171.

A 22 year old woman was brought to the emergency department by her friends for cutting her
wrists and overdosing on Paracetamol after she broke up with her boyfriend. She regrets her actions
which she says were on impulse but has been referred to Psychiatry for further management. What is
the most appropriate next best step?
A. Admit and keep under observation
B. Discharge and follow up
C. Start Antidepressants
D. ECT

172. A 37 year old woman presents with more tiredness than usual, she is found to have angular
stomatitis, no koilonychia. Choose the single cell type you will find on blood film.
A. Macrocytes
B. Microcytes
C. Granulocyte without blast cells
D. Blast cells

173. A 53 year old woman presented with pain in the eye, blurry vision and clumsiness for 3 months.
She had a history of difficulty in swallowing and weakness in her right upper limb 2 years ago. What
is the investigation of choice?
A. CSF analysis D. MRI of the brain
B. Electroencephalography (EEG) E. Visuality Evoked Response test (VER)
C. Electromyography (EMG)

174. A 3 year old child was brought to the G.P with low grade fever for the last 5 days. Mother also
noticed an erythematous macular, non itchy rash on the extremities, mainly on the extensor surfaces
after 4 days of fever. On examination there was a facial rash as well. What is the causative organism?
A. Adenovirus
B. Measles virus
C. Parvovirus
D. Rubella

175. A 35 year old man was found to have hematuria, after 3 days of having sore throat, running nose,
burning and increased lacrimation of eyes and headache. Which of the following would explain best
the reason for hematuria?
A. Thrombotic ThrombocytopoenicPurpura
B. Haemolytic Uraemic Syndrome
C. Post streptococcal glomerulonephritis
D. Berger’s disease
E. Minimal Change disease

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176. A 40 years old man fell onto grass from the second floor. In the A and E he complained of
shortness of breath and chest pain. What is the most probable diagnosis?

A. Cardiac Tamponade
B. Tension Pneumothorax
C. Simple Pneumothorax
D. Flail Chest
E. Atelectasis

177. A woman complains of bloody diarrhoea, vomiting and abdominal cramps 1 week after a holiday
in France. What is the single best investigation?
A. Stool test for reducing sugars
B. Endoscopy
C. Barium enema
D. Stool microscopy and culture
E. Sigmoidoscopy

178. A young male is brought to the Accident and Emergency after an RTA. His GCS on initial
evaluation is 6. What is the most appropriate next step?
A. CT scan
B. Magnetic resonance imaging (MRI)
C. IV Fluids
D. Skull X ray
E. Secure Airway

179. A 45 year old man who has undergone a recent subtotal gastrectomy for peptic ulcer disease has
now developed anaemia with haemoglobin 6.8, tiredness, fatigue and loss of vibration sensation in
legs. What is the underlying cause of his symptoms?
A. B12 deficiency
B. Iron deficiency
C. Folate deficiency
D. Vit C deficiency
E. Metastases

180. A 48 year old man has continuous anterior chest pain, which is worse on inspiration, and has a
temperature of 37.5° C four weeks after a myocardial infarction. His erythrocyte sedimentation rate
(ESR) is 45 mm/hour. What is the single most likely explanation for the abnormal investigation?

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