2021 Flashcards
1
Q
progressive gait unsteadiness
electric shock in the cervical spine
has fibromyalgia and have shoulder and neck pain
Upper muscle extremity muscle strength is decreased
What is the cause?
A
Demyelinating polyneuropathy
2
Q
Lhermitte’s sign or the barber chair is often associated with
A
Multiple Sclerosis
3
Q
Most useful investigation for detecting gallstones and dilatation of common bile duct
A
Ultrasound
4
Q
helping in finding out cause of obstructive jaundice
A
ERCP
5
Q
PCOS trying from last 2 years not conceiving with high BMI took metformin, no USG finding given, asked next treatment?
A
Clomiphene
6
Q
Women came with very foul smelling discharge from vagina
A
Garnerella
7
Q
Swelling is irreducible, above the ligament
A
Indirect Inguinal hernia
8
Q
Visual loss on the Left eye
left eye ischemia, pupillae edema
inv?
A
Carotid Ultrasound
9
Q
3 wk history of intermittent pain to the hip
o/e shows limitation of movement
Diagnosis?
A
Slipped Femoral capital Epiphysis
10
Q
multiple, small infarcts in the Right Parietal and temporal lobes and mass in the left atrium
A
Intracardiac Tumor
11
Q
fever, weight loss, arthralgias and Raynaud Phenomenon
A
Atrial Myxoma
12
Q
abdominal or flank pain, low back pain, hematuria, Urinary tract infection, hypertension
A
Polycystic Kidney Disease
13
Q
cobblestone appearance
A
Intranasal decongestant
14
Q
bloody diarrhea, recurrent attacks of loose stools
A
Ulcerative Colitis
15
Q
Colicky abdominal pain
A
Crohn Disease
16
Q
34 wks gestation of severe RUQ pain
BMKI 38 kg/m2
Total Bilirubin 4.8 mg/dl
A
Acute Cholangitis
17
Q
She feels a lot of guilt
also fears being arrested by the police
A
Acute Stress Disorder
18
Q
insomnia following the birth of her son
decreased appetite and no interest seeing friends, appears restless and tearful
Diagnosis?
A
Postpartum Depression
19
Q
Man has burns 40% of her body, developed high gastric residual volumes and progressive abdominal distention. What is the next step?
A
Plain Xray Abdomen
20
Q
6 day old boy, breastfed and is gaining weight approximately born at 40 weeks gestation at primigravida, medial deviation of the forefoot what is the next step?
A
Karyotype analysis
21
Q
photophobia, history of flue like symptoms recently, On examination T 39, neck rigidity, Ct scan is normal, CSF reports glucose normal and cell count predominantly lymphocytes
What is the most appropriate management?
A
IV fluids and Observation
22
Q
tense bulging fontanelles
head enlargement
A
Hydrocephalus
23
Q
fecal leakage and hematocheiza
conjunctival pallor is present
Colonoscopy - reveals pallor with areas of mucosal hemorrhages and telangiectasia, symptom?
A
Radiation induced Proctitis
24
Q
A
Contact wit5h her previous doctor about prescription
25
Aboriginal child came to you with greenish discharge from nostrils and from ear. What is the most suspected sequel?
Hearing loss
26
A 15 yo boy with h/o sudden outburst of anger who is currently in a special school is now at verge of expulsion WHat would be the drug of choice?
Risperidone
27
Sigmoid Volvulus scenario
Which will lead to definitive diagnosis?
CT scan
28
female complaining RUQ pain, took 10 tab of paracetamol 12 hrs ago when you examined her there is tenderness, showed increase LFT + fever. What is the cause?
Cholangitis
29
25 yo female brought to the ER by the police, for verbal abuse and aggression at shopping center. She is barefoot wearing multi-colored scarf and her speech was classic example of word salad with pressured speech
Diagnosis?
Illicit drugs
30
Child presents with multiple small and large bruises on abdomen and limbs with fine small petechiae as well. What will you do to investigate to confirm the diagnosis?
FBC
31
15 year old woman goes to your clinic worried about last night after drinking
had sex with an unknown man
She took the morning pill and now asking advice.
What is the most appropriate next step?
Reassure
32
A man with SOC, ph. 7.29, oxygen 60 mmHg and carbon dioxide 50 mmHg. Bicarbonate high.
Partially compensated respiratory acidosis
33
Patient on meds with RA causes tiredness - Which med is this
Ibupofren
34
Man complained of Allergic Rhinitis which interferes with his sleep. Pale turbinates and nasal congestion at night. What is the treatment?
Inhale Fluticasone Daily
- intranasal steroids are the treatment of choice for persistent moderate to severe allergic rhinitis.
35
Man MMSE 25 before trial. He live with his son (caregiver). During trial his MMSE was 15. You think it is due to drug from trial. Who do you ask to remove him from trial?
Patient himself
36
Patient with lump FNAC shows breast cancer estrogen reuptake negative progesterone reuptake negative BRCA positive. What is the most appro?
Mastectomy with Axilliary Clearance
37
if the lump is 3-4 cm
Breast Conversation Surgery
38
crackles on the base of the chest
Pulmonary Embolism
39
High grade fever
Foul smelling sputum is present
Aspiration Pneumonia
40
Patient with Hereditary Spherocytosis,lethargic anemic HB and decrease platelet what to do next?
RBC transfusion (because HB very low)
41
Tetanus dirty wound vaccinated before but booster dose given 7 years back
What is the next step?
ADT
42
Pic of a child that look like he has an impetigo
Topical Mupirocin
43
Patient presents with obsession. he counts 20 then repeats again had trauma 2 months ago now pressured speech and sleep more what is the diagnosis?
Adjustment Disorder
44
Female patient with LSIL what is your most approp step?
Repeat test after 12 months
45
A man with past psychiatric h/o is presented to court his lawyer comes to you as his GP for his Medical reports. What is the next step?
Consent of patient
46
Patient had catheter passed in Subclavian vein now after 2 days flushing of face unable to move hand what inv should you do next?
USG
47
75 yo taking shower slips fell on floor with outstretched hand radius fracture Vit D 55Hb10.5 PLT 80 Xray shows osteoporosis in regard to fracture stabilization what will you add to treat>?
Alendronate
48
Patient with Schizophrenia on Risperidone came for checkup when sits on chair he's crossing legs then relaxing then crossing what condition best explains?
Akathisia (motor restlesness, unable to sit, has to keep moving legs add propanol)
49
irregular and diagnosed with atrial fibrillation, creatinine ratio increased GFR less than 30/min
What to add in the therapy?
Warfarin (CHADVASC 2 or more)
50
8 yo comes with mother his teacher say he doesnt obey command he is aggressive hyperactive poor school performance IQ ok language slurred most likely diagnosis?
ADHD
51
Aggressive, hyperactive, poor school performance IQ, ok language slurred most likely diagnosis?
ADHD
52
Impaired non verbal communication
Asperger
53
Motor and vocal tics present
Tourette
54
Syncope and Angio Done, carotid stenosis < 30% next approp step of management?
Aspirin
55
Most common side effect of Risperidone
Gynecomastia
56
mentally dead inside and withdrawn not sleeping for 2 wks, anxious.
Acute stress Reaction
57
Type 1 Diabetes 9yo grl mother monitors 8-9 mmol/L in hospital. 2 reason of difference
Expired Strips
58
Patient with hematemesis and repeated vomiting what to do next?
Endoscopy
59
45yo farmer with soiled lacerated wound had simple scratch wound 5 days ago for which he received a DPT. No other h/o vaccination what is the most appro after debridement
TT and TIG
60
10month child brought to a routine well-child visit. The mother discloses that the child is clingy, fussier, and cries when picked up by others.
Normal development (separation anxiety)
- can start from the child's first bday and can last until they turn 4 years old.
61
48F, comes in with urine leakage problem. She voids frequently day and night. Has intense urge to urinate bust passes only a small amount. Next step?
Urine Microscopy
62
achy joint pain in the lower back, shoulders hips and knees
excessive sweating, polyuria and erectile dysfunction
has an enlarged tongue and hand reveals widening of the joint spaces, low testosterone and hyperglycemia
Diagnosis?
Acromegaly
63
2 occurrences of green
dry mucous membrane and mildly sunken anterior fontanelle
Plain Xray abdomen - to look for double bubble sign in volvulus or duodenal atresia
64
Unstable affect, mood swings, marked impulsivity, unstable relationships, suicidal behaviours, chronic feelings of emptiness of boredom
Borderline Personality Disorder
65
pregnant woman with painful goitre
TSH low T3 and T4 normal. Which of the following confirms the diagnosis?
Iodine Scan
66
gallstone due to pancreatits , CBD 10 cm
ERCP
67
What vaccine is contraindicated in a child with nephrotic syndrome currently on corticosteroid therapy?
MMR
68
What vaccines are contraindicated in immunosuppressed children
BCG, MMR, MMRM
69
28wks pregnant. Contact with child having chicken pox. Known history of chicken pox at childhood. What is the next step?
Reassure
70
Patients taking metformin, Verapamil, Revostigmine, perindropil. Now came with 3 degree heartblock. Which drug should be ceased?
Verapamil
71
Patient has claudication on walking and relieved on rest
Patient femoral pulses are diminished and dorsal pedis not felt. ABI one leg 0.8 and another 1.3
Most appro?
CT angiography
72
Boy fell down from the ladder and complain of severe headache and vomiting ever since arrived
Do series of skull Xray
73
5th metacarpal fracture and treatment
Below elbow cast
74
Patients dad was diagnosed with prostate cancer at age 85
he is healthy
do PSA every 2 years
75
Gross hematuria and proteinuria
USG is normal
Next inv?
Urine microscopy
76
60yo man difficulty in climbing stairs and not able to comb hair, difficulty in abduction
diagnosis?
Polymyalgia Rheumatica
77
pain in the proximal muscles + increased ESR
Polymyalgia Rheumatica
78
ocular (ptosis) facial weakness + limb weakness +
Myasthenia gravis
79
UMN type of lesion + optic neuritis
MS
80
both UMN and LMN type of symptoms
MND
81
Girl collapsed and lost a pulse had to do CPR and had to revive her
\sent to the hospital in ambulance
appro management?
Admit her under cardiac area
82
patient has anemia, macrocytic, thrombocytopenia, abnormal granulocytes. What is the inv of choice to confirm?
Serum B12
83
Macrocytic anemia is due to
1. Vitamin B12 def
2. Folate deficiency
84
Patient attained menopause having hot flush
Want to start HRT
Which is the right management?
continuous oestrogen and cyclical progesterone?
85
long term management of PCOS
Weight loss
86
Patient having primary amenorrhea
no improvement with progesterone challenge
next inv?
USG and Abdomen
87
PAtient is known case of RA on methotrexate and hydroxycloroquine
Want to get pregnant
what's next
Stop methotrexate and continue hydroxychloroquine
88
Patient has history of hematemesis following Ibupofren took for arthritis. It was treated with omeprazole and has gastric ulcer. Management?
Clopidogrel
89
Exercise induced asthma What to do?
Inhaled salbutamol
90
Patient with resting tremors
Levodopa
91
Resting tremors
Parkinsons disease
92
Postural tremor
Hyperthyroidism, anxiety, BET, physiological
93
cerebellar disease
Intention tremor
94
Young woman pain post-coitus, examination normal except left cervical motion tenderness?
Endocervical swab
95
low back pain for several months
no comorbidities present
no history of IV drug abuse
next step?
Xray Lumbo Sacral Spine
96
10 years use of OCP causes what carcinoma
Breast
97
5 or more years of OCP used are at increased risk of developing
Cervical Cancer
98
COPCPS provide some protection against
Endometrial and Ovarian Cancer
99
65Yo M, presents with heart burn and he is on PPI, endoscopy shows low grade dysplasia
What is the msot approp step regarding surveillance
Repeat every 6 months
100
14yo female, pregnated by the uncle is 20wk pregnant. What should you do?
Call the police
101
15yo female patient was homeless for 3 years and she comes with 10 wk pregnancy with ehr 17 yo boyfriend and wishes to terminate the pregnancy
What should you do?
Accept her request
102
complain of infertility for 24 months and has hx of 6 wk abortion of a previous pregnancy when she was 16. Was treated for PID 1 year ago. Which of the ff contributed to infertility?
PID hx
103
Painless lip swelling and face (angioedema) every week and so does her mother and brother. What do you do next?
C1 esterase inhibitor assay
104
Female patient tonic clonic seizure 1st episode xray CT blood test normal she takes only people community transfer one place to another what is your advice
Cant drive for 6 months
105
Patient booked an appointment ask if possible to meet outside
Say not possible
106
75yo man comes with periodic substernal chest pressure
significant for hyperlipidemia
Smokes a pack of cigarettes daily
he is prescribed with sublingual nitroglycerin to take as needed when anginal pain occurs and daily medication to help prevent anginal episodes
Medication functions through?
Coronary Artery vasodilation
107
62F, involved in a motor vehicle collision.
Weakness of hand grip bilaterally and the triceps reflex is decreased on both sides
Decreased pinprick sensation is present on the fingers
What is the cause?
Brachial plexus injury (uncommon)
108
becomes irritable and sleeps poorly
reacts negatively and always seem on the edge and worries about almost everything
feels tired and has difficulty concentrating
diagnosis?
Generalized Anxiety disorders
109
nulliparous woman complains of lower abdominal discomfort and chronic constipation
cramping with menses
enlarged uterus and irregular and mobile with prominent posterior mass
best nxt step?
Pelvic USG
Pssible dx- Leiomyoma
110
Sunburst appearance
Osteosarcoma
111
Auscultation of the lungs show decreased air antry into the left lower base
next step?
Chest Xray
112
multiple drug for multiple morbidity
lab finding increased NA k =6.5 and creatinine =1.7 anaemia
What is the next most approp step?
IV glucose with insulin
113
