AMC recalls 2014

Manu Recalls

04/12/2014

Do recalls very well they are time saving and you will see them in your exam for sure Please pray for me

1-Chardiovascular risk calculation chart from jm 1- Pt with MI 5 years a go come with total cholesterol;4.5 2- Pt with bp;140/95 bmi;28 smoker fbs;5.4 stroke in father at the age of 70 mx? Study tables in jm chapter of HTN 3- GDM screening 4- A 41 y/o female flushed with artheralgia weight loss night sweeting t; 37.4 which reach 38 most appropriate next step? Ana Bc Ds dna Ans : If the full stem denotes SLE then A If not then B 5- Male with homosexual partner watns hiv screening after some weeks come with fever sore throught exudate hepatosplanomegali and macolopapular rash and the result of elisa and westernblot were negative what will you do? Repeat hiv tests Ebv test Ans: Ebv test

JM252

6- Mm scenario 7- Pt with cough breastlesness and an xray which a balck mass was seen in cxr and there was h/o smoking I choose lung cancer Ans: mostly that is right Scc 8- Pt with hypercalcemia phosphor upper limit of normal with rise in cr and urea dx? Renal failure Malignancy Ans: mostly Malignancy as in CRF there is hypocalcemia Adam Jp It looks like Malignancy (MM) bc can cause renal failure and hypercalcemia Ireen so I think B bc renal failure due to other hypocalcemia not hyper. here hypercalcemia is due to Malignacy not renal failure I

9- 2 qustion about collangitis scenario with hypotention and ercp 10-A girl with in intermittent pain in lower abdomen for 3 days which worse during micturition at 9 days after ending of her period and has such pain in 4 weeks ago which spontanusly disappeared after 3 days dx?

Ovulation Ep Ans: Ovulation……………..but do not forget endometriosis if the pain is of long period 11-Placenta abruption 12-Fat female with oligomenorea fsh2.2 lh8 prl470 tsh8 next sep? Brain mri Vaginal us Progestron Testestrone Ans: A controversy Shilpi Singh if TSH and PRL under normal range then testosterone to confirm PCOS. but if tsh n prol increased then A

13-As naproxen 14-Dermatophibroma picture 15-Infant with drowsiness poorfeeding ill fever rash what to do Penicillin Bc Ans: Penicilin JM271 16-Ctpa 17-v/q scan 18-tt vaxination 19-hepatitis A or malaria 20-needle stick hbsag positive next? Concelling 21-mulerian agenesia 22-terner 23-12 month old infant cannt walk alone but other milstone were normal what to do? Review 3 month later 24-Old female after husband die with depretion symptom 25-Party drug abuse 26-Old guy with police say maphia control me 27-Psvt accompanied wpw ecg? Sotalol 28-Palpitation and lightheadness after running for 15 kms which ecg? Multiple pvc Af Atrial flutter V fibr Ans: the answer is not included as the answer her has to be SVT or less likely VT 29-Dig toxicity ecg 30-Hirshprong scenario next step Xray Barium flow through Ans: xray (to be reviewed after studying the subject from JM) 31-Giardia symptom in truk driver

32-Nursing home resident pt with dearrhea for 4 days and fecal incontinency next step s/e s/c sigmoidoscopy colonoscopy Ans: colonoscopy Nikita Bhatia jm pg number 319..... fecal impaction is encountered typically in the aged, bedridden debilitated patient. it may closely resemble malignant obstruction in its clinical presentation. spurious diarrheo can occur which is also known as fecal incontinence Nikita Bhatia so in order to rule out malignancy we will do colonoscopy... Nikita Bhatia according to kaplan... colonoscopy is clearly the most accurate diagnostic test.... sigmoidoscopy will only reach the lesion within the distal 60 cm of colon. If the lesion is there then the sensitivity of sigmoidoscopy is equal to colonoscopy. only 60% of cancers occur in distal area

33-Some cirrhosis symptom with fever abdominal pain and confusion dx? Sbp spontaneous bacterial peritonitis 34-LSIL 35-EDH ct scan 36-Headache pecialy after coughing for 3 weeks after mva dx? EDH Subdoral heamatoma Post tromatic syndrome Brain concoction Ans: Subdural haematoma Fady Nasif B ? it must have a vascular component as long as it worsens with cough Fady Nasif B can be presented by subacute type and it's d.t venous leaks/tears rather than arterial tears with EDH , so cough inc the headache ? Mahwish Sheikh in EDH there would be luicid interval ,severe headache and other neurological signs also.

37-Sever croup with syanosis first step? O2 38-Gord scenario 39-Renal failure with unilateral artery stenosis Ace i 40-50 y/o man wants prostat cancer screening but doesn’t have any risk factor or symptom Talk about pons n cons of prostate screening Psa n dre 41-Domestic violence in female don’t want any body know 42-Aboriginal mom without eye contact but there wasn’t cultural issue so I choose bring one of family member with you in next visit 43-Postnatal depression beside treatment what to do Family involve 44-Schisophreni treatmat 45-Old pt with abdominal distention constipation n use lagxative for long time dx? Sigmoid volvulus

46-Secom caner symptom Lethargy 47-Pt on pneumonia treatment with penicillin n azithromycin after 2 days rash appear what to do? There was pic of vesicopostular rash Allergy drug test Take swab from lesions Ans: B Mostly

……But if steven Johnson syndrome the answer is A

Noor Eldeen whats the dx ?? may be steven johnson syndrome !! Michael Gamal Noor Eldeen steven johnson syndrome is also severe reacton may cause dt drug allergy Noor Eldeen SJS may be caused by adverse effects of the drugs vancomycin, allopurinol, valproate, levofloxacin, diclofenac, etravirine, isotretinoin, fluconazole,[11] valdecoxib, sitagliptin, oseltamivir, penicillins, barbiturates, sulfonamides, phenytoin, azithromycin, oxcarbazepine, zonisamide, modafinil, [12] lamotrigine, nevirapine, pyrimethamine, ibuprofen,[13] ethosuximide, carbamazepine, bupropion, telaprevir,[14][15] and nystatin.[16][ Noor Eldeen yes i think if dx is sjs then a Alain Diago SJS is a spreading purplish/reddish skin rash that spread. And it may have blister. And shedding of skin. But here its vesicopustular rash I think something wrong with the description of the Skin rash. .

48-64 y/o Pt with cough sputum fever cracle and widsprede patchy opacity in cxr treatment? Penicillin Coamoxyclave Doxyciclin Ans: needs work out on pneumonia, but If atypical pneumonia then Doxycicline JM 269 otherwise coamoxclave is the answer 49-Old female with gonorhea without sexual contact what to do Cefteriaxon iv 50-Cavazaki mx 51-Symptomatic uti in 13 y/o girl 52-Asthma dx 53-Bowel obstruction symptom with a lump below n latral pubic tubercle ix? Ct Xray Us Fna Ans: xray 54-Lump in below n latral pubic tubercle which is not coming out with cogh or reduced ix? Fna Ans: fna is wrong answer …the best answer may be sonar 55-How dx incisional hernia? Lye down n cough 56-Gram negative septisemia 57-Acne and weight gain is side effect of? Li Respridon Aggmentation of li n respridone

Ans: Lithium 58-Diverticulitis senarion next step? u/a us ct 59-Asperger 60-Most common palce of endometriosis Uterosacral ligament 61-Child with headache Paracetamol 62-Girl with mam wants clamidia screening mom rings for result Bring your doughter 63-Alcohol and concive 64-Preeclampsia dx 65-Adolescent with depretion n insomnia Venlafaxine 66-Breast cyst ix 67-Breast solide cyst whats the type? Dermoid cyst 68-Diabetic foot ulcer with yellow discharge what to do? Mri 69-Sudanian kid with sezure less than 1 mine without fever is verywell right now what to do? Ct Eeg Vit D level Ans: mostly EEG Jm 1259……..but some suggested Vit D level Aryan Saif Mujtaba I think it is C...because I read a article fromhttp://www.ncbi.nlm.nih.gov/pubmed/ "There is growing interest concerning the role of vitamin D in various medical conditions such as diabetes and oncological, cardiovascular and central nervous system disorders. Although vitamin D deficiency is known to be highly prevalent among epilepsy patients, only a single study, published nearly forty years ago, assessed the effect of vitamin D on seizure control. Here, we measured serum 25hydroxy-vitamin D (25(OH)D) levels and normalized it by administration of vitamin D3 in 13 patients with pharmacoresistant epilepsy. To see if vitamin D3 has an impact on seizure frequency, we compared seizure numbers during a 90-day period before and after treatment onset. We found that seizure numbers significantly decreased upon vitamin D3 supplementation. Median seizure reduction was 40%. We conclude that the normalization of serum vitamin 25(OH)D level has an anticonvulsant effect" Hina Asher Eeg will be inconclusive , it's sudane, the most common group for vit d deficiency because of dark skin that is resistance to uv light so they are always deficient to vit d that will impair ca absorption as vit d is needed for calcium so hypcalcemia is the cause of these seizures correct vit d level and reassure Emad Askary Mary Melad, B. See JM p.1259, standard minimum investigations.

70-Epigastric pain radiates to the back settle after 2 hours n pt is fine what to do? Lipase Gasteroscopy Ans: Lipase (acute pancreatitis) 71-Pancreatic cancer has worst prognosis 72-Pancreatic caner scenario ix? Ct

73-Thin membrain disease recall 74-Ortostatic proteinuria dx n ix 75-HOCM scenario ix Echo 76-Keratitis 77-Dependant personality 78-Borderline or conduct recall 79-Pt is confused and his layer want you witness the will 80-Sle pt on nsaid beside that what will you give Hydroxycolorquine 81-Oxycodone urine level recall 82-Kid with pertosis what will you do? Ab and exclusion 83-6 y/o child with hematuria and proteinuria dx Iganephropathy Psgn ATN They didn’t say any thing about history if any infection Ans: as long as there is no history of infection we have to think of IGA neohropathy If infection present then PSGN 84-Liver abcess 85-Child with petechi n easybruising cervical lanphadenopathy plt=5000 What to do? Plt Chemotherapy Ivig Ans: if the complete scenario contains history of viral infection then it is ITP and IvIg is the choice while if the full stem shows that all other blood series are affected then it is ALL and chemotherapy is the best choice 86-Pathological fx in spain with its xray what to do? Bone scan Serum protein electrophoresis Psa Ans: mostly Bone Scan……..but think about DEXA scan if you suspect osteoporosis and Psa if you suspect malignancy 87-Femal with non productive cough for 3 days otherwise very well what to do? Come back if not improve 88-OA and sticker All the best Please pray for me Amc-MCQ 14 oct 14 1) Case on a child with slight jaundice on 2 nd day of birth. Cause?

2) 18 yr old athlete, father died at the age of 40. What investigation? Echo? 3) Defence mechanisms ; altruism 4) Girl with OCd, excessive hand washing. c/o Rash onn hands due to compulsive handwashing… treatment? Sorbolene cream, fluvoxamine , olanzapine 5) Child with svt (no ecg) how do you fix it? Cold water was an option 6) A nursing home bus driver had a grand mal epilepsy with no trigger factors. What will you advise him? A) drive after 6 months B) never drive C) report to the authorities 7) Lots of psychiatry 8) Preg woman wth unsymptomatic ovarian cyst, what to do? 9) Mucinous cystademona 10) Question on capsule endoscopy (old recall) 11) Herpes on the trunk, asking for treatment. 12) Swelling on the anterior 1/3 of sternocleidomastoid. Diagnosis? Brachial cyst 13) 19 year old, fights with everyone, keeps stealing stuff. Diagnosis? Antisocial personality 14) Woman with normal hb, wcc but low platelet counts (35) what will you do? A) give platelets and other random useless options 15) Recurrent uti, bilateral swelling,sister had the same problem a) horseshoe kidney b) cant remember other options 16) Patient with neck stiffness only a) meningitis and other options 17) Malingering case from the old recall. 18) Hypnogogic hallucination? 19) An xray photo of tibia and fibula, the tibia is completely displaced. Asking for management? A)external fixation b)internal fixation I only got one Ecg, but lots and lots of psychiatry.

Thank you everyone for all your support and help. Please remember me in your prayers. May we all pass. Confidence is key! And ofcourse a good nights sleep!  (Ps., sorry for the delay I did not have internet access earlier, and this is all that I can recall, I hope this helps)

1. Man with history of alcoholism has inability to flex fingers and grasp objects. Which of the following will you do before intervention? Pic similar to this one but ring finger flexed.

A) X-ray hand B) MRI C) USG Hand D) CT Ans:C Causes of the disease are mostly genetic as the disease runs in families and it is more in men than in women and it is seen most often in people of Northern European (English, Scottish, Irish, Dutch, French) or Scandinavian. Shilpi Singh No routine radiographs are necessary, but ultrasonography can demonstrate thickening of the palmar fascia, as well as the presence of a nodule. In addition, ultrasonography of a thickened cord may be useful prior to intralesional injections so that the underlying tendon can be identified and avoided during the injection.

2. Man comes with complains of pain in right ear. He also complains of blood mixed with saliva. Which of the following if affected will lead to this condition? A) Gums B) Larynx C) Tongue D)Trachea Ans: c…..tongue carcinoma

3. Man with history of hemochromatosis. He is in intensive care unit. Has flapping tremors. He is confused and restless. He also has ascites with shifting dullness. Ascites tap done which shows

Cells – 300 LDH – Which of the following is the most appropriate immediate management? A) Amlodipine B) Albumin C) Lactulose D) Cefotaxime Ans: D Mahi Shah Fari Shaikh agreed that it's hepatic encephalitis and lactulose would definitely be included in management ..... But see what they have asked is immediate management.... Lactulose is basically non-digestible sugar prevent ammonia absorption. Thus helpful in prevention of further development of encephalitis but NOT CURE OF IT. Spontaneous bacterial peritonitis is LIFE THREATENING infection of ascitic fluid, furthermore antibiotic will also prevent ammonia production by reducing bacteria in gut...... I hope this helps, I tried to find reference for you but information is scattered... Mahi Shah If the fluid contains bacteria or large numbers of neutrophil granulocytes (>250 cells/µL) (a type of white blood cells), infection is confirmed and antibiotics are required to avoid complications. In addition to antibiotics, infusions of albumin are usually administered. NOTE: In our question cells are 300...... http://en.m.wikipedia.org/.../Spontaneous_bacterial... Mahi Shah Fari Shaikh these are recall questions so might be possible that person who recalled qs skipped fever part...... Even if fever is not given, do you think we should wait for fever to occur in order to commence antibiotics in life threatening condition ?

4. Man who is mechanic and drives commercial vehicle has history of seizures. He has been advised to not drive for the next 6 months. He however believes that he should continue driving as he doesn't want to disappoint his customers. He starts driving within 2 weeks of having seizure. Which of the following is the most appropriate action? A) Notify his employer B) Notify licencing authority C) Let him drive as he needs to continue work D) Ban him from driving Ans:B

Shan Saleheen B, DLA will make the decision, but, treating doctor can give a non-judgmental medical report to DLA. "Expectations of patients and driver licensing authorities (DLAs) that treating doctors should adjudicate on fitness to drive undermine the doctor–patient relationship, discourage reporting of seizures, encourage doctorshopping and expose the practitioner to legal risk.19 The author’s preference is to provide a concise medical report allowing the DLA to make the decision (Figure 1)." Shan Saleheen http://www.racgp.org.au/afp/2014/march/epilepsy/

5. Mother presented with 2 year old girl child who has genital warts. Mother has history of genital warts during pregnancy which has resolved. Which of the following is the most likely cause? A) Auto inoculation by the mother B) Child acquired it during birth C) Sexual abuse D) Acquired infection from water source Ans: c Alexander Kuzminov 60 years of age will suffer an osteoporotic fracture. JM5 p.991: BMI < 18 is a risk factor for osteoporosis. DEXA scan is the gold standard for the diagnosis of osteoporosis. I guess the fracture has been appropriately managed and the patient is being visited during the follow up.

24. A mother brings a child to you. Everyone in the family is overweight or obese. The child’s BMI is only 20. What will you do? A) Reassure the mother that he is normal for his age B) Prescribe supplements C) Estimate bone age Ans: difficult to be answered because the child age is not provided….but may be c Reshma Rafi bmi is not reliable in chidren.. but among these i go for a Reshma Rafi Here we can counsel the family.. Cannot commence rx now Alain Diago we need the age of the child here. to compute for BMI should be weight for age. Age will determine if child is normal, underweight or obese. BMI of 20 for a 7 year old child can be obese and BMI of 20 for a 12 year old child can be normal

25. Mammography although not mandatory in Australia, is now offered to women under a Government scheme. It has helped in early detection of breast cancer in many women. Which of the following is a concern about mammography screening in Australia? A) Missed diagnosis of breast cancers B) It is expensive C) Mastalgia Ans :A

JM 951

26. A 50 year old man comes to you with history of reflux and burning sensation in epigastrium and. He is heavy smoker and alcoholic. An endoscopy was done as part of his assessment which showed a reddened areas in the lower esophagus. What is the most appropriate management?

A) Decrease alcohol B) Quit smoking C) H Pylori testing D) PPI’s

Ans: D proton pup inhibitors

27. Man comes to you with history of progressive dysphagia. He initially developed dysphagia for solids. Now he has dysphagia for liquids as well. During night, he has regurgitation of food. Which of the following is the most likely cause? A) GORD B) Esophageal Cancer C) Achalasia D) Barrett’s esophagus Ans: c cancer B

…..But if there is prominent loss of weight it is oesphageal

Emad Askary Shona Amber, C. JM5 p.511: “ Intermittent dysphagia for both liquids and solids is characteristic of a motility disorder such as achalasia. Malignant oesophageal obstruction is usually evident when there is a short history of rapidly progressive dysphagia and SIGNIFICANT WEIGHT LOSS.”

28. Young couple comes to you. The husband has history of Rheumatoid Arthritis. He is on methotrexate and sulfasalazine. They planning on starting a family. What will you advise? A) Continue methotrexate stop sulfasalazine B) Continue both methotrexate and sulfasalazine C) Stop both methotrexate and sulfasalazine D) Stop methotrexate continue sulfasalazine Ans: c

…..as sulfasalazine has no effect on semen

29. Man around 30 years comes to you for enquiry about prostate cancer screening. His father died of prostate cancer at the age of 75. His uncle also has been detected with prostate cancer. What will be your advice? A) He needs screening now B) Regular 2 yearly screening

C) Nothing to worry and reassure D) Start screening at aged 40 Ans: mostly c and may be with little possibility d According to RACGP “Screening for prostate cancer is not recommended unless: 1. the man specifically asks for it; and 2. he is fully counselled on the pros and cons” Also see JM 1077 Shan Saleheen 'Screening is not recommended unless the patient specifically requests it and he is fully counselled on the pros and cons of screening.' RACGP recommendation

30. A woman, 30 years old comes to you with to enquire about breast cancer screening. Her mother was diagnosed of breast cancer at the age of 65. Her older sister has been diagnosed of ovarian cancer at the age of 36. What will be your advice? (I’m very sure of the age in the question) A) Start mammography now B) 2 yearly USG C) Self breast examination D) Reassure her Ans: mostly d Rumaisa Shaukat D here Meshkatul Islam unless Potentially high risk§ ( 90% the acute process resolves with conservative management. 98-peptic Ulcer bleeding episode..two attempts done for hemostasis endoscopically but no success..next? a-Operate n Suture b-Again try endoscope c-Gastrectomy d-heater probe Ans: D 99-pt wid chronic duodenal ulcer,now developed pyloric stenosis,wt ques u will ask? a-vomiting immediately after meal b-vomiting 1 hr after meal Ans:B

Saifun Nahar vomiting may be intermittent and usually occurs within 1 hour of a meal.medescape

100- old recall of typical chronic fatigue synd,wt will u ask? Wt u think is the cause of ur condition.

101-ecg

of sinus bradycardia given,in a lady wid central obesity,wt next u ll do?

a)echo b)tsh c)urine drug d)atropine Ans:b Mybol Sous By exclusion: Pacemaker is recommended from 2nd degree HB , atropine is recommended in sinus bradycardia < 40 b/minute. So, TFT……it was an answer to another similar question

102-A patient came with palpitation, breathlessness. He has done ABG and shows PH: 7.54, Po2: 102, Pco2: 28, what would you do next a) Rebreathing mask b) O2 high flow c) Na bi Carb d) Intubate Ans:A Shan Saleheen respiratory alkalosis due to hyperventilation

103-11-A 25 year old man came after MVA with horeseness of voice, loss of aortic knuckle, and widening of mediastinum, BP stable.(Same recall) a) Transcutenous Echo b) Transthoracic Echo c) CT angiogram d) MRI Ans:C Noni RJ C. If the patient stabilizes in the ED and does not require emergent operative treatment, a chest CT with contrast is performed to define the extent of thoracic injury and exclude aortic rupture. If the patient is unable to undergo CT, due to the need for immediate operation, transesophageal

echocardiography can be performed in the ED or operating room to assess the aorta and heart. Adam Jp Sepehr Sadeghi There has been a shift from an invasive (x-ray aortography) to a noninvasive diagnostic strategy for evaluating suspected thoracic aortic dissections [23]. In the 2000 IRAD review, most patients had multiple imaging studies performed (mean of 1.83 per patient); the initial study was computed tomography (CT) in 61 percent, transesophageal echocardiography (TEE) in 33 percent, aortography in only 4 percent, and magnetic resonance imaging (MRI) in only 2 percent [7]. Recent experience suggests that CT is even more prevalent as the initial study of choice, especially due to its widespread availability in the emergency department setting.

104- A 4 yr child wid fever 39, cough n breathlessness,nasal flaring. a)iv bezylpenicillin b)flucloxacillin c)adrenaline Ans: A …pneumonia 105-pt on sertraline,developed diarrhea n abd pain,next? a-switch 2 venlafa b-switch 2 another ssri c-switch to tca Ans: B

Rumaisa Shaukat B hb qs similar Rest of the ques were almost new in a sense that they were old recalls wid new n twisting options.but if you have gud approach n understanding of each recall of past 6 months,you can solve that twist. if you have prepared topx of recalls v well then time management is nt that big issue during exam as told by every1 on goldstar, v gud luck 2 all. Plz remember me in prayers. Special thanx to Rumaisa dear,she is a blessing 4 goldstar.stay blessed dear. N yes to saifun naihar,my last month recall partner: )

MY RECALLS 13/10/14 I have tried to recall as much as I can …I hope this recall will be helpful to all the goldstars. Please read the recall topics well coz it helps especially the last 3 months before your exam…don’t forget about the handbook too ;) In the real exam questions are really long….some are good coz more info is given…time management is important too…all the best goldstars!! Please keep me in your prayers if possible….;)

1. Uterine prolapse caused by what ligament? a) Round ligament b) Uterosacra ligament c) Broad ligament Ans: B 2. Salmonella outbreak in your GP setting. What will you do? Weird options but I choose to compare the food that the people with disease ate and the ones not infected….kinda case control type 3. Baby with cleft palate . mother took carbamazepine during pregnancy and drank wine ( standard drink) daily. What is the cause of cleft palate in baby? a) Alcohol b) Genetics c) Carbamazepine

pic something like this but obvious cleft palate…. Ans: B 4. Hb ques cerebral tumour page 222 MCQ 3.042 exactly the same! 5. Old lady with right lower lobe pneumonia ( cxr given with right lower lobe haziness) . symptoms she had was productive cough with sputum , blood tinged. SP02 was 92 % . otherwise she was well. Treatment with choices of abx a) b) c) d)

Penicillin Amoxycilin / clavulanate Doxycycline Azithromycin

CXR was something like the one in the first one NO lateral view was given…… Ans: If >65 years then A If >65 and can tolerate oral or 0.5 mL/kg/h during management of hypovolaemic shock.. Elevated creatinine can be due to pre-real acute kidney failure that must be treated with 250-500 mL saline over 30 min. (Oxford Handbook of Medical Sciences 9th ed. pp.680 & 804 & 848)

33.Incisional hernia scenario…..this guy had midline incision and developed a swelling on the incision line…no picture given….asking what will help you diagnose it ? a) Ask the patient to stand and cough b) Ask the patient to lie down and cough c) Ask the patient to lie down and raise the head to chest Ans: B Noor Eldeen INCISIONAL HERNIAS EXAMINATION. Lay the patient down, and put your hand through the weakened area in his abdominal wall to feel the size and shape of his hernia. It may be elliptical, or irregular, and he may have more than one. Ask him to raise his head and shoulders off the couch without using his arms. This will fill the sac and show you its true size.

34.CRAO scenario with cherry spot picture given. The old lady had pain in eye for 3 hours….came to ED now ….what is the management? a) b) c) d)

IV acetazolamide Globe massage Timolol Pilocarpine Ans: A…..but globe massage is one of the steps ….JM 825

The picture given in exam was something like this….. 35.Post streptococcal glomerulonephritis scenario given…..with a boy having urti and noted to have ankle edema. Bp was a lil high for his age…. Urine dipstick shows proteinuria and hematuria. What is the diagnosis? a) Ig A nephropathy b) Post streptococcal glomerulonephritis c) Thin basement membrane disease Ans: B 36.Good pasture syndrome scenario….with this guy having bibasal crackles , proteinuria,hematuria…..asking what is the diagnosis? a) b) c) d)

Glomerulonephritis Thin basement membrane disease Anti glomerular basement antibody disease Ig A nephropathy Ans: C

Anam Tahir good pasture syndrome also known as anti glomerular basemtn antibody syndrome...C

37.Sciatica , lumbar radiculopathy scenarious…..so read all these well

38.Guy with back pain after lifting heavy things. Pain resolved after a week. Now develops back pain and tenderness at L2 region. Noted to have fever 37.8 degrees. What is next step of management ? a) b) c) d)

Ct scan X ray spine MRI spine Bone scan

Ans: mostly b….As

Plain X-rays of the lumbar spine are not routinely recommended in acute non-specific low back pain (pain