A.

FATIMA DOH NOVEMBER

Q1: A pregnant lady comes to the clinic with vomiting and nausea.
She is having kindey damage her creatinine is high . What will u give her:

A-0.05% clobazine
B-0.025% cyclizine
C-2.5 % hydrocortisone
D-0.5%diflucortocolone

Q2. A 62 years old man with shortness of breath and heart faliure symptoms. (long scenario ) with
various drugs used for heart failure treatment and doses were given
What of the following will not affect his management.

1. Change atenolol 50 mg to bisolol 6mg.

2Increase frusemide to twice daily.
3. Increase ramipril to 5mg.
4.Add dapagliflozin 10mg

Q:3 What is NOT a cause of anterior knee problem. ?

- osteoporosis tendon esthenopathy

-Osgood-Schlatter
-Pre patellar bursitis
-criciate ligament tear

Q.4 A 43 old male patient with bp 100/70 HR 40 PULSE 120 urine output decreased lactic acid greater
than 6. What does raised lactic acid does NOT show.

- greater than 6 shows increased morality.

-score shows future prognosis.
_this score shows aerobic respiration.
_shows the diagnostic criterion

Q.5 There is a young boy named Ali who started having auditory hallucination and started saying he
see Aliens. He cried alot his friend brought him to the psychiatrist explaining his condition . He was
started on quiteiapine. What labs would u follow him up with at 3 months visit.

-urea , electrolytes, lfts , rats.

-lfts , weight, lipid profile ecg.
-FBC , lipid profile
-weight, lfts , HBA1
Q6 : A patient comes with the following labs. *a; chart was made. With following readings.

-ph :7.27
Po²; 11.4
Pco²; 3.9
Hco3; 14 (reference ranges were given)

-metabolic alkalosis
-metabolic alkalosis with respiratory compensation
-respiratory acidosis
-mixed metabolic and respiratory acidosis

Q7.A patient comes with a painful nodule that turned to with purulent patches and purple ends. What
is the the patient most probably has??

- pan arteritis nodosa.

_inflammtory bowel disease.
-sarcoidosis
-celiac disease

Q8: 42 years old man with previous history of rheumatic fever comes to the hospital with symptoms
of right heart failure small pulse with atrial fibrillation what's the best investigation.

-culture
-CT
-cardiac Catherization
-TEE

Q9;A 48 year old man with polydipsia polyuria, with facial fullness and abdominal marks come to the
clininc with history of weight gain , urinanalysis shows 2 plus glucose, what is the person suffering
from :
-nephrotic syndrome
-Cushing’s Disease
-diabetes insipidus
-addiosn disease

Q10: a 28 year old man come to the physician with midline facial abnormalities and anosmia with
color blindness: which of the following labs would correctly show his hormonal profile :

-low fsh , high lh , normal testosterone

-high LH high FSH high TESTOSTERONE
-low fsh low LH low testosterone
q11: a previously healthy 65 years man comes to the physician for a routine health exam. His blood
pressure is 155/95 and is not being controlled despite multiple anti htn medications :
which of the following Is the most apt medication :

-amiloride
-amlodipine
-spironolactone
-clonidine

Q12: A man with a very finicky nature , who wants to organize his stuff and wash his hands after every
hour, what of the following is not a part of his disease:

- it has a genetic predisposition

- it is more common in men as compared to women
-it occurs more in th 30 to 40 years age
-exposure and response prevention is recommended

Q13. An old hospitalized man at 3 rd post op day presented with shortness of breath and 98. Degree
fever, with oinkish soputum and difficulty brething which of the following drugs would u give this
patient a chest x ray given hilar markings prominent
:
- ceftriaxone
-pencillin
-codeine
-rivaroxaban

Q. 14 TURNER GREY sign is shown in?

-Dudoneal atresia
-acute pancreatitis
- chronic pancreatitis,

Q.15 which of the following is NOT the function of BNP;

Natriuresis
diuresis
atrial contraction
inheart failure

Q. 16 a 67 years old patient comes with the complaint of pain in the groin with fever, and tender
prostate, which of the following would be given to the patient

.-Sifting 5mg 28 days.

-Tramadol 400 mg od.
-Ofloxacin 30g BD 14 days.
-Trimetorpirm 200 mg bd 7 days

Q 17 ; charcot’s triad

RUQ pain, fever, Jaundice

Q 18 ; Bronchial Asthma Air remodeling includes all except :

(don’t remember all choices)

-thinning of basement membrane of airway * (thickening is the remodeling)

-type 3 hypersensitivity collagen deposition something

Q19 about what’s not going to affect electrical STIMUALTION?

a. vagal stimulation.
b. Adrenaline.
c. Hypercapnia.
d. k level.

Q20 A 45-year-old man is evaluated for recent onset type 2 diabetes mellitus and hypertension for fat
pad and striae the last 1 year. On physical examination, he has moon like face, dorsocervical.
Laboratory studies measuring 8 to 12 mm wide are noted on his upper arms and abdomen. reveals
the following as well as 24-Hour urine cortisol excretion which was 5 times upper the without contrast
reveals a 5-cm right with and normal cut value and CT scan of the abdomen (see lab results bilateral
adrenal hyperplasia
what will you give her |
 A. Eplerenone.
B; Surgical excison
B. Drug name.

Q.21 pt. taking OCP with dose of ethinyl estradiol 30microgram has acne, Wt. gain, oil greasy skin,
what to do ?

-give progesterone only pill.

-give one with low estrogen.
-medroxyprogesterone injection.
-3rd 4th generation progesterone

q 22A 50 years old man complaining of increasing ring and shoe size, with frontal bossing and . which
of the follwinh investigations we need to do??

- short syncathen test

-dexamethasone suppression test
-ACTH stimulation test
-IGF -1

Q23 a patient comes with a history of seizure, there was no prior complaint of any neurological
deficit. Comes to you which of the following would u do first >?

- EEG
- Nerve conduction studies
-witness
-serum electrolytes and blood test

q 24 : A lady comes to you with a malar rash on the face which seems to get worse in the sun , she
was givena trial of steroid ointment , but no effect ,on labs ana was negative, what would u treat her
with now ?? a picture of an african woman with rash on face )

-hydroxychloroquine
-prednisolone
-metronidazole
-lidocaine ointment 0.5%

25;Q A 7O year old man comes to the ER because of crampy abdominal pain and and massive fresh
per rectal bleeding ;
what could be the most probable cause of the pateints per rectal bleeding

-diverticulosis
-diverticulitis
-ischermic colitis (sorry forgot the last option)

q26;a 42 years old lady with jaundice fatigue and itchiness . with slight yelow tinit to her skin and
raynauds phenomenon msrked hepatosplenomegaly , alp 1200 , what is going to be elevated in this
patient:

- anti smith antibodies

anti smooth muscle antibodies
anti mitochondrial antibodies

q27:A 72 years old man complains of nausea, he was diagnosed with some cancer for which he
recived extensive chemotherapy : following labs were given ;
what is the person suffering from.
ca; 5
phosphate 8 hco3 ;24137 k ; 4.5

-dehydration
-renal infarct
-tumour lysis syndrome

q28 a patient with tuberculosis came with the complaint of visual disturbance etc, what is the
medium and probable drug involved

- ethambutol lowstein jense medium (right answer)

29; -when standing up patient complain of tachycardia and dizziness but when measure bp no
hypotension. What is the diagnosis?

a. standing orthostatic tachycardia syndrome.

b. orthostatic hypotension
c. vasovagal.
d. carotid sinus
30; a 22 year old man comes to the emergency , with right knee pain while playing soccer , he
hyperextended knee , popping sound was heard , on exam pain at anterior pulling at 20 degree.
diagnosis

- anterior busrsitis
- torn mrdial meniscus
-anterior cruciate ligament damage

32. A man with cough blood tinged and blood in urine , and long scenario with C ANCA present. What
is the most likely diagnosis :

- aspergilosis
-wegners granulomatosis
-churg struss sundrome

q:33 a 27 year old man comes with a one day history of progressive weakness and diffivulty
swallowing . which of the following is the most definite diagnostic test (DEEP tendon reflexes were
normal) :

-acetylcholine receptor antibodies

- nerve conduction studies
-EMG

Q;34 74-after vaginal delivery Dr is delivering placenta what is the stage of labor:
-1st .
-2ND
- 3RD
-4TH

Q 35 ;AN old man diagnosed with life ending disease [end stage prostate disease] and family ask you
not to tell him?

-ask the pt. whether he wants to know or not (how much of his disease he’d like to be informed)
-respect family’s wishes and don’t tell him.
-set directly with him and tell him.

q36; a woman comes with progressive weaknes and diffciculty breathing and droopy eylids , admitted
for respiratory distress. What will u give her ???

-edrophonium challenge
-iv methylprednisolone
-plasmapherisis

Q37; GERD history with epithelium lining esophagus changed from squamous border to columnar
down till 1cm below diaphragm (or of gastric mucosa) Dx?

-Barret’s esophagus.
-Achalasia.
-esophagus carcinoma.
-gastric carcinoma.

Q38; 66-Esophageal cancer case scenario is [pt. has history of achalasia later malignancy detect on by
endoscopy, biopsy has been taken , what is the finding?]

-Adenocarcinoma
-squamous cell carcinoma *
-small cell carcinoma
-lymphoma.
Q39; a woman comes with c/o unstediness with vascular tumour in the right rtina and
hamengiblastoma , which of the following is the diagnosis ?

-Li fraumeni syndrome

-nuerofibramotosis 1
-von hippel lindau disease

q40; what is the most common side effect of metformin ?

-lactic acidosis* [rare]|

-hypoglycemia.
-diarrhea. [most common]

q 41; a man presents with sharp bolt like electric current pain in the right side of his face , brought out
by touching a specific area, what is the next step in the management pf this patient:
- aspirin
-carbamazepine
- lamotrigine

Q; 42 , SINGLE QUESTION ABOUT SENTIVITY SPECIFICITY PPV NNP ( correct answers of all in one line)

q 43; tinel sign : median nerve (one line question

q 44: wrist drop : radial nerve ( one line question )

q 45; A case of Grave’s disease then asks the most sensitive [most specific] serology test

-TSHR antibody(blocking)
- TSHR antibody(stimulator)*
- anti-thyroglobine

Q 46; 57 y/o female smoker of 15 cigs per day in her 40s asking about her concerns of getting
osteoporosis Like her mother she had fracture due to osteoporosis, what to do?

-Do DEXA to measure her bone density

-reassure
- do genetic test.

Q47; -pt. has Dexa scan shows T score of -2.1, she is stay at bed, and already taking calcium, what to
do?

-calcium and vit D

-reassure
-bisphosphonate.
-vit.D.

Q48; fragility fracture risk factor RELATED to which of the following;

-Female
-hypothroidism
-osteoarthritis
-high BMI.

q49; typical case of bell’s palsy ( diagnosis was asked )

q50; a woman with c/o tingling and numbness in hands elicited by extreme dorsiflexion of the hand ,
whats the woman suffering from :

-Dupytren’s contracture
-carpel tunnel syndrome
-radial nerve damage

Q51; 17 year old girl did not have menses comes to the clinic , normal external genitalia , with short
vagina , on u/ s there is no uterus what is the diagnosis ;

- androgen insensitivity syndrome

-kallman syndrome
-mayer rokitnasky syndrome

q 52; drug abuse causing visual hallucinations.[pt. has visual and auditory hallucination, he was IV
drug abuser, now he stopped, but still has hallucination]

-LSD
-Cocaine
-Cannabis

Q53; -male travelled to Pakistan got sick with GE and MS weakness went back home ttt GE with
campylobacter jejuna but remained with the increasing muscle weakness and tenderness what to
inject him? (didn’t mention Dx :GBS) [paralysis, and with sensory loss of legs and upper limb]

-IVIG
-IV Corticosteroid

Q54: Pregnant lady 18 week with asymptomatic bateruia UTI , which of the following drug would u
give her

ANitrofurantoin 100 mg bd for 3 days

B;cefalexin
C;nitrofurantoin 100 mg bd for 5 days
D:Amoxiclav

Q; 55 A pregnant lady with reistant hypertension despite taking multi[ple medications bb blcokers ca
channel blockers, what will u add to her regime now ??

-methyldopa 250 mg tds ( right answer) remaining all options were with wrong doses )

Q;56-what’s not cardio selective B blocker

-Propranolol
-Atenolol.
-metoprolol.

q 57;Paraphimosis picture diagnosis

Q; 58 what’s long-acting Beta agonist:

-Salmeterol*
-Salbutamol
-Terbutaline

Q 56; A 54 yr old man with stable angina scenario, on aspirin nitrates , b blockers and ca channel
blockers GIVEN STILL not controlled . What would u do next??
- CABG
- pci
-escalate the b blocker
- coronary angiography

Q 57; a 33 year old lady with severe symptoms of PMS, and breast tenderness , mood swings etc;
which of the following drug will u give to that patient:
- alprazolam
-venalfixine
-progesterone

Q58; pregnant 8 weeks with hypothyroidism on levothyroxine 70ug and 400 folic

- Escalate thyroxine after 20 weeks of px to 100ug and continue folic acid as initial
- Escalate immediately TO 100 ug continue folic acid initially
-Escalate both
Q 59 ; Old man unilateral tremors and anorexia went with his wife to the dr. and prescribed him a
drug (no mention of Dx or drug), changed his spending of their money and started gambling and kind
of living on the edge, Wife complained to Drs what did the Dr say.

-Disease is progressing and need Dr visit

-normal for his age and kind of disease
-visit psychiatrist
-SE of the drugs visit doc to revaluate the dose

Q60; -s&s of 18 hours post-surgical hemorrhage what is the Type of hemorrhage ?

-1ry hemorrhage .[at the time of the surgery]

-reactionary. [with 48 hr. after the surgery]
-Secondary hemorrhage [1 to 2 wks.].

q61. A man who is unkempt with unhygienic appearance doesnot wash hands etc, tried to cut himself
with razore or many years, and forgot to pick his kids from the school as well, what of the following is
he NOT AT RISK
- active harm to others
-active harm to self
- passive harm to others
-passive harm to self

Q62; a woman comes at 12 weeks pregnancy , today she noticed moderate amount of bleeding
pervaginum. On examination the cervix is closed and n noactive bleeding is observed.. which of the
following is womens current condition .

- incomplete abortion
-missed abortion
-spontaneous abortion
-threatened abortion

Q63; A SCENARIO OF fetal distress and CTG given with late decelrations asking for the cause of it, we
had to diagnose the ctg first and then answer.

- fetal head compression

-umbilical cord compression
- uteroplacental insufficiency

Q64: a 19 year old woman comes to physician because no menses. , normal breast development scant
pubic hair , tall with long arms . blind ended vagina . what is the diagnosis?/

- kallman
- asherman
- androgen insentivity syndrome
-MRKH
65; A 82 year old man with htn with irrerugular irregular ryhtm given , ( atrial fibrillation ) with bp
80/50 and pulse 50. What will u do ??
- iv metoprolol
- 150 j shock in asynchronous mode
- 100 joule shock in syncrnous mode

Q 66; a 45 yeard old lady bitten by her cat , there is swelling despite antibiotic , , last TT was 7 years
ago , wound is clean what will u give her ??
-rabies vaccine
-rabbies vaccine and immunoglobulin
- TT and observe cat
- tt and rabies

Q 67. A typical case of bell’s palsy

68 intrinsic factor produced by ?

69; a woman who is alcoholic comes with a blank look , confused speaks in syllables , she had 6 8
beers last night , which of the follwinh iv should be administered to her first ??

- disulfiram
- diazepam
- chorlhexidine
- thiamine

Q 70 ; diagnosing SIADH QUESTION WITH LABS

THEY ARE STILL RECALLS AND ARE OBJECT

TO ERROR, I TRIED MY BEST THANKS