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1. A 74yo man who has been a smoker since he was 20 has recently been dx with SCLC. What serum electrolyte picture will confirm the presence of SIADH?
a. High serum Na, low serum osmolarity, high urine osmolarity
b. Low serum Na, high serum osmolarity, high urine osmolarity
c. High serum Na, low serum osmolarity, low urine osmolarity
d. Low serum Na, low serum osmolarity, high urine osmolarity
2. A 67yo man after a stroke, presents with left sided ptosis and constricted pupil. He also has loss of pain and temp on the right side of his body and left side of his face. Which part of the brain is most likely affected?
a. Frontal cortex
b. Medulla
c. Cerebellum
d. Pons
3. A 47yo man has a temp of 39C and is delirious. He has developed blisters mainly on his trunk, which appeared a few hours ago. He is well and not on any medications. He last travelled 5 months ago to Italy. Which of the following is the most likely dx?
a. Shingles
b. Pemphigoid
c. Bullous pemphigus
d. Chicken pox
4. A 34yo alcoholic is found passed out in front of a local pub. The ambulance crew informs you that he was sweating when they found him and there were cans of cider lying empty around him. What is the initial stage of inv?
a. CT head
b. MRI head
c. Capillary blood sugar
d. ABG
5. A young boy fell on his outstretched hand and has presented with pain around the elbow. He has absent radial pulse on the affected hand. What is the most likely dx?
a. Dislocated elbow
b. Undisplaced fx of radial head
c. Posterior dislocation of shoulder
d. Angulated supracondylar fx
6. A 32yo man presented with painless hematuria. He is hypertensive but the rest of the exam is unremarkable. What is the most likely dx?
a. TTP
b. Polycystic kidneys
c. Ca bladder
d. Ca prostate
7. A 45yo female complains of pain in the inner side of her right thigh. She was dx with benign ovarian mass on the right. Which nerve is responsible for this pain?
a. Obturator nerve
b. Femoral nerve
c. Iliohypogastric nerve
d. Ovarian branch of splanchic nerve
8. A 79yo stumbled and sustained a minor head injury 2 weeks ago. He has become increasingly confused, drowsy and unsteady. He has a GCS of 13. He takes warfarin for Afib. What is the most likely dx?
a. Subdural hemorrhage
b. Extradural hemorrhage
c. Subarachnoid hemorrhage
d. Cerebellar hemorrhage
9. A 16m child presents with drooling, sore throat and loss of voice. He has fever with a temp of 38.2C. What is your next step towards management?
a. Call anesthesiologist
b. Direct pharynoscopy
c. Call ENT surgeon
d. IV fuilds
10. A young college student is found in his dorm unconscious. He has tachyarrhythmia and high fever. He also seems to be bleeding from his nose, which on examination shows a perforated nasal septum. What is the most likely dx?
a. Marijuana OD
b. Heroin OD
c. Alcohol OD
d. Cocaine OD
11. In CRF, main cause of Vit D deficiency is the failure of:
a. Vit D absorption in intestines
b. 1 alpha hydroxylation of Vit D
c. 25 alpha hydroxylation of Vit D
d. Excess Vit D loss in urine
e. Availability of Vit D precursors
12. A woman who returned from abroad after 3 weeks of holiday complains of severe diarrhea of 3 weeks. She also developed IDA and folic acid def. What condition best describes her situation?
a. Malabsorption
b. Jejunal villous atrophy
c. Chronic diarrhea secretions
d. Increased catabolism
13. A man presented with cellulitis and swelling. He was started on flucloxacillin. What other medication do you want to add?
a. Vancomycin
b. Metronidazole
c. Ceftriaxone
d. Penicillin
14. A 35yo man who has served in the army presents with lack of interest in enjoyable activities and feeling low. He doesn’t feel like reading the news or watching movies as he believes there is violence everywhere. What is the most appropriate first line therapy?
a. Citalopram
b. CBT
c. Lofepramine
d. Chlordiazepoxide
15. A 12yo child with episodes of sudden bluish discoloration and brief loss of consciousness. Exam: clubbing, central cyanosis, systolic thrill with systolic ejection murmur in 2nd left ICS. What is the most probable dx?
a. ASD
b. VSD
c. TOF
d. PDA
16. Pt with hx of alcoholism, ataxic gait, hallucinations and loss of memory. He is given acamprosate. What other drug can you give with this?
a. Chlordiazepoxide
b. Diazepam
c. Disulfiram
d. Thiamine
17. A 22yo woman with longstanding constipation has severe ano-rectal pain on defecation. Rectal exam: impossible due to pain and spasm. What is the most probable dx?
a. Anal hematoma
b. Anal abscess
c. Protalgia fugax
d. Anal fissure
18. A 32yo had a normal vaginal delivery 10 days ago. Her uterus has involuted normally. Choose the single most likely predisposing factor for PPH?
a. Retained product
b. Uterine infection
c. DIC
d. Von Willebrand disease
19. A butcher stabbed accidently his groin. He bled so much that the towel was soaked in blood and BP=80/50mmHg, pulse=130bpm. What % of circulatory blood did he lose?
a. <15%
b. 15-30%
c. 30-40%
d. 40-50%
20. An old alcoholic presents with cough, fever, bilateral cavitating consolidation. What is the most probable cause?
a. AFB
b. Gram +ve diplococcic
c. Gram –ve cocci
d. Coagulase +ve cocci
21. A 67yo man had successful thrombolysis for an inf MI 1 month ago and was discharged after 5days. He is now readmitted with pulmonary edema. What is the most probable dx?
a. Pulmonary stenosis
b. Aortic regurgitation
c. Ischemic mitral regurgitation
d. Mitral valve prolapse
22. A 3yo child who looks wasted on examination has a hx of diarrhea on and off. The mother describes the stool as bulky, frothy and difficult to flush. What is the single inv most likely to lead to dx?
a. Sweat chloride test
b. LFT
c. US abdomen
d. Anti-endomysial antibodies
23. A girl with hx of allergies visited a friend’s farm. She got stridor, wheeze and erythematous rash. What is the most appropriate tx?
a. 0.25ml PO adrenaline
b. 0.25ml IM adrenaline
c. 0.25ml IV adrenaline
d. IV chlorphearamine
24. A 25yo had an LSCS 24h ago for fetal distress. She now complains of intermittent vaginal bleeding. Observations: O2 sat=98% in air, BP=124/82mmHg, pulse=84bpm, temp=37.8C. The midwife tells you that she had a retained placenta, which required manual removal in the OT. Choose the most appropriate C-Section complication in this case?
a. Uterine rupture
b. Retained POC
c. Aspiration pneumonitis
d. Endometritis
25. A 20yo man has a head on collision in a car. On presentation his is breathless, has chest pain and fx of 5-7th rib. CXR confirms this. What is the most appropriate initial action in this pt?
a. Antibiotics
b. Analgesia
c. O2 by mask
d. Physiotherapy
26. A 30yo man presents with deep penetrating knife wound. He said he had TT when he left school. What will you do for him now?
a. Human Ig and full course of tetanus vaccine
b. Antibiotic
c. Human Ig and TT
d. Human Ig only
27. A mother comes with her 15m child. Which of the following will bother you?
a. Shies away from strangers
b. She can’t make a sentence
c. Can walk but not run
d. Vocabulary consists of only 2 meaningless words
28. A 46yo man, known case of chronic GN presents to OPD. He feels well. BP = 140/90mmHg. Urine dipstick: protein ++, blood ++ and serum creatinine=106mmol/L. Which medication can prevent the progression of this dx?
a. Diuretics
b. ACEi
c. Cytotoxic meds
d. Longterm antibiotics
29. After eating a cookie at a garden party, a child began to cough and went blue. The mother also noticed that there were swollen patches on the skin. What is the dx?
a. Aspiration of food
b. Allergic reaction
c. Cyanotic heart disease
d. Trachea-esophageal fistula
30. A 78yo lady on warfarin for atrial fibrillation lives in a care home. She presents with hx of progressive confusion for three days. She was also noticed to have bruises on her arms. INR = 7. What is the most probable dx?
a. Alzheimers
b. Delirium
c. Vascular dementia
d. Subdural hemorrhage
31. An 11m baby had an apnea event. The parents are worried that if something like this happens in the future, how they are to deal. Advise them about infant CPR.
a. Compression with palm of one hand
b. Compression with palm of two hands
c. Compression with rescue breaths 30:2
d. Index and middle finger compression
32. A 28yo business man came to the sexual clinic. He was worried that he has HIV infection. 3 HIV tests were done and all the results are negative. After a few months, he comes back again and claims that he has HIV. What is the dx?
a. Somatization
b. Mancheusens
c. Hypochondriac
d. OCD
33. A 19yo man has been happier and more positive than usual, with more energy than he has ever felt before for no particular reason. He has been getting more work done at the office today and has been socializing with his friends as usual. What is the most likely dx?
a. Atypical depression
b. Hypomania
c. Marked depression
d. Bipolar syndrome
34. A 44yo woman complains of heavy bleeding per vagina. Transvaginal US was done and normal. Which of the following would be the most appropriate inv for her?
a. Hysterectomy
b. Coagulation profile
c. Endometrial biopsy
d. CBC
35. A 38yo woman, 10d postpartum presents to the GP with hx of passing blood clots per vagina since yesterday. Exam: BP=90/40mmhg, pulse=110bpm, temp=38C, uterus tender on palpation and fundus 2cm above umbilicus, blood clots +++. Choose the single most likely dx/
a. Abruption of placenta 2nd to pre-eclampsia
b. Concealed hemorrhage
c. Primary PPH
d. Secondary PPH
36. A 16yo girl came to the sexual clinic. She complains of painful and heavy bleeding. She says she doesn’t a regular cycle. What is the most appropriate management?
a. Mini pill
b. IUS
c. Anti-prostoglandins
d. Combined pill
37. An old man comes to the doctor complaining that a part of this body is rotten and he wants it removed. What is the most likely dx?
a. Guilt
b. Hypochondriasis
c. Munchausen’s
d. Nihilism
38. A 47yo man who is a chronic alcoholic with established liver damage, has been brought to the hospital after an episode of heavy drinking. His is not able to walk straight and is complaining of double vision and is shouting obscenities and expletives. What is the most likely dx?
a. Korsakoff psychosis
b. Delirium tremens
c. Wernickes encephalopathy
d. Tourettes syndrome
39. A 24yo lady who is 37wk pregnant was brought to the ED. Her husband says a few hours ago she complained of headache, visual disturbance and abdominal pain. On arrival at the ED she has a fit. What is the next appropriate management for this pt?
a. 2g MgSO4 IV bolus
b. 2g MgSO4 in 500ml NS in 1h
c. 4g MgSO4 in 100ml 0.9%NS in 5mins
d. 4g MgSO4 IV bolus
40. A pt presents with complete anuria following prolonged hypotension and shock in a pt who bled profusely from a placental abruption. What is the most probable dx?
a. Post viral infection
b. Acute papillary necrosis
c. Acute cortical necrosis
d. HUS
41. A 58yo lady presented with urinary incontinence. She looks anxious for her condition. Urine culture is sterile. Her urodynamic study is normal. What is the next step?
a. Antibiotics
b. Pelvic floor exercise
c. Vaginal Pessary
d. Topical estrogen
42. A 53yo man presents complaining of weight loss, lethargy, increasing abdominal discomfort and gout for the pat yr. Exam: spleen palpated 5cm below left costal margin, no fluid wave. CBC: Hgb=10.5g/dL, WBC=200 – 85% neutrophils, plts=100, Na+=140mmol/L, K+ 4mmol/L, create=151umol/L, urea=7mmol/L. Serum B12 increased. Philadelphia chromosome +ve. What is the most likely dx?
a. CLL
b. CML
c. Lymphoma
d. AML
43. A lady presents with abdominal pain, dysuria, dyspareunia and vaginal discharge. What si your next step?
a. Laparoscopy
b. Hysteroscopy
c. High vaginal swab
d. Laparotomy
44. A 68yo male presented with swelling in the lower pole of the parotid gland for the last 10yrs. Exam: firm in consistency. What’s the most probable dx?
a. Parotid Cancer
b. Pleomorphic adenoma
c. Adenolymphoma
d. Mikulicz’s disease
45. A woman has numerous painful ulcers on her vulva. What is the cause?
a. Chlamydia
b. Trichomonas
c. Gardenella
d. HSV
46. A 56yo woman with MS presents with drooping of the left side of her lips. She also has loss of sensation over her face, hearing impairment and some in-coordination of her movements. What is the most likely anatomical site affected?
a. Cerebellum
b. Cerebrum
c. Spinal cord
d. Brain stem
47. A 1m boy has been brought to the ED, conscious but with cool peripheries and has HR=222bpm. He has been irritable and feeding poorly for 24h. CXR=borderline enlarged heart with clear lung fields. ECG=regular narrow complex tachycardia, with difficulty identifying p wave. What is the single most appropriate immediate tx?
a. Administer fluid bolus
b. Administer oxygen
c. Oral beta-blockers
d. Synchronized DC cardio-version
48. A 29yo woman presents to her GP with a hx of weight loss, heat intolerance, poor conc and palpitations. Which of the following is most likely to be a/w dx of thyroiditis a/w viral infection?
a. Bilateral exophthalmos
b. Diffuse, smooth goiter
c. Reduced uptake on thyroid isotope scan
d. Positive thyroid peroxidase antibodies
49. A 7yo girl has been treated with penicillin after sore throat, fever and cough. Then she develops skin rash and itching. What is the most probable dx?
a. Erythema nodosum
b. Erythema multiforme
c. Erythema marginatum
d. Erythema gangernosum
50. A 56 yo lady with lung cancer presents with urinary retention, postural hypotension, diminished reflexes and sluggish papillary reaction. What is the most likely explanation for her symptoms?
a. Paraneoplastic syndrome
b. Progression of lung cancer
c. Brain metastasis
d. Hyponatremia
51. A 63yo lady with a BMI=32 comes to the ED with complaints of pigmentation on her legs. Exam: dilated veins could be seen on the lateral side of her ankle. Which of the following is involved?
a. Short saphenous vein
b. Long saphenous vein
c. Deep venous system
d. Popliteal veins
52. A 72yo man is found to be not breathing in the CCU with the following rhythm. What is the most likely dx?
 |
a. SVT
b. VT
c. VF
d. Atrial fib
53. A 15yo boy presents with a limp and pain in the knee. Exam: leg is externally rotated and 2cm shorter. There is limitation of flexion, abduction and medial rotation. As the hip is flexed external rotation is increased. Choose the most likely dx?
a. Juvenile rheumatoid arthritis
b. Osgood-schlatter disease
c. Reactive arthritis
d. Slipped femoral epiphysis
54. A 65yo woman says she died 3m ago and is very distressed that nobody has buried her. When she is outdoors, she hears people say that she is evil and needs to be punished. What is the most likely explanation for her symptoms?
a. Schizophrenia
b. Mania
c. Psychotic depression
d. Hysteria
55. Which of the following formulas is used for calculating fluids for burn pts?
a. 4 x weight(lbs) x area of burn = L of fluids
b. 4 x weight(kgs) x area of burn = L of fluids
c. 4 x weight(lbs) x area of burn = ml of fluids
d. 4 x weight(kgs) x area of burn = ml of fluids
56. A 48yo farmer presented with fever, malaise, cough and SOB. Exam: tachypnea, coarse end- inspiratory crackles and wheeze throughout, cyanosis. Also complaint severe weight loss. His CXR shows fluffy nodular shadowing and there is PMN leukocytosis. What is the single most appropriate dx?
a. Ankylosing spondylitis
b. Churg-strauss syndrome
c. Cryptogenic organizing
d. Extrinsic allergic alveolitis
57. A 32yo woman of 38wks gestation complains of feeling unwell with fever, rigors and abdominal pains. The pain was initially located in the abdomen and was a/w urinary freq and dysuria. The pain has now become more generalized specifically radiating to the right loin. She says that she has felt occasional uterine tightening. CTG is reassuring. Select the most likely dx?
a. Acute fatty liver of pregnancy
b. Roung ligament stretching
c. Cholecystitis
d. Acute pyelonephritis
58. A pt with hodgkins lymphoma who is under tx develops high fever. His blood results show WBC
<2800 and has a chest infection. Choose the most likely tx?
a. Co-amoxiclav
b. Erythromycin
c. Piperacillin+Co-amoxiclav
d. Piperacillin+tazobactam
59. A 65yo presents with dyspareunia after sex. She in menopause. She complains of bleeding after sex. What is the most probably dx?
a. Cervical ca
b. Endometrial ca
c. Ovarian ca
d. Breast ca
60. A 6m baby had LOC after which he had jerky movement of hands and feet. What is the most probable dx?
a. Infantile spasm
b. Absence
c. Partial simple seizure
d. Atonic seizure
61. A primiparous woman with no prv infection with herpes zoster is 18wk pregnant. She had recent contact with a young 21yo pt having widespread chicken pox. What is the most suitable management for the pregnant lady?
a. Acyclovir PO
b. Acyclovir IV +IVIG
c. Acyclovir IV
d. IVIG
62. For a pt presenting with Parkinson’s disease which of the following drugs is most useful in the management of the tremor?
a. Apomorphine
b. Cabergoline
c. Selegiline
d. Benzhexol
63. A 60yo woman presents with acute onset of bone and back pain following a rough journey in a car. Exam: tenderness at mid-thoracic vertebra with spasm, she feels better once she bends forward. What is the single most probable dx?
a. Osteoporotic fx verterbra
b. Myofacial pain
c. Whiplash injury
d. MI
64. A 50yo lady with weak limbs when examined was found to have burn marks on finger tips, wasted and weak hands with diminished felexes. She also has weak spastic legs and dissociated sensory loss. What is the dx?
a. MND
b. MS
c. Syringomyelia
d. Guillian-barre
65. A 26yo woman being treated for a carcinoma of the bronchus with steroids presents with vomiting, abdominal pain and sudden falls in the morning. What is the most specific cause for her symptoms?
a. Adrenal insufficiency
b. Steroid side effects
c. Postural hypotension
d. Conn’s disease
66. A 42yo man has been tired and sleepy for the last few weeks in the morning. His work has starte getting affected as he feels sleepy in the meetings. His BMI=36. What is the single most likely dx?
a. Idiopathic hypersomnia
b. OSAS
c. Narcolepsy
d. Chest hyperventilation syndrome
67. A 9m child is brought to the ED with an irreducible firm swelling which descended into the left groin when the child has been crying. Exam: both testicles are palpable in the scrotum. What is the most appropriate management strategy?
a. Reassurance
b. Emergency herniotomy
c. Elective herniotomy
d. Emergency herniotomy + orchidopexy
68. A pt presents with progressive visual deterioration. Exam: large, multiple cotton wool spots in both eyes. What is the single most likely dx?
a. Kaposi’s sarcoma
b. Cryptosporidium
c. CMV infection
d. Pneumocystis carinii infection
69. A 32yo lady complains that she hears everyone saying that she is an evil person. What type of hallucinations is she suffering from?
a. 2nd person auditory hallucinations
b. 3rd person auditory hallucinations
c. Echo de la pense
d. Gedankenlautwerden
70. Which of the following reflexes and innervating spinal nerves are correctly paired?
a. Anal reflex – S1
b. Ankle jerk – L5
c. Biceps jerk – C7 & C8
d. Knee jerk – L3 & L4
71. A 50yo man complains of being pursued by the police for a crime he denies committing. He has poor concentration and impaired short-term memory. He admits to drinking large amounts of alcohol for the last 20yrs. What is the most probable dx?
a. Dementia
b. Hallucination
c. Wernicke’s encephalopathy
d. Korsakoff psychosis
72. A 16yo boy following a RTA was brought to the ED with a swelling and deformity in his right thigh. Exam: airway is patent and is found to have a pulseless leg. Which structure is involved in this fx?
a. Femoral artery
b. Posterior tibial artery
c. Common peroneal nerve
d. Dorsalis pedis
73. A 34yo man complains of arthralgia, abdominal pain and vomiting, a facial rash that is worse in the summer and hematuria. Urea and creatinine are slightly elevated with urinalysis demonstrating red cell casts. PMH is remarkable for childhood eczema. Which inv is most likely to lead to a dx?
a. US KUB
b. Joint aspiration
c. Auto antibodies
d. IVU
74. A 35yo man has a temp=39C, cough with purulent sputum and right sided chest pain on inspiration. He has herpes labialis. What is the single most likely causative organism?
a. Coagulase +ve cocci in sputum
b. Gram -ve diplococci in sputum
c. Gram +ve diplococci in sputum
d. Pneumocystis carinii in sputum
75. A 45yo woman presents with discharge from the left nipple. The discharge is brownish-green and foul smelling. What is the most likely dx?
a. Duct ectasia
b. Duct papilloma
c. Intra-ductal papilloma
d. Mammary duct fistula
76. A 10yo boy presents with generalized swelling. This has been present for 4days and included swollen ankles and puffiness of the face. It started a few days after he had a mild cold with runny nose. His only PMH was eczema. Urine analysis: hematuria, proteinuria 10g/24h, creat 60umol/l and albumin=15g/l. What is the single most likely dx?
a. IgA nephropathy
b. HSP
c. Minimal change nephropathy
d. Wilson’s disease
77. In perforation of a post gastric ulcer, where will the fluid accumulate in the peritoneal cavity?
a. Left paracolic gutter
b. Pelvic cavity
c. Lesser sac
d. Under the diaphragm
78. A pt on HTN drugs develops hyperkalemia. Which anti-HTN is likely to cause it?
a. Ramipril
b. Lorsartan
c. Thiazide
d. Nifedipine
79. A 24yo male on remand in prison for murder is referred by the prison doctor. He is noted to be behaving oddly whilst in prison and complains of seeing things. He has a prv hx of IV drug abuse. On questioning he provides inappropriate but approximate answers to all questions stating that Bill Clinton is the prime minister of England. What is the prisoner suffering from?
a. Capgras syndrome
b. Cotard syndrome
c. Ganser syndrome
d. Ekbom syndrome
80. A 27yo man presents to the ED after a RTA where his foot was stuck under a truck for several hours. He now has swelling on the foot. Exam: foot tenderness, loss of sense in the space between the 3rd metatarsal and big toe and his dorsalis pedis is not felt. What is the most likely dx?
a. Compartment syndrome
b. Arterial rupture
c. Arterial embolus
d. DVT
81. A pt with SNHL and loss of corneal reflex on the left side. What is the most definitive inv?
a. CT of internal auditory meatus
b. Nuclear imaging of brain
c. MRI brain
d. Radio isotope scan
82. A 45yo woman presents with rotational vertigo, nausea and vomiting, especially on moving her head. She also had a similar episode 2yrs back. These episodes typically follow an event of runny nose, cold, cough and fever. What is the most probable dx?
a. Acoustic neuroma
b. Meniere’s disease
c. Labyrinthitis
d. Vestibular neuronitis
83. A 65yo man with cancer of middle 1/3 of the esophagus presents with dysphagia. What is the most immediate management?
a. Chemotherapy
b. Radiotherapy
c. Stenting
d. Gastrostomy
84. A 1yo child is brought to ED. He woke up in the middle of the night crying severely. What initial measure should be taken for this child?
a. Refer to surgeon
b. Discharge with advice
c. Analgesia
d. Antibiotic
85. A 56yo man complains of increased vol of sputum with specks of blood and chest pain. He has a hx of DVT. Exam: clubbing. What is the cause of blood in his sputum?
a. Pulmonary thrombosis
b. Bronchial carcinoma
c. Bronchiectasis
d. Pulmonary TB
86. A female pt with HTN and serum K+=2.7mmol/l. which hormone would you be looking for?
a. Aldosterone
b. Cortisol
c. Thyrotoxin
d. Renin
87. A 30yo man comes with hx of early morning back pain and stiffness. Exam: red eyes. What is the single most appropriate option?
a. Iris
b. Ciliary body
c. Cornea
d. Conjunctivitis
88. A 70yo woman with longstanding anxiety is seen in the OPD. She complains of her heart skipping a beat quite often. This particularly occurs when she is trying to get to sleep. The palpitations are never sustained. What is the most likely rhythm disturbance?
a. SVT
b. VF
c. VT
d. V-ectopics
89. A 17yo has acute pain around his right eye, pain on one side of his face and ear ache too. What is the single most dx?
a. Ear wax
b. Ear foreign body
c. Dental abscess
d. Herpes zoster
90. A young man who has no PMH presented with jaundice, low Hgb, retics 8% and other indices WNL but occasional spherocytes were seen on blood film. What is the single most appropriate inv?
a. G6PD enzyme assay
b. Direct coombs test
c. Repeat blood film
d. Indirect coombs test
91. A 22yo man came to the hosp after an injury in his hand while playing basketball. Exam: avulsion of extensor tendon from the distal phalanx. What is the single most probable deformity?
a. Dinner fork deformity
b. Game keeper thumb
c. Mallet finger
d. Gun-stock deformity
92. A 28yo man is inv for recurrent lower back pain. A dx of AS is suspected. Which of the following inv is most useful?
a. ESR
b. XR sacro-iliac joints
c. HLA B27
d. XR thoracic spine
93. A 4yo girl is taken by her mother to the ED and complains of feeling unwell, urinary urgency and temp=39C. What is the single next best inv?
a. Catheter catch of urine
b. Clean catch of urine
c. US
d. IVU
94. A 6yo child fell on his nose 2d ago. His parents have now brought him with difficulty in breathing. Exam: fever, nasal bones are straight. What is the single most likely dx?
a. Nasal polyp
b. Septal hematoma
c. Septal abscess
d. Deviated nasal septum
95. A 12yo pt came to the OPD with complains of fever, malaise, weight loss, anorexia and productive cough. Exam: temp=39C, pulse=100bpm. His mother says that he has a hx of recurrent chest infections and he is not thriving well. What is the single most likely causative organism?
a. Pneumococcal pneumonia
b. Staphylococcus
c. Mycobacterium TB
d. Pseudomonas
96. A 4yo is brought to the ED by ambulance. His mother reports that he has been unwell with a sore throat for 8h. He is sitting on his mother’s knee and is tolerating an oxygen mask but looks unwell. He has constant noisy breathing and he is drooling saliva. His temp=39C. What is the most imp dx?
a. Acute asthma
b. Bronchiolitis
c. Croup
d. Epiglottitis
97. A 75yo man who has DM and HTN experiences acute monocular blindness which resolves after 1h. What is the most likely dx?
a. GCA
b. Optic neuritis
c. Lacunar infarct
d. Amaurosis fugax
98. A 26yo presents with prolonged constipation, blood on side of stool and very painful defecation. PR exam: very painful. What is the single most likely dx?
a. Ca Colon
b. UC
c. CD
d. Anal fissure
99. A 35yo man with painless left testicular enlargement for the past 6m which is increasing in size and 3x larger than the right side. There is no tenderness or redness. What is the most likely dx?
a. Testicular tumor
b. Hydrocele
c. Epididymal cyst
d. Epididymo-orchitis
100. A middle aged man who has had a hx of chronic sinusitis, nasal obstruction and blood stained nasal discharge. He now presents with cheek swelling, epiphora, ptosis, diplopia, maxillary pain. What is the single most likely dx?
a. Nasopharyngeal ca
b. Pharyngeal ca
c. Sinus squamous cell ca
d. Squamous cell laryngeal ca
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ANSWERS
1. | D | 2. | B | 3. | D | 4. | C | 5. | D |
6. | B | 7. | A | 8. | A | 9. | A | 10. | D |
11. | B | 12. | A | 13. | D | 14. | B | 15. | C |
16. | D | 17. | D | 18. | B | 19. | C | 20. | D |
21. | C | 22. | D | 23. | B | 24. | D | 25. | C |
26. | C | 27. | D | 28. | B | 29. | C | 30. | D |
31. | D | 32. | C | 33. | B | 34. | B | 35. | D |
36. | D | 37. | D | 38. | C | 39. | C | 40. | C |
41. | B | 42. | B | 43. | C | 44. | B | 45. | D |
46. | D | 47. | D | 48. | C | 49. | B | 50. | A |
51. | A | 52. | C | 53. | D | 54. | C | 55. | D |
56. | D | 57. | D | 58. | D | 59. | B | 60. | A |
61. | D | 62. | D | 63. | B | 64. | C | 65. | A |
66. | B | 67. | C | 68. | C | 69. | B | 70. | D |
71. | D | 72. | A | 73. | C | 74. | C | 75. | A |
76. | A | 77. | C | 78. | A | 79. | C | 80. | A |
81. | C | 82. | D | 83. | C | 84. | C | 85. | C |
86. | A | 87. | A | 88. | D | 89. | D | 90. | B |
91. | C | 92. | B | 93. | B | 94. | C | 95. | D |
96. | D | 97. | D | 98. | D | 99. | A | 100. | C |
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