Compile Recall Sept 2011[1]

September 2011 Medicine 1. A man was scratched by a cat and there is a red rash extending from arm to forearm. no tender lymphadenopathy. A) Cat scratch B) Cellulitis 2. A 20 year old man presented with weakness of the left arm. On examination the left arm is oedematous. His axillary lymph nodes are enlarged but not tender. He also reported that his pet cat is unwell. What is the cause? A) Cellulitis b) Axillary vein thrombosis C) Cat Scratch fever 3. A case describing cellulitis. which the most common organism? a. staph b. strepto pyogen 4. Patient clinical features: chemosis, blurring of vision, painful, photophobia, pupils semidilated fixed and irregular when compared to the other side. He has been having similar attacks in the past. What is the long term management of his condition? (A) Acetazolamide (B) Pilocarpine (C) Trabeculectomy (D) Peripheral iridotomy (E) Sotalol 5. A picture shows a patient with chemosis, congested red eyes. He also has history of recurrent genital and aphthous ulcers. What's the treatment of this condition? (A) Amoxicillin (B) IV prednisolone (C) Oral prednisolone (D) Antiviral (E) Chloramphenicol drops 6. 65 year old male patient comes with typical chest symptoms and temperature 37.8C. ECG was given, shows anterior lateral MI. (The stem didn’t mention anything about the initial MI MONA treatment). What is the next most appropriate management? (A) PCI (B) IV GTN (C) IV Prothrombin 7. 52 year old male patient, onset of chest pain 1 hour ago, was brought to the hospital. ECG was given s/o an anterior inferior MI. GTN and O2 were given immediately. Tertiary hospital is 3 hour away. What is the next step in management? (A) Transfer for PCI (B) IV streptokinase 1

Sept. 2011

8. 35 year old nurse working in a rural hospital, smokes 40 cigarettes a day. Presented with productive cough, sweating, malaise, other GPE was normal, temperature was 37.8C. (A) HIV (B) TB (C) Pneumonia (D) Bronchial carcinoma 9. Pyloric Stenosis: USG done. What’s long term management? A. Pylorymyotomy B. Endoscopy 10. Diabetic foot, Tx: A. Gentamycin with metromedazole B. Doxcy C. Erythmycin 11. 18 year old present with thirst, polyuria (4-5 Litres per hour), normal 24 hour urinalysis, urine osmolality (?), urine sodium 137mmol/L. A. Diabetes insipidus B. SIADH C. primary polydipsia 12. 65 year old diabetic patient complains of two days history of pain in lower limbs with redness, tenderness in calf, absent pulses in ankle with reduced sensation below knee? A. Cellulitis B. Embolism C. DVT 13. Picture of amoxicillin induced rash. Patient with sore throat on amoxicillin developed the rash in picture. Next step in management? A. Stop amoxicillin B. Penicillin IV 14. 55 year old male with complain of 30 pack years of smoking, mine workers now complains of cough, Dyspnoea, pleural tap is blood stained, what is the diagnosis? A. Mesothelioma B. SCC C. Small Cell Ca of Lung 15. 60 year old male with redness scrotum and pain, what’s the next best investigation? a. USG b. urine culture c. FNAC 16. 50 year old male with C/O severe right eye pain, what’s best treatment? a. paracetamol b. Sumatriptan c. High dose steroids. 17. Normal looking X-ray, H/O green sputum, cough and occasional blood. WOF is best long term Rx? 2

Sept. 2011

a. Tetracycline for ? b. Anti-TB Rx c. Physiotherapy d. Reassure. 18. X-ray of upper lobe (L) cavity. Pt form Vietnam. What is the best Mx? a. Anti-TB for 6 months b. antibiotics c. CTPA. 19. A long stem regarding the wrist and finger movements. Patient cannot extend wrist and fingers. All other small muscles are normal, where do you think the lesion is? A) Median N B) Ulnar C) Posterior interossei D) Ant interossei E) Radial nerve 20. An old man was found wandering in neighbourhood, with poor attention to self care, forgetful. He was well 2 weeks ago, no h/o trauma, drinks alcohol occasionally. What is the best diagnosis? A) Lewy body dementia B) Vascular dementia C) Alzheimer dementia D) SDH E) SAD 21. Stem similar as above, but forgetful for past few months, now acutely disoriented in the past two weeks. He is living alone, no trauma, moderate alcohol. Dx: A) Lewy body dementia B) Vascular dementia C) Alzheimer dementia D) SDH E) SAD 22. Stem similar as above, but now more acute disorientation for 2 days. A) Lewy body dementia B) Vascular dementia C) Alzheimer dementia D) SDH E) SAD 23. A poor quality CT scan was given, which shows one bowel lumen on left side with a fluid level. patient has h/o pain. Clinical features: bloating and no bleeding. Dx: A) Diverticulitis B) Appendicitis C) Some other options 24. Patient comes with cough with expectoration. His sputum is greenish with occasional blood. WOF is the long term Rx for the condition A) Tetracyclines for 9 months 3

Sept. 2011

B) Anti TB RX C) Physiotherapy D) Reassure 25. 65 yrs old man comes with complaints of loss of ankle and knee jerk. He has a h/o Gastrectomy few years back. His blood test results are as follows: Hb 109 RBC 3.5 WCC 4.5 Platelets 180 MCV 110 MCHC 27 What is the most appropriate diagnosis? A. Iron deficiency anaemia B. Age related anaemia C. Vit. B-12 Deficiency D. Alcholism E. Hypothyroidism 26. 45 yrs old smoker comes with complaints of Rt. Eye ptosis, Vertigo, loss of sensations on the lower half of face, b/l visual blurring, ataxic movements Rt.hand and foot. O/E there is sensory loss of the Rt.upper and lower limbs. What is the most appropriate reason? A. Rt. Anterior communicatinr artery obstruction B. Horner’s syndrome C. Rt. Vertebral artery Thrombosis D. Post Cerebral artery E. Temporal Arteritis 27. A 35 yrs old smoker comes to you with complaint severe hematemises and epigastric pain for the last 3 hrs. His BP is 80/50 and HR 110. After resuscitating him with 2 Litres of normal saline. Which one of the following will alleviate his condition? A. Oral Ranitidine B. I/V Omeprazole C. Adrenaline I/V D. Long term PPIs 28. 80 yrs old pt. came to ED with complaints of Dysuria, Nocturia and recently developed Back pain which is getting worsening by each week. Following investigations: Hb. 90 RBC 3.1 WCC 5.0 ALP 300 PSA 10 (