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July 2019

18/07/2019
Patient had chest pain and SOE.All other test normal.Troponin normal.chest normal. Ask management?

Patient had chest pain and SOE.All other test normal.Troponin normal.chest normal. Ask management?
Also like chronic or acute lymphoma, Hematology questions, Got the q about comparing two Hypercholesterol drug
study.

Man with wrist pain at night for 12 months, pins and needles, also had feeling defect on inner palm and on three
fingers of the hand, Pain on wrist flexion.Diabetes controlled by dietary What Is next?
MRI brachial plexus.
CT spine
Nerve conduct
HbA1c /

3 year child chest cray shows right lower job pneumonia. Physical signs and symptoms consistent to
pneumonia.Asking organism?
S pneumoniae
S aureus
Mycoplasma
etc.

What drug to stop one week before surgery?
ibuprofen
Statins
One ACE drug
metformin

Veterans. Malaise, only lymphadenopathy in axillary region.No fever no sore throat mentioned No H/O travel or
sexual contact. What's Do?
Cat scratch disease
Lymphoma
Infectious mononucleosis

One Dr need to do some research and need clinical access of your patients. What should you do?
1Inform your patient about study
2 give the access
3 only can review clinical record at clinical under supervision

24 years old woman Amenorrhea for 12 months. Menarche 13 years. Previous regular menstruation. TSH and LH
increased. Estrogen decreased. TSH normal. Prolactin normal.Ultrasound 3-4 cysts each side.Ask Dx?
POCS
Premature menopause
Pituitary adenoma
Primary hypothyroidism.

Old man schizophrenia or Almezeimer brought to ED die to confusion and high BP. A few weeks ago he was
admitted and had BP is 170/90 and 155/ 80 with 5 mins interval. When he was discharged in his record saying
follow up with mental health team.
What cause his Hypertension treatment delay?
Stigma
He doesn't have GP

,His discharge record didn't mention follow up

Women with Parkinson was taking levodopa. Abdominal pain, distension and no flatus. HAd H/O appendicectomy 30
years ago.Had X Ray showing Bowel obstruction. What is the cause?
Adhesion obstruction
Drug induced pseudo obstruction
Cancer of colon

A 60yrs of age man was found fallen on bathroom floor with dizziness but was conscious with a
history of poor stream urine and difficulty in micturition and brought by his wife to ER.He has a
history of HTN and DM..his BP is 165/85 and pulse is irregular.ECG showed AF.what
investigation will you do as next most appropriate?
A.blood glucose
B.troponin
C.holter monitoring
D.echo

2 year child h/o fever since 1 day dry cough, mother concerned about infection.
O/e- child afebrile, no wheezing, mild dry cough, nasopharynx looks normal. Management
A- oral amoxicillin
B- salbutamol nebulisation
C- observe at home, consult if gets worsening
D- nasopharyngeal aspirate for viral screen

ECG-AF Question, Next investigation
2D ECHO
REPEAT ECG
TROP
STRESS TEST

Ethical question scenarios
1- man got tested positive for gonorrhea, what is the best way to manage his partner
1-ask pt to share his results wid partner
2-inform partner yourself
3- write a prescription for the partner and hand over to patient
4- ask the patient to bring his partner so you can test her

Boyfriend got German Shepherd, your patient has fear of dogs and wishes to get better. Mx?
Tell her to:
A)Watch video of dogs
B)Listen to dog baking audios
C)Look at dog pictures
D)Volunteer at dog shelter

Nurse confides to you a romantic patient relationship. What do you do?
A)Inform APHRA
B)tell her to stop
C)Write a diary with details

MI 2hr evolution, given o2 morphine and nitrate. Very taquicardic on ECG. Next management?
A)transfer to catheterization
beta block
C) Amiodarone

, D) Adenosine

Tracoma Treatment of index case
A) azithromicin
Doxicilin
C) Metronidazole
D) throughly wash hands and face

Immigrant with suspected TB, O2sat 93%, dyspnea, dehydrated.
Already did x-ray and sputum for culture. Asking for next best managemtne.
A) ABG
MANTOUX
C) MRI

20 year man consulting asking for yellow fever vacvine before his travel, you have adviced him to take other vaccines
as well but he insists only on yellow fever vaccine. What will you do
A- give him onoy yellow fever vaccine
B- give him written text about other risks and vaccination and arrange for another consult
C- ask him to consult another doctor
D- insist on explaining benefits about other vaccines

Pneumothorax 15% asymptomatic. Mx?
A)Review in 24h
B)Admit for observation
C)Chest tube

Red inside under lids, no pain, no itch, tearing up a lot. Treatment? (Photo on comment)
A)Prednisolone
B)Hipemellose
C)Chloramphenicol

Graph asking where would there be no false negatives at the top limit of Antigen level from certain study analysis.
(Photo on comment)

Partogram as soon you open membrane
Drop FHB by 40bpm
Cause
Cord prolapse
Uterine rupture
Placental abruption
Maternal hemorrhage
...

36 woman with breast biopsy atypical ductal cells. Management?
A) Mass excision
Mamography in 3 months
C) Usg in 3 months
D) Mamography 1 year
E) repeat biopsy

Male with breast lump, usg with hipoecoic mass 3cm.
Management?
A) biopsy

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