level).ank management
bromocriptin ( sorry can’t remember other options
40- pt postpartum with amenorrhea can’t breast fed her baby. Dx
em
pituitary adenoma
pituitary necrosis
asherman syndrome
41- girl with 1ry amenorrhea. Her brest ex and pubic hair are normal. She gets abd pain every mon at the same
time.you are not allowed for pelvic examination.what is Dx
//m
Imperforate hymen-more common

Absent vagina
Mullerian agenesis
42- pt has 3 cm pancreatic pseudocyst near the stomach.what is Mx
s:
percutaneous drainage
endoscopic gastrostomy
drainage by ERCP
tp
observation
ht
43- pt has urge incontinence..mx

Bladder training
Anticholinergic
Pelvic floor exercises
44- a child ate prawn pie in restaurant. he developed urticaria and wheezes without any other resp symptoms.
What mx
IM adrenaline
/
IV adrenaline
m
SC adrenaline
Antihistamine
co
45- old pt can’t walk at night.( sorry couldn’t remember the exact scenario..or options)
Vit B12 def
...
46- child with high fever.pain in the rt knee.the passive movement in normal except little flextion.what is Dx
x.
Fr tibia
Fr patella
us
Tibial osteomyelitis
Septic arthritis
47- 5 mon child brought by his father with large bruise on his back. No pitichae. His father mentioned that his
old son has ADHD. What is the cause of fetal condition
pl
Bruise dt ADHD of the older child
baby really fell from the couch
r.m
young female child was brought by her father with swelling at posterior head saying that baby fell from couch
yesterday. Her 7 yr old elder brother is having ADHD. What is the possible cause of female childs swelling:-
(very weird scenario with weird options)
- baby really fell from the couch
- her brother did something
be
- some other weird options cant remember

48- MME 23...he didn’t see well... make him do another test.
49- 2-3 ECG of AF, hyperkalemia,pericarditis,..2-3 qs of polypharmacy.. no ctg or milestone qs.
em
Keep me in your prayers.good luck to you all.

//m
RECALLS 19thjune 2015 Bangkok….

A scenario of antisocial personality disorder
Old recall of 12 month child not unable to understand NO
Question on caustic soda ingestion
s:
A scenario of an patient admitted in ward becoming agitated to an extent that you have to call the security
guard sto handle the patient..what to give ?
Im halo
tp
Iv diazepam
old lady has had problems with urination and defecation for the last 10 years, she started to have
ht
urine incontinence since last year, as she is on two-handed walker and cant tolerate the urge until she goes
downstairs to the toilet. what is the most important cause of her incontinence :
A. detrouser instability
B. neurogenic bladder.
C. old age
CXR with bowel loop in chest ! H/o of multiple rib fracture 10 yrsback !! Ask for treatment !!
A. surgical repair
B. Cardiocentesis
/
C. Thoracotomy !!
m
Husband took her 40yrs old wife with the compliant of regular collision with her 8yrs old son. Husband has also
complained that her wife is very much worried about their financial thing & about his small injury. When you
co
asked that lady she said she doesn’t feel Depressed but recently she doesn’t feel happy also. She is coping with
her friends & families well. What’s the dignoseshere ?
A .generalized anxiety disorder
B. major depression
x.
c. ocd
8. biostatistics question of hepatitis incidence in 2010
us
9. question on number needed to treat
10. altruism doc belief of kidney donation old scenario
11. Exactly the following pic, was 6 weeks of 20 mg PPI with complete resolution of symptoms. Now did the
endoscopy and found the following abnormality, some intestinal metaplasia but no dysplasia, what is nest?
pl
Pneumatic dilations
Double the dose of PPI
No intervention
r.m
Endoscopy after 24 months
be
em
//m
12. You are doing a study in a group of university student to check the effect of vitamin C on common cold.
s:
What will increase the validity of this research?

Randomization
tp
Random allocation
13. nocturnal enuresis scenario asking invertigation
A urine culture and sensitivity
ht
B .renal ultrasound
14. pt with uncomplicated varicocele came for surgery, drug eluting stent from 2mo, next
a. Defer surgery for 12mo,
B. proceed to surgery,
c. stop clopi then surgery

15 .a young man developed palpitation after 15km of walk … no history of heart problem nothing mentioned of
pulse rhythm … 5 ecg strips were given but very bad quality .. I just picked up blindly 
/
16 .that old recall of vancomycin … patient was on amlodipine for htn
m
17. a scenario of aortic dissection and xray was given … there was widened mediastinum... asking for
investigation
co
a. TEE-if unstable
b. ct scan –if stable
18 .that old colovesical fistula recall
19 .there was a question patient taking many drugs for heart disease like metoprolol , acei , verapamil … heat
x.
rate 50 and was feeling lightheadedness and sycope asking which combination causing this and one of the
options was metoprolol and verapamil… I chose that as we don’t give bb with verapamil … don’t remember
us
other options sorry 
20 .a scenario lactose intolerance asking for investigation
Stool for reducing substances
Small bowel biopsy
pl
21. hb question in patient was operated for perforated appendix and on 5th postop day developed fever
tachycardia asking cause of this –pelvic abscess
r.m
22. asenarioa of hemolytic anemia.. normal mcv , high retic count but coombs test positive
A .hereditaryspherecytosis
B .autoimmune hemolytic anemia
23.old patient asking for prostate screening but no symptoms and no family history every thing normal what to
do
be
a. do psa
b. perform dre
c reassure
em
24 .Adult girl with no history of chest diseases… come with pneumonia symptoms o2 saturation 85% ,,, alert…
how to give oxygen
a- Nasal 100% o2 ..2L
b- Hudson mask 100% o2.. 15L
c- Cpap
//m
d- Intubation, ppv
25. COPD man of 60 years c/o of deteriorating level of consciousness ..ABG given PH 7.30 Co2 50 O2
60mmmHG…..
a.due to Hypoxia
s:
hypercapnia
Acute confusional state due to systemic illness
26.ctg question
tp
A ) Sinusoidal pattern show profound feta distress,

B ) deceleration at or near end of contraction with slow return to baseline shows umbilical cmpression,
ht
C )acceleration excess leads to urgent cs,

D )dec variability for 3min leads to urgent cs
A patient from Iraq is having a dry cough and fever for the last 2 weeks, on Ex: chest clear, what is your
diagnosis:
TB
Mycoplasma pneumonia
Rheumatic fever
/
Hb question picture of varicocele
m
29 .posterior triangle lump asking investigation
A . Biopsy of lump
co
b.Fnac
29 . posterior triangle lump asking investigation
A . Biopsy of lump
b.Fnac
x.
c. us
d.ct
us
JM 635-636 . . if LN enlargment examination then FNAB . . if swelling not due to LN us >> FNAB . . here mention
only lump not sure its lymph node so if asking about initial its Us. any neck swelling strrt wd fna. Chk jm.
N if thyroid swelling strt wd us
30. pregnant women going shighai will stay in 5 star hotel which vaccine to give
pl
a. influenza
b typhoid
c.Cholera
r.m
31 . A man come to you with complain of vision he is unable to outer of his right visual field and inner of his left
… where is the defect ?
Right optic nerve
Left cortex
be
Chiasma
Left optic nerve
Right cortex
em
This much I can recall… I didn’t get many recalls rest of the questions were difficult with long stems and labs …
they were taking alott of time  I don’t know what I did … just need prayers … a very special thanks to
Ayesha omer ,danijela, durain, prashanth bro, zairish , eeshal, rafia, smriti sis, drnavpreet , marina, peter who
helped me allot and last but not the least the GOLDSTAR and the great admins … plz whenever you all pray
remenmber my name … I need just prayers now
//m
1.a agitated person brought to ur emergency department with police who was shouting and telling he saw the
paint in the wall..DX
s:
a.delirium
tp
2.65years old lady came unhappy about her sexual life,as she is having discomfort during intercourse.on
examination everything normal,except a small cystocele.what u do?
ht
1.HRT
2.vaginal cream
3.surgery
4.reassure
5.pessary
3. 8 year old chid come with limping, T 38.8 complaining of knee pain for 7 days, all knee exam with movement
was normal but hip movement was markedly restricted Dx
1.septic arthritis
/
2.transient synovitis
m
3.perthes
4.scfe
co
4.Which of the following is least likely to be relieved on HRT
x.
1.depression
2.insomnia
us
3.hotflushes
4.vaginal dryness
5.urinary frequency
pl
5.Young woman with irritability and headache during menstruation.whats best relieve her symptoms?
r.m
1.Fluxetine
2.Relaxation therapy
3.Primrose oil
be
6.Picture of molluscum contagiosum . exclusion?

em
1.no exclusion
2.untillscb over
//m
3.untill full recovery
4.after commencement of treatment

s:
7.Sheep farmer with RUQ pain with H/O cholecystectomy and hemicolectomy for carcinoma colon 2 yers
ago.usg pic given.but I cant recognize the pic.
Next inv
tp
1.Hydatid serology
ht
2.Triphasic CT scan
8.2 Capsule endoscopy scenario where colonoscopy and endoscopy was done .next what to do??
9.A 22 week pregnant patient present with right iliac fossa pain.she vomited twice.there was no abdominal
tenderness or rigidity,she has appendectomy when she was 19.what is the cause of her pain
1.acute appendicitis
/
2.intraabodominal adhesion
m
3.red degeneration of unrecognized fibroid
co
10. A woman thinks that she has weak heart for long duration.she lives with her daughter.a few days ago she
developed chest pain after hearing the news of her daughters marriage.her daughter is planning to move with
her husband in a different town.O/E no abnormality was found.troponin was within normal limit.which
condition will reveal the womans dx
x.
1.H/O separation from her own mother during infancy
us
2.Chest pain after hearing her daughters marriage
3.depressed mood after hearing about her daughters marriage
pl
11. 80 yr old woman fall from a low high chair and intramedullary nail is given for her femoral fracture.what is
next advice during discharge??
r.m
1.alendronate
2.bone scan
3.warfarin for 6 mnth
be
4.heparin
12.very weird scenario of a young woman present with sevre chest pain aggrevated by inspiration.on exam ahe
em
has a cruntcy systolic sound (I clearly remember ) in left sterna border,she has H/o pulmonary embolism
before.what inv to do to reach dx??
1.ana
//m
2.ctpa
3.V/q scan
Diagnosis is pericarditis due to SLE
s:
13.a 50 year old man present with hypertension with asthma and reflux nephropathy .lab inv were given.there
was high urea,high creatinine and proteiuria 900 mg/day.what is the choice of anti HTN?
tp
1.amlodipine
ht
2.losartan (ARB)…*** B. Losartan first line treatment, amlodipine 2nd line
3.perindropil(ACEi)
4.indapamide
5.BB
/
15. 3 salmonella case in your gp practice in the last week.what study will you do to find out the cause of this
m
outbreak?
co
1.Case control
2.Cohort
x.
3.case series
us
16. What study will you do to find out association of naevus and occurrence of melanoma in your community
1.Case control
pl
2.Cohort r.m
3.RCT
4.Case study
17. what is the appropriate study to make the relationship between HTN and MI?same option as before
be
18.that hepatitis incidence scenario.value of 2009 and 2010 was given and find the incidence of 2010.
em
19. A young woman with H/O blurring of vision for 2 days.O/E 6/12 on right eye 6/36 left eye.whats the
appropriate next
1.visual evoked potential

//m
2.LP
3.CT
s:
20.a 80 year old man present with 2 days h/o blurring of vision.there was no headache and opthalsmoscopy
cant be done due to cataract .what is initial inv?
tp
1.esr
ht
2.lp
3.carotid artery duplex

4.mri ??
21.a man present with left hand and leg weakness.he is on aspirin.she has bilateral carotid artery stenosis of
50% and h/0 coronary angioplasty 5 years back.what to do?
/
1.add warfarin
m
2.add clopidogrel
co
3.carotid endarterctomy
4.continue same medication
x.
22. Young football player presents with an open wound at his leg with displacement of ankle at ER.Whats most
us
imp initially?
1.TT
pl
2.Wound debridement
r.m
3.Antibiotic
4.realignment of foot
be
23.Young patient presents with ankle dislocation,loss of pulse and some paleness at ankle at ER.what will you
do next
em
1.Reduction in ER
2.Send him to OT
3.Immobilize with plaster

//m
4.surgery
24.a middle aged man with long history of diabetes present with pain and redness in leg,temparure was raised
s:
and there was venous dicsolration around ankle.next inv.
1.duplex usg of leg

tp
2.blood culture
ht
3.angiography
25.another clear DVT scenario

26.acute limb ischemia scenario.what is the next immediate management??
1.iv heparin
/
m
2.femoral embolectomy
co
3.sc enoxaparin
27.9 mont old child present with fever 38,cough,dyspnoea,tracheal tug present but chest was clear.after
admission he was given oxygen and iv fluid,whats ur dx?
x.
1.rsv bronchiolitis
us
2.sterpto pneumonia
28.another moderate croup scenario with 02 saturation 93% asking next appropriate?
pl
1.supplemental 02
r.m
2.oral prednisole
3.iv methylprednisolone
be
29. 45 yr old man with H/O ca colon of father at 56 and maternal aunt at 65.how to screen
em
1.FOBT 2 YRLY
2.Colonoscopy 5 yrly?
30.a 36 year old female has 3 child , she ha sGDM on her 32 during her birth of 2 nd child.what is the screening
//m
test for her?
1.ogtt 2 yearly
s:
2.fbs 3 yearly
3.ogtt yaerly
tp
4.hba1c
ht
Table 1. Risk factors for GDM

• Previous GDM
• Previously elevated blood glucose level
/
• Ethnicity: south and southeast Asian, Aboriginal, Pacific Islander, Maori, Middle
m
Eastern, non-Caucasian African
• Age ≥40 years
• Family history of diabetes mellitus (first degree relative with diabetes mellitus or a
co
sister with GDM)
• Obesity, especially BMI >35 kg/m2
• Previous macrosomia (baby with birth weight >4 500 g or >90th percentile)
x.
• Polycystic ovarian syndrome
• Medications: corticosteroids, antipsychotics
us
Women with a history of GDM should receive:
pl
• a postpartum glucose tolerance (16) American Diabetes Association, 2013 E
test at 6–12 weeks
r.m
• a fasting blood glucose test (167) RACGP, 2012 B
•
be
every 3 years
em
32.A young lady with H/O rhinorrhea,low grade feve,photophobia with some neck stiffness.
LP-
protein,glucose both are normal,
rbc-200,
//m
lymphocyte-3oo,
neutrophil-20
whats your management

s:
1.iv ceftriaxone
tp
2.iv acyclovir
3.analgesia and observation all that is needed

ht
33.another typical TB meningitis scenario with increasd lymphocyte and decrased glucose
34. 65 yr old lady with H/O DM,ischaemic heart disease was on antidabetic,antihtndrug.her routine inv shows
HbA1c-normal
RBS-normal
/
Cholesterol-4.4
m
She is on strict dietary control and do regular exercise for a long time.which is your next mx
co
1.start statin
x.
2.increse her antidiabetic medication
us
3.advise her to increase exercise
pl
35. case of anal fissure and urine retention , after bladder catheter to relief retention wt to give next
1. GTN cream
r.m
2.DRE
3.proctoscopy
36. pt wth mass infront tragus with saliva dribbling next

be
1.ct head and neck

2.fnac3.us
d- intraoral xray
em
37.pic of old lady with painful swelling infront of tragus with redness.cause
1.duct stenosis
//m
2.duct stone
3.coxakie virus
s:
4.poor oral hygiene
38.pic of rectus sheath hematoma

tp
39. which of the following UNLIKELY cause fetal growth restriction

ht
1.cmv
2.triosomy 13
3.thalassaemia minor with hb 8
4.mother with essential hypertension require methyldopa

5.lupus nephritis
/
40.a man present with fracture femur and on clopidogrel for drug eluting stent for 2 months.he has petechaie
m
but all coagulation profile is normal.next to do?
co
1.stop clop for 7 days and do surgery then
2.give platelet transfusion and do surgery then
x.
3.do surgery now
us
41.a mother come with her child complaing of continuous bleeding after fall from coffe table.on exam there is
bleeding frenulum and some old bruise in forhead and leg.there was no
petechaie,lympadenopathy,heaptomegaly.cause
pl
1.ITP r.m
2.non accidental injury
3.VWD
42.a old man with lymphadenopathy generalized with bold value given typical of leukemia rbc count low ,wbc
count 86ooo and paletel 70000 asked management
be
1.prednisolone
em
2.radiotherapy
3.platelet transfusion
No option for chemo
If u read above post, it says CLL with generalised lymphadenopathy should be treated as Lymphoma. MOst
//m
commenly used drugs for NHL are CHOP

(C)yclophosphamide,
(H)ydroxydaunorubicin
(O)ncovin (vincristine),
s:
(P)rednisolone,
U can not treat generalised lymphadenopathy with radiotherapy.
43. pt on many medications , indapamide, verapamil, perindopril , aspirin….. present wth light headedness and
tp
mobitz type 2 ecg given wt to do next

ht
1.valsalva manover
2.cease verapamil
3.temporary pace maker
4.ceaseindapamide
44.another que pt on many medication metoprolol,digoxin,frusemide ecg was given mobitz type 1 and nusea
vomiting and abd pain was there,digoxin level was given and it was normal.what to do?
1.cease digoxin
/
m
2.cease metoprolol
co
3.temporary pace making
4.angiogarphy
x.
5.cease metoprolol and commence verapamil
us
45.there were many cvs que with polypahrmacy and another ecg was i think it was inf MI so i chose refer for
coronary angiography but those cvs que were really weired and i totally forgot those 
46.a pt with heart failure on many drugs stop medication for 2 weeks now came with odema upto knee,chest
pl
was clear and with sinus tachycardia what to give?
r.m
1.digoxin
2.metoprolol
47.another heart failure scenario pt on many medication and on digoxin .125 mg present with odema
be
,crepitation.first what to give

1.40 mg frusemide mane
em
2. 0.5 mg digoxin stat
3.metoprolol mane
4.all drugs together

//m
No option for ACEI

the priority in options re >>>>>1-lasix >>>2-ace >>>3-digoxine
48. 55y old lady known with insulin depebdent DM, has had right leg amputation 5yrs previously, now bp
s:
175\90, normal regular pulse, BMI 32, LDL 2.8, s. triglyceride 4.5,hba1c was 8.5,fasting glucose was 9.5, which
of the following is important to keep her other left leg from amputation,(no smoking no hx of smoking mention)
meticulious foot care
tp
control her bp
tight glycemic control
ht
reduce LDL
reduce her body weight
49.a 8 year old boy with h/o nocturnal enurosis come with URTI,on urine exam there is hematuria 1 plus no
proteinuria,after 2 weeks URTI was resolved but golerular red cell presents but no cast,cause
1.Nephrotic
/
2.IGa
m
3.UTI (but not mentioned simple)
co
4.GN
50.a young man present with 25% pneumothorax with history of asthma.vitals was stable and pt not in
x.
respiratory distress but only reduced air entry and in middle lobe and trachea is also in midline.mx
us
1.do cxr and send home
2.admit and observe
pl
3.waterseal drain r.m
4.needle thoraocentesis
51. young adult prepared for living kidney donation ,dr says he will be alright after operation , what the ego
mechanism of the man have influenced on the doctors comment??
1.altruism
be
2.reaction formation
3.sublimation
4.regression
em
52.a 6 yearold boy present with nocturnal anuresis .what is the mst appropriate next inv?
1.urine dipstick analysis
2.urine culture
3.usg
53.got 4 vaccination que all are typical scenario one about MMR with egg allergy,one with grandmother DTpa
//m
case,one pregnant lady go to chaina that influenza case,another grandmother and parents with pertusis
scenario
54.a patient got admitted to hosp for some abdominal surgery.all lab value nrml except calcium was 1.86 and
s:
has history of parathyroidectomy what to give?

1.ca gluconate infusion
2.ca carbonate
tp
3.calcitriol
4.cholecalciferol
ht
55.another weired que abt hypocalcemia there lab value was 1.9 with no S/s.bt another thing was there was
anemia,asking for what to do?
1.hemolytic screen
2.iv calcium injection???
3.blood electrophoresis another weird option
cenario where a girl came with menorrhagia ,looking pale and hypocalcemia there lab value was 1.9 with no
S/s.bt another thing was there was micocytic anemia,asking for what to do?
a. hemolytic screen
/
b. iv calcium injection
m
c. blood electrophoresis
d. give vit k injection
co
e. give FFP
56.old recall of episiotomy site 8 cm hematoma and ans was explore
57.recall of epidural anaesthesia what inv to do?
1LFT
x.
2.coagulation screen
3.RFT
us
• epidural anaesthesia-- FBE>LFT>RFT
ecall of epidural anaesthesia what inv to do?
A.LFT
B.coagulation screen....
pl
C.RFT
2. Pre epidural anesthesia investigation? ?
r.m A.liver function
B.full blood picture ......
C.urea & creatinine
3. a pregnant lady having labour pain.pre requisition of giving epidural anaesthesia?
a)LFT
be
b)Renal function test ......

Pre epidural anaesthesia inv??
Lft
em
Fbc
Urea and creat
coagulation screen
58.a 3 month old child vomit out of milk for 3 days.he was gaining wight previously bt no wt gain last week.all
electrolytes value was normal and urine tset also normal.dx
//m
1.gerd
2.pyloric stenosis
3.uti
59.a man works on a farm of another area brought by police for breaking a window with brick.he said he
s:
remember nothing except loss of his job from his farm.dx

1.depersonalization
2.automatism
tp
3.dissociative fuge
4.derealization
ht
5.conversion
60.a child present with dry harsh cough with no fever for 2 weeks.inv
1.np aspirate
2.serology
3.cxr
61. a case of acute tonsillitis with swollen and red tonsil and uvula shifted to left.1 hr after giving penicillin inj
the pt develop sevre stridor with hoarseness.next?
1.endotraceal intubation
/
2.im adrenalin
m
3.02 by mask
4.drianage of peritonsillar abcess
co
62.case of a pt persent with foul smelling cough,high fever with rigor.there was no xray but they give the
finding ,it was opacity in middle zone with air fluid level,after giving flucloxacilin what next
1.transpleural drainage
2.waterseal drainage
x.
3.aspiration
No option for continue antibiotic
us
63.a 32 weeks pregnant with motor vehicle accident came with bp 90/56,pulse 110,fundal height 36wk,next
managmnt
1.cross match 4 bag blood
2.iv dextrose 2l over 6 hours iv NaCl 2l
pl
3.usg
4.cs
5.amniotomy
r.m
64.a 41 old lay taking carbamazepine and drink alcohol 1sd per day .pic of cleft lip.cause
1.genetic
2.carbamazepine
3.alcohol
be
65. - case of bacterial meningitis in 4 yr old boy high fever develop convulsion serum na 120 after treat seizure
wt next
1.fluid restriction
em
2. 5ml/kg 3% hypertonic saline

3.normal saline
66.another scenario was pt came with confusion and taking indapamide ,acei,bb,and other drug.all lab value
was normal except na was 120.cause
1.siadh?
//m
2.indapamide
s:
tp
ht
3,acei
67. - yong woman with 3 hx of drowsiness last month, last episode occur ehen she was in shop in the time of
attck she feel detached from everthing but can remember the event.what will lead u do dx/
1.ct head
2.eeg videotelemetry
3.ask witness
/
68. 35 yr women feel discomfort down below , condition developed after twice intercourse with new partner
m
now condition resolve when her partner go away last pap smear 18month ago was normal wt to do next
1,repeat pap
co
2.check chlamydia pcr in urine
3.cervical smear for HPV
x.
69.a pt present with lymhadenopathy,fever,arthalgia,has multiple epicosed of sex with prostitutes,lab value
us
was given,monospot test negative,atypical lymphocyte present.dx?
1.hiv
pl
2.ebv r.m
3.cmv
4.hepatitis
70.tricotillomania scenario.asked management

be
71.worst interaction for renal disese

em
1.gentamicin+cloxacilin
2.gentamicin+cholramphneicol
//m
3.gentamicin +cephalosporin
4.interaction with penicillin

s:
72.a man for army recruitement doing urine exam and usg.on usg there is a 3 cm heterogenous solid mass on
upper pole of kinney which was confirmed by ct.next mx?
tp
1.percutaneous biopsy
ht
2.nephrectomy
3.repeat ct after 6 month
73.typical sigmoid volvulus scenario

74.a man present with abdominal pain, but there was no vomiting just mentioned no flatus or stool have not
passed with history of appendectomy ,no drug history given,no h/o constipation given,a xray given that was like
/
diffuse gas shadow and some air fluid level I marked it pseudo obstruction as there was no vomiting another
m
typical option were given
co
75.18 yr old boy was playing football when had trauma to left side of abdomen before 6 hrs ,paramedic already
started iv fluid ,now presents with bp = 80 / 55 and pulse 110 what is next step ?
1.give 1Lbolus NS
x.
2. ct scan abdomen
us
3. cross match & give blood
4. U/s
pl
) Laparotomy
76. . homeless guy with bags going to police for shelter with 3 bags as he thinks some ppl want to kill him cause
r.m
of the use of x rated cd. That old recall bt big scenario
1.full medical assessment
2. admission for psychiatric work up
3. antipsychotics
4. admit him
be
5.history frm police
77.another scenario of a agitated man came with police said that he believes that her neighbor place a camera
em
on his roof and he knows his wife is with them.what next to lead to dx?
1.history from police
2.call his wifr
3.admission
//m
78. a young guy comes and says he cant sleep so has started on marijuana . he is a good student , has a steady
long term relationship with his present gal , family v supportive , has come along . tells u to give him pills to
correct his sleep so that he can get better as he is sure its sleep that’s a problem . no suicide ideation .ur mx ?
s:
1.zolpidem tertrate
2.sleep hygiene and routine
3.tell him to stop marijuana
tp
4.venlafaxine
79.84 old lady patient of anxiety disorder , breast ca , mets in the bones ,son calls up and requests u not to tell
ht
his mother abt it . what shall u do ? old recall with different option
1.call a family meeting without mother

2.tell the son to book another appointment
3.come with his mother in next visit
80.old recall no Urine output for 3 days after knee sx , creatinine was raised . whats the next appropriate inv
1.renalangio
2.usg bladder
/
3.ct abdomen
m
81. obstructive sleep apnea scenario, obese with waist118cm and neck circumference 26cm given, wots
important in mx in long term?
co
1.Weight loss
2.metformin
3.cpap
4. sugery
x.
82.orbital floor fracture.which will u find?
1.instable TMJ
us
2.subconjunctival hemorrhage
3.loss of visual acquity
4.anasthesia of check
No diplopia is in option
pl
83. Scenario of the female who was on peritoneal dialysis and cope with that and suddenly refused the dialysis
,she has fever of 38.2 and some rebound tenderness on abdomen.what is the consistent finding with this?
1. blunted effect
r.m
2. depressed mood
3. denial
4.disorientation
be
84. A mother complaining that her 10 months old child can’t sit supported, he was born 35 weeks, asking for
the cause of the delay
1.Normal delay
em
2.Due to prematurity
3.Cerebral palsy
85.scenaro of hyperkalemia pt present with confusion,K was 6.5,urea and CR also very high.next
1.urgent hemodialysis
2.rectal calcium resonium
//m
3.5%dextrose with insulin 10 unit

86.a girl go to school with her parents but recently don’t go out of car to the school,go to friends
birthday party but dnt stay at night,which one is relevant to her condition
1.auditory hallucination
s:
2.anxiety when her father go out of home

Rset I dnt remember
87.3 scenario of asthma,one is 3 yer old preventer,one is 8 year old,another is that give 12 puff salbutamol
tp
again scenario
ht
88. Diaphragmatic hernia stable patient history of accident 5 years back there was a CXR showing loops of
intestine asking Mx
1.surgery
2.drain
3.thoracotomy
4.thoracocentesis
89. . Sterile pyouria with wt loss and hematuria Dx
A. renal tb if not bladder cancer
/
B RCC
m
90. old recall with cxr, not typical for sarcoidosis but hilar nodes prominent in one lobe and patient complains
of intermittent abd pain with hematuria.what next investigation?
co
1.Ace level
2.Mt test
3.urine microscopy and culture
4.ct abd
x.
91.xray of scaphoid fracture.asking for follow up after
1.1 day
us
2.1 week
3.2 week
92.young boy typical vasovagal syncope scenario
93. parkinson pt needing antipscychtc wot imp in hx before giving antipscychtc?
pl
Previous antipscychtc sensitivity, hx of family drug allergy
r.m
94.paracetamol poising case came after 4 hours.whats to do next?
1.n acetyl cystine
2.paracetamol level
3.activated cahrcol
95.55 year old patient with low folic acid, howel jolly body, stomatitis, normal bowel, weight loss, inv?
be
1.Small bowl biopsy

2.colonoscopy
em
3.vitb12
96.gout with renal failure scenario asking management
1.prednisolone
2.naproxen
3.colchinine
//m
4.allopurinol
97.child OCd scenario.asking treatment .fluvoxamine
98.a pic of labour it was like that ctg dropped to FHR to 70 min for 3 min then agin become 120m what next
appropriate?
s:
1.cs
2.oxytocin
3.fetal scalp PH***
tp
99. boy with history of Mumps at 8 yeras and history of using cyclophosphamide for GN at 18 yeras and now
ht
using sulfasalazine for some reason he presented with sperm count 1 million and severely abnormal motility
and abnormal form.what's the cause?
1.Sulfasalazine
2.Cyclophosphamide
3.Mumps
100.a young 25 yr women with rash on face and hands with sewlling of joints .what is the consistant xray
finding.
Ana is 1/640,speculated
/
Dna 25
m
Ra factor 14
1.chondrocalcinosi
co
2.punched out lesion
3.periarticular osteopenia
4.periarticular erosion
101. . Pt. after doing gastric bypass surgery . now complaint of lightheadedness , diarrhea , bloating 30 min.
x.
after meal , this picture is due to ?
1.Hypoglycemia
us
2. Reactive hypovolemia (early dumping syndrome)
3.vagal stimulation
4.hyperglycemia
102.another post bariatric surgery( surgery for obesity) scenario after 2 month present with vomiting,dyspagia
pl
but forgot those .new que nt old so pls read abt this
103.another clear scenario of prodomral schizo in that case a 25 year lady didn’t say what happened with her
around her rest forgot
r.m
104. . A mother came with her 18 months old baby who has 39 degree fever for the last 12 hours reduced
feeding but no skin rash. On examination he looks well unstressed or tired he has red tympanic membranes
with rednned tonsils . the mum concerned about out break of meningitis around. How to manage :
be
1. Do nasopharyngeal swab for viral testing.

2. Give IV ceftriaxone
3 . do LP
em
105.old recall od hereditary spherocytosis with secvere anemia and low reticlocyte.asking acause
1.aplasia due to parvo
2.hemolysis
106.another child BMI 19.9.BMI chart was given and by plotting BMI on chart.asking whats is true
1.normal
//m
2.overwight
3.obese
4.BMI is not used for Child
107.lactose intolerance scenario
s:
108.what should be the part of screening test for 75 year old women?
1.fbs
2.fbe
tp
3.mamo
4.pap
ht
109. 37yr female,has 3 children,h/o sterilization.now presents with cin 1 in pap smear.pap smear report 2 yrs
ago was normal.now what to do
Pap after 1 year
Colposcopy
Cone biopsy
My exam was mostly recall with different option and a twist.dnt knw how was my exam some scenario were
very confusing and I even confused in known recalls ,did silly mistakes.. time management is very important .i
just finished 30 min ago and couldn’t review all flags.. just one thing to say do recalls recalls recalls recalls..and
/
tnx to GOLDSTAR for this wonderful group.pls pray for me.
m
2.09.15
co
An aboriginal child with yellowisn discharge from ear and nose and retracted tympanic membrane . what is the
intial trearment in this case
Amoxicillin
Iv penicillin
x.
Ear toileting
myriingotomy
us
Most common cause of neurological defect in newborn if mother is on
Anticonvulsants
Antipyschotics
Marijuaina
pl
Opioids
Which of the following is least likely to be relieved on HRT
a. depression
r.m
b.insomnia
c.hot flushes
d.vaginal dryness
e.urinary frequency
be
Engineer man in coal mine present with nocturnal cough, pt heavy smoker , on examination every thing normal
chest clear and normal cxr, wt to do next
a.endoscop
em
b.ct chest
c.repeat cxr after 6 month
d MRI
which of the following UNLIKELY cause fetal growth restriction1.cmv
b. triosomy 13
//m
3.thalassaemia minor with hb 8

4.mother with essential hypertension require methyldopa
5.lupus nephritis
s:
patient on third postoperative day after parathyroidectomy with perioral numbness and tingling. At the time of
tp
discharge calcium is normal.RX?

iv calcium carbonate
ht
vit D
calcium and vit D
7. 4 yr old boy high fever develop convulsion, lp reveals turbid fluid ,serium na 120 .How will you treat ?
a. fluid restriction
b.3% hypertonic saline

c. 0.9% normal saline
8. old pt with known bilateral chronic osteoarthritis, develop parasthesia and numbness in the lateral side of leg
/
below knee condition worse at night and improve after walking for 10 min, wt is the important thing to examin
m
in this pt
a..SLR sign positive
co
b.Any tenderness in lateral condyle
c.Any loss of sensation in the lateral side of leg
9. After administration of Cefazolin a young patint developed allergic reaction in the skin (PIC of multiple red
x.
rash on the back).Rgarding management of this patint in future with cephalosporin which is correct?
us
pl
r.m
be
a.Cephalosporin other than cefazolin

em
b.No cephalosporin
c.neither penicillin and neither cephalosporin
d. ceftriaxone
//m
10. A 19 yrs girl presented with slight lower abdominal pain.On USG 6 cm SOLID mass beside uterus.whats your
DX
aTeratoma
s:
b.Mucynous cystadenoma
c.Corpus luteal cyst
d.Endometriosis
tp
Teratoma .Mucynous cystadenoma

Ultrasound is the preferred imaging modality. Ultrasound
ht
Typically an ovarian dermoid is seen as a cystic

• typically large cystic adnexal mass
adnexal mass with some mural components. Most
lesions are unilocular. • multilocular with numerous thin septations
The spectrum of sonographic features includes: • loculations may contain low-level internal
echogenicity due to increased mucin content
• diffusely or partially echogenic mass with
/
o different locules may contain different
posterior sound attenuation owing to sebaceous
m
degrees of echogenicity
material and hair within the cyst cavity
o echogenic interface at the edge of mass that
co
obscures deep structures: the tip of the
iceberg sign
• mural hyperechoic Rokitansky nodule: dermoid
x.
plug
• echogenic, shadowing calcific or dental (tooth)
components
us
• presence of fluid-fluid levels 5
• multiple thin, echogenic bands caused by hair in
pl
the cyst cavity: the dot-dash pattern
• colour Doppler: no internal vascularity
r.m
11. Young patient presented with severe loin pain for 6 hours.on routine microscopy of urine RBC 3+.whats
the appropriate next investigation
be
a.XRAY abdomen
b.CT abdomen
c.IVP
em
12. CT sacn of cerebral hge.BP 180/100.g GCS-11.what to do next

//m
s:
tp
ht
a.Decrease BP
b.NPO with frequent neurological observation
c.NG tube
d. intubation
14. 26 yr old women complaints of mild increase in her menstrual flow for last 3 months.She also feels feels
/
irritable during mens.She believes that her decreased libido affecting her marriage.what is the appropriate Mx
m
of this patient?
a.High dose OCP without pill free week
co
b.Sertraline 100mg
c.Evening primrose oil
15. Hyperkalemia ecg, poly pharmacy patien,on amidarone, amilodipine, fruesmide, aspirin.
x.
a.aspirin+amidaron
us
16. Ankylosing spondlytics, xray was given,.. but patient was having some tomach problem, and also 57 year
old.and mild pain from 20 years.
pl
a.paracetmol
b.naproxen
c. methotrexate
r.m
d. sufosalazine
e. infliximab
17. Pts collapsed at work site, was having some spiritual belifs that God tell him if he fast for 40 days he will
finish war in worl, bmi 13. Temp 36.5… in ER but now not letting you examine himself, after giving iv fluids,
be
thiamine, what next.

a.start clonazepam
b.start clnazipine,
em
c.resperidine(if olanzapine was present tht will b ans.bmi less.olanzapin will increase)
18. Trichotillomania senerio, 12 yr old child, remain depress, when in tension pull hairs. And always remain
inside the room playing games on pc.
a..family therapy
//m
b.cbt
19. male with sperm count 19 million, 40 motility and 65% abnormal sperm.
Spontaneous pregnancy is not impossible.
No chances for pregnancy.
s:
Hormone therapy to male cane help.

ivf
20. Pts at 8 week gestation, mother have h/o of GDM, then developed DM.. when to do GDM testing. No option
tp
for now.
Ogct at 26
ht
Ogtt at 26
Ogtt at 20 ( normal 24-28week. Who has risk done earlier.also in 24-28 repeat)
Fasting insulin level at now
21. Patient with blunt abdominal injury. Initial Investigation of choice. Bp= 90/58
a. usg
b. ct abdomen
c. laparotomy
/
22. Old lady senerio , nothing was given just cariac issue, she was pallor, so whats next.
m
a.fbot
b.parentral fe
co
c.paked cells??
d. colposcopy
23.A farmer faced drout , now facing financial problem, complain of late insomnia, lack of pleasure , loss 15 kg
x.
from his wt, any many other symptoms of depression, his family concern abt him and the pt refused to take any
medication as he doesn’t believe he is sick, he admit he is tired and exhausted but not depreesed,, it is called as
us
a-denil
d-rationalisation
pl
24. old recall of patient going for kidney donation . doctors said that every thing will be alright after operation.
Type of defence mechanism seen in doner befor operation
a. reaction formation
r.m
b. altruism??
c.depression
25. boy recently complain of headache, abd pain , nausea vomiting, refuse to down out car wn see his friends
and reluctant to go for school parties and peer group, wt is important to ask
be
a- family hx of irritable bowel

b- ongoinic academic deterioration-separation anxiety
26. presented with frsh blood during diffication has hx of ca prostate treated by radiation 4 yr ago wt the cause
em
of blood per rectum

b- ca rectum
c- diverticular disease
27.An old recall of mass in front of tragus with dribbling of saliva. Next Investigation
//m
a. ct head and neck

b. fnac
c. biopsy
28.An old lady postmenopausal sexually active presented with postmenopausal with greenish brown discharge.
s:
On examination cervix and pelvis normal. Cause of dischrge

a.chlamydia???
b. gonorrhoea
tp
c. ca endometrium
d. ca cervix
ht
29.A university student ask for certificate cause she did exam and she was not good in exam , certificate will
help her

30.A 13yrs girl 5 weeks amenorrhoea after rape in a party by unknown person. Left home from 8 months.What
/
to do
m
a. inform police
b. inform parents
co
c. inform sexual assault
31 An recall of pregnant women with 13 weeks of gestation come for abortion
Refer her to another collegue which has similar thinking
Refer her to tertiary hospital for further evauation
x.
32. 3 year old child came with asthma attack every month for last 12 mo, he takes inhaled salbutamol. What to
use for prevention
us
Inhaled salbutamol
Inhaled fluticasone
Inhaled salbutamol/fluticasone
SCG
pl
33. borderline personality for management ???
a.CBT
r.m
b.Dialectical therapy
c.Exposure therapy
34. Fundoscopy was done. Patient has DM, Hypertension. Now come for vision loss painless for 3 hours. Crao
conirmed
be
a..IV acetazolamide
b..Topical pilocarpine
c.Ocular message
em
35.Nursing home pt, for dementioa tx, fall from bed, now abd distention. Cx
a.LBO
b.SBO
c.sigmoid volvulus.
.pseudobstraction
//m
36.A child brought by his mother .she complains that he is always obese in the class. On examination ht. 96
percentile and wt 97 percentile. Which investigation is required to reach the diagnosis
a. TSH
b. urine cortisol
s:
c . advanced bone age

d.blood sugar
tp
37. An old recall of brain tumor with CT head

39. A 3 yr child brought by mother with slight fever and neck rigidity . csf analysis reveals
ht
Glucose and proteins normal

Lymphocytes 200
Neutrophils 10
a.analgesics and observe
b.amoxycillin
c.penicillin
d. acyclovir
40. Lady at nursing home who said not to transfer to hospital when she is severely ill. Now fracture femur and
/
m
a.Admit to ED
b.Refer to palliative specialist
co
c.Decrease morphine dose.
d. arrange family meeting
41. An old recall of old man on morhine ,drowsy and dehydrated wife concerned that his medication is causing
x.
harm to him.
a. decrease the dose of morphine
us
b. hydrate the patient
42. Scenario of 11 month old. The baby was born at 31 weeks gestation. Child could not sit with support(or
without support?)
Neonatal history of 2week hospitalization after birth. What is the cause?
pl
a.Delay motor due to prematurity
b.Cerebral palsy
c.duchen muscular dystrophy
r.m
43.A study conducted for cervical carcinoma screening. Which is most important step in conducting the study
a. consent of patient
b. in which country study done
be
c. some other options

44. A young woman with H/O blurring of vision for 2 days.O/E 6/12 on right eye 6/36 left eye.whats the
appropriate next
em
1.visual evoked potential

2.LP
3.CT
//m
55 yr old woman with H/O trauma to the chest with upper 2 rib # presents with some calcification in
mammograph.whats next ( Pic of mammograph)
a.Percutaneous Core biopsy
b.USG
s:
c.FNAc
d.CT scan
56. A child 5 days old brought by mother complaining that child is crying excessively . otherwise child is growing
tp
normally, gaining wt. on examination everything normal and child is having systolic murmur
a. reassurance
ht
b. urgent referral to paediatrician

57. x ray showing one sided hilar lymphadenopathy , raised creatinine
Sorry I forgot the rest of the scenario. Investigations to trach the diagnosis
Ace levels???
Mountex test
58. A mother of 8 yr old boy states that he doesnot listen to her.so she beats him sometimes and lock him up in
the room.she says that she cant sleep well and feels irritable most of the time.whats your next step in mx
/
a.Talk to the boy
m
b.Notify child protection authority (In Australia is a duty as a Gp to report any child or elderly abuse them they
will investigate and find the solution.Even if you only suspect, first report)
co
c.Send the mother to good parenting service
d.Treat mothers depression
e.Call police
59.A 4 yr child wirh fever , red tender tosills ,increased difficulty in breathing uvula shifted to one side.
x.
Treatment of choice
a. intubation
us
b. drainage…....as there is no stridor.....otherwise>>>intubation
c. antibiotics
d. o2 therapy
60. 45 yr old man with H/O ca colon of father at 56 and maternal aunt at 65.how to screen
pl
a.FOBT 2 yearly
. b.Colonoscopy 5 yrly
c.sigmoidoscopy yearly
r.m
61. person come for melanoma screening . what is most important in history ?
a. a family history of causin melanoma
b.childhood history of sunburn
c.family history of basal cell carcinoma
be
d. exposure to sunlight
62.pt diabetic on polypharmacy :warfarin , betablocker furosemide,temperature 37.8 pulse 60 thigh red
swollen tender
em
a.Cellulitis
b.DVT
c.hematoma
63. scenario of PCo and amenorrhea complain…what is the starting drug for management?
a.Metphormine
//m
b.Clomiphene
c.Ovarian drilling
64. a child with head circumference at 75 th percentlle and hypotonia with open ant. fontenella . investigation
a. usg cranium
s:
b. tft
65. PPHge of 600 ml blood normal labor was induced by oxytocin and on examination uterus is relaxed …MX???
a.Iv Ergot
tp
b.Prostaglandin
c. Blood transfusion
ht
d. bimanual compression
66. Features of post partum depression. 23 year young women with H/O multiple jail stay,prostitution,drug
intake.she left her home at the age of 13 and doesnot want to talk about this.whats your dx
a.conduct disorder
b.drug abuse
c.borderline
67.she thinks she will throw the baby against the wall ,so she tell her husband not to leave the baby alone with
/
her) what type of feature
m
a.Obsession
co
b.delusion
c.overvalued idea
68. A lady with H/O crush injury got admitted in hospital.After catheterization there is small amount of dark
urine.her CK level is very high.regarding fluid mx whats is your target
x.
a.NS infusion with urine output >2ml/kg/hr ( rhabdomyolysis so normal salin infusion with urine output > 2ml
us
/kg/hr )
b.NS infusion with uo >o.5 ml/kg/hr
pl
c.NS infusion with uo >1ml/kg/hr r.m
69. An adolescent boy fell on the ground while playing and regained consciousness within 5 mins and starts
playing after 30 mins . –vaso vagal
70. After removal of central venous line a lady developed facial swelling and swelling around neck.what is the
most appropriate inv
be
a.CT chest with contrast

em
b.CT head,neck
c.CXR
71. sss.
//m
s:
Immese face in cold water

Iv adenosine
tp
Iv verapamil
Sotalol
ht
72.Old patient presented with sudden vertebral # with no prev H/o back pain,.ca level normal, parathormone
upper limit of normal.what inv will you do next to reach dx
a.PSA
b.Bone marrow examination

c. biopsy
/
73. A lady presented with light headedness and palpitation she has similar episodes in last 3 months. On
m
examination BP is 85/60 and pulse 98/min and after head tilt BP is 110/72 and pulse 74/min. treatment ?
co
Atropine
Pacemakers
Fluids
A young pt with repeated dizziness and fall when standing only . Head tilt test lowers BP to 70/50 �
x.
A. Fludrocortisone�
B. NS�
us
C. Increase salt and water intake
�D. Hemaxel
E, BB
pl
18 y old lady undergo tilt table test. After 10 minutes BP 70/40, HR 47. Wt initial ttt
A.fludrocortisone
r.m
B Increase water & salt intake
A lady presented with light headedness and palpitation she has similar episodes in last 3 months. On
examination BP is 85/60 and pulse 98/min after head tilt BP is 110/72 and pulse
74.MIN. treatment?
be
A. Atropin
B. Pacemaker
C. Fluids
em
Cbb
1st...Orthostatic hypotension
2nd.. B (vasovagal syncope)
3rd.. B (mixed syncope) not sure of this one though..
Postural orthostatic tachycardia syndrome T/m- BB, fluticasone
//m
HR should be known to differentiate between vasovagal and POTS? vasovagal (cardioinhibitory)- BP decreased, HR decreased-
pacemaker POTS (vasodepressor)- BP decreased, HR increased- beta blocker, fluticasone is also an optio
74. Patient is on multiple medications. Blood count shown – Hb low, MCV 70. What is the cause?
a. Aspirin
b. Diclofenac
s:
c. Chloroquine
tp
75. scenario of pyloric obstruction due to duodenal ulcer.
Vomiting immediately after meals

ht
Vomiting after 1hr

Vomting after 2 hrs
76. Patient with renal failure , uremia and increase creatinine, with PTh= 11 and phosphate very increased
,calcium normal upper limit what to do
a..Parathyroidectomy
b.phosphate restricted diet
c.ca supplementation
/
m
77. pt with hypertension ,DM, well controlled congestive heart failure presents with palpitation and irregular
pulse which one is appropriate first
co
a.digoxin
b.warfarin
c.metoprolol
d.aspirin
x.
78 SLE pt on multiple immunsupperesant medication ask abt wt the vaccine CI
us
a.typhid
b.BCG
c.Influenza
d.Hepatitis A
pl
WHO: BCG, OPV, Measles, rotavirus, yellow fever
79. 3 y with harsh dry cough for 2 weeks what the next step
r.m
a.Nasopharyngeal aspirate
b.CXR
c.Seology
be
80. A patient with on verapamil presented with mobitz 2 heart block . asking for trearment
Stop verapamil
em
Temporary pacemakers
( Mobiz type 1- drug, MI or vasovagal coz , Mobiz ii- never drug coz, MI is coz)
81. Pt. with multidrugs taking , perindopril / indapanide for HT , sertraline , valproate , aspirin , amoxil for
recent inf. Had hair loss , cause ?
A)Sertraline
//m
B)valproate
c)Indapamide / perindopril
82. Pt with scenario of endocarditis culture shows bovis , after treatment what next to do ?
s:
A) ECG
B)colonoscope
C)blood culture
tp
D)2 dimensional echo

ht
83. An old scenario of ulcer on tongue. Asking for diagnosis

/
m
co
x.
us
Squamous cell carcinoma
Apathous ulcer
Basal cell carcinoma
pl
Lichen planus r.m
84. 8 yr old girl with recent URTI hematuria noticed in routine UA , what is the next step ?
a. renal biopsy
b. u/s
c.start treatment with steroid
be
d.repeat UA after getting healthy from URTI
85. Mother of child 1 yr old , she refused to vaccinate her child

A) follow her wish
em
B) call child authority

C) try to persuade her about the benefits of vaccination
D) vaccinate the baby even without her approval
//m
86. An old man work in his home reconstruction , come to ask you because he knows that some of materials
used had asbestos in their composition , what advice ?
A) you will get asbestosis at 5-10 yrs later
B) he must do cxr routinely
C) asbestos is not serious disease
s:
D) there is low risk to develop asbestosis

tp
87. a man comes to ED with open wound at chest on examination, vital signs are stable, there is dullness at the
left lower lobe of chest & reduce breath sound in the left side. What to do?
strap the wound with pressure
ht
intubation
underwater-sealed
needle aspiration
88. An x ray showing loops of intestines inside the chest and history of trauma few months back. Asking for the
treatment?
a. surgical repair
/
b. barium swallow
m
89. A 31 year old lady is now pregnant for 10 weeks, twins, in her first pregnancy baby was born in 34 weeks
co
because of placenta abruption, except normal antenatal care what to do now additionally?
Vitamin supplements
Iron and folic acid supplement
admit in hospital from 34 weeks
x.
serial CTG from 34 weeks
90 cleft lip baby with most likely cause , mum taking carbamezapine?
us
a. Genetics
b.carbamezapine
91. a recall of colles with xray. Asking when to ask patient for review?
a.1day
pl
b.7days
c.2weeks
r.m
92.An old recall with pt on dialysis, refuses suddenly for tx, what to look for in patient?
a Blunted effect
b.disorientation
c.depression
be
93. pt on clopi fx femur, old recall?

a.Urgent surgery
b.stop clopi then surgery
em
c.plt then surgery

94. Old recall renal failure, gout scenario, wot to give?
a.Steroid
b.colchicine
c..allopurinol
//m
95. old recall ,Sle pt joint finding? (RACGP- a)

a.Periarticular erosion
b.Periarticular osteopenia,
c.deformed joint
s:
96. girl afraid to stay at friends home for night stay, dun want to get out of car wot imp in hx?
a.night terrors???
tp
b.hallucinations
97 old recall of ankle injury open wound with displacement,cold and pale, foot next most imp?
ht
a.debridement
b.tetanus prophylaxis
c.surgery
98. orbital fllor fracture,wots most consistent finding?

a.diminished vision
b. subconjunctival haemorrhage
/
c.anesthesia on cheek,
m
d.inability to open mouth
co
99. A mother came to you with her 14 yrs old daughter and told to you that the daughter mis behave with
mother and is not performing good at school and is always locked in the room. What will you do?
a.ask ther mother to talk more about her daughter
b. talk with daughter infront of mother
x.
c. ask to talk with daughter alone
d.ask the mother to talk with her in front of you
us
100. 55y old lady known with insulin depebdent DM, has had rught leg amputation 5yrs previously, now bp
175\90, normal regular pulse, BMI 32, LDL 2.8, s. triglyceride 4.5, which of the following is important to keep
her other left leg from amputation,(no smoking no hx of smoking mention)
pl
a.meticulious foot care
b.control her bp
c.reduce her body weight
r.m
101. Patient on venflexin well controlled now developed pressure speech, euphoria. What to do.
a.add Na volporate.
b.add olanzapine.
be
c.add chlorpromazine
102. gullian bare typical , asking initial investigation :
a.needle electromyography
em
b.nerve conduction test

c.LP
103. menoupause 11 month ago , 3 days bleeding , negative pap
a. episode of follicular activity
b.cystic glandular hyperplasia
//m
c.cancer cervix
d.endometrial cancer
104. old lady with detrusor instability
105 testicular swelling , no other complains , all examination normal:
s:
a.AFP
b.review in 3 months
106. sleep apnea typical weight not mentioned next appropriate :
tp
a.surgery
b.CPAP
ht
c.weight reduction
107. A case of rhinorrhoea ,clear discharge from nose . Asking for investigation
a. CT brain
b. mri
c. fluid analysis for reducing substances
108. A case of early dumping syndrome

109. An adolescent boy with episode of sudden fall in the playground regained consciousness with 5 mins and
started playing within 30 mins . diagnosis
/
a. postural hypotension
m
b. arythmias
c. vasovagal syncope
co
110. patient non compliant on dialysis came after 5 days last dialysis with dypnea and weakness what is you
next action:
a.call dialysis unit??
b.ABG
x.
c. ecg
d.xray chest
us
111.A patient after non complicated PCI .collapsed after a meal and developed stidor . Ask for the immediate
treatemet?
a.jaw thrust,chin lift
pl
b.IM adrenaline
c.oxgygen
d.insert in line
r.m
be
em
112. pregnant got fever,igm EBV next

a.check her anatenal record for igg EBV
//m
b.offer termination
c.reassure her…tell her to come back if symptoms appare There is little evidence of a teratogenic risk to the
fetus in women who develop infection during pregnancy [73]. Transplacental transmission of EBV appears to be
rare [74]
UPTODATE itc C here..igG is not done as screening..as no rx is required, best to reassure.. Danijela Stojkovski
s:
113. picture of finger gangern in rhamtoid arthritis patient investigation

a.ANA
tp
b.ANCA
114. patient on opioid for cancer drowsy given naloxon on the way awake then drowy again pin point pupil mx:
a. repeat naxalone
ht
b.CPAP
c.reduce o2
115. primi head 4/5th pelvic high ,celphalic presention,(didn't mention short,free floating) cause;
a.contacted pevis
b.placenta previa
c.abnormal presentation
d.macrosomia
/
m
This is all what I am able to recall friends . I think it is very important to do the recalls and related topic
co
carefully. 6 months recalls are sufficient with murtagh and handbook . I would like to thank all my friends who
helped me in clearing my doubts and helped me in preparing for AMC examination . I think it is very difficult to
prepare for this exam with the support of this group. THANKS GOLD STAR
x.
Recall June 2015-06-16:
1-picture of erthyema nedosum in refugee 40 yr patient with wieht loss,haemptysis,crepatiation on rt side lung
us
base;
Sarcodosis
Cancer lung
Pulmonary TB
pl
2-picture of large overian cyst in ct ;c/o of rt iliac fossa pain
3-picture of extradural hage
r.m
4- sernerio of headache 3 weeks after sever trauma to head (the helemet destroyed)no loc .:subdural hage.
5-x ray chest given normal for patient old age and c/o of 2 days sudden progressive dyspnea,no
PMH.:pulmonary embolism
6-xray chest for patient with hx of lung lobectomy surgey,now c/o of cough of blood intermittent with
progressive dyspena a picture of ILF asking long term mangent;home Cpap
be
)X-ray of chest with history of lung cancer and surgery done years back and now present with cough,dysnoea
asking long term mx-
cpap
em
home continuous oxygen

oxygen nasal prongs
7- child with a picture of nephrotic syndrome with LL edema,creatinine,urea elevated,k upper
limit5mangement;
a-home restriction of salty food
//m
b-admit for salt and water restrication

8-child after fracture shoulder developed protein in urine+1cause? Body reaction to trauma,orthostatic
protenuriea
9-cause of amenorrhea and irregular menses in athletes;hypothalamic dysfunction.
s:
10-familial hypercholestemia: tendenos xanthoma

11-needle injury for HCV ( Ribaverin)
12- sudaneese after one attack of epilepsy now he is fine inx help in diagnosis:
tp
ca and vit d.
13-sudaness with anal fistula acuse anal abscess
ht
14-sudanees child 3 months irritable and not eating will investigations:hb 9,alkaline phos high ,bil 24 slightly
elevated 25 vit d 15(low)asking which in lab showing the cause:I choosed vit d.
14-case of esinophilic gastritis treatement:busoinde PPI,inhaled fluticasone
15-NNT 50
16-incidence 2010 for Heptitis B ??375.
17-a case of pulmonary edema distressed what immediate invest:

a-urear,cr,electrolyte
b-x ray
/
c-ECHO
m
d-Arteial blood gases
18- patient non compliant on dialysis came after 5 days last dialysis with dypnea and weakness what is you next
co
action:
a-call dialysis unit b-ABG c- ecg d- xray chest
19- pupereal fever on 5 day ,hx of open perinal tear refused to suture
20-post partum bleeding1500 ml iv synctonin given next; a-im ergotamine b-bimanual uterine message
x.
21-case of rotator cuff tear 2weaks pain shoulder with limited abduction and flexion of shoulder next:a-
paracetmol b-MRI c- intrarticular Cortisone injection
us
22- two cases of oestoprotic fracture vertebra in anorexa nervosa.
23- patient after non complicated PCI .collapsed after a meal and developed stidor what is the immediate
treatemet:a-jaw thrust,chin lift b-IM adrenaline c-oxgygen d-insert in line
24-a case of intoxicated patient with fever,visual hallcuniation,confused initial treat:a-d5% b- thiamain IV c-
pl
antibiotics 3-oral diazepam loading.
25- homeless went to police satation asking for help afraid from mafia senerio of psychostic disorder what is
the next action:
r.m
a-admit to psychotic unit b-do physical examination c-collateral history from police.
25-patient with Hiv positive elisa ,westron blot negative : what to tell the patient:
NO hiv b- should do PCR c- repeat westeron blot after 3 months.
26- pregnant got fever,igm EBV next: check her anatenal record for igg EBV b-offer termination c-reassure her
be
27-toddler diarrhea what to investigate:no need to inv.

28-13 y female with urine culture (10)5 ,no need to treat
29-empolymenet request patient with urine protein 1+,atypical cell without nuclei what to do next: us- ct -
em
cystscopy -urea,cr.?????
Antoun Khalil the discussion was about microscopic hematuria where the initial step is urine microscopy .. if
the bleeding is glomerular,the red cells are atypical
"Glomerular haematuria usually contains a high proportion of bizarrely shaped cells, each different to the
other, while red cells emanating from non-glomerular sources are smooth disks, each
//m
similar to the other"

"In this event(glomerular bleeding) it is reasonable to assume that a renal parenchymal disorder is responsible
for the microscopic
haematuria and that the risk of urinary tract cancer is minimal. In this situation there is generally NO
s:
INDICATION for proceeding with

detailed imaging and urological investigation unless the risk profile of the patient is high for urinary tract
cancer"
tp
So here urea/creatinine first I think

ht
he only type of cells without nuclei is red blood cells .. maybe the scenario lack the history of hematuria or it's
just microscopic hematuria
in case of microscopic hematuria we first do urine microscopy..if atypical RBCs detected..it's a glomerular
bleeding , so we first make sure of kidney function to determine if the patient needs nephrology consultation or
not
30-case of female lady with flushing,arthalgia,weight loss,fever,check temp37 then become after 4h 38.8 the
best inv to confirm diagnosis:ANA ANCA SPUTUM
40-ecg looks to me normal only inverted p wave in inferior for patient on indampide and aci compliaing of easy
/
fatigue and dyspnea on getting upstair,lung,heart exam normal inv: full blood examination - xray chest –
m
fasting blood sugar
41- picture of finger gangern in rhamtoid arthritis patient investigation :ANA ANCA.
co
42-treatment of border personality disorder:dilacterial therapy
43:mild post partum depression adjunt therpy: family support
44 student cut hand ,teacher called you what first thing to ask: a-any need urgent medical itenervation for cut
wound of the hand b- ask psychiatric crisis eevulation
x.
45-contraceptive in mentally retarted with exceesive bleeding: a-Mirena b-IUD CUPPER c-implant
46-child with opv oral avialbe only OPV injections what to advice:
us
47:student with watery diarrhea,working in restaurant advice;
a-encouge hand hygiene b- wear glove c-exculsion from school d-exculsion from restruant.
48- 15 y old girl decrease wight,BMI,decrease her grade at school no hx oa anorexia nor exercise what will help
in diagnosis: ??? whT IS THISrecurrent cough and cold.
pl
49-diabetic ulcer infected: MRI
50- picture of dacryocystitis :iv fluoxcilline
r.m
51-post thyrodectomy 3 days now c/o of perioral numbness cause:ca normal,hco3 (35)
a-anxity b- tetnay( resp alkalosis ionized ca decreased. So normal ca but tetany dev due tonxiety causes
hyperventilation and wash out co2 it causes binding of albumin with calcium and decreases ionized calcium
be
em
which seems not to be the cause here so
52-sign of hyperventation : is dyspnea on rest

//m
53- Scenario of pancreatic cancer inv:ct abdomen

54: senerio of diverticulitis invest: ct with contrast
55: Scenario of liver abscess
56:ecg of complete heart blood child took white pills from his father :a-digoxin- b-TCA.
s:
57-xray of Ank Spond what is the first medication:naproxen.

58:MI recent patient suddenly breasthlessness bp droped 80/50 ecg SVT mx:DC cardioversio –DC defibeliator –
IV adenosine
tp
59-anaphylatic what to give im adrenaline ,iv,sc,oral

60-patient on opioid for cancer drowsy given naloxon on the way awake then drowy again pin point pupil mx:
naxalone again -CPAP- reduce o2
ht
61-copd pt on 6lLO2 , saO2 83%

paCO2 80
paO2 50
what u will do?
a.intubate
b.decrease O2
62-warfain in recent dvt ,perforted peptic ulcer operation what to do:2 unit ffp and operate.
/
63-patient on clozpine will controlled except for increase sleep: what to do:
m
Add respiderone –increase clozapine dose –decrease clozapine dose-add na valporic-amphatamine.
64-miratazpine as treat in depression+insomnia case.
co
65-scrtoal picture swollwn 25 yr 2 days organism :clamdyia
66-scrotal swelling intial investiogation
67-same q found cyst lesion no tumor what next ivx:no need – AFP-FNAC-Biopsy
68-bleeding form on nipple duct in an old women 79yr what next inv:a-mamogram b-fluid nipple discharge
x.
cytology c-us
69-senrio of GERD WITH epigatric pain alcoholic,smoker,eating spicy food,obse what is the best mangemt:stop
us
alchol,stop spicy food,stop smoking, sleep semisetting postion.
70-primi head 4/5th pelvic high ,celphalic presention,(didn't mention short,free floating) cause; a- contacted
pevis b-placenta previa c-abnormal presentation d-macrosomia.
71- macrosmia patient with jaundice unconjucated bil 280 mx: a-reassure b-phototherpy c-blood exchange d-
pl
phyentoin.
72- Senerio of amidarone given in AF on warfarin now present with leg swelling mild temp37.9 invst to do first:
INR –duplex –CT-biposy.
r.m
73-case of haematemsis now hx of previous 2 attacks received at that time endoscopy asking what treat to
give this time with least encephalopathy:
Octeroid-endoscpy-TIPSS-RENOPSLPEEN SHUNT
74- picture of gastric outlet obstruction, asking the amount of k need to infuse during 24 hrs: 5- 25 -50- more
be
than 50- no need to give k .(I choosed 50 but right answear more than 50 should be around 150).
75-Senerio of ALzhemir with MME 18/30 IMPROVED TO 28/30 AFTER INTAKE OF antidpressent medication
diagnosis...pseudodementia
em
76-cause of ca 4.8 ph normal esr high pth normal ;diagnosis: cancer-renal failure-1ry hyperparathyroid.
//m
s:
tp
ht
77-patient developed middle cerebral artery infraction history of basal renal impairment on 2th day of
admission cr raised with decressed e –GFR causes; renal emboli-aspirin-glomuronephritis.
78-case of MI cholesterol 6.5 what to give : statin.
79-female make fight with her daughter for keeping worry beside worry on fininacial issues now started to loss
interest,energy,keep inside her room,not taking diagnosis: a-GAD-b-Depression??(for the first part of sernio it is
GAD but at the end a picture of depression.)
/
80-case of mild proteniura + what to do first:repeat urine dipstick-do after walk-protin/cr ratio-biposy.
m
81-same question asking what to do to reach diagnosis? Same options.biopsy
82-PCOS increases risk of ovarian cancer-endometrial cancer-cervical cancer.
co
83-PCOS asking for conceive which drug to start: metformin-clomphiene.
84-female patient got abortion 12 weeks primi asking when to conceive :start as soon as possible??? –take
ocps-after 12 month….
85-MS usually confused with conversion syndrome.
x.
86-infective balanitis white +pus treatement.,steroid mupiocin cream?
87-your college making wrong dicisions on his patients asking for dizapam:inform medical board-advice him –
us
write to him-ask his GP.
88-epliptic pt had a certificate not to drive ,found him driving who to infrom:driving license authiority.
89-gestational DM WHEN TO DO follow up screen after fist postpartum visit :3y FBS-2Y OGTT-2Y FBS-no need (
OGTT 6-12 wk, FBS
pl
90-worst cancer 5 yr prognosis: cancer pancreas(no options of metastatic breast cancer).
91-Senario of acute limb ischemia in pt with AF what to start to give: hepain iv-asprin-embolectomy.
r.m
92-long term management of acute closed angel glaucoma :laser iridtomy-tuberculectomy.
93-pt on rifampicin what to advice: increase acei-change the contraceptive-increase insulin-decrease insulin.
94-pertusis in child advice : a-give abcs to all family whatever with cough b:-give only to with cough.
95-senario of brachial pleux injury : lss of senestion to lateral cutanous sensation of forarm old recall.
96:coal miner with xray normal what next: ct chest-……
be
97: female patient presented hamptysis with xray with lung t.b ,skin test positive after giving full reigemen what
next to: isolate in hospital-send home…..
98: patient with left supraclavicular L.N ,heavy smoker,wright lss 8kg over last 6 months xray chest normal
em
FNAC of L.N confirm malignant cells,what next:ct chest-biposy of LN….

99- Senario of fibroadenoma.
100- ear pain,excessive saliva weight loss most common cause:SCC tongue
Sorry guys these are all I can recall,thanks a lot for all member of Goldstar I think the exam will be very diffult if
this group wasn't present. thanks for everybody special to admins,special thanks to my friend Mikel Harrias
//m
who added me to this group,many thanks to all members who were very active to find the most logic
answers.PLS time now to pray to me and all other candidates to pass.
s:
19 june 2015, Bangkok, Thailand

tp
1.Hyperkalemia ecg, poly pharmacy patien,on amidarone, amilodipine, fruesmide, aspirin.

ht
/
m
co
a.aspirin+amidaron
x.
us
2.For a good screening test … a) good sensitivity B) good specificity
3.Patient on venflexin well controlled now developed pressure speech, euphoria. What to do.
pl
a.add Na volporate.
b.add olanzapine.
c.add chlorpromazine.
r.m
4.Trichotillomania senerio, 12 yr old child, remain depress, when in tension pull hairs. And always remain inside
the room playing games on pc.
a..family therapy
b.cognitive therapy
c.some other therapies
be
5. 1 yr old Child with seizures Na (125).

10ml/kg NS
5ml/kg 3% saline
em
6.Pic of cleft lip baby with most likely cause , mum taking carbamezapine
Genetics, carbamezapine
7.ecg, cudnt make out of it at all, pt taking digoxin, potassium supplements, ca bloker, asprin but ecg neither of
brady, hypokalemia, hyperkalemia nor digoxn txcty
//m
Inc digoxin, inc potassium, and other some weird options

8.old recall with cxr, not typical for sarcoidosis but hilar nodes prominent in one lobe
Ace level
Mauntex test
s:
Ct chest
old recall with cxr, not typical for sarcoidosis but hilar nodes prominent in one lobe and patient complains of
intermittent abd pain with hematuria. What next investigation?
tp
1. Ace level
2.Mt test
ht
3.urine microscopy and culture

4.ct abd2
9.loin pain for 24 hours & haematuria in an old man.inv?
Ct, cysto, ivp
10.svc obstruction scenario, definitive dx?

Cxr, ct head neck, ct chest
/
11.colles fx xray,when to ask patient for review
m
1day,7da ys,2weeks
12.old recall with previous dvt hx, now pain and swelling in thigh and pigmentation around ankle, tx
co
Enoxaparin, ivheprain, antibiotic
13.Same q dx asked
14. pt with dm with af taking warferrin,insulin swelling & redness in thigh temp 37.8,dx asked . 3 to 4 q like
same scenario.
x.
15.pt after taking antipscychtc have weight gain, most imp next investigation
Lipid profile, tsh, fbs
us
16.gdm scenario , with mum dbtc
Ogtt 20wk, ogtt 26wk, ogct now
17.after knee surgery oliguria after 3days
Renal angio, usg, ivu.
pl
18. aboriginal with excess drinking smoking and obese came for asking for his weight problem
Reducing fat will reduce , adress envrmntal or social issues weight
r.m
19.pt with pst mi hx, labs given with chlostrl 4.5, wot next
Add statin, reduce weight some other options
20.pt comes for psa screening, no symptoms,no family history, on p/e D/R/E is normal. Whats next?
Explain risk and benefit of psa screening
Do psa now
be
Other options
21. 19yr old with solid mass adjacent to uterus
Cystic teratoma, endometrioma, corpus luteal cyst, mucnscystadenoma
em
22. . pneumothorax 25 percent pt stable with no sx just reduced air entery,R/R 29,
Admit and observe for 24 hours
drain insertion
come with cxr next day
23. . asthma in child 3yr, prevention
//m
Ncr, steroid, salmeterl with ics

24. pneumonia scenario child with grunting high fever, dx
Rsvv, pneumonia.
25. asthma child releived on 6 puff salubtml
s:
12 puff salbutml, ipratropium, steroid

26. . old recall with premature baby and delay milestone, also hx of hospitalization, cause
Cp, prematurity
tp
27. parkinson pt needing antipscychtc wot imp in hx before giving antipscychtc

Previous antipscychtc sensitivity
ht
hx of family drug allergy

h/o forgetfulness like that I cant remember
28. dothepin most dangerous sideffects
C oma, arrhythmia
29 pt on opioid become drowsy, dehydrated wife think opioid harming him, next
Reduce opioid, continue same dose, hydrate
30. .old recall with pt on dialysis, refuses suddenly for tx, wot to look for in patient
/
Blunted effect, depression
m
31. a man wants to donate kidney…. Something like that …. Other altruistic feature in option .i marked that.
32. after mva abruptio scenario with tender uterus and bp 90/50,what next?
co
Arrange 4 cross match blood
2l ns in 2hr
amniotmy
usg
x.
33. old recall pt found unconscious by neighbors, dark urine, dehydrated, na+: 149, next
Ns with more than 2ml/kg/hr urine output
us
5 % DA more than 2ml/kg/hr output
4 percent dex in 1/4 ns with output more than 2ml/kg/hr
34. old recall child in morning not recognizing parents, +++ ketones
Dka, ketotic hypoglycemia Ketotic hypoglycemia
pl
35. nocturnal enuresis scenario of child most appropriate investigation
Urine dipstck, urine cs, us
r.m
36. old man with microcytic anemia, dyspnea on climbing stairs, next
Fobt, oral iron, iron tx
37. pt with low folic acid, howel jolly bdy,angular stomatitis, normal bowel, weight loss, inv
Small bowl biopsy, colo, vitb12
38. old recall with pregnant with genital herpes, wot to diagnose latency
be
Pcr, igm now, biopsy from ulcer( I marked pcr)

39. pt on stent, fracture femur, platelet normal , only bruise over skin. Next?
Urgent surgery, stop clopi then surgery, plt then surgery
em
40. pt with uncomplicated varicocele came for surgery, drug eluting stent from 2mo, next
Defer surgery for 12mo, proceed to surgery, stop clopi then surgery
41. child with urti, few blood cells and +protein, after 1 week urti resolve but urine analysis same, dx
Glomeruo nephritis, iga, nephrotic, bening transient proteinuria
42. drugs causing most neurological deficits in child if used in last trimester
//m
Antipscychtc, anticonvulsant,benzodiazepine
43.meconeum stained liqur,FHR 144b/min,LOT position, what action taken like that acc to CTG?
a.urgent c/s
b.decision after fetal scalp mpniroring
s:
c.baby sleep
d.normal ctg, wait.
(The head engages in the left or right occipito-transverse position, but then rotation to occipito-anterior fails to
tp
occur and the head remains in the transverse position. If the second stage is reached the head must be
manually rotated, rotated with appropriate forceps (namely, those with no pelvic curve—for example,
ht
Kielland’s forceps), or delivered using vacuum extraction.
Such vaginal deliveries must not be undertaken if there is any acidosis (fetal blood pH <7.15) as cerebral
haemorrhage may result. They are now often undertaken in the operating theatre (trial of forceps) so that a
rapid change to caesarean section can be made if there is any difficulty. Some obstetricians have abandoned
these more difficult vaginal deliveries in favour of caesarean section.)
44.young man pain in back at night,increase during bending. Inv?
/
HLAb24
m
Xray
45. .Old recall renal failure, gout scenario, wot to give
co
Steroid, colchicine, allopurinol
46. .old recall sle pt taking steroid which vaccine contraindicated
Bcg, Pneumococal, influenza
47.15 yrs old girl pigmentation over face & hand, joint finding
x.
Periarticular erosion, Periarticular osteopenia, deformed joint
48. old recall,pt do excess exercise bmi 19,checks in mirror several times,change dress several times, etc ,dx
us
anorexia nervosa,bdd,hypomania,ocd
49. .old recall of pt becoming tachpnc,palpitations on entering shopping malls ,believes he can acquire hiv by
touching doors of mall etc,dx
ocd,panic disorder with agorophohbia,hypomania
pl
50.4 q from meningitis, very confusing
51 Ms scenario with variable visual acuity next
Lp, vep, ct
r.m
52. lung abcess scenario with ab given,next
transplural drainage,laprotomy,drain
53. burns scenario with seigning of nasal hairs horseness,next
intubate,irrigate
be
54. old recall of ankle injury open wound with displacement,cold and pale, foot next most imp
debridement,tetanus prophylaxis,surgery
55. ankle injury with cold pale foot dec capillary return so next imp
em
reduction in ed,take to ot,xray,antbtcs

56. 45 yr pt concerned for bowel cancer,father diagnosed at 57,maternal aunt at 67,his fobt negative but hes
worried,wot next
fobt 2yrly,colo yearly,sigmoidscopy 2yearly,bowel resection
57. .54 yr female 11 month post menopause ,now presents with 3 days bleeding
//m
a.return of follicular activity

b.cystic
glandular hyperplasia
c.endometrialca
s:
d.cervical polyp
e.atrophic vaginitis
58.62 y/o lady menopause from 55 yrs, sexually active purulent vaginal discharge
tp
Chlamydia
Endometrial ca
ht
Cervical ca
59.another q, same stem, pap smar normal brownish discharge
60.23y/o .pt taking dexamphetamine for ADHD.what will happen if u abruptly stop the drug?
Anhedonia
Paranoid
61. engineer man in coal mine present with nocturnal cough, pt heavy smoker , on examination every thing
normal chest clear and normal cxr, wt to do next
a- endoscop
/
b- ct chest
m
c- repeat cxr after 6 month
d- mri
co
62. business man got bankrupt , many financial problem, complain of late insomnia, lack of pleasure , loss 15 kg
from his wt through 3 months, any many other symptoms of depression, his family concern abt him and the pt
refused to take any medication as he doesn’t believe he is sick, he admit he is tired and exhausted but not
depreesed,, wt this called
x.
a-denil
us
d-rationalisation
63. pt 4 days after parathioroid sx for parathyroid adenoma, develop finger and perioral numbness ca level 2
days back at time of discharge was 2.02 (it was low then the normal limits given) was low wt to give
pl
a-ca carbonate
b- ca carbonate and vit d3
c.calcitrol
r.m
calcium iv
64. presented with frsh blood during diffication has hx of ca prostate treated by radiation 4 yr ago wt the cause
of blood per rectum
be
b- ca rectum
c- diverticular dis
ca colon
em
65. pt wth mass infront tragus with saliva drippling next

a-ct head and neck
b- fnac
66. 35 yr women feel discomfort down below , condition developed after twice intercourse with new partner
now condition resolve wn her partner go away last pap smear 18 ago was normal wt to do next
//m
a- repeat pap
b- check chlamydia pcr in urine
c- cervical smear for HPV
67. malingerer ask for certificate cause she did exam and she was not good in exam , certificate will help her
s:

tp
68. MMR vaccine with mother come into clinic. She said baby is egg allergy. What to do?
MMR is not related to egg and give vaccine now.
ht
MMR should not be given as baby is egg allergy.

69. Lady at nursing home who said not to transfer to hospital when she is severely ill. Now fracture femur and
Admit to ED
Refer to palliative specialist
Decrease morphine dose.

70. .An old man with sudden acute back pain ,on XR fracture of spine, on bone scan only uptake on the site of
fracture what investigation confirms the diagnosis?
/
A. PSA
m
B. serum electrophoresis
C.MRI
co
D.CT scan
71. .Young man after a quarrel had a fracture of floor of eye what is the more consistent symptom with that
A- conjunctival hge
B-can't open the mouth completely
x.
C- loss of sensation in the skin around
D- reduce the visual acuity
us
72. .Scenario of dog phopia what initial mx
A- see pictures of dogs
B- keep dog pic in her diary
73. 10 month infant mild hypotone, head circumference was 25 percental at birth but now at 95 th. Open
pl
anterior fontanel. What should be done?
A. reassure
B. cranial US
r.m
C. check TFT
74. . 15 year old with appendicitis and not in good condition the doctor believes he cannot give consent what
should be done parents not available but sister is on the way
A. wait for sister
be
B. do surgery withough consent

C. give signature of two present doctor in the hospital
75.pt comes with RUQ pain,nausea,jaundice for 1 ay, bp 90/60. After giving iv fluid & antibiotic what next
em
Usg
ERCP
76.8 yr old boy school performance average, cant remember … audiology & ENT referral was in option, I
marked that.
77. ocd scenario in 6 yr old boy
//m
Paroxetine
Fluvoxamine
Tca. I marked b
78. a student come insomnia, depressed… 6 months after failed in exam
s:
Adjustment disorder
Cannabis abuse
79.xray of bowel obstruction, bad quality, cant understand. Inv was asked.
tp
80. case of anal fissure and urine retention , after bladder catheter to relief retention wt to give next
1. GTN cream
ht
2.….oil
3.proctoscopy
81.q of hypernatremia, cant remember.
That’s all I can remember. Do recall very well most recent specially last 2 months.thanks admin to creat s uch a
platform for discussion. I don’t know how I did in exam, I was little bit confused & exhausted. Plz keep me in
your prayers. Special thanks to Danijella, Raza khan, Rafia mitu, Lutfun Sonia, Farzin,Rumana Murad.
/
A.E.Rumana… best of luck for all examinee……
m
ZAIRISH RECALLS 20 june, 2015u
co
1- Young female presented with chest pain on inspiration and systolic murmur . which of the following lead u to
the diagnosis?
x.
A- ANA
us
B- D-dimer
C- C protien
2- 40 yr old man present with dyspnea from 1 yr ,on auscultation chest is clear , the Xray was given and it was
pl
clear to me . on labs increase Ca, inc. Cr, inc. urea . wats next investigation ?
r.m
A- ACE levels
B- CT chest
C- CT abdomen
3- Cervical spine injury bp 80/55, HR 50 , what is the most NEXT most appropriate step:
be
A-atropine
B-iv colloids
em
C-trendelenburg
4- Patinet presented with hemiperesis with CT sacn of cerebral hmge.BP 180/110.g GCS-11.what to do next
A.Decrease BP
//m
B.NPO with frequent neurological observation

C.NG tube
5- recall of 3 cases of salmonella

s:
6- In degenerative hip disease which of the following position lost first ?

tp
A- EXTENSION
B- ROTATION
ht
C- ABDUCTION
D- ADDUCTION
E- FLEXION
7- Diabetic p.t on multidrugs like digoxin, warfarin , presented with red , tender of calf and the circumference of
the leg is more than the other leg . temp. 37.8 . nothing mentioned abt INR . diagnosis?
/
A- cellulitis
m
B- DVT
C- hematoma
co
8- Same q. asking treatment?
A- iv flucoxacilin
x.
B- Vit k
C- iv heparin
us
D- enoxaparin..INR
9- CTG showing HR: 119 ,acceleration 10-20 , variability 15 , no decelaration
pl
A- normal ctg
B- 1% hypoxia
C- 10% hypoxia
r.m
D- abnormal ctg
10- teratogenic drug in pregnancy?

be
A- alcohol
B- covcaine
em
11- which of the following drug if given in the 3rd trimester will cause neurological damage in fetus?
A- anticonvulsants
B- anti psychoyic
//m
12- P.t on 3rd pod presented with shortness of breath n tachycardia , GFR 30 , V/Q shows decrease perfusion .
wats the most approprate management?
A. iV heparin
s:
b. enoxaparin
c. ctpa
tp
13- A 30 yr old indoor worker came for melanoma screening .wats the risk factor ?
ht
A. melanoma in cousin
b. sunburn in child
c. BCC in family
14- After one year of post menopause, she has 3 days bleeding. What is the cause of her bleeding?
A. Atrophic vaginitis
B. Cervical cancer
/
C. Follicular activation
m
D. Endometrial cancer
co
15- 60 yr old man presesnted with angular stomatitis , iron def. anemia, low folic acid . wat is the most
appropriate initial investigation?
A. colonoscopy
x.
b. small bowl biopsy
c. fobt
us
16- old man with a mass infront of his tragus. He complain about saliva drippling. What is the initial
investigation?
pl
a. U/S of the swelling
b. X-Ray head and neck
c. CT head and neck
r.m
d. FANe.
e. biopsy
17- In order to have a good screening test which one is the most important ?
be
a. good sensitivity
b. good specificity
em
18- schizo p.t on antipscychtc have weight gain, most is the next investigation?
a. TSH
b. FBS
c. Lipid profile
//m
19- which of the following is LEAST likely to be reliefed on HRT ?
A. depression
s:
B.insomnia
C. hotflushes
D.vaginal dryness
tp
E.urinary frequency
ht
20- A little toddler came with parents because he ate his grandma pills ,she is on multidrugs for heart faluire
and post herpatic neuralgia , u did an ECG (hyperkalemic ecg)
Which drug did the boy ingest?
a. beta blocker
b. Digoxin
c. K supplement
d. Metformin
/
e. TCA
m
21- p.t presented with frequent falls , on multidrugs ,no ecg. which drug combo is the cause?
co
A. frusimide and amiodarone
b. asprin and amiodarone
c. amlodipine and amiodarone
x.
22- p.t presented for cholestrol check , 20 cig per day, BP 140/90 , and colestrol 5.5 . your advice ?
us
A. start anti hyper.
b. start statins.
c. smiking cessation program
pl
d. check cholestrol within 3 months r.m
23- p.t non complaint with drugs for DVT . wats long term treatment ?
A. warfarin for 6 months

b. heparin for 6 mo
c.caval filter
be
24- adrenal mass of 1.3 cm. all labs normal .wats next ?
em
A. exision
b. ct in 6 months
25- A 28-year-old man is brought to the emergency department after he had an accident while he was driving
and had his right ankle injured. On exam, his vital signs are stable. The right ankle joint is laterally displaced and
//m
there is a laceration over the joint. Which one of the following is of greatest importance as the most initial step
in management?
A. Wound debridment.
s:
B. Tetanus immunisation.
C. Intravenous antibiotics.
D. Reduction of the displacement.
tp
E. X-ray of the joint.

ht
26- A lady with H/O crush injury got admitted in hospital.After catheterization there is small amount of dark
urine.her CK level increased.regarding fluid mx whats is your step?
a.NS infusion with urine output =>2ml/kg/hr

b.NS infusion with uo >o.5 ml/kg/hr
c.NS infusion with uo >1ml/kg/hr d.Glucose infusion
27- old pt. with long history of constipation, taking laxatives now presented with mild pain for 48 hr.mild
/
destination vomiting , physical exam is normal. diagnosis ?
m
a.fecal impaction
co
b.ca colon
c.diveticlosis
d. sig. volvolus
e. psedo obs.
x.
28- Young man after a quarrel had a fracture of floor of eye what is the more consistent symptom with that
us
A- conjunctival hge
B-can't open the mouth completely
C- loss of sensation in the skin around
pl
D- reduce the visual acuity r.m
29- young women with irritability and headache before and during mensturation .wats best relieve her
symptoms?
A- FLOUXITINE
B-RELAXATION THERAPY
be
C- PRIMORSE OIL
30- pic of molluscum . exclusion?

em
A-nO exclusion
B- untill scabs healed
c- untill full recovery
//m
31- 80 yr old women faal from wheel chair a and intermedullary nail is given for her femoral fracture .wat is
next management?
A- alendronate
s:
b- warfarin for 6 mo.

c- heparin for 6 months
d- bone scan
tp
32- wat will u do to find out the association btw melanoma and nevus?
ht
a- cohortcohort
b- Rct
c- case control
d- case series
33-wat is the study to see relationship btw htn n MI. )same options as abv.
/
34- 9 mo old boy presented with temp 38, tracheal tug and clear chest. O2 and hydratrion given .Dx?
m
a- rsv
co
b- strept pnemonia
35- colon cancer screening recall
x.
36- A child presented with next stiffness, lymphocytes 300, neutro 20 , nothing mentioned abt protien n
glucoe.wats mx?
us
A- blood culture and iv ceftriaxone
b- obsever and analgesia
c-iv acyclovir
pl
37- anal fissure q. after cathetarisation wats next?
r.m
A- GTN
B- DRE
38- OLD LADY pic in nursing home .. a swelling infront of tragus .wast the cause?
be
A- stone
b- poor hygiene
em
c- duct stenosis
39- A 2 month old baby had severe bleeding from frenulum after hitting coffe table.Which is the investigation
you will do next?
//m
a) APTT
b)Factor 9
c)Platelet count and morphology
s:
40- a young man with 25% of pnemothorax with history of atshma . vitals stable , no resp. distress but reduced
entery of air in the same side . mx ?
tp
A- admit and observe

b- do cxr
ht
c- thoracotomy
d- underwater drain..
41- vac. q. abt MMR

42- p.t on discharge day found to hv low ca , after parathyroidectomy wats next?
A- CALCIUM infusion
/
b- calcium gluconate
m
c- calciferol
co
43- epidural anasthesia , wat to do ?
A- lft
b- coagulation profile
x.
44- a man c/o fever,x ray shows fluid level,dull on percussion rt middle jone of lung,foul smell cough .wat to do
us
after antibiotics
?
a.transpleural drainage
b.ippv
pl
c.lobectomy
d.needle aspirate
r.m
45- old recall pic of a baby with cleft lip . mother drinks alcohol everyday . she is on CBZ for epilepsy . what
could be the reason for it ?
a- genetic
be
b- carbamazepine
c- alcohol
em
46 - young women with 3 histories of drowsiness in previos month , recently she had an episodse in a mall at
the time of attack she felt detached but remember the event. wat will lead u to the diagnosis?
a- ct head
b- eeg
//m
c- witness
47 16 yr old girl with bmi 32 , recently hv a sexual activity . wat to in screening?

s:
a- pcod
b- chlamydia
tp
48- . homeless guy going to police for shelter with 3 bags as he thinks some ppl want to kill him cause of the use
of x rated cd. wats imp. in management ?
ht
A- clinical assessment
b- admission for psychiatric work up
c- antipsychotics
d- admit him
49- 7 yr old girl afraid to stay at friends home for night stay, donnot want to get out of car wot imp in hx
/
a- Absence of sx in fathers absence
m
b- night terrors????
c- hallucinations
co
Shiva Lotfi, Will go for B on this as we were reading some nice article in GS about dependent personality where
night terrors were mentioned.
50- A boy had fight with his girl friend and he has said that ‘I will kill my self’. Now he is in hospital and he is
angry with nurse and said to nurse ‘I will kill you’.After a while said He wants to go home & apologized for his
x.
deeds. What should be done now?
us
A.Permit him to going home freely with his girl friend
B.Permit him to going home but coming for follow-up
C.detain him for observation.
D. Call police
pl
51- sleep apnea q. long term mx . ?-wt reduction
r.m
52- 21 yr old girl with BMI 15 , came with ammenorhea and infertility . progesteron test neg. wat will help her
to coceive?
A- correct her bmi willlead to conception

be
b- IVF
C- ICSI
em
53- An old female patient on peritoneal dialysis for many months and well controlled on that.She suddenly
refuses to be .Which of the following is the reason?
a- depressed mood
B- disorientation
//m
C- blunted affect
SOlved many time.if the patient refuses with out any symptom that is depressive mood , if she refuses with
some symptom like abdominal , then its disorientation
54- A mother complaining that her 10 months old child can’t sit supported, he was born 35 weeks, asking for
s:
the cause of the delay?
A- Normal delay
tp
B- Due to prematurity
C- Cerebral palsy
ht
An old female patient on peritoneal dialysis for many months and well controlled on that. She suddenly refuses
to be .Which of the following is the reason A. depressed mood B. disorientation C. blunted affect
patient on peritoneal dialysis, suddenly refuses to be treated, she also has mild abdominal rebound tenderness
which of the following helps diagnose the problem? A. depressed mood B. disorientation C. blunted affect
A patient on peritoneal dialysis who was going well suddenly declined to have dialysis. On examination she was
having slight temperature and mild tenderness in upper abdomen. What finding you will most likely find in this
patient? A- Disorientation B- Depressed mood c- Blunted affect
/
55- Farmer with the injury falling of the tractor 5yrs ago, broke his rib, now complains of breathlessness and
m
chest pain, xray given. What to do next?
co
a. Thoracotomy
b. drain
c. Surgery
d. Thoracocentesis
x.
56- chest xray with hilar adenopathy and hematuria with abd. pain . ca inc. urea and cr. inc. wats next
us
investigation?
A- ace
b- ct chest
pl
c- ct abd r.m
57- vasovagal syncope q.
58- gout with renal failure . mx.
59- Child if any body cough in the home he goes and take a shower rx parents tried all measure without any
be
benefits
a- Fluoxetine
b- Paroxetine
em
c- Fluvoxamine
60- boy with history of Mumps and history of using cyclophosphamide, and now using sulfasalazine for some
reason he presented with sperm count 1 million and severely abnormal what's the cause?
a-Sulfasalazine
b-Cyclophosphamide
//m
c-Mumps
61- young women rash on face and j.t swelling . wat will be the finding?
a- punched out lesion
b- periarticular osteopenia
s:
c- periarticular erosion
62- child bmi q. chart was given

tp
63- wat should be the screening in 75 yr old women ?

a- fbs
ht
b- fbe
c- mamography
64- weired ecg asking initial management

a- tpa
b- nitate
c- coronary angio
/
m
co
x.
us
pl
r.m
be
em
//m
s:
tp
ht

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Hyperkalemia ecg, poly pharmacy patien,on amidarone, amilodipine, fruesmide, aspirin.

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