Recall November 2013

1. 1one child with epiglottitis 2. lady 10 days after hyterectomy- CTPA 3. Clostridium difficile was given in stole finding - Metronidazole PO 4. Diarrhoea associated abg- PH-7.2 and pCO2 2.5kPa 5. NF- 1 (café-au-alite spots) what arethe chances. 1) 1: 2 2)1:4 3)zero 6. A question 40 weeks pregnant women with vaginal bleed, bdominal pain. Uterus tense and tender.- Placental abruption 7. Annual incidence of ds. 700 (gmc website question) 8. breast cancer studies in 2 hositals 2009, in 2014 recurrences - I answered prospective case control????????? 9. Girl with borderline disorder (mock question- laceration and all those signs) 10. untreated depression what will it lead to- suicide 11. lady attempted suicide with drug overdose and is not ready to take treatment, will kill her as she reach home- Assess under mental law??? 12. dementia- progressive deterioration of memory 13. fluid of rehydratn 4 vomitng? 14. contraception 6 weeks after delivery, breast feedding, will plan for another baby in 6 months, contraceptive- POP 15. One with Wernicke's as diagnosis (total 4 thiamine and wernickes questions were given. Yes 4) 16. plus there was a question bph and retention >> catheter prceded by tamsolusin? 17. a women caoe frm abroad. No malaria prophylx. Lymphadntgy. Diagnsis? Hiv, dengue, (no EBV was given) malaria 18. male pt with b/l ureteric obstrtn.hydronephrosis was given. Creatin was 380. Want to atnd her dauter marge 19. pregnent pt at 10 wk has proteinuria.and h/o uti in chldhud. Diagn?' 20. PID- Ceftriaxone+ Doxy+ Metronidazole 21. pt with lung cncer ab to die. Masive pleural efusn. Management. Pleuderosis / chest drain / lung transplant 22. 37 yr old female shows inflamtry chnges in pap smear 23. 3rd nerve palsy- i answered midbrain 24. amsay hunt was answer with facial palsy and vesicles in ea

25. chld with asthma. Best diagnstc inv 26. A question about fall on outstreched hand, anatomival snuffbox tenderness27. A lady has 2 children, asking about a contraception with minimum chances of pregnancy, what is the best- I know it was female sterilization but I answered IUCD ;( ;( 28. pt thnkng hmself as profser of medicine – Delusion 29. exposure of chicken pox... i wrote preg women who have neg antibody titres shud b immunized 30. female pt fels vertgo at work 31. 22 yr alchlc pt asoc, opens hs eye to pain. Initial inv? 32. ear foreign body- hook 33. mri of intrnal austic meas 34. Halpike maneuver - vertigo on getting up from bed 35. sid efct of lithum? 36. question about pt. on digoxin, with nausea, vomiting- Check digoxin level 37. schizophrenic patient with tardive diskinesia and ...., not compliant with medication... i answered fluphenazine decanoate???? 38. diabetic under going gastrostomy 39. a pregnant pt was cnstipatd.what l u gve here. 40. oxycodne phosphate. Pt cnt take it nw. Next 41. kid with hypertrophic villi had celiac 42. Femur shaft fracture- femoral artery 43. he was unable to dorsiflex leg n ankle n knew jerk were normal but btw first and second toe the sensations were gone and they asked abt the nerve injured - peroneal nerve 44. pregnant women with constipation eating fruits and vegetables, taking 1 litres of fluid, I answered increase fluid intake 45. pt. with injury, something fell on lower leg, severe pain in lower leg, o/e tense, tender leg- compartment syndrome 46. a 70 yr old pt hav a large gal stne. Incidntal findng. Management? 47. a pt who had colles fracture a month back n again a fracture now what would u give to prevent fractures ??? 48. patient with displaced ankle, swelling, absent pulses in footE- reduce ankle or A. consult vascular surgeon I answered

reduce # 49. a pt who had a hx of taking cocps and is a smoker ... her aunt has ovarian ca . she is 30 yrs whts the most imp risk factr for ovarian ca 50. lady with history of renal stone going to middle east agin, advise- increase fluid intake 51. a gal on lng n shrt actng insln. Becme hype at 4pm. Redce dose of mrning lng actng 52. the pt with chlamydial urethritis is at a high risk of gettipng which infect ??? i ansd epididmytis 53. chld took grand ma medctn.and dilate pupils,etc. What ws the med 54. and the pt who had swelling and testes couldnt be felt had hydrocele right 55. terinal pt on mrphne, ratlng breath sound. What l u gve for noisy breath – anti muscarinic 56. paracetamol overdose above threshold level- NAC 57. 19 years old boy, stay alone, collected 200 toys- autistic spectrum disoredr. 58. Paracetamol overdose, suicdal gesture, below treatment threshold level, She wants to leave the hsp and prmse she wnt take it again. 59. guy who was post mi and now presented with inc jvp and b/l crackles ... whats the first iveg – xray, echo 60. a chld inhale foregn bdy. Best inv? Nasendoscopy, lat neck xray 61. blurd optc disc, flame hemorges, edematus edema 62. and there was one question where pt had inc end sytole n dec spetal wall sth ... was the ans dilated cardiomyopathy 63. ypertensive male with TIA, BMI-23, consume 21 units alcohol a week ansd 20 cigarettes per day... what advise- i answered stop smoking 64. the kid who had prolong bleeding from nose and inc aptt had hemophilia right 65. pain relif for hepatc mets. Cnt take mrphne due to cnstipatn- amitryptalline / gabapentine 66. one guy had facial pain and facial pain both on.right side and fever too did what did he have ??? 67. the cot death was to b prevented by the kid laying on his

back n feet toward the cot or sth right? 68. u/l facial pain with fever with swelling around eye- periorbital cellulitis 69. painless sudden loss of vision u/l, flame hemorrhages, papillodema- Central retinal artery occlusion (no option of htnsv retinopathy was given) 70. patient stable on morphine 60 mg BD PO, not able to take oral drug- I answered 60 mg bd morphine s/c 71. a painter who fainted and hit his head had gcs 15 presented in.er which invesg will u do?? ct xray braim or carboxyhemoglobin levels ??? 72. pt injury. He is respndng,bt opens eyes on verbl cmand. Wht was the answr. Observe for 30,urgent ct, late ct, 73. question abt ovarian cancer the ans was family histry right ??? most imp risk factor 74. one pt had macrocytic anemia and hypothroid so he had vit b def right ??? 75. male pt with 6.4 hb. Treatment? Blod tranfusn, irn infusn? 76. DM and gynaecomastia- I answered Hemochromatosis 77. pregnant at 34 wks. Hb 10.6. Treatment? 78. Acute fibrillation- Bisoprolol 79. one.women with low mood n at times.exessive shopping had bipolar right ? 80. the guy with difficult chest movement had an injury arnd the neck or sth which nerve was damaged ??? pherenic ??? 81. Bipolar non compliant with drugs, had acute attack of depression stabilised on antidepressants. prophylactic drugsmood stabilizers 82. Female with history of breast abscess several times, with discharge and bump at the junction of skin and areolamammary duct fistula 83. Crohn's disease, presenting with faeculant dischrge from vagina- i answered sigmoid colon 84. a women who had an injury of sternum now after ten has tender firm mass in the outer quadrant 85. Membranes ruptured 48 hours ago, baby has grunt breathing, intercostal recessions, temp-36.2, HR-145/min, RR- , investigation- I answered Chest Xray 86. baby with purulent stcky eye dschrge. Mangement

87. 8 weeks old baby with fever-38, ........ admit for infection screen and start IV antibiotics 88. pt was in gardn. Sudnly colapsd. Ecp showd incmplte heart blck 89. child developed jaundice few days after birth, fully breast fed, growing well, yellow stools- Breast milk jaundice 90. abt turner syndrome ... these pts have ovarian failure or wht ??? 91. Pt on morphine takes 60mg twice (120/day). Well controlled. Give 20mg every 4 hours by elixir (120/day) 92. wht abt the gout question which drug was causing the prob ... nsaid or colchinine or wht ??? 93. one was trauma with left sided abdominal tendernessspleen rupture? 94. 15 weeks pregnant, want to screen fetus for cong. anomalies- amniocentesis 95. what about..stroke featureStroke, CT- infarct- . initial management. aspirin 75 mg / clopido. i chose clopido. 96. child with oral lesion and palms and sole rash – coxsackie 97. rash in chld increasd with amoxil 98. chld had 3 atcks of tonsillitis last year, whats managementtreat when ill (all other options were for surgery) 99. man has joint painz, xray shows bony erosnz? Diagnsis 100. female wrkng in oldhome, have rash with intense itches. Whts mechansm? 101. mengiococal meningitis –ceftriaxone 102. every morning, cant extend his finger, straighten his ring finger and reduces it with a click- Mallet finger / Triger fnger? 103. pt on tamoxifn han intrmenstrual bleed. Inv? 104. post menupausl woman have vagnal bled. Inv? There were sep optnz of hystro and biopsy 105. diabtc pt lost central visn. Posible patholgy in retna or lense 106. a diabetc chld refuses to eat.and nt doing wel. Refr to where? Paedctrn, psycholgst,dietcn 107. cx cancer...smoking is a risk in her history?? 108. patient underwent lap cholecystectomy and one port below umblicus, which structure is pierced? I answered Linea

alba 109. Patient underwent TURp, what abnormality can be seen.... hyponatremia 110. Patient DM, HTN on medications, with constipation, confusion,polyuria and polydipsia, Calcium-3.04, serum electrophoresis- negative, Xray normal- drug inducedbendroflumethiazide 111. patient DM, immunosuppresed, treated for foot abscess, pain in back, tenderness L3-L4, fever, blood culture positive for stap. aureus. what investigation will u do? thought lumbar abscess- I answered Ct scan, was confused between, CT/MRI and nuclear bone scan 112. pt has tibia frctre. Pop aplied. Dvlopz pain. What l u do skin and pulses normal 113. Milestones>normal vs speech difficulties 114. Breast tender lump- inv ? 115. Prolapsed disc 116. Anterior MI ecg. Management? Pci / alteplase 117. 2nd ecg. Pericarditis / aortic dissection / PE 118. Testes drain para-aortic nodes 119. testicular torsion 120. multiple fracture history in old lady. Inv ? Dexa Scan 121. erythema multiforme 122. dense hemiplegia features. Which artery involved ? MCA 123. Eye involved, c/l hemiparesis. Which artery involved ? PCA 124. Absent femoral and popliteal pulses.. which site involved ? aorto-iliac, ilio-femoral, external iliac, internal iliac 125. Mass visible on chest . lymph node biopsy of hilum 126. Mediastinitis features 127. hypoglycaemia of alcohol 128. heroin addict want to end. Methadone 129. shy dragger syndrome 130. metronidazole for trichomoniasis 131. oral candidiasis treatment 132. h pylori antibodies negative. Symptoms persist. What is next best inv oesphagogastrodeudonoscopy 133. USG of pelvis and abdomen for unhealed PID 134. superficial inguinal lymphnodes for lesion on labia 135. 30 yrs old man, 2 days after urti- hematuria. Diagnosis ?

Iga / Post strep 136. cardiac tamponade 137. I/M adrenaline for anaphylactic 138. dressler syndrome. 2 wks Post MI 139. metabolic acidosis after diarrhea 140. bladder cancer- cystoscopy 141.Young woman worried about her weight, BMI 22, cleaning until 3 am, excessive spending shopping, Low Potassium. (Bulimia) 142.A woman paints her house, headache, fell. Investigation? (CT) 143.Pts having reduced central vision - which drugs responsible (I think this is cataract - s.e of corticosteroids) 144. *that pts with dm and reduced vision should be cataract too 145.H pylori serology can be negative while organism still present. Urea breath test is more sensitive. No.100 - this is scabies - allergic to organism skin and droppings 146.Child milestone is isolated speech delay. Children by 18 months old should have 6 words vocabulary. That child was 24 months old, can only say mama daddy and one other word The oral candida also has candida on throat - anti fungal suspension? Chlorhexidine mouthwash wont reach there. 147.There were quite a bit of hypercalcimea and drugs side effect and interactions.