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REGALLS

21 SEPTEMBER 2OO9

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c. Encephalilis d. Cerebral infarct

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e. EDH a. Gout

aÅl^';lis -

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came from overseas (Thailand) complaining of dyspnea. CXR was normal. is the next most appropriate investigation:

7

b. Psoriatic arthritis

c. Rheumatoid arthritis

NB.

2.

-¿ i'r-f--" No oseudooout ootion

ì'-ç':S"$

'---:-'

Lpa@{reurned

c. Sputum

from ovetseas trip (asia), complains of headache, fever,

ahdoyi/nal pain, I nitial investigatìon?

examination

,r' 8. pfi with hislory of chronic

He

a. Blood cullure

fi}

dianhea, axillary & inguinal lymphadenopathy, what's

diagnosis:

a. Syphilis

(!etooorirm c. FBE

@Hrv c. Crohn's dis

d. Abdominal Ultrasound

with classic DKA. What s the initial Rx: (lab results given

comes with chest pain for several hours with respiratory tract infection, pain getting better when he lean forward, ECG given (showed ST elevation) What is the diagnosis?

ffiaAøage ,Ãhe

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z

@rvituics

./

el t-

b. lnsulin lM

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(þericarditis b. PE

c. Dextrose 5% c. Ml d. Calcium

d. Endocarditis

old patient wilh parkinsonism on treatment of levodopa & carbidopa for Now he presents with flickering movements on his mouth. What would

4.A

,/

,/

10.

Ply'rural area with history of t hour chest pain, given aspirin & morphine.

ECG

inferior Ml. nearest hospital is 3 hours away. What will you do next:

y"

do:

fi.ìDecrease levodopa/carbidopa b. lncrease levodopa/carbidopa

b. angiography

c. Add benztropine

c, referral to hospital.

Alcoholic ot confused '----)--nt'-

d. Propranolol

_b.rought

to ED lV thiamine is

do next:

a. Oral glucose

e. Benzhexol

./t

Æ-Íéatment Náyears

alcoho & discharged

confused, history of DM on with same history & given now. What will you give this

old

of metformin \ "thiamine then

{$v c

gtucose.s%

Naloxone

lime:

d. NS tv 0.9% a. thiamine

e. lV glucose 4%

+lV

NS 0.9%

b. insulin

12

re showing dilated ventricles), brought with complains of last few hours. Neck stiffness and confusion was found

a. Factor Vlll

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b

Meningiti*s

with history of easy bleeding. Her father & brother are called "bleeders" s the investigation:

Von Willebrand factor

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c. LFT i:

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c. Rt MCA

d.haEt. i';n Proflle

fitr¡lt,: "-5.,lrrt io ÊD with

given thiamine & 02 but didn't improve. whals

::ii 'c..0

d. Lt MCA

.íoNá

r,ît,¿lcxone

í-' b,

the

lady presents with thyrotoxicosis signs whats the management while for the result of TFT? a. Propylthiouracil

ilaltrexone

b. Carbimazole

d^ o-l-¿(i'c ated for chqigl,çg,uþeration treated by communily nurse present with confusion, what is your investigation?

a Blood culture

Pronanolol

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2}Tfalienl with fever, rash, neck stiffness and initable what's the initial

tl

Dy

@

-,,rlanagement? @lV penicillin bLP

d.

f,¡mbar puncture

c. Acylclovir lV

e,

CT æan

7,/e"ti"ntwith

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ffi

A.yéíng woman who is known heroin addict is brought to the ED by her rgdiredics. She is found unconscious, with pin point pupils and shallow breathing tlb boyfriend admits that she was on prescription drugs as well as alcohol smoking :rønjuana cocaìne, methadone/heroin. What would be the most appropriate drugs l.'d causes constriclion of pupils? a. $4aijuana,

ûc9;-iç

P-*'^J-¡'rJa

b. B blockers c. CCB (Ca Channel blockers)

d. Diuretics

¡.,Alcohol.

-...

ùa f'U'TJlr)'

lady with mild fever,pøicarditis and history of PE) What wìll help you

:-a

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heroin.

.-,

-- 't-,-/

uic^r.Årås 9->D' a. Echo -T4

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;.'C.mine,

].û&thadone/

DM and HT what do you do prescribe?

to,

-$,

1t*"^J'p

-f*

b. ECG Wi-

lftirl with syncope has a history of father and grandfather died in ærly age old) due to unknown cause. What is the next investigation?

"&rs

J!r.no --a.

.?

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@nrun

t0"P¡'l'r+

tif'

What is the diagnosis?

UOy witn history of migraine with aura,

¡ow presents with bluning of vision

comp@ñlers.

r:lll1 0.f''-u

I

t{ever drlve again

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a. b. 24.

ft¿"&e' Lt L

CLL Mu

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fr

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d. IVP

3. Pt with renal stone measures 2.5 cm, Rx: (pt symptomatic, renal stone symp +ve)

), a

rsw!

2 /r-s-

ffi\

fd)Cystoscopy e, IVP cholelithiasis and USG was done and stones shown(pic given)' What

eatlent with -¿ù was the best investigation?

Æace ?

L.ITF 16. Pt with chest injury after MVA, iqcrease{[VP, 4gffìed heart sound. CXR showed loss of aoriic'knuckle ano wìdéñffioiasti-num.T-h'ãtìs the next most appropriate

d. Cholangiography

righ

s

the

the

- both breasts, the red areola, skin on the I an ischemic hearl cond hey tried to position

UAK grven

17. Man involving in MVA, left sided chest

k)

atic

b.

Meast condition?

18, Patient with history of abdominalêUrgery presented with intestional obstruction symptoms. AXR given, What is thftËgnosis?

a. Chronic Breast abcess

b. Phyllosarcoìdes tumour

c

management'

( t^--vù ''*-c'h a. Echocardioorm 6) Pericardiacéntesis +

c. HIDA scan

a.

small bowel

þ^

obstruction

ù \,t

l/\-\)

Pagets disease

d.infiltratinq carcinoma .

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fl. p

60/m, intercostal recession. He is maintain on 02 45%, after4h still unwell, dx?

TTN-:\-/ *\ -HMD

ì

( 1'2]^.yu--

I-r, \4

r

Q.-

-(ú'*

[/econium aspiration

28.Baby delivered noi'mal vaginal delivery, well after birth in cot, cyanotic, no murmur. Dx? TOF

on@àay ¡a¡y

fi^;;x-'l

185, A 5 y o boy gets drowned and his mum calls 1 1 1 then starts CPR. Which is the most important factor to influence the outcome of this boy's resuscitation?

A how good his mum is doing the CPR B if the water was salty or not a) left temporallobe

C when he had his first

b) frontal

C

breath

ffi'#€

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soon the ambulance anived

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@rightparietal e) occipital

oz

&"^il'M,

CLf- q32

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c) left parietal

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186. .** The pre-menstrual vaginal discharge is commonly due to:

¿Æ

@ ?

IrQ ùø^ f" IV t tUù \l)

@candida 1il). Unlversity youns girlcomes to you with inflamed ph??^Tg

P^lilÌi" lljÎrt

;dte is concerned she might have mononucleosis coz a friend of her had it.....Dx?

186. . Wife brings her husband in ED coz the right half of his tong is swollen. He had a treatment with ampicYllin?? Mx?

C viral pharingitis

Qe

D bacreroides vasinalis

glandular fever

t

tn

Á.

tûto

B prednisolone iv

181.29 y o African lady in labor, complete dilated cervix, fetus head +1, 0/E you see she had "f-emale circumci,sion". her vagina alloty

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Abmedio-lateralepisiotimy

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tl'ztyJ

D posterior episiotomY

182. 12 hours a*er a assisted derivery (ventouse), morher experiences

B retrograde

u

r@ttreter

continuous

Mx?

exercise

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#t:i:::: Ïi:i:Ï:il;::t 1gg.6modhsoldbaby,breastfed,broughtbyhisparents,veryconcernedand

distredõzihe

baby cries every day, starting late evening till midnight when he fall

retrogram

insertion

Ð transvaginal scan

89. 82 y o lady, from nursing home, found to have colon/cervical? Cancer for which surgery is necessary, She refuses to start any treatment for this Ca. She seems to undlrstands this health issue, ever she's having few other health conditions, What should you do? 1

E cystoscopy

çe1'ùu$u 'N83.

Ø*ò**'

known alcoholic, broughtin ED because some mental to remain in the hospital, His father, 62 y o wants to and has also "some mental problems". The GP is an alcoholicto take him home, He or social worker says that their house is insalubrious/dirty, with rodents feces, etc What should you do?

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