patient had ear pain and now has facial weakness ptosis and drooling from corner of mouth.

he has an erythmtous vesicular rash. what will you do oral acyclovir oral prednisone methotroxate clindamycin gabapentin 16 year old came with a deep laceration on the forearm. You explained the complication regarding not closing it and she seemed to understand it and still refused suturing. Her mother told you to suture it. What will you do? Suture the wound under GA Put sterns trips and apply a bandage Get a psychological and mental assessment Send to court Suture the wound under block

A doctor was drawing blood to test a patient with HIV and accidentally pricked himself. What will you do now? Give him antiretrovirals Test both patient and doctor for HiV
Don't allow dr to draw blood for 3 months Report to medical board Give him immunoglubulins

A 43 yo male came to you with a black expanding skin lesion over the last month. What will you do? Reassure Reassess in 3 months Exisional biopsy Punch biopsy Topical steroids

Ct abdomen given for a person with abdominal pain. The ct showed a very enlarged liver with multiple well circumscribed circular lesions in the liver. Patient has a history of jaundice and fatigue. What will you do? Hida Cholecystectomy Core biopsy Liver resection Punch biopsy

Ct abdomen of a 33 year old male involved in a football accident. He has moderate abdominal pain in the RuQ and the ct showed subcaosular hematoma of the liver

Young athlete came to you feeling that he has an irregular rhythm. On examination everything is normal even pulse is regular. You placed him under 24 hour holter monitor. An EcG was given and I saw multiple foci of premature ventricular contractions. What would you advise him?
Cardiac cath Metoprolol Reassure him Tell him to see another hospital

ECG of 2nd degree heart block patient pulse is 45 not responding to atropine next step adrenaline dopamine cardioversion permenant pacing venous pacing

mother brought 6 month old son because he wakes her a lot at night. she is tearful, crying and anxious. She tells you she have not slept sine he was born. whats wrong with her? insomnia psychotic

sleep deprived Mood disorder postpartum depression

patient with rheumatoid arthritis got a flare up and they want to adminester azthioprine. (I dont know why). what test should be done before starting it? Tb Gold test thiopurine something xanthine oxidase defeciency CRP ESR

patient underwent a colonoscopy via your team. the other doctor perforated the colon during it. the patient comes for advice regarding medicolegal interaction. what will you do? Talk to him about complications of colonoscopy give him a list of lawyers let him see the social representative of the hospital ask him to go seek advice from another hospital

young male with unilateral scrotal swelling. you feel the swelling encapsulating the testis , no tenderness, spermatic cord felt clearly . what to do next? ultrasound cough implulse transillumination ct pevis ct abdomen

62 Y/O man came to you with daughter because she found him in the garden unconscious twice. ECG provided and Pulsr rate was about 30. his blood pressure is 85/60 and temperature is 34.9 C. Whats the cause of his condition?

Sinus bradycardia Hypothermia Sick sinus syndrome 2nd degree Heart block RBBB or LBBB

young girl 10 years old pallor MCV 65 HB 8.6 ferritin 40 what will you do? iron supplement b12 folate HB electrophoresis Top of Form

15 year old girl collapsed at a marathon. CPR was done since she was pulseless and reverted in matter of minutes. she was transferred to the hospital. and Every test is normal which include an ECG, serum elec, CBC, xray.she is eager to go home. her father died at age of 28 (cause not mentioned). what will you do? Discharge her and arrange outpatient consultation Discharge her permenantly Admit her under cardiologist supervision Tell her to see another hospital

young man with chest pain following a cough ? X-ray shown DX x-ray showed widened mediastenum esophageal rupture pneumothorax hemothorax

PE cor pulmonale

vegetarian came in with pallor and fatigue hb 9 mcv 130 folate b12 iron thalesemia lead

picture of a man with cellulitis on abdomen. he is on ampicillin . picture showed that the border has been crossed by the infection? change to amoxiclav change to gentamicin add cefotaxime increase dose

Patient with an ENT infection came to you 5 days later with headache, weakness in left side. he is febrile with 39.9 C and he is tachycardic. there is also blurring of vision and now he is confused and agitated. A CT is done (not provided). what would you most likely see? Pyogenic Brain Abcess SDH EDH Brain Tumor ICH 2 X-ray Pictures of colles Fracture after closed reduction how will you cast it? Full extention at wrist with below elbow cast Full flexion at wrist with above elbow case Semi flexion with below elbow cast semi flexion with above elbow cast full extention at wrist with above elbow cast patient on warfarin admitted due to headache, decreased function of left upper and lower limbs 5 days. CT without contrast showed midline shift of the cranium.

ICH SDH EDH SAH Meningioma X-ray of left clavicle fracture. the fructure is fully displaced. what will you do? Intramedullary wire fixation arm sling only rotator cuff repair single screw fixation neck collar and brace young man in a football accident pain in LUQ BP 80/55 next step CT abdomen US urgent Laprotomy abd xray HIDA patient post knee replacement by 2 hours is oligouric. only 20 ml of urine. creatinine mildly elevated TX? oral fluid increased iv fluids furosemide dopamine sulfasalazine

X-ray showing left apical white shadow. patient has ptosis myosis and anhydrosis next step Ct chest Ct abdomen CT brain MRI brain bronchoscopy

X-ray of pulmoany edema . patient is dyspnic tx other than oxygen? furosemide spironolactone iv fluids intubation c pab Top of Form

patient now with RUQ pain fever 38.9 and jaundice. 2 days before episodes of dark urine. his bilirubn high GGT 525 ALP 421 AST& ALT 50,80 whats the most likely cause acute cholecystitis cholangitis acute hepatitis pancratitis ca of head of pancreas

ECG of V fib. CPR was started and DC shock delivered with 200 J next step? continue compression for 2 min amiodarone IV lignocaine IV adrenaline IV dopamine IV

young male with unilateral scrotal swelling following football injury. you feel the swelling on the testis , no tenderness, spermatic cord felt clearly . what will you find? swelling in translumable swelling is not translumable cough impulse positive constipation RIF tenderness

mother brought 2 month old son due to URTI. child is healthy. mother is underweight , silent and withdrawn. whats wrong with her?

Depression psychotic sleep deprives Mood disorder Normal

ECG of inferior MI pateint givin morphine, oxygen, nitroglycerine, aspirin . symptoms appeared 30 minutes before primary tretment admit for cardiac cath tpa repeat previous treatment clopidegrol metaprolol

76 year old female complaining of constipation she had and appendicectomy 30 years ago . what is the most likely reason? dietary constipation obstruction by adhesion sigmoid volvulous drug abuse

what feature is of vericocele? translumable spermatic cord can not be identified positive cough impulse cold scrotum erectile dysfunction

24 yo pregnant lady at 19 weeks gestation . diagnosed with UTI what is the best treatment as she is pencillin allergic? Trimethoprim

Metronidazole Chlarithromycin Aminogycosides Tetracycline

child with 2 weeks symptoms of cough diagnosed as pertussiss what will you do Vaccine and continue school remove from school remove from schoool and antibiotics stay in school and antibiotic conservative treatment

patient now with RUQ pain fever 38.9 and jaundice. his bilirubn high GGT 525 ALP 421 AST& ALT 50,80 recent trip to BALI whats the most likely cause HEP A HEP B Acute cholangitis ACute Cholecystitis CA pancreas teacher complaining to mother that her 8 y/o daughter is imitating intercourse at school this question was repeated twice what will you do? family councelling report possibility of sexual abuse psychiatric consult for girl
ignore the problem report to social authority what is the possible reason? sexual abuse parents are divorced psychiatric problem precoucious puberty

lots of pictures in my exam: Pelvic ct of adhesion obstuction x-ray of colonic pseudo obstuction facial palsy Red eye --> glucoma ---? only answer possible for treatment is piliocarpine rest are antibiotics 10 ECGs for SVT, V tach , 2nd degree heart block , A fib and bradycardia , INF MI , PE

COPD patient dyspnic and ABGS drawn Ph 7.3 O2 66 HCO3- 21 co2 44 what to do?
bronchodilator only oxygen bronchodilator and iv hydro iv hydro cpap bi pap

Mother brought a 18 month child due to seizures. He always seizes when he has a high temperature. What is your advice? Low risk to turn to epilepsy Unusual after 6 years of age Dont let his temperature go up Let him sleep with a cooling blanket on top of him He needs assessment after 2 years

62 year old lady with no history or family history of DM cme to you for routine test. Test of choice? FBS every year OGtt evry year OGTT every 2 years

HBA1c every year HbA1c every 2 years

Child comes in for routine exam. Every time exam was done showed protein ++ in urine . everything else is normal?

Anti GBM Nephrotic syndrome Iga nephropathy Post strep Lupuis nephritis

Patient came to you complaining that he had multiple episodes of hyperttention sweating fluching and palpitation plus headache. On exam everything is normal. You send him home later he comes to you with the same symptoms. Again exam is normal. What do yo do?

Fasting Blood Sugar Prolactin level 24 hour cortisol collection 24 catecholamine collection

Patient came to you with hemoptysis and hematuria. What do you test for

Anti GBM IgA serology ANCA ANA

Immune complexes

Patient develops bilateral frontal headache with loss of vision. She is taking COCPs. Advice?

Stop taking them Change to other type of OCP Decrease estrogen Give danzen Hysterectomy

Patient has diarrhea and weight loss and fresh blood. He is 76 year old. He is tired and fatigued. Best investigation? FOBT Colonoscopy Open laparotomy Laproscopy FBE

51 yo patient came for routine exam. He says he is afraid of colon cancer . no one in his family has it but he is still afraid . what to do? Colonoscopy FOBT 2 years Tumor marker Refer to gastroenterologist Send him home

68 yo menopaused lady on HRT for 5 years. She stoped them 2 months ago due to a publicity about breast CA. now hot flushes came more severe than before. MX? Resume COCP O or P pills alone Testosterone Danzen Mirena

Patient normal in all aspect for routine exam except for a thick erythematous subcutaneous line on medial aspect of the thigh. MX Bed rest and elevation Heparin Antibiotics Surgical intervention Biopsy

Patie nt came with exertional dyspnea and nocturnal cough. Nonsmoker. CXR normal PFT shows FEV1/FVC 65% Asthma Acute bronchitis Croup Emphysema Chronic bronchitis

Patient with history of bifrontal throbbing headache recurrent. Treated well by paracetamol now comes with severe unbearable headache. MX

Ergotrine stat Increase paracetamol dose Codeine +paracetamol Gabapentin Midazolam 17 year old patient came to you as she never had a period. She complain of monthly abdominal pain for 3 days for the last 6 months.breast and axillary developed 5 years ago . Whats your diagnosis

Biggining of ovulatory cycles Imperforated hymen Premenstruation Genital tract anomaly Premature menopause

Male patient came to you and told you that he feels like a female. And he enjoys wearing women clothes and wearing makeup. Whats this condition called Transexuality Homosexually Poor selfesteem Schizoid personality Schizophrenia

female patient young age around 29 came to you because she has ammenorhea for 12 months. she is not pregnant and denies any recent intercourse. Fsh 2.9 (just below border)

LH 3.3 (3-11) TSH .04 (.05 is lower border) what caused her ammenorhea? PCOS Premature Menopause Hypothyroidism Microadenoma pituitary Hypothalmic Dysfunction

36 year old female patient came to you requesting weight loss pills. her BMI is 23 and she says she looks like a Elephant. whats the diagnosis?

Body dysmorphic Schezophrenia Paranoid Anorexia nervosa Bulemia nervosa

36 year old female patient came to you in the clinic. her father died 6 months ago. she lost 15 kg in 1 month and is not eating. she says she is not depressed or sad. she admits selfinduced vomiting on multiple occasions. Anorexia nervosa Bulemia nervosa body dysmorphic abnormal grief response

Typical case of miningiococcemia and the question said what is a dangerous sign? trunk rash non blanchable rash hyper alertness kernig's sign sunset eyes

76 y/o came with painless hematuria what to do next?

IVP bladder CT Renal US Renal CT Cystoscopy Patient came to you telling you that her daughter whom you counselled the day before is not talking to her. she is afraid that she wants to use OCP and is depressed and wants to confirm it with you. what to do?

tell her that you dont talk about other patients tell her everything arrange that both come for counselling tell her to come with her next time arrange a family meeting

81 year old patient you have managed for 10 years told you the next time she needs intervention or resuscitation don't do anything. she became sick and came to hospital and it was lifethreatening. you decide to do nothing. her daughter yelled on you and asked to treat her. waht will you do

Treat the patient tell the family ask for court order call your superior

long stem but patient is a very heavy drinker and came to you with a shifted apex beat and bilateral basal crepitation and 0.7 CTI. what the dx?

alcoholic cardiomyopathy mitral stenosis mitral regurge obstructive cardiomyopathy MI

35 year old man went to thailand and came back with fatigue and tiredness. he also has cervical and inguinal lymphadenopathy. whats dx?

HIV CMV HEP B HEP C Brussela

10 yo patient has cough and fever and wheezes. you discharge him on treatment and came back 12 hours later worsening condition. what to do? later neck X-ray Tongue depresser

i forgot the rest

thin women menopause and you started HRT. whats the 12 month benifit from using HRT in HER?

Decrease Hot flushes Decrease ovarian Ca Decrease osteoporosis Control Cycle (Dont know what the hell was this answer for?) Decrease Risk of DM

15 yo boy very aggressive bad performance in school no friends and despises relationships what could have caused this?

ADHD Sexual Abuse Depression Autism

You wish to place a women on HRT due to menopause what will you give her?

continuous COCP Only progesterone only estrogen cyclic COCP

Cyclic estrogen

A couple comes to you because they are unable to conceive for the last 6 months. All tests are normal for both patients. the female has a 28-30 day regular cycle. Next approppraite step? IVF Review in 6 months Ask about their intercourse timings Semen analysis TVUS

a 35 yo women comes to you with the complaint of post coital bleeding. the bleeding is about 56 ml and also come with increased abdominal pressure but milder (1 ml). se has never ever had a pap smear and abdominal ultrasound and pelvic US are normal. what si the most appropriate next step?

Do a pap smear Do a pap smear in 6 months coagulation factors TVUS

couple comes to you because of infertility. they have been trying to conceive for 14 months. Female tests are all normal. Male has azoospermia and u did an ultrasound and found he is missing both his vas deferens. what is the most appropriate step to do?

IVF Sweat chloride test testosterone level testicular biopsy