INICET MINI MOCK

 E-BOOKS

 

GET IT AT https://telegram.me/Abins_007 

  

 

GET IT AT https://telegram.me/Abins_007

 

 

QUESTIONS

 

1. A primipara at fullterm in labor has passed show and the cervix is 3cm dilated. What is the single most appropriate management for her labor?

a. Repeat vaginal examination in 4h

b. CTG

c. IV syntocin drip

d. Repeat vaginal examination in 2h

 

2. A 36yo pregnant woman comes for evaluation with her husband. Her husband has been complaining of morning sickness, easy fatiguability and even intermittent abdominal pain. What is the husband suffering from?

a. Ganser syndrome

b. Couvade syndrome

c. Pseudo-psychosis

d. Stockholm syndrome

 

3. A woman comes to the ED complaining of pain in the right side of the abdomen, she has 7wks amenorrhea. Her pregnancy test is +ve and US scan shows an empty uterus. What is the next step?

a. Laparoscopy

b. HCG measurements

c. US

d. Laparotomy

 

4. A 23yo woman who has had several recent partners has experienced post-coital bleeding on gentle contact. What is the single most likely cause of her vaginal discharge?

a. Cervical ca

b. Cervical ectropion

c. CIN

d. Chlamydial cervicitis

 

5. A 68yo woman presents with post-coital bleeding following her first episode of sexual intercourse in 10yrs. What is the single most likely cause that has led to post-coital bleeding?

a. Endometrial ca

b. Atrophic vaginitis

c. Endometrial polyp

d. Cervical ca

 

6. A 28yo woman 8wks GA had PID treated prvly and now comes with vaginal bleeding, rigid abdomen, BP=80/50mmHg, pulse=140bpm. What is the most probable dx?

a. Threatened abortion

b. Miscarriage

c. Missed abortion

d. Tubal pregnancy

 

 

7. A pt presents with headache, blurring of vision and acuity loss. On fundoscopy, dots and blots were noted with huge red swollen optic disc. What is the most probable dx?

a. CRAO

b. Branch RAO

c. CRVO

d. Optic atrophy

 

8. A 25yo primigravida of 8wk GA presents with severe lower abdominal pain, vaginal bleeding and passage of clots. The internal os is open. What is the most likely dx?

a. Appendicitis

b. Placental abruption

c. Ectopic pregnancy

d. Abortion

 

9. A man developed intense pain after using the end of a pencil to scratch his inner ear. He took out the pencil from his ear and realized the end of the pencil with the rubber part is still stuck in his ear. What is the most appropriate management?

a. Remove with a hook

b. Instill olive oil

c. Remove GA

d. Remove with magnet instrument

 

10. A 49yo man first presented with increasing difficulty in swallowing. Several months later he developed weakness in his right foot. Now he can no longer feed himself, he chokes on food and has become confined to a wheelchair. What is the most likely dx?

a. Cerebral tumor

b. Myasthenia gravis

c. Lambert-Eaton syndrome

d. Motor neuron disease

 

11. A 10yo boy with lower abdominal pain for the last 10d presents with a hx of passing 6-8 loose stools. Temp=38.8C. He is tender in the right lower quadrant and has an anal fistula. Choose the single most likely cause of abdominal pain.

a. IBD

b. IBS

c. Pyelonephritis

d. Uretric calculus

 

12. A 28yo woman with hx of drug addiction wants to start a family and have a baby. She would like to stop taking heroin and asked for something to help her stay away from it. What drug tx would you give her?

a. Naloxone

b. Acamprosate

c. Methadone

d. Chlordiazepoxide

 

 

13. A pt with vesicles in the maxillary divison of trigeminal nerve. Which area of mucus membrane will be involved?

a. Palate

b. Cheek

c. Cornea

d. Conjunctiva

 

14. A 52yo man presents with visual hallucinations and features of cognitive impairment. What is the most likely dx?

a. Frontotemporal dementia

b. Lewy body dementia

c. Delirium tremens

d. Alzheimer’s disease

 

15. A 40yo woman who has recently returned from working in the middle east complains of thirst, episode of loin pain, urinary frequency, dysuria and has passed a urinary stone. All inv are normal. She plans to return to the Middle East in a month’s time. What is the songle best advice to prevent recurrent stone formation?

a. Drink less milk

b. High fibre diet

c. Increase fluid intake

d. Low calcium diet

 

16. A 32yo man presents with 3d of scrotal pain. Exam: thickening o the left testis and it is hot to touch. What is the most appropriate management?

a. Analgesia

b. Reassurance

c. Antibiotics

d. Referral to surgeon

 

17. A 34yo woman presents with truncal obesity, easy bruising, hyperglycemia, high BP and depression. Which of the following inv’s will be most helpful in localizing the cause for Cushing’s syndrome?

a. Serum cortisol

b. 24h urinary cortisol

c. Low dose dexamethasone suppression test

d. High dose dexamethasone suppression test

 

18. A 22yo man presents with a red, hot, swollen, metatarsal phalangeal joint, sarcoilitis and onycholysis. What is the single most likely cause of his condition?

a. Gout

b. RA

c. Reiter’s syndrome

d. Psoriatic arthropathy

 

19. Which of the following conditions requires operative management?

a. Cellulitis

b. Dyshidrosis

c. Erysipelas

d. Fournier’s gangrene

 

20. A 55yo pt presents with collapse and complains of abdominal pain that radiates to the back. An expansile abdominal mass if felt on examination and the pt is in shock. What is the single most likely dx?

a. Ruptured aortic aneurysm

b. Renal colic

c. Trauma

d. Endocarditis

 

21. A house-bound 78yo man with severe COPD has had a gradual deterioration over recent months and is now breathless at rest. He is on maximal inhaled medical therapy. Result: pH=7.36, PaCO2=5.9kPa, PaO2=6.9kPa. What is the single most appropriate additional tx?

a. Aminophylline PO

b. ACEi PO

c. Antibiotic PO

d. Oxygen

 

22. A 79yo man has a swelling of the right groind which was clinically dx to be indirect inguinal hernia. What is the single feature of the hearnia sac that would confirm the dx?

a. Comes through femoral ring

b. Doesn’t pass through the deep inguinal ring

c. Lies below and lateral to the pubic tubercle

d. Passes through the deep inguinal ring

 

23. A 56yo woman with hx of breast cancer 10y ago has undergone radical mastectomy and axillary LN removal, now complains of swollen upper limb 3wks after an insect bite. The bite site is better but gross edema is still present. What is the cause?

a. Lymphedema

b. Breast Ca

c. Allergy

d. Filariasis

 

24. An 11yo boy came to the hospital with pain after falling off his bicycle. XR= fx at distal radius with forward angulations. What is the single most probable dx?

a. Dinner fork deformity

b. Cubitus valgus

c. Gun stock deformity

d. Garden spade deformity

 

25. A middle aged man with a lump in front of his neck which moves up while he’s swallowing. US shows a mass replacing the left lobe of thyroid. And spread to the sternocleidomastoid and adjacent muscles. What is the most probable dx?

a. Thyroid ca

b. Pharyngeal pouch

c. Bronchus ca

d. Thyroid cyst

 

26. A 28yo male complains of severe pain while trying to grasp any object. It started since he participated in skiing and had a fall and caught his thumb in the matting. Exam: rupture of the ulnar collateral ligament of MCP joint of the thumb. What is the single most probable deformity?

a. Dinner fork deformity

b. Game keeper thumb

c. Mallet finger

d. Gun stock deformity

 

27. A HIV +ve 55yo man presents with painless lymphadenopathy, fever, night sweats and weight loss. What is the most probable dx?

a. Hodgkin’s lymphoma

b. NHL

c. ALL

d. AML

 

28. A 22yo man says that he can hear the voice of his deceased uncle telling him that he is being spied on. The pt is distressed by this becoming low in mood and anxious and has not left the house for 2wks. He is starting to drink increasing quantities of alcohol. He is noticed to have thought-block and passivity phenomena. What is the single most suitable med to treat his  symptom?

a. Diazepam

b. Disulfiram

c. Fluoxetine

d. Olanzapine

 

29. A middle age Asian presents with episodes of fever with rigors and chills for last 1yr. Blood film: ring form of plasmodium with schuffners dots in RBCs. What is the drug to eradicate this infection?

a. Doxycycline

b. Mefloquine

c. Proguanil

d. Quinine

 

30. A 50yo man presents with flight of ideas which are rambling and disinhibited. He is distractible, confused and overactive. What is the most likely dx?

a. Dementia

b. Mania

c. Schizophrenia

d. Psychosis

 

31. A pt presents with a lid lag, bulging eyes, opthalmoplegia and thyroid bruit. What inv will you do?

a. TFT

b. Eye sight

c. Tensilon test

d. US

 

32. A 30yo lady complaining of right ear deafness with decreased corneal reflex and past pointing. Acoustic analysis shows SNHL. What is the next most appropriate inv to do?

a. CT brain

b. CT acoustic canal

c. MRI brain

d. MRI acoustic canal

 

33. A 29yo woman who returned from Egypt 2wks ago now presents with difficulty in breathing, chest pain, cough and purulent sputum with an episode of blood staining. She is on COCPs. What is the most likely dx?

a. Pulmonary embolism

b. Pneumonia

c. Lung abscess

d. Pneumothorax

 

 

34. A 37yo man presents with some raised lesions on the shin. He came with cough and also complains of arthralgia. Exam: bilateral hilar lymphadenopathy and erythema nodosum is present. What is the single most likely cause?

a. CD

b. UC

c. Sarcoidosis

d. Streptococcal infection

 

35. A young lady with cervical ectropion bleeds on touch. What is the most appropriate next inv?

a. Transvaginal US

b. Cervical smear

c. Punch biopsy

d. Serum estradiol

 

36. A 28yo man with recent onset of dyspepsia after eating spicy food and alcohol consumption. H. pylori fecal antigen was negative. He returns after 1m with similar symptoms despite being given omeprazole 40mg. What is the single best initial inv?

a. Hydrogen breath test

b. Gastroscopy

c. Barium meal

d. None

 

37. A pregnant woman returns from Sudan, now presenting with intermittent fever, rigor and seizures. What is the dx?

a. TB

b. Malaria

c. Meningitis

d. Lyme disease

 

38. A pt is unresponsive and cyanosed. What is the most definitive 1st step in ?

a. Chest compressions

b. Check airway

c. Call 999

d. Mouth to mouth

 

39. A man was bitten by a drug addict and comes to the hosp with a wound. What inv should be undertaken?

a. Hep C

b. Lyme disease

c. Hep B

d. Syphilis

 

40. An 18yo woman says that she can’t walk around as she is very big for that room. What is the most likely hallucination?

a. Extracampine visual hallucinations

b. Liliputian visual hallucinations

c. Alice in wonderland syndrome

d. Hypnagogic hallucinations

 

41. A middle aged lady presented with fever, altered sensorium, bleeding gums and jaundice. Labs: deranged renal function tests, normal PT/APTT, fragmented RBCs and low plts. What’s the most likely dx?

a. Cholesterol emboli

b. HUS

c. TTP

d. Hepatorenal syndrome

 

42. A child came to the ED with severe asthma and not responding to salbutamol nebulizer and vomiting many times. What is the most appropriate management?

a. Salmetrol

b. Montelukast

c. Prednisolone

d. Budesonide inhaler

 

 

43. A 23yo woman presents with offensive vaginal discharge. Vaginal pH=4.5. What is the most likely organism?

a. Gardenella

b. Trichomonas

c. Candida

d. Mycoplasma

 

44. A 62yo man has had ano-rectal pain aggravated by defecation for 3d. Rectal exam: purple, tender lump at the anal verge. Flexible aigmoidoscopy: normal rectal mucosa and hard feces. What is the best management strategy?

a. Anal hematoma

b. Anal fissure

c. Rectal ca

d. Diverticulitis

 

45. A 43yo presents with severe vertigo on moving sidewards whilst sleeping. What test would you do to confirm the dx?

a. Hallpikes maneovure

b. Romberg’s test

c. Trendelenburg test

d. Heel-shin test

 

46. A 34yo man has an intermittent epigastric pain for 3wks. It is worse by food but helped by some tablets he obtained from the pharmacy. He had a similar episode 3yrs ago and his doctor gave him a course of 3 types of tablets at the time. What is the most appropriate next inv?

a. Abdomen US

b. Barium meal

c. Serum H.Pylori antibodies

d. C13 urea breath test

 

47. A girl with sickle cell anemia has painful bleeding and vaso-occlusive crisis during her periods. What is the best possible management for this pt?

a. COCP

b. Tranexamic acid

c. Copper IUS

d. Depot provera

 

48. A 70yo pt comes with swelling in the parotid region for the last 10y. Exam: gland is soft and cystic. Choose the most probable dx?

a. Pleomorphic adenoma

b. Carcinoma of the salivary glands

c. Mikulicz’s disease

d. Adenoid cystic carcinoma

 

49. A 74yo man has been admitted unconscious with no hx. He has a GCS=6 and a dilated left puil which becomes insensitive to light. What is the single most likely dx?

a. Extradural hematoma

b. Meningitis

c. Opioid OD

d. SAH

 

50. A 27yo man presents to the ED with 2d hx of severe headache and pyrexia (38.9C). CT: petechial hemorrhage in the temporal and inf frontal lobes. What is the most likely dx?

a. Brain abscess

b. Meningococcal meningitis

c. Cerebral malaria

d. Herpes simplex encephalitis

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS

 

1.A

2. B

3. B

4. D

5. B

6. D

7. C

8. D

9. A

10. D

11. A

12. C

13. B

14. B

15. C

16. C

17. D

18. D

19. D

20. A

21. D

22. D

23. A

24. D

25. A

26. B

27. B

28. D

29. B

30. B

31. A

32. C

33. B

34. B

35. B

36. B

37. B

38. B

39. C

40. B

41. C

42. A

43. A

44. A

45. A

46. D

47. D

48. D

49. D

50. D