SHAKOREE'S NOTES OF AMC MCQ RECALLS JUNE 2018 Dr. Omar Shakoree
Dr. Omar M. G. Shakoree (MBChB) SHO A&E Surgery Department of Emergency Sulaymaniah teaching hospital Sulaymaniah, Iraq. E-mail:
[email protected]
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For my family For my teachers For my colleagues For my patients For better care I collected these notes Omar Shakoree
In these notes you may see a non-solved MCQs, this happen because these MCQs are not completely written by the recallers, never mind you can ust pass it and go for the next, you will find it in next few papers . Here, you will find bulks of MCQs collected from every website and social media, and brings together. The recalls for passing AMC MCQ Exam are very important, some will get 90% of recalls during there exam, others may get 10%, the average of repetition of recalls is about 45-60% of your exam.
BULK ONE 1.Woman patient has been booking late afternoon bookings for .. months. She feels lonely and later become attracted to the doctor. One week later , she called the hospital for home visit for tonsillitis. What will be ur advice? a) Visit her home with surgery staff member b) Explain her that she will not be seen by that doctor anymore c) Tell her to come to emergency depertment d) Ask her to call other medical services BBBBBBBBBBBBBBBBBBBBBBBBBBBBB 1. 4 years old girl. Mother notice purulent amount of blood in her underwear for 10 days. On examination , there is small amount of blood stained in vulva. What is ur first step in the management? Not developed any pubic hair and no breast development. a) Report child protective service immediately for sexual abuse. b) Microsopic blood culture of the Swab from the vulva c) oral Amoxil (not sure) AAAAAAAAAAAAAAAAAAAAAAAA
2.
. Old woman with urgency and nocturia for a long time. Now having incontinence for like a month. She couldn't reach the toilet downstairs. She also has bilateral knee OA. What is the best management for her? A. Fluid restriction at night B. Install a camode in her bedroom. C. Oxybutynin D. Paracetamol CCCCCCCCCCCCCCCCCCCCCCCCCC
3. 52 years old woman with incontinence of urine during coughing and laughing. Her laughing. Her urodynamic study shows that her incontinence occurs during low volume study. study. On examination she had mild rectocele. Her symptoms showed some improvement after pelvic floor exercise but she could not satisfied this result. What will your appropriate step management? A-Bladder neck suspension B-Topical Estrogen cream C-Weighted vaginal cones Do not remember AAAAAAAAAAAAAAAAAAAAAAAAAAAA 4. Men 35 years with history of difficulty in micturition for 2 years. Difficult to start and dribbling at the end of micturition. a) BPH b) Bladder stone c) Urethral stricture d) Urethral valve e) Cancer (not sure) CCCCCCCCCCCCCCCCCCCCCCC………..YOUNG CCCCCCCCCCCCCCCCC CCCCCC………..YOUNG AGE
5.
Old man with urinary incontinence. Not severe but it causes a problem when he goes out. First step of Mx? a) Pelvic floor exercise b) Bladder train c) Prazosin d) Anticholinergic agent BBBBBBBBBBBBBBB………….if BBBBBBBBBBBBBBB…… …….if scenario of urge incontinence inco ntinence
6. a)
Women with UTI and she suffer from significant persistent pain. She is also depressed, insomnia , low mood, etc. Mx? Tramadol
b) Diazepam c) Citalopram d) Diclofenac …………..none………….best is amytriptilline ……..drug of choice if combined pain+ depression Woman with yellow eye with facial palsy pic (same option) 7. Diabetes ulcer on the foot pic. diabetic pt, non healing ulcer, pic 2 ulcers in medial malleolus, and foot pulses not pulpable. X ray already done. what to do for Mx? A) blood culture B) white cell scan C) swab from ulcer D) venous dupplex USG E) MRI foot EEEEEEEEEEEEEEEEEEEEEEEEEE If says discharge from the ulcer ………..CCCCCCCCC
8. 14 month baby who has history of roll over on 4 month, sitting without support from 8 month , claps hand, plays peak a boo, now has started walking without support, moves things from one hand to other , babbling but no words... normal development Gross motor delay Fine motor delay Social delay Speech delay 23 year old woman, choatic anxious agitated, multiple wrist lacerations. This happens post breakup with boyfriend. Admitted. Shouts on nurses. Found ith inflated bp apparatus around neck. Cause:
A. Passive agression B. Acting out C. Schizophrenia D. Genuine attempt of suicide DDDDDDDDDDDDDDDDDDDDDDDDDD 15 years Boy previously a good student now present with agitation , violent , admit to occasional marijuana use, multiple needle marks on forearm but don’t want to talk about it. a) Respiridone b) Paroxetin c) Methylphenidite BBBBBBBBBBBBBBBBBB………….only BBBBBBBBBBBBBBBBB B………….only accepted ……….cannot use u se antipsychotics with agitation of drug addicts
1. Patient had history of pancreatitis. Some time ago .now presented with distension tenderness visible vessels percussion positive 37.5 temp liver enzymes raised, confused and slightly drowsy. Dx 1. Bud chiari 2. Pancreatitis 3. Alcoholic cirhosis ( dont remember other options) 4. Spontaneous bacterial peritonitis Old scenario and the temperature was elevated ……….DDDDDDDDDDD If normal temperature ………….AAAAAAAAAAAAAAA
2.
patient comes for dryness of eyes for 3 years.... all tests for sjogren positive. ANA(+) ,. Ask for the next tx A Hydroxychloroquine B steroid C methotrexate D hypomallose tears
E. prednisolone eye drops DDDDDDDDDDDDDDDDDDDDDDDDDDDDDDD 12 week pregnant with lower abdominal pain. Normal nuchal usd at 11wk. Heavy PV bleeding, BP 80/50 incomplete miscarriage Rupture ectopic Missed miscarriage. AAAAAAAAAAAAAAAAAAAAAAAAAAAA
level You are a doctor in a town, where 6 people out of 100 are non-smoker. What are the chances of stroke. The chances of stroke in smoker is 50%more than nonsmoker. Now the pharmaceutical company is introducing a medicine which reduces the chances of stroke by 1/3rd in smoker population. What is the percentage of the smoker population ill get stroke due to drug? 1. 4% 2. 6% 3. 9% 4. 12% 5. 20% BBBBBBBBBBBBBBBBBBBBBBBBBB 3.
37 ek pregnant lady with mild pre-eclampsia for induction of labour. Bishop score 2.What will you do? Elective LUCS Induction with PGE 1 and ARM after 4 hours Induction with PGE 2 and ARM after 12 hours. Urgent LUCS Syntocinon infusion
CCCCCCCCCCCCCCCCCCCCCCCCCC Mother 41+ 3 days with no abnormality. Previous child born by LSCS due to obstruction of labor. Bishop score 2. a) Induction with prostaglandin b) Induction with ARM c) LSCS d) Admission for fetel examination e) CTG after 1 week CCCCCCCCCCCCCCCCCCCCCC……….risky CCCCCCCCCCCCCCCCC CCCCC……….risky to give PG in this female as she has CS before
72 year female come for routine check up. Her mother develop colon cancer at the age of 65 year s. She doesn’t have any bowel symptoms and haven’t done any screening test before. She want to know her risk? a) Nothing to do b) Colposcopy …………..NONE …………..do FOBT
1. A 44 years old man attends your OPD with complaint of increasing swelling over last 12 hours on his right thigh. He is a diabetic and hypertensive and has been previously operated 6 weeks back for a fracture femur. He is on Ramipril, Simvastatin, Warfarin, Amiodarone, NSAIDs, and antacids. On examination you find that the right thigh is 4 cm greater in circumference than the left thigh and is tender. His temperature is 37.8. Which of the following is the reason for his presentation? A. Arterial embolus B. Cellulitis C. Deep vein thrombosis D. Edema E. Drug interaction CCCCCCCCCCCCCCCCCCCCC
Woman 55 years came to doctor for regular medical check up. Her mother has CA cervix at 63 years. Maternal aunt has breast CA at --- year . and father has colon cancer at 72 years. What to check her? a) Colposcopy 2 yrly b) 5 yrly cervical cancer screening c) 5 yearly colon cancer screening d) mammogram yearly BBBBBBBBBBBBBBBBBBBBBBBBBB CCCCCCCCCCCCCCCC……………. CCCCCCCCCCCCCCCC… …………. FOBT done every 2 years NOT 5 years DDDDDDDDDDDDDDDD……….done every 2 years
HRT risk per year; which is correct? a) Brea Breast st CA 10% 10% inc incre reas asee per per year year (2.3 (2.3% % per per year year)) b) Gall stones 2% decrease per year (increase) Heart disease 1% increase per year ………….none 1.
Patient post laparotomy on PCA (patient controlled analgesia) giving morphine 1g now found that he is drowsy but responds to command wht next Cease drug Change Pca dose to 0.5 mg change to nurse administered on demand Oxygen BBBBBBBBBBBBBBBBB……….only BBBBBBBBBBBBBBBBB ……….only accepted DDDDDDDDDDDDDDD……….if respiration affected Best answer………..give naloxone 2.
Pt posted for surgery on femur on multiple meds. Which should
be stopped at least a week before 1. Ramipril 2. Metformin 3. Ibuprofen 4. Thiazides 5. Amitryptilline CCCCCCCCCCCCCCCCCCCCCC
Woman BMI 26 . has .. surgery for some cancer and came for follow up. She is suffering from sleep apnoea, osteoporosis , diverticular disease , .. cancer , asthma. Doctor advice her to reduce weight. Which of the following is the complication of her obesity? a) Sleep apnoea b) Osteoporosis c) Diverticular disease d) Cancer e) Asthma AAAAAAAAAAAAAAAAAAAAAAAAAA……..Directly AAAAAAAAAAAAAAAAAAAAAAAAAA… …..Directly related to obesity
Woman with BMI 32. Smoke 10 cigarettes per day?. Has premenstrual headaches etc . Apart from reducing weight , what is her Mx? a) Smoking habit b) History of premenstrual headache ???? SCENARIO NOT COMPLETE hat is seen in anorexia nervosa ? a) ankle oedema b) tachycardia c) vitiligo AAAAAAAAAAAAAAAAAAAAAAA
Man whose hand deeply injured by screw driver , 5 weeks ago, he found supercial laceration and give diphtheria tetanus toxoid , now , the hand is swollen and painful. What to do beside antibiotics? a) Elevation b) Aspiration c) Tetanus toxoid d) Tetanus immunoglobulin only e) Dpt CCCCCCCCCCCCCCCCCCCCC……………if CCCCCCCCCCCCCCCCC CCCC……………if said not vaccinated then toxoid and ig A man complaint of ‘feeling something in his body‘ and anxiety. BP160/- . Give beta blockers 1. Investigate for pheochromocytoma 2. Investigate for hyperthyroidism 3. Arrange psychiatric counseling AAAAAAAAAAAAAAAAAAAAAA
past history of dvt pt on UFH perioopertively n switch to lmw heparin after 5 days undergone rt hip surgery develop dvt after 10 days that what to do In investigation only platelets r decreased A- ffps B- vit k C- cease heparin and switch to other anticoagulant D- platelets infusion CCCCCCCCCCCCCCCCCCCCCCC
Woman with CCF , taking digoxin and perindopril regularly. Long list of lab result given. ECG show pulmonary congestion(given) and she has
progressive dyspnea a) Add furusemide b) Add c) Cease digoxin and give K+ supplement d) Cease perindopril and give K+ supplement e) Urgent rhymthm inversion? AAAAAAAAAAAAAAAAAAAAAAAA
Boy in MVA , seatbelt injuty to left chest. On examination , dimished sound on left sided , condition not improving . on arrival , chest and abdomen pain ith BP 90/60 , HR – 110/min. Give IV fluid in hospital. After one hour , he complaint of shoulder pain with BP 80/60 , HR . 120/min .no pneumothorax seen in xray. Mx ? a) Chest drain b) Intubation and IPPV c) Needle thoracocentesis d) Laparotomy e) Laproscopy DDDDDDDDDDDDDDDDDD…………..after resuscitation………….spleen rupture Woman present with back pain after lifting heavy weight.. Ask about degree , she said 4/10. Pain not radiating to other site. What factors can cause chronic pain? a) Being woman b) No radicular pain c) Pain 4/10 Aaaaaaaaaaaaaaaaa………only accepted Woman fall on outstretched hand at the back door of her house. Her xray on
6 weeks postfracture heal finely. She came to followup on 8 week post fracture only show mild intermittent pain. Mx? a) Repeat xray wrist b) Sling for better stability? c) CT d) Arrange occupational therapy for back door safety DDDDDDDDDDDD……….only accepted ………..better analgesia and exercise a young girl had 1 week history of depressed mood , 2 weeks back she had sexual assault. A.acute stress reaction B.PTSD C. malingering disorder AAAAAAAAAAAAAAAAAAAAAAAAAAA X ray pic with man persistant dry cough, dyspnea . heard PSM murmur.x ray pic. Dx? a) Pulmonary hypertention b) Pulmonary TB c) Rheumatic fever CCCCCCCCCCCCCCCCCCCCCC…………MS overdosed on 25mg indapimide (diuretic dose)? dose)? Or something. Was admitted and not able to sleep despite benzodiazepam. benzodiazepam. Nurse found her staring at ceiling and other times agitated. Cause: a) dementia b) depression c) catatonia …………NONE…………..delerium 1. scenario of a lady who become agitated and confused at shopping center for 1-2 mins. She has h/o same attacks . and
during attack she stares blankly, doesn’t respond to any command followed by conusion. Sometime during conversation with relatives it happens and she doesn’t follow the conversation. What is ur dx? a) Panic attack b) GAD C) Complex partial seizures d)PTSD CCCCCCCCCCCCCCCCCCCCCCCCC a child with red & swollen scrotum not tender no fever A.idiopathic scrotal edema B.hydrocele C. varicocele AAAAAAAAAAAAAAAAAAAAAAAAAAAA Ans→ idiopathic scrotal oedema pt with carcinoma of ceacum asking most likely symptom?? A.altered bowel habit B.lethargy/ tiredness C.black coloured stool D.recurrent colicky abdominal pain BBBBBBBBBBBBBBBBBBBBBBBBBBBBB
1. your in a rural area and 4 cases of trachoma come to you then you find out extra 20 how can you treat acute indexes ? Apart from hand washing , what will u give? b-oral azithromycin c-doxycyclin d-don’t do anything e-penicillin AAAAAAAAAAAAAAAAAAAAAAAAAA
1.
Old man with recurrent falls in nursing home, he is found to have many bruises in head, ECG showed sinus tachy, multiple ventricular ectopics and ventricular hypertrophy (written), on enam/thiazide combination, BP standing 150/90 standing and systolic 90 in sitting, sitting, what invx for diagnosis? D) holter monitoring E) 24 hr BP F) Repeated BP measurements with postural change G) CT head CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC 40 years old man complain from persistent abnormal thoughts that’s making him washing his hands at least 10 times after touching the key or door.he is on SSRI but want to try non pharmacological therapy to help him get rid of this thoughts Teach him how to avoid touching the doors or key Explain him that this thoughts is normal to relieve his anxiety Refer him to insight oriented psychotherapy Have psychological evaluation CCCCCCCCCCCCCCCCCCCC
Picture ask for Dx. (same option)
Doctor after night shift from emergency department went to bar. He found his colleagues there and some are having illicit drugs. They have to go to hospital for duty 2 hours later. What will u do? a) Report to director of emergency department b) Tell directly to those colleagues c) Leave and said nothing d) Inform APHRA DDDDDDDDDDDDDDDDDDDDDDDD -
Scleroderma hand pic. Asking Dx.
Child comes with excessive vomiting for several times with abdominal pain.No features of diarrhea. Finger prick test for glucose is normal .What is the immediate danger to him? 1. Cerebral oedema 2. Hypoglycemia 3. Hypokalaemia 4. Hyperkalaemia CCCCCCCCCCCCCCCCCCCCC…………only CCCCCCCCCCCCCCCCC CCCC…………only accepted with recurrent vomiting
10. 24yr old male with dysphagia and history of asthma in childhood. Endoscopy showed narrowing and inflammation of middle esophagus, biopsy showed eosinophils in mucosa. What is the best treatment? a. Oral Antibiotic b. PPI c. Budesonide CCCCCCCCCCCCCCCCCCCCCCC Old age pt presented with c/o epigastric burning nd regurgitation his investigations shows followin result what will you do for most appropriate management? (
1.oesophageal dilation 2 laproscopic cardiomyotomy 3 nifedipine CCCCCCCCCCCCCCCCCCCCCCCCC Hereditary Hypercholesterolemia...which is found? A)Corneal arcus B)Tendon xanthoma C)Periorbital xanthelesma D)Fatty liver BBBBBBBBBBBBBBBBBBBBBBBBB Egyptian woman who doesn’t understand English have to do endoscopy procedure. Her daughter can speak English fluently and husband understand
the procedure well. Who should interpret? a) Her daughter b) Her husband c) official interpreter d) non medical staff from hospital e) 2 outside general practitioners? CCCCCCCCCCCCCCCCCCCCCCCC Patient with ECG of AF. But the vital signs are BP -80/60 and unstable . Which of the following is the best management?? a- Digoxin b- Verapamil c- Cardioversion d- Sotolol e- Disepynamide CCCCCCCCCCCCCCCCCCCC .Cystic fibrosis case, what will be the chance to have disease child if one of them is carrier? a) 0% b) 25% c) 50% d) 50% of all male & no female AAAAAAAAAAAAAAAAAAAAAAAAAAAAA cyst in anterior neck(pic given), no pain, lump for 6 wks had h/o Sx of oesophagus surgery 10 years ago and another surgery(can’t remember) 2 years ago. Dx a. branchial cyst b. epidermoid cyst c. metastatic cancer CCCCCCCCCCCCCCCCCCCC
Woman with 2-month h/o affected mood, in customer service role, missing ork, can’t be bothered to go to work, gets teary eyed often, recently hit her car to the pole, not paying attention, worries in the night about losing her job, does not listen to her favorite music in the car, married 1 month ago to a caring person. a) Adjustment disorder b) Dysthymia c) Major de depressive ep episode d) Generalized an anxiety di disorder e) Bord orderline Pe Personal nality di disorder CCCCCCCCCCCCCCCCCCCCCCCCCCCCC Patient with history of DVT, HTN with DM patient on warfarin, metformin, statin and then add amiodarone, 2 days later suddenly got swelling at right thigh and become painful, become painful, redness and Temp 37.8. Right thigh size is 4 cm larger than left. Diagnosis? A. Rhabdomylosis B. Hematoma C. DVT D. Cellulitis E. Drug reaction CCCCCCCCCCCCCCCCCCCCCCC
Couple came for counseling of Schizophrenia. Husband’s mother has long term Schizo. He is around 25 yrs old and is completely normal till now. No symptoms in the wife. What are the chances of Schizo in the child? a. 10 fold increase in risk b. More than 20 fold increase in risk c. There is no such risk in the child d. There is an increased chance of Schizo spectrum disorders in the child DDDDDDDDDDDDDDDDDDDDDDDD
30-year old lady came for regular antenatal visit at 36 or 38 weeks of gestation (don't remember exactly). She had no problems and everything was normal except a foetal bradycardia of 60/min. An emergency c section was done but the infant still had the bradycardia of 60/min. What is the cause? A. anticardiolipin B. factor V Leiden C. Protein C D. Lupus anticoagulant E.anti Ro EEEEEEEEEEEEEEEEEEEEEEEEEE
53. A little less redder than this pic ^^ Tx a) prednisolone b) timolol c) chloramphenicol AAAAAAAAAAAAAAAAAAAAAAAAAA . Malaria senario. . Asking which of the following most likely to exclude malaria?? A.Thrombocytopenia
B.daily fever C.splenomegaly BBBBBBBBBBBBBBBBBBBBBBBBB 58yr od male pt, since six month watery diarrhea mucus or blood ,with 3 kg eight loss.presented with a hx of increasing difficulty to stand from sitting And walk upstairs. What is the cause? a) Thyrotoxicosis b) IBD c) celiec d) campylobacter jujeni e) bowel cancer AAAAAAAAAAAAAAAAAAAAAAAAAAAA 59. A 7 years old girl with soiling in her underwear, she tells lies about accidents at school and hide her soiled underpants and cry and quarrels with her brother when he calls her smelly. What is your diagnosis? a)Regression b)Conduct disorder c)Oppositional Defiant Disorder d)Delayed milestones e)Depression CCCCCCCCCCCCCCCCCCCCCCCCCC 58. an infant presented with a discharge from the umbilicus. On cleaning a red granulomatous lesion was see, treatment a. topical silver nitrate b. surgical excision c. steroid ointement d. antibiotic AAAAAAAAAAAAAAAAAAAAAAAAAA 59. . diverticulitis scenario. Ct was given. What next a. antibiotic and bowel rest
b. surgical exploration c. colonoscopy d. laparoscopy and proceed AAAAAAAAAAAAAAAAAAAAAAAAAAAA 60. a middle aged female presents with lt wrist pain after colliding her car ith a pole. On examination her lt pupil was constricted and also had decreased field of vision which she was unaware of. What is the next app in? a. ct head b. iop measurement c. slit lamp examination AAAAAAAAAAAAAAAAAAAAAAAAA
61.Old woman 75 years of age is admitted to the hospital following a community acquired pneumonia. She received antibiotics and is well on the 5th day. She suddenly developed rigors, chills and high grade fever on the 4th day. What is the most likely explanation? a. Hospital acquired pneumonia b. IV cannula related bacteremia c. empyema d. Pulmonary embolism AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA 62.Heart failure case man with AF on Ramipril, metoprolol, digoxin. Went on trip for 2 weeks and stopped his medication. Now with bilateral oedema up to knee in legs. And ankle swellings Lungs is clear. And the patient is not dyspneic, What is the most appropriate management? 1. Serum creatinine and elecrtrolyte 2. Echo BBBBBBBBBBBBBBBBBBBBBBBBBB 63. 63. 17. 17. Fami Family ly with with a new newbo born rn baby baby move moved d to to a smal smalll vill villag agee in rura rurall Australia, father called up GP to inform wife sad all the time, low mood,
crying but taking good care of baby, cannot get her to the hospital as he is busy with new work, what next: 1. Make a home visit 2. Send a social worker to check on woman 3. Insist husband to get the woman & baby to clinic 4. Admit the woman, baby can be with dad 5. Wait for the husband to call back again CCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC 8 yr boy with redness on scrotum, perinium n extending to penis no fever askin diag 1. idiopathic scrotal edema 2. torsion of testies 3. epididmorchitis AAAAAAAAAAAAAAAAAAAAAAAA A patient has surgery and on 10th post op day she developed dyspnea & agitated, he being a heavy drinker and a smoker. What is the next appropriate thing to do? A. ABGA B. Chest Xray C. Blood alcohol D. CTPA E. Ultrasound AAAAAAAAAAAAAAAAAAAAAAAAAA………..always 1st step in any AAAAAAAAAAAAAAAAAAAAAAAAAA………..always patient with acute dyspnea 2. A patient on Thyroxine. TSH is low. What investigation to do? CT scan TSH and T4 Glucose Electrolyte and cr BBBBBBBBBBBBBBBBBBBBBBB
Mother with 2 pre-school children said that ‘she doesn’t want to take care of her children anymore’ . what to do? a) Report to child protective service b) Arrange mother for psychiatrist referral AAAAAAAAAAAAAAAAAAAAAAAAA Man came to psychiatrist for …. His examination are all normal. He has history of criminal record for assault , theft etc . After counselling section, he confided to the doctor that he wants to kill his ex-partner. What next? a) Warn his ex-partner about it b) Send him for forensic assessment c) 3-4 continuous councelling session with him AAAAAAAAAAAAAAAAAAAAAAAAA A 6 years old boy contact with a chicken pox friend in school, he is neither vaccinated nor infected previously, first step of mx a. check serology b. immunoglobulin c. give vaccine to the child CCCCCCCCCCCCCCCCCCCCCCCCCCCCCC AAAAAAAAAAAAAAA…………….done AAAAAAAAAAAAAAA……………. done in pregnancy NOT in kids 25 years old man came to ask for the advice about the PSA screening in Prostate Malignancy as his grandfather diagnosed at the age of 70 and his neighbor now diagnosed to have as he is now 65.What information will u give to him? a. Screening is is no not in indicated in in th this ag age b. DRE is the good testing than PSA in this age c. Can do now d. It has high false positive rate DDDDDDDDDDDDDDDDDDDDDDDDDDDDD
55 years man whose friend has prostate CA. ask for screening. His DRE is normal. What next? a) Serum PSA b) TRUS c) Come back when symptoms appear ???? ALL WRONG …………reassure the patient ………no symptoms mentioned + normal DRE Man with surgery for clerk 1 metastatic melanoma , excise about 2mm margin of normal cell. Malignant cell is around 1.5mm . He doesn’t have any other symptoms. Mx? a) Regular observation b) Axillary LN biopsy Bbbbbbbbbbbbbbbbbbbbbbbbbbb https://www.racgp.org.au/afp/2012/july/melanoma-guide/
80 yr old lady with features of carcinoma of caecum.What would be the most easily found symptoms?? 1. Tiredness,lassitude,fatigue 2. RIF mass 3. Altered bowel habit 4. Bleeding PR 5. Melaena AAAAAAAAAAAAAAAAAAAAAA 96.Child,post viral ITP. Non blanchable petechial rashes. No other abn finding or bleeding. On FBE Hb n WBC normal. PLATS 35×10 9. Treatment? A. Strict bed rest
B. Steroids C. Immunoglobulins AAAAAAAAAAAAAAAAAAAAAAAAA Eye completely closed with redness and fever, O/E difficulty in eye movements asking for investigation 1. CT head 2. Opthalmoscopic examination 3. Eye swab 4. Blood culture AAAAAAAAAAAAAAAAA…………orbital AAAAAAAAAAAAAAAAA…………orbit al celluliutis
Woman has regular menses for 4-6 wk interval, pain on left iliac fossa for 3 days, aggravated while urination, her lmp was 9 days back, she had similar episode 4 wks back, which lasted for 3 days, cause? a. Ovulation b. complicated ovarian cyst c. dysmenorrhea d. early PID AAAAAAAAAAAAAAAAAAAAAAAA 102. Adrenal mass 5cm,incidental. Next? A. Surgery B. Observe C. biopsy CCCCCCCCCCCCCCCCCCCCCC…………better CCCCCCCCCCCCCCCCC CCCCC…………better to do hormonal hormona l assessment 1st The most common long term complication of streptococus pneumonia meningitis ? a) cerebral palsy b) deafness c) epilepsy
BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB An ambulance brought you a young lady who lost consciousness with body temperature of 40° (hyperthermia) and BP was 155/90 when they found her collapsed at a friend’s birthday party. What is next in Mx? Naloxone Benzodiapines IV Normal Saline. Cold blanket and Cool N saline DDDDDDDDDDDDDDDDDDD…………..1st step Old lady with mild dermentia , took medicines regularly. Now, she said she doesn’t want to take medicine . His son also told that she seems well without taking her meds. What to do? a) Accept patient’s wish b) Send medical staff daily to give her meds c) Warn her that she cant go home if she doesn’t take these meds BBBBBBBBBBBBBBBBBBBBBBBBBBBB Old recall of son dont wanna take care of her demented father anymore Social review(exact word) Discharge with his son and review later Immediate arrange nursing care support
Patient who have performed IVF came for follow-up. How can know if it is successful? (sth like that) a) Transvaginal USG b) Perform APPA c) Measure B hcg CCCCCCCCCCCCCCCCCCCC
AAAAAAAAAAAA……….gestational sac doesnot appear before 4th week
Young woman comes to you complaining of heavy menstrual bleeding with pain. She describes that clots of blood are lost in the first few days of menses ith severe back pain. You ask her for some investigations that need to be performed. She gets irriated and says she just wants a treatment. Which of the following is the apporpraite next treatment ? a. Tranexemic acid from day 1 of menses b. Mefanimic acid from day 1 of menses c. Mirena d. Oral contraceptive pills BBBBBBBBBBBBBBBBBBBBBB 9. Girl (age not mention) stay with her foster mother. She is normally shy and not talk much but lately she has unusual sexual behavior with her neighbor (sth like that). Mother is upset and decide to send her back to her original foster care. Management? a) Examine the general development of the girl b) Referral to child psychiatrist c) Arrange to send her back to foster d) Arrange the case conference with mother and child proctective service DDDDDDDDDDDDDDDDDDDDDDDDD ….sexual abuse
I got 2 questions about SVT 2 STEMI NSTEMI ecg
Q 1A study is conducted to check the efficacy of antibiotics prior to suturing ound what is increase in absolute risk reduction? Values were 2. 4
98. 96 Options were 1% 2% 33% 50% 98% BBBBBBBBBBBBBBBBBBBBBB………….absolute BBBBBBBBBBBBBBBBB BBBBB………….absolute risk was 4 % now 2% so absolute risk reduction = 2% Q2 patient wants to be your friend on social media what you should do? Tell them they can discuss only medical related issues They can message you directly Accept the request but don’t contact directly Decline the request Delete your social media site DDDDDDDDDDDDDDDDDDDDDDDDDDDDD Q3 resident while doing laparoscopy causes injury to liver surgeon comes and control but it results in laparotomy what should be done? Tell the patient he made error Tell the patient it was complementary complication Don’t tell as patient is recovered AAAAAAAAAAAAAAAAAAAAAAAA Q4 surgeon does some harm to patient while doing surgery and ask resident to tell the patient nothing happens what he should do Should report about surgeon(only option I m able to recall) Q5 nurse tells dr she is hep b positive what should be done? Terminate her job Ask her to tell patients about her status before any procedure No need to change her role CCCCCCCCCCCCCCCCCCCCCCCCCCC
Q6 A locum at private gp service finds patient record incomplete and some orders about patient treatment are not followed what you should do? Maintain records and patient call up system Ask consultants when they return Urge patients to go to some other doctor AAAAAAAAAAAAAAAAAAAAA
2 more options Q7 a patient presents with 3 months history of nausea and epigastric discomfort he has icteric sclera he consumes 50-60 grams of Alcohol. Lab investigations were given all liver enzymes including total and conjugated bilirubin were raised and serum lipase was also raised on Usg there was dilatation of intrahepatic channels not extrahepatic no other abnormality what you will do? ERCP CT abdomen MRCP Endoscopic ultrasound BBBBBBBBBBBBBBBBBBBBBBBBBB Q9 in a community there is increase violence because of alcohol use what you should do as a medical practitioner Financial and psychosocial support Appoint police at high risk areas Distribute pumflets to people on medical effects of excess alcohol AAAAAAAAAAAAAAAAAAAAAAAAAA 2 more options Q10 there was a CT scan picture in which right kidney was normal but left as abnormal distorted large mass most appropriate next was asked
Percutaneous biopsy Repeat CT scan after 6 monts MRI Renal artery angiography Left nephrectomy EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE Q11 mother is worried about excess wt gain in baby there is 100 gm wt increase in one wk mother is restless and tired of baby care what should you do? Increase breast feed Increase formula feed Asses her about post natal depression Refer him to lactational consultant CCCCCCCCCCCCCCCCCCCCCCCCC………..1st : there was a CT scan picture in which right kidney was normal but left was abnormal distorted large mass most appropriate next was asked Percutaneous biopsy Repeat CT scan after 6 monts MRI Renal artery angiography Left nephrectomy EEEEEEEEEEEEEEEEEEEEEEEEE A study is conducted to check the efficacy of antibiotics prior to suturing ound what is increase in absolute risk reduction? Values were 2. 4 96. 98 Options were 1% 2% 33% 50%
98% BBBBBBBBBBBBBBBBBBBBBBBBBBB patient wants to be your friend on social media what you should do? Tell them they can discuss only medical related issues They can message you directly Accept the request but don’t contact directly Decline the request Delete your social media site DDDDDDDDDDDDDDDDDDDDDDDDDDDD resident while doing laparoscopy causes injury to liver surgeon comes and control but it results in laparotomy what should be done? Tell the patient he made error Tell the patient it was complementary complication Don’t tell as patient is recovered AAAAAAAAAAAAAAAAAAAAAAAAAA surgeon does some harm to patient while doing surgery and ask resident to tell the patient nothing happens what he should do Should report about surgeon(only option I m able to recall) nurse tells dr she is hep b positive what should be done? Terminate her job Ask her to tell patients about her status before any procedure No need to change her role CCCCCCCCCCCCCCCCCCCCCCC
2 more options a patient presents with 3 months history of nausea and epigastric discomfort he has icteric sclera he consumes 50-60 grams of Alcohol. Lab investigations ere given all liver enzymes including total and conjugated bilirubin were raised and serum lipase was also raised on Usg there was dilatation of
intrahepatic channels not extrahepatic no other abnormality what you will do? ERCP CT abdomen MRCP Endoscopic ultrasound BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB Chronic COPD patient want to quit smoking he has tried 4 times previously but feels restless and agitated what is the strongest indication for start of nicotine therapy? His withdrawal symptoms His duration of disease Family history of smoking Obesity AAAAAAAAAAAAAAAAAAAAAAAA……….NICOTINE DEPENDENT
in a community there is increase violence because of alcohol use what you should do as a medical practitioner
Financial and psychosocial support Appoint police at high risk areas Distribute pumflets to people on medical effects of excess alcohol AAAAAAAAAAAAAAAAAAAAAAAAA 2 more options mother is worried about excess wt gain in baby there is 100 gm wt increase in one wk mother is restless and tired of baby care what should you do? Increase breast feed Increase formula feed Asses her about post natal depression Refer him to lactational consultant CCCCCCCCCCCCCCCCCCCCCCCCCCCCC Biostat question - gp has done screening for blood pressure and other things total population - 200 people with HTN 50. Find point prevalence per 1000 population for hypertension in 2010 A - 25 B- 50 ………….NONE ……………250 study is conducted to check the efficacy of antibiotics prior to suturing ound what is increase in absolute risk reduction? Values were 2. 4 98. 96 Options were 1% 2% 33% 50% 98% BBBBBBBBBBBBBBBBBBBBBBBBBBBBB Wife brings Ptx (husband) with worsening Parksonismsyx(marked
bradykinesia,rigidity,lack of self empathy and agitation) presenting with auditory and visual hallucinations comes to you for advice.Ptx is currently on carba and levodopa 75mg with little to no improvement for more than a year nowWhats the appropriate next step Donezpil Quietapine Haloperidol Increase Levodopa Pramipexole EEEEEEEEEEEEEEEEEE………. EEEEEEEEEEEEEEEEEE………..only .only accepted ……haloperidol not allowed in parkinsonism….increase levo will increase the side effects of hallucination………so best is to add another drug as the patient is worsening Patient with history of DVT, HTN with DM patient on warfarin, metformin, statin and then add amiodarone, 2 days later suddenly got swelling at right thigh, right thigh size is 4 cm larger than left, no fever. What is the cause A. Rhabdomylosis B. Hematoma C. DVT D. Cellulitis E. Drug reaction CCCCCCCCCCCCCCCCCCCC Graph was exactly as below. Question asked which point in the graph A,B,C is the point is upper limit of antigen for the "normal population" and 100% chance of zero false positive. 1. a patient presents after RTA with a 6 cm laceration in the anterior part of tibia. His tibia seemed grossly deformed and distal pulsations were absent . What is the next appropriate management/ a. debridement b. tetanus toxoid c. bone reduction CCCCCCCCCCCCCCCCCCCCC CCCCCCCCCCCCCCCCC CCCC then AAAAAAAAAAAAAAAA
2. picture of a submandibular swelling of 6 months duration. FNAC was done hich showed malignant cell. What is the next app investigation a. usg neck b. ct neck c. Mri neck d. repeat FNAC CCCCCCCCCCCCCCCCCCC…………..look CCCCCCCCCCCCCCCCC CC…………..look for metastasis One qs woman had shortness of breast dizziness and chest pain ecg done showing svt troponin normal nxt step Tissue plasminogen activator Oral gtn Repeat troponin aft 6 hours Oral ibuprofen cccccccccccccccccc………..only accepted 26 yr old pregnant old pregnant female at female at 34 weeks AOG, comes to you bcoz her son had a case of chicken pox,prior to getting pregnant she did VZV IG Negative and Negative and requests for vaccination.Asking most appropriate next step 1 Repeat VZV IG antibody test 2 Give VZV vaccination and IG 3 No need to vaccinate now 4 Vaccinate after delivery 5 idont remember not relevant AAAAAAAAAAAAAAAAAAAAAAAA……….. AAAAAAAAAAAAAAAAAAAAAAAA…… ….. all others are totally rong…………better is to give ivig PSA qs. 50 ur old man concerned about ps cancer asymptomatic no f/ho prca on Dre regular not enlarged nxt step Discuss about risk and benefet of psa Follow up Dre aft a week Dre annually Bladder usg AAAAAAAAAAAAAAAAAAA,,,,,,,,,,,,only AAAAAAAAAAAAAAAAAAA,,,,, ,,,,,,,only accepted
50 yr Old man enlarged prostate smooth. Psa 20 increased... aft one week also psa same level nxt step Prostate biopsyDre No intervention BBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBB BBBB then AAAAAAAAAAAAAAAAAAAAA One back pain qs...48 year old female gardening had back pain took analgesics and now after 4 weeks still pain lumbar tenderness no neuro defecit...nxt step Plain x ray spine Mri spine Bone scan AAAAAAAAAAAAAAAA…………….not AAAAAAAAAAAAAAAA……………. not improving persistent pain………..look at the algorithm
Syphilis rprqs... pt had rpr 0 at beginning then then 1:200 then aft 6 months and now 1:2 Also mentioned were some ppha and some antibodies which were both positive at 6 months and at present...qs was asking wat does this mean Pt has had syphilis 6 months back Pt has syphilis now Pt had syphilis one year back AAAAAAAAAAAAAAAAAAAAAAA
One more qs about some red tender swelling in the perinatal region no discharge no ulcer nothn causative organism was asked E. coli Cocksackie virus Chlamydia Gonorrhea Syphilis CCCCCCCCCCCCCCCCC………….epididimoorchitis
BULK TWO : Hydrocele picture give scenario said man had progressive swelling since TWO years and now had discomfort...testis wasn’t felt felt as a seperate entity but can get above the swellling and vas deference felt normal nxt step asked Use truss Urgent surgeon referral usg Aspiration Biopsy CCCCCCCCCCCCCCCCCCCC HPV during pregnancy Can give Give after delivery Give if antibody negative Aboriginal dm qs...how often to screen BBBBBBBBBBBBBBBBBBBBBB Papillary thyroid cancer wat to do Totally thyroidectomy Partial thuroidectomy Radioactive ablation AAAAAAAAAAAAAAAAAAAAAAAAA Many Thailand return travellerqs...study all diseases in Thailand very well scenarios can get rly confusing Mom bring to you 12 months baby said to you has egg allergy and want to give him MMr vaccine , what you should do : Give him titre and observe Don't give
Give him and put him under supervision . (no choice of its not related ). Ccccccccccccccccccccccccccc Case of statistic of Aspirin and stroke. 100 % Case of radial nerve injury . where's the lesion . x-ray of ant.shoulder dislocation , which nerve will affected : radial axillary unlnar. BBBBBBBBBBBBBBBBBBBBBBBBB 2 ecg : 1 heart block 2nd degree asking for the best . 2 AF asking most common cause . Pregnant lady in 35 wkcomplaing of pain in both hands especially when akin up , asking for best mangment : Syrgery hand split reassure . BBBBBBBBBBBBBBBB………..provided BBBBBBBBBBBBBBBB… ……..provided that it is carpal tunnel http://healthywa.wa.gov.au/Articles/A_E/Carpal-tunnel-syndrome Pregent with h/o c/s because of breach (once) , now deliver normal after six from complete delivery she bleeds from uterus whats uterus whats the cause : Atony rupture DIC AAAAAAAAAAAAAAAAAAAAAAAA Prolonged labour what should do . Case of food poising after party , which attend by 20 , pplwhats the most
common substance induce toxin : Cheese 6 14 Egg 4 17 Cake 10 17 Grape 10 20 CCCCCCCCCCCCCCCCC……………highest CCCCCCCCCCCCCCCCC ……………highest percentage The most best method to know the effect of vit.d on Australian people Rct Chort case control cross sectional . AAAAAAAAAAAAAAAAAAAAAA Impetigo pic , when school exclusion ends . Female with to boys 9 and 7 years come to you and said her partner physical abuse in front of boys , and she want to report him , who's else should be informed .? Colon Cancer , nearly around 5 or 6 question covers most of the topics (cover it good ). Bulimia nervosa young female , what should expect to assoiate with : Depression psychosis GAD stomization. AAAAAAAAAAAAAAAAAAAAAAA 22 yrs male , try to enter the military by illegal way , they bring him to you , he said after war Iraqi scene I saw on internet , I heard sounds that you should be soldier , what in history will help you : Relation with other . Grades in uni. BBBBBBBBBBBBBBBBBBBBBBBB…………delusions BBBBBBBBBBBBBBBBB BBBBBBB…………delusions in young male
…..look for prodrome of schizophrenia Husband very aggressive and explosive for the last two years,put all his money in new business which failed,had an affair with another woman 6 months ago,no depression , suicide ideation or drug abuse history, management? Diazepam, Risperidone ,clozapine ,mirtazapine BBBBBBBBBBBBBBBBBBBB…………..mania ** Woman, 42 yrs, comes complaining of back pain, pointing towards the L4/L5 area. On exam the area is tender and she has difficulty in flexion and extension. The woman has hx. of breast ca, 10 yrs back that went into remission and now she is disease free. She describes she got this pain while she was doing gardening. What should be you next investigation in management of this pt? 1MRI lumbosacral spine 2- Xray lumbosacral spine 3- Continue activity 4- Physiotherapy AAAAAAAAAAAAAAAAAAAAAAA *** 40yr man, numbness of 4th& 5th fingers, weak thumb& index opposition, loss of princer grasp, flexion of wrist and fingers are normal. hat is the most likely site ? a- cervical neck lesion b- carpal tunnel nerve entrapment c- brachial plexus d- nerve entrapment elbow e- cervical region CCCCCCCCCCCCCCCCCCCCCCCCC
1. young girl came to the clinic asking about contraception pills, she Is 19 years with normal examination, she said that she recurrent attacks of headache that is associated with naisea and photophobia for which she takes sumtriptan, what is the best for her ? A mirena B progesteron inly pulls C estrogen patches D combined oral (coc) BBBBBBBBBBBBBBBBBBBBBBBBBB Patient with decreased Hbwith cyclical menorrhagia. Hysteroscopy and DandC done. Both normal. Wtsnext a. levonorgestralreleasingIUCD b. progesteronefromday15-25ofcycle c. oral tranexamic study d. D.COCP AAAAAAAAAAAAAAAAAAAAAAAA A pt w/ COPD is admitted w/ cholesystitis. He undergoes cholecystectomy uneventfully and is transferred to the floor. Suddenly, he becomes weak & severely hypotensive. If the pt’s symptoms were due to adrenal insufficiency from chronic steroid use, one would expect the following: A. Elevated renin B. Elevated cortisol C. Decreased ACTH D. Elevated ACTH E. Elevated aldosterone DDDDDDDDDDDDDDDDD…………he stopped the drug now so no (-) feed back CXR shows widen mediasternum with obliteration of aortic knuckle. MVA history recently. BP 100/70. PR – – 120/ min. Next?
a.Bedside ultrasound (FAST) b.Urgent CT aortogram c.Admit to CCU d.Aortic stent BBBBBBBBBBBBBBBBBBBBBBB Pt with esophageal varices endoscopically repair done twice now bleed again which approach better to lessen chance of hepatic encephalopathy 1 octereotode 2tipss it causes hepatic encaplopathy 3 splenorenal shunt 4 leveen shunt AAAAAAAAAAAAAA…………he is bleeding now Pic of cataract, what’s the long main treatment: Phacomalciphcation . Laser . Reassure . AAAAAAAAAAAAAAAAAAAAAAAAAA Young female complaining of dysparunia , on ex: you find cystic swelling hich main treatment; NSAID Marsibalisation Ocp BBBBBBBBBBBBBBBBBBBBBBBBBBBB , description of pt after mva and asking for scoring of GCS (The choices were only numbers 6- a Malaysian student, uni student, his gf went back to attend dad’s funeral now this guy become restless ,irritable and cant sleep and complains that his gf taling behind his back Dx? Suspicious cannabis
Grief reaction Panic psychosis Reactive psychosis Onset of schizo DDDDDDDDDDDDDDDDDDDDDDDD…………only DDDDDDDDDDDDDDDDDDDDDDDD…… ……only accepted. ac cepted.
BBBBBBBBBBBBBB…………it BBBBBBBBBBBBBB…… ……it is her dad who died not his h is dad
77
Ur pt is diagnosed as Ca lung , what you should do to break bad news : Tell the pt. The diagnosis Ask pt. If he wants his wife to attend meetings. Tell his wife to tell him about diagnosis.
BBBBBBBBBBBBBBBBBBBBBBBBBBB Child with lead level 0.75 (normal0.32given).What to do next? a.CheckIQ b. Educatemother c. Refer for chelation therapy BBBBBBBBBBBBBBBBBBB June 2018 1-A mother has regualr referrals to pediatrician for her child every 3 months. You gave her a referral letter today. For how long it is valid? 3months 12 months Unlimited Until the child turns 18 BBBBBBBBBBBBBBBBBBBBBBBBBBBBBB…..valid BBBBBBBBBBBBBBBBB BBBBBBBBBBBBB…..valid for 12 months 2- violence and crime are rising due to alcohol use following drought and financial breaks in a town. You town. You are asked as a gp to devise a plan. Which one is the most approptiate? Involve the police Limit alcoho retails Design pamphlets about alcohol harms Set up an organizatiob for financial and a nd psychosocial support DDDDDDDDDDDDDDDDDDDDDD…………..best DDDDDDDDDDDDDDDDDDDDDD……… …..best here
3- homosexual man with two partners. partners. He uses condoms, Not condoms, Not iv drug abuser, HIV and othet STDs negative. Everything was ok 12 months ago too. When u chek again? In 12 month In 3 months
Never again ……………..now and every 12 months ……..this is the best answer https://www.racgp.org.au/your-practice/guidelines/redbook/6communicable-diseases/62-sexually-transmissible-infections/ 16 year old female presents with Sickle cell anaemia and heavy menstrual bleeding. What is the best treatment of choice? A. Combined Oral Contraceptive Pill (COCP) B. Inj Depoprovera C. Mirena D. IUCD E. Implanon CCCCCCCCCCCCCCCCCCCCCCCC Contraception — A 2012 systematic review including eight studies found no evidence that hormonal contraception use in women with SCD increased their risk of clinical complications [71 [71]. ]. The Centers for Disease Control and Prevention (CDC) and (CDC) and the World Health Organization (WHO) consider all methods of combined (estrogen-progestin) and progestin-only hormonal contraception and the copper-releasing IUD safe and effective for women with SCD.
https://www.uptodate.com/contents/pregnancy-in-women-with-sicklecell-disease? sectionName=Contraception&topicRef=14519&anchor=H12&source=se
A patient comes to reduce weight. What is the important factor for her obesity? obesity ? a. bmi b. waist circumference c. waist hip
BBBBBBBBBBBBBBBBBBBBBBB For health risk…………CCCCCCCCCCCCC risk…………CCCCCCCCCCCCCCCCC CCCC Question about a diabetic patient who had ahypoglycemic episode at the gym and lost consciousness. After treatment, trea tment, asked GP when to drive. A. after 6 weeks B. with a licensed companion c. if blood serum is at 3.0mg/dl ……………..NONE . It is critical critical blood glucose glucose to be above 5 to ensure safety when driving. People with this condition in general are not eligible to drive but a conditional licence (not commercial), may be granted following advice from an endocrinologist or diabetes specialist. In some instances, awareness of hypoglycaemia can return. https://diabetessociety.com.au/downloads/Driving%20and%20Diabetes http://www.austroads.com.au/ forgot the others pt presented with fever. 38.with moderate ascites, gynecomastia , spider nevi, flapping tremors. vitals given. whatsur initial step of management of this patient ? a. full blood examination b. LFTs c. ammonia level d. abdominal USG e. Abdominal paracentesis EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE A case of spontaneous rupture of membranes at term.Now cervix is 8cm dilated and head at ischial spine .CTG shows heart dropping to 70 for 3 minutes with baseline heart rate 110bpm.What next? a. Fetal scalp ph
b.Immediate C sec c.Ventouse delivery d.CTg e.stopsynto EEEEEEEEEEEEEEEEEEEEEEEEEEEE Child with meningitis setting. Given with antibiotics and IV fluids. On 2nd hospital day patient had a five minute seizure. Labs showed: Na 118 Cl 95 (other parameters normal) Cause? A. SIADH B. Subdural collection AAAAAAAAAAAAAAAAAAAAAAAA Old man. Afib. Abdominal pain. Wat other test with ct- serum lactate A scenario of an old man with history of atrial fibrillation and now comes with severe abdominal pain. What other than CT angiography will you do? a) CT abdomen b) Serum lipase c) Serum lactate CCCCCCCCCCCCCCCCCCCCCCCCCCCC
Man with urinary retention mass two fingers above the pubic symphysis. DRE showed enlarged prostate with smooth median sulcus palpable. Catheter was inserted. What is the most appropriate next step? A. Urine Cytology B. PSA C. TRUS D. CT E. Creatinine
BBBBBBBBBBBBBBBBBBBBBB old man presented with the lesion shown in the photo management? A leave it B local excision C excision with 2 cm margin D Topical imiquimod ???? NEEDS THE IMAGE patient taking amisulpride, complaints of gynaecomastia and sexual dysfunction. What to give? Aripiprazole olanzapine clozapine d.quetiapine AAAAAAAAAAAAAAAAAAAAAAAAA 30yrs old indigenous woman , with h/o MS. Exertional dyspnea and Shortness of breath for 6wks. Low grade fever,no cough, basal crackles both lung . X ray given given A) Pul hypertension ?? Pul fibrosi fibrosiss C) Left heart*failure D) TB E) Lymphoma CCCCCCCCCCCCCCCCCCCCCCCCCCCC The XRAY showed widened PA with almost bat wing appearance. Right heart not enlarged. Lady comes on 10th postpartum day with pain due to perineal tear. Now on examination there is perineal wound that is 2 cm long,1cm wide and 1 mm deep. It was clean with no discharge. What to do next? Apply local antibiotics
Put on oral antibiotics Simply keep the wound clean Suture the wound under local anaesthesia Suture the wound after cutting the edges CCCCCCCCCCCCCCCCCCCCCCCC Q183574- Child (3-4 year) with fever 39C and history of cough unwell for 3 days. I think he has wheeze but minimal lung signs on exam. CXR given. Asked which investigation wud u do for further assisting in diagnosis? a. pneumococcal PCR b. pleural aspirate c. blood culture d. FBC CCCCCCCCCCCCCCCCCCCCCCC
Q183497-CT scan of diverticulitis in elderly woman with scenario of fever 39.5, LIF pain, mild leukocytosis, history of constipation and peri colic abscess found. Most appropriate next treatment?(CT given) A. Broad spectrum antibiotics with gut rest B. Prednisolone C. CT guided drainage D. Laparoscopic surgery E. sigmoid resection AAAAAAAAAAAAAAAAAAAAA………..except AAAAAAAAAAAAAAAAAAAAA……… ..except if he said that the abscess is more than 5 cm Q183123-patient with severe low back pain for 2 weeks . the pain has started gradually for long time ago . he noticed weight loss during this time. DRE show irregular prostate with palpable median sulcus A. CT lumber spine B. PSA C. TRUS
D. CT scan Next …………..BBBBBBBB …………..BBBBBBBBBBBBBB BBBBBB BEST ………….CCCCCCCCCCCCCCCC Case of MDD, anhedonic. Given with a SSRI medication. What other mode of treatment can you give? A. role playing B. rational emotive therapy C. positive imagery ……………………….better problem solving Q183102-A patient recently travel to Asia with 2 weeks cough and low grade fever. Pain in epigastrium with Chest X-ray. What is the diagnosis? With XRAY picture that has widened mediastinum. A. Viral pneumonia B. TB C. Bacteria pneumonia D. Fungal pneumonia E. Lymphoma AAAAAAAAAAAAAAAAAAAAAAAAAAAA Q183070-A lady with BMI of 35. How will you manage her in addition to exercise for long term management? A. Low Carbohydrate food B. Lipase inhibitor C. Diuretics D. 4000 kj diet e. freiquentfollo up BBBBBBBBBBBBBBBBBBBBBBBBBB Q183047- A woman works at a part-time job (OFFICE CLEANER), and complaints of early morning headache, frontal & bilateral, dull in character, varying in intensity, she takes paracetamol& paraceta mol& codeine in increasing dose, which only cause relief for 2-3 hours. What is the cause?
A. Drug rebound headache B. Migraine C. Tension headache D. Cerebral tumo E. Pre-menstrual headache CCCCCCCCCCCCCCCCCCC 6. 15 yo girl with drop in school performance, CONSTANTLY fight with father, when u ask her about this, she says” what’s the point for all these things”, what’s the most important next step for management? A. Liaise with father. B. Talk with her. C. Talk about safety plan with parents and her. D. arrange cognitive behavioral therapy for her E. tell her school to support her more BBBBBBBBBBBB……….new BBBBBBBBBBBB………. new option then CCCCCCCCCCCCCCCCC 5. Q183018- 40 year old woman after lifting some heavy thing while gardening develop pain in the right buttock and tenderness in her back, no neurologcdeficity what will you advise? A- spinal xray B- spinal MRI C-bed rest D- referral to orthopedics E- observe EEEEEEEEEEEEEEEEEEEEEEEEEEEEEE . Old female with depression for for 6 wk after dead of her partner ,sleeps ,sleeps badly, she lives alone now, afraid of the dark she had the same symptoms in the past when she lost her child , what is the prompt Rx? DX:normal grief A)Olanzapine ?? ECT C) midazolam
D) venlafaxine E)temazepam EEEEEEEEEEEEEEEEEEE……….Grief EEEEEEEEEEEEEEEEE EE……….Grief ….just ttt the insomnia 3. 48 year old woman. Complains Complains of heavy menstrual menstrual bleeding for last 4 months. She underwent a hysteroscopy and D&C last 3months ago b. Her haemoglobin is 9.5 g/dl. What is the most appropriate management in this case? A-oral tranexamic acid during the period B-northisterone from 15-25 days of cycle C-Levonogesteral IUCD D-implanon E-COC CCCCCCCCCCCCCCCCCCCCCCCCCCCC 2. A 21 year old female presents with lethargy, her lab results reveal a Hb of 9.5 gm/dl, a Ca level of 1.9 (normal is 2.1), INR of 1.5, what would be your management? A. IV vitamin K. B. Oral iron C. IV Calcium Gluconate. D. FFP. E. Blood transfusion EEEEEEEEEEEEEEEEEEEEE………..only EEEEEEEEEEEEEEEEE EEEE………..only accepted AAAAAAAAAAAAAAAAAA………….if AAAAAAAAAAAAAAAAAA…………. if said epistaxis as old recalls June recalls 1. 45 year old woman who smokes a lot. She is on COCP for 8 years. Her BP is 155/- mmHg. You suggested to cease her OCP. But she is reluctant to change her method of contraception since it has controlled her heavy bleeding during menstruation and she doesn’t want to conceive. What is the most appropriate contraception for her? a. Tell her to quit quit smoking so that she can continue continue to take OCP b. Tell her her to use condom condom
c. Offer her copper IUCD d. shift to POP e. continue OCP DDDDDDDDDDDDDDDDDDDDDDDDDD Scenerio Of inferior MI within 2 hour hour what to do next A. RTpa B.angiography C. nitroglycerine BBBBBBBBBBBBBBBBBBBBBBBB
Study to asses the efficacy of drug aRCT bCross sectional AAAAAAAAAAAAAAAAAAAAAAAAAA Test has 95% sensitivity and 95%specificity for screening of chlamydia in a specific age group of 50 years ( Mostly ) with a prevelance of 1% of this disease in this age group aThe prevelance is low to commence a result bThe test has a high PPV cThe test test has high False positive AAAAAAAAAAAAAAAAAA……………only AAAAAAAAAAAAAAAAAA…………… only accepted……….better answer that it has high negative predictive value due to low prevalence Heavy smoker with +ve F/H of smoking , smokes once he gets out of bed , which of the following is the most mo st reliable in managing ? a No. of cigarettes he smokes bThe family history cSmoking once he wakes up CCCCCCCCCCCCCCCCCCCC………..look CCCCCCCCCCCCCCCCC CCC………..look at the algorithm algo rithm of RCAGP…..patients who smokes in the morning needs double pharmacological ttt
https://www.racgp.org.au/your-practice/guidelines/smoking-cessation/the-5as-structure-for-smoking-cessation/
Melanoma asking about the most appropriate step aLocal excision bWide excision with 2 cm margin NEXT……………AAAAAAAAAAAAAAAAAAAAAAA NEXT……………AAAAAAAAA AAAAAAAAAAAAAA Photo of a child with vesicular Rash ( seemed like chicken pox ) asking about school exclusion aTill all lesions crust bWeek cAfter antibiotic administration d No exclusion AAAAAAAAAAAAAAAAAAAAAAAAAA
Patient usually comes to you with his sister , Today you are about to tell him that the investigations revealed Lung Cancer , What to do ? aAsk him separately if he wants his sister to enter with him bTell the sister first cTell him infront of his sister when he enters AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA A girl ( did not state that she is Aboriginal or immigrant ) with typical Rheumatoid fever , what to do next ? aESR bRF cSpirometry AAAAAAAAAAAAAAAAAAAAA
Typical scenario of Sarcoidosis asking about the NEXT investigation aSpirometry bSkin Biopsy cANA AAAAAAAAAAAAAAAAAAAAAA…………..NEXT BBBBBBBBBBBBBBBBBBBBBBB……………BEST Male with thyroid mass with hoarsness of voice and dullness on percussion aPapillary Carcinoma bAnaplastic Carcinoma cThyroid nodule dMultiNodular Goiter AAAAAAAAAAAAAAAAAAAAAAA Female has Low Thyroxin ( mentioned in the lab investigations ) with Normal TSH ( within the normal RANGE RANGE ) aDo MRI Brain bGive Thyroxine AAAAAAAAAAAAAAAAAAAAAAAAAAAA Anaemic patient with chronic pyelonephritis , what to give ? aErythroPiotein bIron AAAAAAAAAAAAAAAAAAAAAAAAAAAAA Patient came with confusion , her labs were too much ( but High Urea and Low sodium ) , what is the cause ? aUrea b Na BBBBBBBBBBBBBBBBBBBBBBBBB……..old BBBBBBBBBBBBBBBBB BBBBBBBB……..old recall…urea was NOT very high Bicycle accident and the child vomits 2 times until her father brought her to the ER , after reassuring him about his child’s case , The Father wants to take
her and leave despite explanation that she has to complete the observation period , what to do ? aAsk the child if she would like to go with him bReport to child protection authority cExplain why she is under observation dTell him to go home and come back again to take her CCCCCCCCCCCCCCCC………..1st ……..if still insisted……….BBBBBB A Question about a female that was recently diagnosed as metastatic ovarian cancer wants to end her life. Her MME was 25/30 aStart anti depressant bTell her about the centers who offer euthanasia c Neuropsychiatric assessment CCCCCCCCCCCCCCCCCC………….1st step U r an intern and the urologist who performed the operation to this patient prescribed antibiotic which isnot applicable with the hospital protocol , what to do ? aInform the infectious diseases senior bDiscuss with Urologist cDo nothing BBBBBBBBB
Mamu Aboriginal counseller zoledronic acid dtoesophagitis StroniumRanelate also dtoesophagitis Alendronate viral pneumonia after coming back from Thailand Transdermal Estrogen Patch stop syntocinon stop syntocynon
give the vaccine and catch up mmr , polio , DTP, HBV ( The longest choice J ) Hyperkalemia 5.5 on Ramipril , stop Ramipril Dialectal Psychotherapy of typical border line Feeling inferiority picky at her food lewy body dementia temporal lobe epilepsy DVT The patient who masturbates in front of the nurses Morphine for painful breathing Bilateral basal creptitations … BNP Use Pop dtContraIndicated OCP Mirena for menorrhagia Mefanemic acid for painful menorrhagia Methotrexate induced hepatitis measure the blood glucose at 2 and 3 am DKA Scenario how to follow up , Hb A1c Duputyren Contracture , MCC Alcohol Restless leg syndrome .. Iron Study Diagnosis of Migrane Post operative oliguria with fever , Blood Culture DMSA scan to assess the kidney function Direct Hyperbilirubinaemia , US SBP .. Paracentisis Cystic fibrosis assessment for both of them Chronic IschaemiaScenario .. Do Ct angiography Chronic Ischaemia ..advise to do supervised exercise AboRiginal with chronic ear discharge , after ear toilet ….. Ciprofloxacin ear drops the child with repeated urine analysis after resolved URTI showing non glomerular casts , what next ? Gout and renal impairment ..colchicine angioedema dtramipril
Back pain .. continue activity another question of back pain … continue activity Gleason score 4 .. continueservillance Waist – Hip Ratio in assessment of obesity risk on health methadone toxicity ( pin point pupil ) after renal transplant .. TB farmer left leg Iridotomy( long term management of Acute closed Glaucoma ) GastroGraphin study dt Rupture Oesophagus Colon cancer Sigmoid Volvulus Brace under elbow PSA according to algorithm PSA according to algorithm Scaphoid fracture .. Plaster cast epigastric hernia … Mesh Herniorraphy Divercation of Recti … picture Inguinal Hernia , 1 cm .. Reassure Orbital floor fracture ..anesthesia on cheeks acute pancreatitis .. Lipase Pancreatic cancer .. ERCP Renal Stone .. CT Abdomen epididymo-orchitis … chlamydis first catch urine Chronic bloody diarrhea scenario … Sulphasalazine hospital acquired pneumonia resistance to metronidazole in TTT Of PU Delayed passage of meconium … Hirchsprung Bag and Mask ventilation screening of Ca Colon … FOBT 2 years Pap smear after 2 years HPV Vaccine Fasting blood glucose every 3 years frenulum .. Non accidental injury separation anxiety
school refusal history Conduct Personality disorder young female starts sex ..give her and her boyfriend condom ideas of harming the baby dissosciative behavior sleep apnea scenario prompt effect … ECT 15 weeks diagnostic for Down syndrome … Amniocentesis Macrosomiadt DM with pregnancy avoid feotal scalp electrodes 24 month old .. 2 pronouns chlamydia causes infertility molar pregnancy Stress Incontinence after failed exercise … cloposuspension stop HRT after 6 years cyclic HRT Low frequency of Breast feeding how much alcohol do you drink? Asherman Syndrome … HysteroGram anemia and neutropenia 2- Cyclophosphamide hemorrhagic cystitis 3_ OCD diagnosis 4- Breaking bad news in a case of old man recently has been diagnosed with a pancreatic cancer. What to tell him? You have an advanced stage of pancreatic cancer. From which stage you want me to start telling telling you about your illness . The good news is that this illness will have a treatment options in the horizon. You have an advanced illness in a gland in your stomach. 5- Exposure and response prevention first step 6-ECT tribunal 7-ECT for elderly woman having depression 8-Widow having a psychiatric problem one year ago. Delusion of imposter 9-Post operative delirium 10-Post operative low oxygen saturation
11- Cerebral infarction 12- History of melanoma and brain lesion now 13- Menoragia pop?!!! 14- SLE treatment RA with renal failure Medical error doesn't harm the patient. Tell him or not to tell? Patient has been abusing by her husband now. She called you she is hiding behind the room door and you are listening to her husband shouting. What to tell her. Elderly woman and her son is abusive to her. Refuge Dissociative fuge 5 years old boy tetanus Lynch syndrome Chlamydia cause infertility Recruiting doctors for new positions. You are a member of the committee and your colleague is trying to access the candidates files. What to do? Inform the board. Inform hospital director. Discuss with you colleague. Discuss it with the hr responsible. Inform the board. Inform hospital director. Discuss with you colleague. Discuss it with the hr responsible. The surgeon prescribed an antibiotic for a patient postoperatively. The Woman came before her appointment to dispense opiates. She said that the pharmacy didn't dispense the right no of bills. The pharmacy confirmed to you that he didn't make that mistake. What to do? Write in the file that she lied about her opioid dependence. Document the discrepancy between what she has said and what the pharmacist told you. Prescribe opioid for her. A minor needs urgent surgery. His sister 16 yrs old (not sure) is available ith him now. From who you will take the consent? The sister. Consent on phone from parents. From the patient himself. Dermatology lesion take initial lesion swab or skin biopsy MND what is the best to diagnose Patient came for routine antinatal check 8 week of gestation . 3 weeks ago she started pregnancy Hba1c follow up in a young child
Pregnant woman wants to be protected against gestational diabetes Painful hematuria Lobar pneumonia high fever chills what is ttt Lung cancer prevelance decrease after age of 70. What is the cause? Epistaxis lethargy anemic Postoperative delirium day 3 Alcoholic Patient (alcohol level is frankly mentioned but I don't know if it's significant or not) in the custody of police who brought him to you. When you tried to talk to him he was agitated and uncooperative. What to do. Give him Haldol or keep him under observation till you finish taking history. Lewy body dementia Female elderly patient with mass tender hernia irreducible and no impulse on cough surgical exploration Left leg Umbilical Granuloma description. Ask for ttt. Picture of the eye Severe redness in the eye. History of hay fever and back pain. Diagnosis Picture of Hypopion post operative 2 cases of percentile charts. 6 month old baby weight 6 kilogram the mother came to you complaining about his low appetite. bmi 18 Withdraw venlafaxine Cholelithiasis Pain on the outer part of the thigh patellofemoral or illiotibial band Back pain observation. Back pain continue daily activity BRCA 1 mutation. Genetic risk assessment Ventricular arrhythmia amiodarone Hyperkalemia 5.5 on Ramipril Redman syndrome Optic neuritis visual evoked potential Diarrhea followed by proximal weakness, areflexia and no sensory affection in 45 years old man asking initial diagnosis A plastic crisis parvovirus
Community program for std in aboriginal community Dignosing down in 15 week Diagnostic paracentesis in Gestational diabetes Htn 160/ 100. Previous high readings. Ascitis freusemide and spironolactone Rupture Esophagus gasrtographin Immunisation catch up Stop syntocinon 2 questions Polycystic kidney disease Aids prostitute negative Monospot test Ramipril induced angio edema QuantiFERON-TB before infliximab Hirsch sprung disease Centrally cyanosed no breathing baby Ivf how to confirm the success A Sherman syndrome hysterosalpingogram Endometriosis diagnosis Kawasaki disease Pre-eclampsia Air in biliary tract Hepatitis a in a nursery. Best way for prevention Colorectal cancer screening Incomplete abortion Open angle Glucoma intraoccular pressure Retinal detachment hit ball eye Anaesthesia on the cheeks ERCP jaundice and dilated bile duct Methylphenidate toxicity cardio toxic OCD exposure and response prevention what to do initially Depression problem solving Mephenamic acid A group of 7 vaccine against serotype disease has been introduced Since 2002 but over time the incidence of disease has been increased. What is
the cause?! Lung abcess 5 cm mass in kidney confirmed by ct.
Hello everyone. I got around 60% recalls and the new questions were also managable..Iam not able to clearly recall the new questions. But most of them are same topic related. Most of my recalls recalls from Aug – Nov 2017 and also from my same month exam questions June ’18 . Sorry for the late upload
1.melanoma eye pic refer to plastic surgeon
2. baby after 6 hours of delivery develops jaundice. Cause A) Neonatal sepsis B) Hemolytic anemia C) Beast feeding
1.
Girl 16 years history of weight loss of 10 kgs, BMI 15. Her
school performance is good and recently fall in grade. What in history will help in diagnosis? A. Episodic fatigue B. Sleep disturbances C. Feeling of worthlessness D. Feeling of inferiority E. Idea of guilt
1. A 30 years old woman with increasing dyspnea, dry cough since 2 yrs with painful lumpy red swelling/skin lesions lesions on legs and shins. On examination, there are red, painful, lumpy lesions in leg and bilateral ankle swelling. ACE level ( 120 ) increased. increased. Which inv for confirming diagnosis? (No given X-ray) A. CT scan chest B. Skin biopsy C. Blood culture D. Aspiration A woman works at a part-time job ( office cleaner ), and complaints of early morning headache, frontal & bilateral, dull in character, varying in intensity, she takes paracetamol & ibuprofen, which only cause relief for 2-3 hours. What is the cause? A. Drug rebound headache B. Migraine C. Tension headache D. Cerebral tumor E. Pre-menstrual headache Scenario was clear drug rebound headache 2.
patient taking amisulpride, complaints of gynaecomastia and sexual dysfunction. What to give? 1. Aripiprazole 2. Olanzapine 3. Clozapine 4. Quetiapine
3. patient with history of claudication, smoke 30 pack cigarette per day, drink alcohol , obese with diabetic history . he is not fit for surgery. He asked you for the appropriate advice that will improve his symptoms of claudication? A. Reduce smoking B. reduce alcohol drinking C. supervised exercise D. control his hypercholesterolemia 4. Most Common cause of low milk production 1. Low fluid intake 2. Less adequate baby feeding 3. Baby is not put on breast feeding frequently
A lady presented with her baby 5 times in 2 weeks at 10 weeks following delivery - all normal, established breastfeeding, baby growing well on 90th percentile. What relevant info will you ask the mother? 1. Past obstetric history 2. premorbid personality 3. history of psychosis 4. Thoughts of harming her baby 5.
Found glucose and ketones in urine. Rbs was 9. Follow up withhba1c A child 6 YEARS old with history of asthma presented with upper respiratory tract infection, urine examination showed very high serum glucose and ketonuria of 2+. what is the most appropriate test to follow up this child? 1. HbA1C 2. serum creatinine and electrolyte 3. FBS 4. OGTT . 5. Blood gases 6.
. Male with absent vas def. - check cf in both male female
Couple come for infertility problem for the last 12 months. On testing examination and tests of the female are unremarkable. Male has azospermia. And bilateral absence of vas deferens. Which of the following is most appropriate before the starting the treatment of infertility? 1. No testing required as they can not have a child 2. Testing of both male and female for cystic fibrosis 3. Refer for IVF 4. serum fsh and lh for male
7. An old woman taken many tablets, now unconscious, pinpoint pupil, his son brought her to hospital, and also tablets she might have taken, methadone, oxycodone, buspirone patch 1. methadone B. oxycodone C. buspirone 24 months old baby brought by his parents for development assessment. What should he have achieved? A. Can pronounce 2 personal pronouns B. Know family name C. Know 4 colours 34 year old male with a history of fall on an outstretched hand with pain and swelling. XRay was given, (showed scaphoid fracture. Very clear fracture line through the middle) What is the best treatment option for this patient? a. Crepe bandage b. Plaster cast c. Analgesics d. Compression screw e. Plate fixation 8yr old brought due to behavior changes. Noticed to have blank stare, with fidgeting of right hand, head twitching to right side, sometimes chewing. These occurs in clusters for 3-4 days in a week, for 3O to 60s, Post ictal confusion, then symptoms free & back to normal for several weeks. Asking Diagnosis?
8. 1.
1. absence seizure 2. Juvenile myoclonic epilepsy 3. Temporal lobe epilepsy 4. Tourette syndrome A child with left kidney smaller than the right, what is the best measurement for renal function? DMSA - dimercaptosuccinic acid to see anomaly scar tissue due to vesico reflux 2. DTPA 3. IV urogram 4. USG
A 74 year old man is being screened for prostate Ca. His PSA 2 years ago as 1.5ng/ml; now PSA is 3.8ng/ml. Only %5 of biopsy done showed adenocarcinoma, Gleason score is 4. How will you manage this patient? 1. TURP 2. Radical prostatectomy 3. External beam radiation therapy 4. Androgen therapy 5. Active surveillance
9. Afib. Abdominal pain. Wat other test with ct- serum lactate A scenario of an old man with history of atrial fibrillation and now comes ith severe abdominal pain. What other than CT angiography will you do? 1. CT abdomen 2. Serum lipase 3. Serum lactate 10. Patient with RA she takes ibuprofen and methotrexate to control her disease, they mention the time it was years for both of drugs, patient complains of upper abdominal pain, and her labs are given ALT, AST, GGT, even bilirubin all were high, which of the following cause this condition? A. Methotrexate induced hepatitis
B. Ibuprofen induced hepatitis C. Autoimmune hepatitis D. Viral hepatitis E. Alcoholic hepatitis
11.
Woman 25 years old is going to travel to India presented asking advice about vaccination. She has previous 1 dose of polio vaccine, had DPT at birth, 2 and 4 months age, 1 dose of MMR at 13 month , and tetanus booster at 15 year age. What vaccines should she received before travel? 1. MMR, diphtheria and tetanus 2. polio, diphtheria and tetanus 3. polio, MMR, diphtheria and tetanus 4. polio, MMR 5. MMR 12. ‘The moon is made of cheese, I came by bus’ Q . On interview. Asking about the appetite. Patient told “That is concern with food. Food which does not comes from moon, moon made of cheese. But I came her by bus”. Which of the following will have in this patient? A. Depression B. Dissociation C. Disorganized behavior D. Delusion E. Depersonalization
13. 52 yr old woman whose son is a drug addict, beats her every day. She is afraid & presents to you. What will u do for the safety of the woman? 1. tell her that she is obliged to inform the police 2. informs the police 3. urge her to go to the refugee center 4. send the son to correctional facility 5. advise female support group
14. An 18 year old girl presents with , malaise and tiredness for months. No other symptoms. Hb is 8.9, serum ferritin is 35, INR is 1.5. Calcium is 1.9. Long question. What to do next ? A. Blood transfusion B. IV calcium C. Injection vitamin k D. Fresh frozen plasma E. Vitamin D tablets Here I was stuck.neither the hb nor she was bleeding..i was between iv calcium and vitamin k…since she was at risk of bleeding I choose vita k.
Syphilis rpr qs... pt had rpr 0 at beginning then 1:200 then aft 6 months and now 1:2 Also mentioned were some tpha and some antibodies which were both positive at 6 months and at present...qs was asking wat does this mean Pt has had syphilis 6 months back Pt has syphilis now Pt had syphilis one year back
Please read the recall topic well…options are in twisted way END of JUNE 2018 Good luck