JAMES recalls

Sydney 17/10/2015
Clifton centre
1-history of young guy with bat bite what to give(NEW Q)
A-antibiotic
B-antirabies
C-nothing
D-wash
2-hx and ecg of antlateral mi with 2 h
A-pci
B-asprin
C-antithroblisim
3-htn and mi study
4-mother refuse to give vaccine
A-force to give vaccine
B-respect her wishes
C-explian the importance of vaccine
5-hyperkalemia ecg treatment
6-23 youg age man with father died from ca colon at 35 and his anut died at 43 what to
do
A-fobt
B-colonoscopy now
C-colonscopy at 40year
7-middle age female with hx of mi come for follow up with normal ecg what to do
A-follow up after 3month
B-give metoprolol
C-give thrombolitc
8-pic of neck abceces with clear hx
9-relative rish of asprin same old recall
10-you notice that your collegue take maurjwa between the rest of seeing pation what to
do
A-inform medical board
B-talk to him
10-same old recalls of frosumide +amiodarone
11-hx of rta patien present with heamothorax wih ct picture what to

A-under water seal

B-observation
12-prostate ca tx in old age
13-gout with renal faiulre
14-asthma with pnuemothorax
15-pic of melanoma
16-noctural enuresis intial invx
17-old recall of kidney donor what to check
18-asperger scenario
19-grief scenario what to do?
20-mother ask about her daughter invx ?
21-farmar wih hx of ca colon with ct of liver metastasis what to do
A-triph ct
B-colonscopy
C-ultasound

Lydia Recall
Melbourne October 2015
1. As a Gp 3 Salmonella cases in your practise last week. What a study you will do?
Case Control
Case Serious
Cohort study
2. What is the appropriate study to make the relationship between HTN and MI?
Cohort study
Case Control
Randomization
3. What is the study to correlate occurrence of melanoma in naveous?
Coho t stud
Case Co t ol
Ra do izatio
4. Which of the following is least likely to be relieved on HRT?
Depression
Insomnia

Hot flushes
Vaginal dryness
Urinary frequency

5. A young boy restless and destructive in the class, play with video games and have one friend
and no eye contact, mild language delay but good at mathematics and some other subjects,
he and his friend play video game together, well with brother and mum ?
Asperger
Adhd
Specific language delay
Autism
6. A lady has been travelling in an aeroplane and just returned presented with dyspnoea,
temperature of 38.5, and chest pain on coughing and inspiration. What is the possible
diagnosis?
Pulmonary embolism
Pneumonia
Acute pericarditis
7. Midsystolic and Systolic click on the apex
Aortic stenosis
Mitral stenosis
Mitral Prolapse
Pulmonary Hypertension
8. New question of multiple weak muscles and many impaired reflexes asking investigation?
EMG
Vit B12

9. CT of a patient presented with intermittent abdominal pain and dyspnoea

Paraoseophageal hernia

10. Old lady was found lying on the ground by her neighbours, she was drowsy and dehydrated,
noticed dark urine when urinary catheter inserted.What is the next step of management?
Normal saline with urinary output 2ml/kg/hr
Dextrose 1/5 saline with urinary output 1ml/kg/hr
5% dextrose with urinary output 2ml/kg/hr
Normal saline with urinary output 1ml/kg/hr

11. ECG of Hyperkalaemia

Calcium Carbonate
Resonium
Sodium bicarbonate

12. Child was bought to the ED after consuming some white tablets which belonged to his
grandmother, she has ischemic heart disease and taking medications for pain aswell. Which
of the following medications will cause such an ECG?

Potassium tablets
Digitalis
Analgesics

13. A patient is presented with light headedness and has this ECG

Temporary pacemaker
Permanent pacemaker

14. Old man came complaining of dizziness and light headedness and this is his ECG((

15.

Carotid massage
Adenosine
DC

ou g

a e ith hest pai a d has this ECG. Whats the

ost app op iate?

Admit and observe

Angiography and angioplasty
Thrombolysis

16. A lady with vaginal redness and white plaques attached to her vaginal wall asking
investigation
Clue cells on KOH
Hyphae and rods on smear
Urine PCR for chlamydia
Vaginal culture and sensitivity

17. Young female after sex with new partner got soreness in vagina, dysuria n also discharge
mild few days,spontaneously resolved in a week and now asymptomatic came to u, cause?
Chlamydia
Gonorrhoea
HSV
Candida
18. A lady came with result of Pap HGSIL.What next to do?
Colposcopy
Loop excision of the transformation zone
Cone biopsy
Repeat pap
19. 45 years old lady has 3 children from her pervious husband, she has regular periods and
married to a 50 years old man who has never fathered a child before. They have been trying
to o ei e ut of o use. Whats the most possible cause?
Maternal age
Paternal age
Semen abnormalities

20. 55 year old patient with low folic acid,Howell jolly body, stomatitis, normal bowel, weight
loss investigation needed?
Colonoscopy
Small bowel biopsy
Vit b12
21. A mother came to you o e s a out he
ea old daughte . he tells ou that shes ot
gaining weight as the previous tow year, she finds undigested food as corn and pees in her
stool. In your examination you found the girl looking good with no abnormality, her muscles
are good. What will you do?
Antigliden antibodies
Sweet chloride test
Reassure the mother this is normal
22. A guy had splenectomy years ago, came with a lump in the incisional site. How do you
examine him ?
Stand and cough
Lie and cough
Lie and pull his legs towards him

23. An old lady on dialysis usually comes with hypertension at the beginning of the dialysis,
du i g the dial sis sessio he lood p essu e is good, a d afte the sessio shes
hypertensive again. What should you do?
Add antihypertensive
Add Frusemide
24. A patient on peritoneal dialysis who was going well suddenly declined to have dialysis. On
examination she was having slight temperature and mild tenderness in upper abdomen.
What finding you will most likely find in this patient?
Disorientation
Depressed mood
Blunted affect
25. A patient with BMI 25 and waist circumference 79 cm, his fasting blood sugar is 5 and
holeste ol le el is . . Whats the ost sig ifi a t isk fa to i
ea isk of CV?
Blood sugar
Cholesterol
BMI
26. A man presented with swelling in front of tragus and accompanied by dripping of saliva.
Next investigation?
Ultrasound
CT
FNAC
27. Young woman with history of 3 attacks of drowsiness last month, last episode occur when
she was in shop in the time of attack she feels detached from everything but can remember
the event. What will lead u do dx?
CT head
EEG
Ask witness
LP
MRI

28. Business man got bankrupt, many financial problems, complaining of late insomnia, lack of
pleasure, loss 15 kg from his weight through 3 months, any many other symptoms of
depression, his family concern about him and the patient refused to take any medication as

he does t elie e he is si k, he ad it he is ti ed a d e hausted ut ot dep essed, hats

this called?
Denial
Reaction formation
Depersonalisation
Rationalisation

29. A o a lost he othe a d othe I do t e e

months). What in history will intervention is a must?
Wants to join them

e the du atio e a tl

30. Male patient with loin pain and haematuria. Next appropriate investigation?
Plain X-ray
CT
Ultrasound
31. Patie

t o i g to the ED ith k ife i his hest. Whats the

Remove the knife in ED
Remove the knife under general anathesia
Remove the knife under with a chest tube

ost app op iate to be done?

32. Patie

t ith d sp oea ith p eu otho a a d t a hea shifted. Whats e t?

Chest X-ray
Needle thoracostomy
Under water seal drain

33. Boiler worker presented with dyspnoea, his chest X-ray shows pleural plaques. Next
appropriate investigation?
CT
Pleural biopsy
34. A patient brought to you with complaint of confusion. He was taking Indapamide and ACEI.
His la s sho ed se u Na
ol/l. hats the cause?
Indapamide
ACE inhibitors
Siadh
35. 4years old boy high fever develop convulsion,LP reveals turbid fluid,serum Na 120. How will
u treat?
Fluid restriction

3%hypertonic saline
0.9%normal saline

36. A 4 years old child with fever 39.5, grunting respiration and dyspnoea, vaccination up-todate. Whats the possi le o ga is ?
Streptococcal pneumonia
Meningococcal pneumonia
Mycoplasma pneumonia
37. A builder coming with confusion and nausea. All labs are normal except for platelets 7500.
Whats the possible cause?
Sun stroke
Thrombocytopenia
Occult malignancy
Splenectomy

38. Question about Psychiatry where a guy has thought insertions asking about possible
diagnosis?
Psychosis
Schizoaffected
39. A girl came asking for certificate because she did exam and she was not good in exam,
certificate will help her. What will you do?
Refer her to university medical section
Give her certificate
Refuse to give her certificate
40. A man with attempted suicide discharged after Rx, now presents with loss of interest in job
n lack of o e t atio ut sleep a d eat ell. Whats the ost p o a le diag osis?
Recurrent depression
Factitious disorder
Conversion
41. A Chinese student came to you with abdominal pain and rumbling stomach. His exams are
very soon. What will you give him?
Smooth muscle relaxant
Antidiarrheal

42. A mother came with a 14 year old child with loss of eye brow and scalp hair. On inquiring
the child she said she feels an urge to pull her hair when is tensed and anxious and she is
ela ed afte doi g so. Whats the treatment?
Behavioural therapy
Dialectal therapy
43.

ea
e e
test

s old o a e ith his othe , she o plai s that he et his ed at ight a d hes
d . He does t et hi self i the o i g. The o looks good a d ou did a dipsti k
hi hs egati e. Whats the e t step i
a age e t?
Reassure
Antibiotics
Urine culture and sensitivity

44. A patient presented with dyspnoea and cough with productive foul smelling sputum and
ou p es i ed a ti ioti fo hi . Whats the e t step i
a age e t?
Trans pleural drainage
Underwater seal drainage
45. A child with BMI 25 and percentile chart was given and was plotted on 50%. What to tell the

mother?

Overweight
Obese
Normal weight
Underweight
BMI is not a good indicator for children

46. A boy with joint pains. ANA +ve a t e e

complications?
Cardiomyopathy
Uveitis
Small bowel ulceration

e the o RF e. Whats the lo g te

47. A patient had a previous Myocardial infarction, he stopped smoking, on good diet, regular
e e ise, a d his holeste ol le el is . Whats the advice you should give him?
Keep going on exercise and diet
Review the cholesterol level in 3 months
48. A lady came to you and want to quit smoking, what the next step in management?
A smoking quit program
49. A pregnant lady came to you with multiple bruises in her thigh as a result of husband abuse.
Whats the e t step i
a age e t?
Provide an immediate shelter
Confront the husband
Call the police
Take pictures for reporting
Arrange couple meeting
50. A girl came to you obese, with dark axilla and dark rash on the neck, with multiple stria, her
pe iod is egula . He lood p essu e is
/ . Whats the ost possi le ause?
Cushing disease
Addison disease
PCO
Metabolic disease
51. A patie t a e to ou ith Dopple fi di gs a DVT f o
management?
SC enoxaparin
IV heparin

popliteal to ti ial. Whats the

52. A man came to you with complaint of claudication after walking for 100 meter. His legs are
a a d ell pe fused ut the do salis pedis is ot felt. Whats the e t step i
management?
Gradual walking program

(So

a t e e

e othe optio s ut the e as o optio fo a giog aph I thi k

53. A boy came to you with history of ear discharge 2 weeks ago, his tympanic membrane looks
dull a d et a ted a d the es ello dis ha ge f o his ea . Whats the est step in
management?
Amoxicillin
Ear toilet
54. A gi l af aid to sta at f ie ds ho e fo ight sta , do t a t to get out of a . Whats the
most important in history?
A se e of s pto s i fathe s a se e
Night terrors and sleep walking
Hallucinations
Irritable bowel
55. A

a ith sleep ap oea. Whats the lo g te

Weight reduction
CPAP

a age e t?

56. Child with 48 hours rhinorrhoea and lots of absence among his classmates due to influenzaLIKE illnesses, asking best to do?
Check influenza
7 days off school
Wear a face mask
Oseltamivir
Give vaccine
57. Gout s

e a io ith Kid e failu e GFR<

Prednisolone
NSAID
Colchicine
Allopurinol

. Whats the est t eat e t?

58. A question asking why to screen for chlamydia?

Chlamydia causes infertility
Chlamydia is asymptomatic

59. Old lad a e ith hest pai o

best step in management?
Packed RBCs
Oral iron

li

i g the stai s a d sho t ess of

eath. Whats the

60. A mother came with her child for vaccination of MMR but she was concerned because her
son has an egg allergy. What to tell her?
A test should be done before giving the vaccine
The es o elatio et MMR a i e a d egg alle g
The baby should be monitored after giving the MMR vaccine
61. A CTG with 5 beats variability, no accelerations, no decelerations, heart rate is 144beat/min
a d passed e o iu . Whats this ea s?
Hypoxia
Urgent foetal scalp sampling
Normal CTG
Abnormal CTG as baby is sleeping
62. P e e st ual loati g, u easi ess a d i ita ilit , hats the
Relaxation therapy
Fluoxetine
Primrose oil

a age e t?

63. 26 year old woman complains of mild increase in her menstrual flow for last 3 months.She
also feels irritable during menses.She believes that her decreased libido affecting her
marriage. What is the appropriate management for this patient?
High dose OCP without pill free week
Sertraline 100mg
Evening primrose oil
64. A peri menopausal lady came with complain of hot flushes. She asks for something to
elie e this a d she does t a t a u p edi ta le leedi g. What to p es i e he ?
Continuous HRT
Cyclical HRT

65. A patie t ith i fe tio a t e e e

prescribe?
Amoxicillin
Amoxicillin and Clavulanic acid

hat e a tl

ut has alle g to pe i illi . What to

Gentamycin, Metronidazole and Vancomycin

66. 24 years old man who used to be Australian football player presented with pain in his
shoulder that persisted for about 3 weeks. He has a history of multiple neck injury. He had
an episode of diarrhoea before this pain. On examination there is restriction on abduction
of shoulder and sensation loss on a point on the outer upper arm. Cause?
C5 nerve injury
Brachial plexus injury
Radial nerve injury
67. A patie t afte pa ath oide to
management?
IV calcium
Calcitriol
Ca carbonate and Vit D

de eloped u

ess a ou d

outh. Whats the est

68. Scenario was given,hb low, MCV high, and the blood film has hypersegmented RBCs asking
for diagnosis?
Iron deficiency anaemia
Vit B12 deficiency
69. A girl came with neck stiffness, fever, mononuclear cells 250, RBCs 200, Neutrophils 10.
Whats the e t step i
a age e t?
Ceftriaxone
Observation and analgesics
70.

ea old hild othe sa hi

most likely cause?
Ketotic hyperglycaemia
Ketotic hypoglycaemia

a de i g i ga de a d aski g fo

eakfast. Whats the

71. 5 years old boy with cough from 12 months before, was on Salbutamol and also taken oral
Prednisolone. He has an eczema history, both parents are smokers,( typical asthma
s e a io hi h o e is the est edi atio fo p e e tio hi h is used i INHALATION
MODE ?
Monteleucast
Chromoglycate
Salbutamol
Fluticasone

Salmetrol

72. Adult with long history of dysphagia, more after certain types of food lasting for few days,
also histo of asth a, e dos op do e e eali g ultiple o st i tio s, hats the ost
likely diagnosis?
Eosinophilic esophagitis
Achalasia
Ca oesophagus
73. Old lady with constipation, all labs normal except for increasing of Ca. what investigation to
be done to reach diagnosis?
Abdominal CT
Parathyroid Ultrasound
74. An old man with sudden vertebral fracture T7-T8, ESR elevated, Normal Calcium, decrease
Haemoglo i . Whats the e t app op iate i estigatio ?
PSA
Bone marrow electrophoresis
75. ECG ta h a dia, patie t has o t olled hea t failu e o th o i e. Whats the e t
management?
Beta Blocker
Digitalis
Stop Thyroxin
Decrease Thyroxin
76. An old patient has difficulty with initiating urination, he forces to urinate with the sense of
i o plete u i atio , ut he does t suffe f o u ge du i g ight. Whats the ost
probable diagnosis?
Urethral stricture
Begnin Prostatic hyperplasia
Cancer prostate
77. Woman with 2 days history of vison problem on left eye and pain behind the eye,right eye is
normal.Left eye with 6/12 and right with totally normal vision, normal papillary reflex and
o al o e e ts of e e pa ti ula l e tio ed. Whats the e t i estigatio ?
CT head
Visual evoked potential
LP
MRI

78. A woman after removal of central venous line lady developed facial swelling and swelling
a ou d the e k. Whats the ost app op iate i estigatio ?
CT chest with contrast
CT head and neck
Chest x-ray
USG Doppler
79. A question about self-prostate examination
Not sensitive and not specific
I do t e e e othe optio s
80. A gi l ith e u e t dizzi ess e tigo e e
management?
EEG
Ct
Reassure it will be gone
ENT referral

o th. Whats the

ost i po ta t step i

81. 28 years old female worried about breast ca as her friend had it. On examination she is ok,
o fa il histo . Whats ou a age e t?
Mammography now
Reassure no further investigation
82. 43 years old lady presents with painful upper outer firm mass in her right
most possible diagnosis?
Fibro adenoma
Breast cyst
Breast cancer

east. Whats the

83. Young man playing football falls on the ground suddenly, regains consciousness within 5
i s a d sta ts pla i g afte
i s. Whats the ost p o a le diag osis?
Vasovagal syncope
Postural hypotension
Cardiac arrhythmia
84. Child if anybody coughs at home would go and take a shower. Parents tried all measures
ithout e efits. Whats e t i
a age e t?
Fluoxetine
Paroxetine
Fluvoxamine

85. A CT of a man with history of

diagnosis?

alig a t

ela o a

ea s ago. Whats the

ost p o a le

Cerebral tumour
Metastatic malignant melanoma
Cerebral haemorrhage
Cerebral infarction

86. A question about a girl who is infected but was not vitally stable her blood pressure was
90/60. Asking about nest important step in management?
Antibiotics
Iv fluids
87. A old a o plai i g of i i al de e tia thats ot i te fe i g ith his life. His isio is
6/8 on left and wears glasses for it. He lives with his wife in their house. He drives a small
bus in his community and came to you for check-up fo e e i g his d i i g li e e. Whats
the most appropriate action?
Check his visual acuity if ok give him the licence
Tell him he cannot drive anymore
Check his mental state if MMS above 25/30 give him the licence
88. An ultrasound picture of a young man given asking the most appropriate next step?

Reassurance
Alfa feto protein
CEA

89. A patie t ith MI histo

o ths ago, p ese ted ith a ute hole stitis. Whats the
appropriate management?
Percutaneous cholecystectomy
Analgesics
Antibiotics
90. Which drug taken in 3rd trimester has prolonged neurological consequence in baby?
Anticonvulsants
Antipsychotics
91. A pregnant lady with a history of gestational diabetes. When to screen for GDM?
FBS at 20 weeks
OGTT at 20 weeks
Insulin resistance now
92. A fa e a e to ou afte a di t i ju i his leg. He did t take a teta us a i e
efo e. Whats the ost i po ta t afte de ide e t of the ou d?
Tetanus immunoglobulins
Tetanus toxoid and tetanus immunoglobulins
Tetanus toxoid and tetanus immunoglobulins and full vaccination
Tetanus toxoid and tetanus immunoglobulins and penicillin

ost

93. Patient with renal failure, uraemia and increase creatinine, with PTH 11 and Phosphate very
increased, Calcium normal upper limit what to do?
Parathyroidectomy
Phosphate restricted diet
Ca supplementation
94. A patie t u de e t al e p osthesis a d o
Warfarin dose,
INR Dose
1.54
1.8 5
1.8 6
2.1 ?

a fa i . Whats the a fa i dose eeded?

5
6
7
8
9

95. Child with URTI, few blood cells and +protein, after 1 week URTI resolved but urine analysis
has fe lood ells, hats the diag osis?
Glomerulonephritis
IgA nephropathy
Nephrotic syndrome
Benign transient proteinuria
96. 55y old lady known with insulin dependent DM, has had right leg amputation 5yrs
previously, now blood pressure 175\90, normal regular pulse, BMI 32, LDL 2.8, s.
triglyceride 4.5,hba1c was 8.5,fasting glucose was 9.5.Which of the following is important to
keep her other left leg from amputation?
Meticulous foot care
Control her blood pressure
Tight glycaemic control
Reduce LDL
Reduce her body weight
97. A pregnant lady sits on a needle in train came for advice?
Give antiviral drugs
Test serum HIV now

 Serology test of needle

Serial check for HIV 3. 6. 12. Mon later
98. 9 year old boy is brought by an ambulance as he fell down from gymnastic equipment at
school. He had one vomiting, no LOC, remembers the fall. On exam a slight swelling over
forehead. GCS 15/15. What will u do?
Discharge with head trauma assessment sheet
CT
Observe for 4 hrs
Observe for 24 hrs
99. Melanoma risk factor in an IT guy.
Sun burn in childhood
Family history of bcc
Irish back ground
Recent diagnosis of melanoma in cousin
100.

A disoriented man and his lawyer asks you to witness. What will you do?
Refuse to witness
Seek legal advice
Witness

101. Old patientwith drug eluting stent and on clopidogrel, now falls and has a fracture of
neck femur FBC and platelet morphology normal but has bruises on the body what should
be done?
Stop clopidogrel immediately and do surgery in 1 week if there is no stent
Do surgery now
Give FFP and do surgery now
102. A patient with uncomplicated varicocele came for surgery, drug eluting stent from
2months.What is next?
Defer surgery for 12 months
Proceed to surgery
Stop clopidogrel for 1 week then surgery
103.

A CT was given of a man with blood pressure 180/110 mmhg and asking management?

Reduce blood pressure

Nil by mouse and observation

104. Alzhei e ase ut so

a t e e e its details
105. X- a e
ad a t fi d a si ila o e of a patie t ith histo of ul e ati e olitis,
p ese ted ith lood stool, a do i al pai a d o iti g. Whats the e t app op iate?
Colonoscopy
Colectomy
106.

X-ray of Small Bowel obstruction asking next appropriate?

Barium follow through

o
a t e e e othe optio s

107. Chest X-ray of apatient suffering from cough with blood tinged sputum, fever 38.5.
Whats the ost app op iate t eat e t?

Procaine penicillin
Amoxicillin/clavulanic acid

108. A Chest X-ray of hilar LN prominent in one lobe and patient complains of intermittent
a do i al pai ith hae atu ia. Whats the e t i estigatio ?

Ace level
Urine microscopy and culture
CT chest

109. A peri menopausal woman complains of mild hot flushes and irritability. She says that
her husband is fed up with her and told her to go and see a doctor to give her some pills.
Whats the e t a age e t?
FSH & LH
TSH

17 october recalls.. Brisbane..

1.female with a history of lower back pain fom many years now came with unilateral red
eye..??
Uveitis..scleritis..episcleritis..conjunctivitis
2. 21yrs girl comes for ankle sprain..what else would you check..?
Blood sugar..smoking..
3. man 55yrs..no family history of prostate cancer.. overallhealthy..family history positive for
colorectal cancer now came for prostate screening? What advice would you give
4..another question regarding prostate screening
5..woman with mother diagnosed breast cancer and sister with ovarian cancer.. came for
screening
.dia eti
age..

s.. o sig ifi a t histo

health othe

ise hat ill ou s ee at this

7..diabetic man with brother also diagnosed as diabetic..what to screen

8.5yr old child..with no dry nights..toilet trained at 2yrs..have h/o consecutive 2 to 3 wet days in
a week from last few months.. otherwise remains dry.. fist test to order
9..oldrecall..husband came with his wife complaining of having high mood .. now she flirts with
you and then becomes angry..dia
10.patient on venlafaxine..becomesirritable..what to monitor..?
11.child with anxiety disorder on antipsychotics and showed much improvement but still he
sometimes become agitated and irritable..? cause?
Normal growing adult behaviour..ADHD..side effects of drug..not enough dose
12.old man with scrotal swelling.. first investigation
13. pic of varicocele.. dia
14.right homonymous hemianopia.. site of lesion asked
15.scnario of lewy body dementia
16.indegionus female with depressive symptoms.. hears voices of her dead mom and
brother..what to ask first

17.diabetic patient came with ankle sprain..xray showed joint sparing at tarsal bones.. whatinx
will you order
18..another question on ankle sprain.. sporty boy .what to screen
19.pregnant female at 34weeks..came after recent flight with chest pain.. during her visit she
beame breathless gradually..and chest pain increased on deep inspiration.. dia?
20.croup scenario
21.asthmascenario..post exercise and night cough. What reventor will you give?
22.asthma scenario..5yr child..monthly breathlessness.. whatpreventor will you give
23..3yr old asthma child..with atopic dermatitis n eczema in family..prevention was asked?
24.child with runny nose..what advice will you give.. SCHOOL EXCLUSION..old recall
25.young boy with sun burn.. to find the risk of developing melanoma what should be present
in history?
26.a female with drug abuse..gives a history that she used to be unable to finish her school
o k a d thus did t o plete he s hool..had o sta le elationship..aand she says she is
always depressed because of this.. what will you find in her history for her cause of drug
abuse.?
Childhood ADHD..familyconflicts..sexual abuse
27.female who left high school to live alone and to practice her alternate medicine..she is
having no social life but she hapilly talks with her clents and the one who are interested in her
medicine..what type of personality disorder?
28.alcoholic came with severe epigastric pain and vomiting.. dia? Duodenal ulcer/gastric
ulcer/varices
29.old lady with history of constipation.. came with vomiting and nausea..she has not passed
stool.. Xray was given..it was more likely a large bowel obstruction.. rectal flatus probe was
passed ut did t gi e he elief.. e t t eat e t optio
30.hip replacement surgery..now have lower abdominal pain..Xray shows air upto sigmoid
colon..treatment asked
31.post hip replacement surgery .. nowdyspnea progressive.. treatment?
32. history of postpartum depression in previous pregnancy.. prophylaxis in 2 nd?

33.female with diarrhea n weight loss in last months.. visitedbali last year.. stool culture
normal.. nowwht investigation will you do next
34.child with only history of crying.. parents are concerned.. what to find in history? I marked
delayed meonium passage
35.ECG pic.. showing 2nd degree heart block.. was on a lot of drugs.. fainted last night in garden
on cold night and his daughter found him.. treatment asked
36.old man with a black lesion on ankle.. what investigation first
37.you want to study effets of vitamin C.. what to do to make results good..?
RANDOMIZATION/RANDOM SAMPLING
38.what is most important in any study design..?? RANDOMIZATION
39.family history of pancreatic carcinoma.. what to screen
40.old recall .. mentally retarded girl with mennorhagia.. ocps failed. What next?
41.old recall.. old man and woman being in a open sexual relationship in a nursery..told by a
nurse?
42.chlamydia diagnosed in a male who had been on a holiday and had relationship with many
female during the trip.. not want his wife to know..? what to do
43.young man with new onset single seizure attack.. advised not to drive for 6months..tells you
that he started driving two weeks ago as he considers himself healthy.. what will you tell him.?
44.ECG pic of ventricular tachycardia.. what drug to give first
45.CT abdomen of a female with right hypochondrial pain.. it seemed lie a hydatid cyst..
46.a man developed weakness in his right arm a few days ago.. he already gives a long history
of weakness in both legs ? what investigation most ippropriate
47.a man joined a research for effect of an antihypertensive,,then he became well with the
drug and wanted to quit the research .. what will you do?
Force him/respect his opinion/refer him to some other doctor for his hypertension/quitfrom
research and continue treatment
48.PIC of herpes in an old man from 4weeks.. treatment?
49.postpartum contraception but want to conceive early

50.pic of a blackened nail.. just came after snow skiing.. treatment?

51.chestXray,, seems metastatic lesions in lungs.. what investigation next..?
52.superior vena cava syndrome.. what next inves?
53.Xray of toxic megacolon.. what first treatment option
54. female with burning sensation on right cheek. Loss of pain and temperature sensation on
right face and left body..where is lesion?
55. historyof..gradually decreasing loss of vision in both eyes,, now sudden loss of vision in one
eye.. what investigation first?

OCT-2015 recall- Perth

1. A diabetic mother gave birth , the baby apgar 6 in 1 minute, 9 in 5 minute, Blood sugar
level was 25 at birth, given breast feeding and 2 hour later the sugar level become 20.
General condition was good. What is your management?
a.
b.
c.
d.

Breast feed
IM glucagon
IV glucose
HBA1C

2. 3 day old baby with bilirubin 280, what will you do?
a. Phototherapy
b. Exchange
c. Reassurance
d. Increase Breast feeding

3. A 40 year old lady, come for general medical check-up, BMI-25, BP normal, No family
history of DM and Hypertension, how will you monitor regarding with her glucose level?
a. OGTT 2 yrly
b. RBS 2 yrly
c. FBS 1 yrly

Other are I forgot.

4. 5 yr CVD risk chart. The risk levels are given so easy on..

5. A sexually active lady came to your clinic as she missed to take her day 6 and 7 pills, she
had sex on day 8 and then she started her 1st ocp on day 10, what will be your
contraceptive advice?
a.
b.
c.
d.

Continue OCP
Emergency pill
Start new pack
Stop ocp and monitor whether she got pregnant or not

6. 50 yr old man whose father had recently died with the CA prostate come to your clinic
regarding with the screening for prostate cancer.. You have done DRE, which was
normal.
What will you do?
a. PSA in next 2 wk
b. Do nothing
c. TURP

7. 2 thalassaemia minor parents want to know the risk of getting the affected thalassaemia
minor offsprings in their marriage. ( the question was exactly the same, I was confused
what to choose between affected and thalassaemia minor , sometimes, easy one will
become difficult in exam )
a.
b.
c.
d.
e.

25
0
50
75
100

8. A primigrav lady in 39 wk, in labour pain, os 3cm and liquor meconium stain, CTG
normal, what is your management?
a. Fetal scalp blood sampling

b. Continuous CTG
c. LSCS
d. Induce the labour

9. Farmer, getting high fever, abdominal pain, anaemia but no rash. Liver function test
showing Hepatitis pattern. What is your diagnosis?
a. Brucellosis
b. Ecoli
I forgot the remaining options but no Q-fever and other zoonosis was not in the
options.

10. One easy handbook question, Amoxil follow by diarrhea, asking the causal organism.
a. Salmonella
b. Shigella
c. Clostridium defficile
d. Ecoli
e. Vibrio cholera

11. Fatty lady getting menopause. The vagina show oestroginized.

a. Peripheral conversion of ----- to oesterone
b. Peripheral conversion of ---- to oestradiol
c. Exogenous oestrogen
Other I forgot, I choose B.

12. A middle age man came with TIA symptoms, no other CHADS2 feature, but he had
history of GI bleeding, what is the drug of choice.
a. Aspirin
b. Clopidogrel
c. Heparin
d. Warfarin

13. A man came with TIA, choice the most benefit drug with rapid action in emergency.
a. Streptokinase
b. Warfarin

c. Heparin
d. Clopid
e. Aspirin

14. A farmer came with lacerated wound, he had completed 3 Tetanus vaccine and his
latest booster dose was last 6 yr ago. What is your management?
a. TT
b. TT and IG
c. Antibiotic

15. A 6 yr old girl had sexual behavior in school, old recall.

a. Sexual abuse

16. Single man came back from ASIA had sex with many women and after 3 month he got
sore throat, fever, lymphadenopathy. Diagonosis? ( there was some other features
leading to HIV but I forgot, My answer was HIV )
a. HIV
b. Syphilis
c. Malaria
d. Dengue
e. Reiter

17. An old lady got head surgery, on post op 3 day, she got confused and her Na level was
120. There was no sign of dehydration and hypertension.
a.SIADH
b.Dehydration

18. An old man got bloody saliva and pain in ear. The vocal cord examination showed
paralysis of vocal cord. There was a mass in posterior mediastinum. Primary site of
tumour?
a.Mouth and gum tumour
b.Tongue

c.Submandibular
d.Posterior nasal tract

19. An old lady recently moved to her daughter house, having cough at night and early
morning. Dyspnea and wheezing also present. No fever and no relevant past history.
What is ur diagnosis?
a. Asthma
b. Post nasal drip
c. Emphysema
d. Pneumonia

20. There was 2 similar questions in which, chronic smoker having ulcer in medial malleous,
pulse absent, discoloration + and painful, mixed with venous insufficiency sign, arterial
insufficiency sign and metabolic disease- DM and HT. Asking the cause of the ulcer.
a.venous ulcer
b.arterial ulcer
c.diabetes ulcer

21. old lady come with memory loss, recurrent history of fall and urinary incontinence.
Asking diagnosis.
a.normal pressure hydrocephalus
b.EDH
c.SAH
d.SDH
e.Alzheimer

22. An old recall of pseudodementia.

23. CXR showing APO. A man come with dyspnea and history of heart disease and
hypertension present. There was no oedema and no chest pain. Management?
a.Digoxin
b.Frusemide
c.Amoxiclav
d.Amlodipine

e.captopril

24. A middle age lady came to emergency with severe distressing wheezing. Which is not
relieved by hourly salbutamol. What is the best management?
a.IV hydrocortisone, nebulized salbutamol, Oxygen
b.IV hydrocortisone, IV NaHCO3, Oxygen
c.Intubation
25. A 19 yr old girl, left her family last 3 yr ago, comes to you with history of criminal
offences, drug abuse and prostitution..Which of the following is the most likely
diagnosis?
a.Borderline
b.GAD
c.I forgot the other but I am sure there was no drug abuse, antisocial and conduct
disorder in the options as usual.

26. A 2 mth postpartum lady ,having the thought of falling her baby when she touch her
baby and she tried to stop thinking like that but not successful. Diagnosis?
a.OCD
B.Anxiety
c.postpartum depression
d.postpartum psychosis
( over valued idea was not in option )

27. 52yr old menopausal lady come with dyspareunia during sex last night but not asso with
bleeding. Her latest pap smear was 2yr ago and which was normal, she got menopause
last 2 yr and had no sex for a long time. Diagnosis?
a.vaginal atrophy
b.Ca cervix
c.Ca endometrium

28. Parents bring their 2 yr old son, having difficult breathing for 3 day, last night he got
fever and severe respiratory distress and loud stridor. Management?
a.Nebulised adrenaline
b.antibiotic
c.Bronchodilator
d.oxygen

29. 16yr ballet dancer, present with amenorrhoea , BMI 15 and breast bud present. what is
next management?
a.FSH
b.review in 3-6 mth
c.refer to adolescent health unit
(no USG screening in the option )

30. Which of the following is the feature of anorexia nervosa?

a.Bradycardia
b.Alopecia

31. Which of the following is the most teratogenic substance?

a.Mariguana
b.Amphatemine
c. diazepam
d. methadone

32. Old lady come with pain in LIF, which of the following is the investigation of choice?
a. USG
b. CT
c. Colonoscopy
d. Sigmoidoscopy
e. IVP

33. X-ray showing shoulder dislocation,

a. Sensory loss in deltoid
b. Sensory loss in lateral aspect of forearm
c. Sensory loss in medial aspect of forearm

34. A man comes with varicose, the clinical finding would be

a. Spermatic cord can be palpable separately
b. Spermatic co d a d its o te ts a t e e a i ed
c. Soft and reducible mass

35. Long lab data given.How will you differentiate hyperparathyroidism and Malignancy?
a. High alkalinephosphatase level
b. High calcium level
c. Dehydration
(no phosphate level , no clinical feature and no past history were not in the option )

36. A child come with multiple ulcer in tongue, buccal mucosa and tonsil, there was also a
small ulcer on his lip. High fever present. Diagnosis?
a. Herpengina
b. Herpes simplex stomatitis
c. Glandular fever

37. 39 wk pregnant lad o es to ou e ause she did t feel fetal o e e t fo da s,

general condition good. No pain and no loss per vagina. A CTG was given showing
normal pattern. How will you advice her?
a. Come back in 24hr
b. Come back in next routine followup
c. Admit and induce
d. Admit and observe
e. Continuous CTG

38. A teenage girl comes with discomfort in her lower abdominal and USG shows 4cm solid
and cystic mass in uterus. Asking diagnosis?
a. Dermoid cyst
b. Corpus luteum
c. Endometrium CA
(no Teratoma in option)

39. A picture of chronic smoker man showing all 5 fingers are amputated.
Asking causes?
a. Burger disease
Sorry I forgot the other options.

40. A business man come back from trip, history of MI present,he got sudden chest pain and
dysponea, ECG given, not showing MI pattern.
Further investigation?
a. CTPA
b. Echo
c. CXR
d. Carotid USG

41. 68 yr old lady coming for vaccination, her daughter is going to deliver a baby in 2 month,
ask about other vaccination in addition to her annual influenza vaccine.
a. Pneumococcal
b. DTP
c. H-influenza vaccine
d. Hepatitis vaccine
e. TT

42. A public transport bus driver recently got first time seizure, he is not having any history
of epilepsy. As a doctor, how will you advice him regarding with his job?
a. Avoid driving for 6 mth
b. Notify the DOT
c. Notify his employer
d. He can drive now

43. Mother bring her 13yr old son, small in his class, parents are in normal height. His bone
age is 11, what is ur advice?
a. Reassaure
b. Increase nutritional support
c. He will remain small in the future

44. A patient having Crohn disease and you will start infliximab to him. Before starting
Infliximab, which action need to be done?
a. Screening for TB ( It was shown in weird name, but it is the answer)

45. A child having fever, neck stiffness and photophobia, CSF showing viral infection
pattern.
Asking causal organism.
a. Ecoli
b. Echo
c. Herpes
d. H-influenzae
46. A CT showing small SDH, asking diagnosis.

47. A photo of lower limb of man having fever , malaise, lymphadenopathy , showing ulcer
on foot and pus discharge present. asking investigation..
a. HIV
b. Sorry I forgot the others.

48. A photo of a child showing rash on the abdomen, history of fever and antibiotic given,
after that, rash appear. I am not sure there was pruritus or not?
a. Chicken pox
b. Measles
c. EBV
d. Allergy

49. A child came to emergency ater being trapped in a fire. On examination husky voice
present. next management?
a.
Intubate
b.
Oxygen
c.
iV fluid
d.
Observe
e.
Discharge

50. Parents bring their 4 yr old daughter with known case of heredictory spherocytosis,
having marked pallor, spleen is 4 cm below the costal margin. HB-4.6, other lab data
given but I forgot. Asking the management.
a. Splenectomy
b. IV fluid
c. Monitoring

d. Reassaurance

Notes about my October exam - Ashraf

Some of questions or topics I can remember:
1- Nicotine replacement therapy
2- Which type of study you need to know why chlamydia is spreading in community
3- Neonatal jaundice
4- Fibroadenoma and breast cancer
5- Sexual abuse in school girl was found mimics sexaul actions in school
6- Triad of cholangitis
7-Penicillin rash
8- G6PD deficiency and Gilbert
9- Tetanus prophylaxis
10-ECG of VT
11- ECG of VF
13- Treatment of SVT
14-CT brain of white patch in patient taking warfarin
15- Long lab results I think for multiple myloma
16- Prostate cancer
Anorexia nervosa confusing scenario
17- Bulimia nervosa confusing scenario
18- Grief reaction confusing scenario
19- CXR of pleural effusion asking for diagnosis
20- Question for intercostal tube but with some confusion about choices
--------------------------------------------------------------------------------------------------------------------

oct 17th recalls

1. MVA patient with 96% saturation on room air, finding it hard to breath b/c of intractable
pain and taking shallow breaths due to pain, multiple bilateral rib injuries, ct provided
showing small hemothorax on rt side what is the immediate treatment to help him
breath
Intubation

Morphine
Chest strapping
Underwater seal

2. Pt wit infertility on sulphasalazine and past hx of methotrexate and mumps>>> old

recall
3. Hb Pic of molluscum in child >>asking for exclusion
4. Old recall of microgynon 30 and continuing pain and want to conceive after 12 months
5. Me tall halle ged gi l ought
othe aski g fo o t a eptio t ial of OCP did t
work well options had mirena , implanon, ablation,
6. Old recall of vaccination for grandma whose daughter is expecting a baby
7. Question about meningococcal prophylaxis where friend of child had spent night at
their place and was later diagnosed to have meningococcemia. Valid Options included
ceftriaxone orally
8. MMR a i atio if hilds

othe had egg alle g

9. MMR vaccination if child had history of perioral swelling after eating egg
10. Pt tested positive after triple therapy on urea breath test what is the cause.. options
included resistance to antibiotic amoxicillin , low yield of urea breath test
11. Study to find out association btw HTN and MI
12. Mother came to clinic who has a drug addict son violent towards mother what will you
do options included a) call police b) call son and talk to him c) ask lady to call police D)
gi e he add ess of o e s shelte
13. Pt on clopidogrel weeks after coronary stenting presents with fracture femur , how will
you proceed
Regarding repair

14. Case of pericarditis

15. Ecg of hyperkalemia K 6.5 asking for management
16. Old patient with prostatism collapses in bathroom cause >>> stroke, vaso vagal syncope
17. Athelete collapses on ground returns to play after 30 min cause vaso vagal , cardiac
arythmia
18. Ecg of mobitz type two ECG on polypharmacy asking what to do options included stop
digoxin , pacemaker
19. Two questions about pneumonia
20. Influenza case asking management
21. Pregnant lady with measles presents within 24 hours of rash asking management
options included do nothing , administer immunoglobulin , trace contacts
22. 3 years old Child develops pertusis has a five moth old sibling nothing mentioned about
completely immunized asking for management
23. Scenario of brucellosis about diagnosis ( organism)
24. Jaundice in a full term healthy baby feeding well developed after one week asking for
causes conjugated was 120 total bilirubin 240
25. Another scenario of neonatal jaundice with bilirubin 410 asking for management
options included exchange transfusion , photo therapy , discharge
26. ECG of STEMI presented within two hours asking for mangemt options included aspirin
,morphine , coronary angio ,tPa

Oz land recalls

15/10/2015 Istanbul
1) photo of old woman with red parotid
Bad oral hygiene
virl infection
sialadinits
2) male young age neck swellinggradually over one year
not painful not tender
did not increase in size
healthy no symptoms

typical this picture

a-lymph node
b-lipoma
c-abscess
3) severe persistantpain infront of the ear with redness
a-herpes simlex
b-trigeminal neuralgia
c-herpes zoster
4) woman came from long airplane trip complaining of dyspnea, stitching inspiratory
pain on left side with left lung base crackles and fever
a-pneumonia
b-blohm disease
c-pulmonary embolism
5) the woman you asked about her family history.. ((the wheel of the busover the hill
..ride bicycle . What im speaking?))
a- circumstantiality
b- derailement
6) woman severely depressed wtbis the indication for ect..
suicidal idea
7) woman have severe morning depression that resolve by the day she refusing to take
anti depressantwhatsyor advice??
a- Partial improve by six months
b- if you did not take medicine the disease will progress to suicide
8) postoperative delirium in non alcoholicold female agitated and aggressive
a-lorazepam
b- diazepam
c-olanzapine
d-respiredone
e chloropromazine

9) patient requested DNAR but her son incisted to do full support for her
a-refer to hospital legal
b- incest to do what the patient want
c- family meeting
10) xray of hilar lymphadenopathy and bilateral basal infiltration with along history of
dyspnea presented with hematureaand hypercalcemia
a- ACE level
b- CTchest
c- ESR
11) sudany 3 child came for vaccine what else will check
12) woman with cervical abscess asking for diagnosis
13) Anthology pic

for treatment?
14) Pregnant woman 18 weeks with pain in her thigh and sweeling of the ankle what in
history is suggesting diagnosis?
a- previous pregnancy had dislocated symphesis pubis
b- coz of she sit for long time in squatting position
c sister had stroke in 35 tears old
15) Mmr vaccine and egg allergy

16) School exclusion

17) case of leg swelling, redness, diabetic temp 37 , tx

Lmwh
Ab
Warf
IV heparin
18) Case of swollen limb hot red with fever and history of DVT intialinvestigation ?
Doppler
blood culture
cbc
CT
19) Brochiliitesaskig for the organism
20) TB meningitis asking for the organism
21) Ecg of inferior MI
22) ECG of first degree heart block
23) ECG of sinus bradyseverly symptomatic
24) Meningitis postexposureprophyalxais
25) CRAO what investigation ?
26) Lewy body dementia asked for diagnosis

27) child with monthly asthma

Best for prevention ihalation
SCG
Fluticason
Salbutamol
Salmetrol/ fluticason
28) child 4 yrs with two yrabd pain on off u can feel a mass on rthypochondrium
Wilms
Vesicouretric reflux
neuroblastoma
29) Waldenstrommacroglobulinemia (pic)
patient came with rigors and fever and right lower lobar pneumonia or some infection
like this admitted and started ampicillin and azithromycin minimal time generalised
vesicular rash appeared asking management
a. Immunoglobulin
b. cease ampicillin and start ceftriaxone
c. prednisolone
d. Ganciclovir
e. Amphotericin
30) preg with placenta previa 39 week presented with bleeding twice, no she is fine
admit her underobservation
discharge home
induction of labour
cs
31) year sold woman came for check up , speculum examination done revealed cervical
erosion, her pap smear two years back and was normal.
Refer her for colposcopy.
Treat her with local cream
Cauterization
Pap smear
32) 27- pat with renal failure got utitx
Gentam
Nitrofurantion
Trimethop/sulpha
ampicillin
33) farmer with rthypochondriakpian, hx of hemicolectomy, us provided ix
Hydated serology
Biopsy
Ct
Cs
34) woman with itchyness and red vagina
see hyphy

35) parents got a new born wt is ur advice

dtpa to parents
dtpa to parents and grands
influenza vacc
36) secondary amenorrhea woman 2 yrs
Lh, fsh above n. , E low, prolactine 250
Not intersested in concieving
Pop
Menopausal hormons
Coc
37) woman secondary amenorrhea two yrs, E n, lhsfh, testosteron, prolactine all n ,
cause?
Pcos,
Pitutary Adenoma
Idiopathic hypothalamic dysfunction
38) woman with child 3 yrs ago cannot concieve , no contraceptives, regular cycles, mid
cycle sex,, cause
Abn sperm count
Tubal damage
Long leutialphace
Bad timing of sex
39) worse combination of ab on renal function
I choosedgenta and >>>>>>>>>>>>>>
40) hypertensive man on ace, diuretics and another drug, presented with high jvp, leg
edema sinus tacchycardia, no basal cripitationtx
a bb
b digoxin
c spironolactone
d verapamil
41) asthmatic child with attack, 6puffes of salb his o2 is better 95% but still irritable
nebulizatin by atrovent
12 puff
hydrocortison
42) In labour .after epidural anasthesiafetalht rate decreaded to 70 then gradually
back to normal. Wt to do nxt
immediate CS
I chose iv fluid
TOCOLYTIC

43) woman came to u saying her 15 yrsson is abusing her like beating her, she think he
is drug dealer...
tell her obligations to talk the police
Admit her son to hospital for drug addiction
Refer her to refuge shelter
notify child protection authority
44) pat with sudden severe epigastric pain, vomiting, hx of gastric ligation 6 months ago
next ix
Barriumswalkow
Ct
urgent surgery
45) obese woman felt a mass in groin, on exam mass below and lat to pubic tubercle
non reducible not affected by cough or straining
pt is well no complaint?
Us
Biopsy
CTabdomen
FNAC

Recalls 15-10-2015
Istanbul
1-male pt , with RA, on methotrexate and hydroxychloroquine, planning to start family what ur
advice:
a-stop methotrexate and continue hc
b-stop hc and continue methot
c-stop both and give leflonomide
d-stop both and give adalimumab
2- picture of child 4 yrs old with paraumbilical hernia , mother saying asymptomatic , small ,long
period whats management:

a- Aspiration
b- Surgery
c- Reassurance
3-picture of male child 2 yrs old , cong ing hernia, exam showing soft swelling , partially
reducible, investigation:
a-no invest
b- us
c-ct
4- 48 yrs old , splenectomy 7 yrs ago via midline incision dt trauma , now with swelling , large ,
at site of the scar, how to confirm diagnosis:
a- coughing with lying down
b- coughing with standing
c- elevate pt shoulders passively while lying down
5- old age , fall on rt side, pain on ant hip region, x ray : no hip fr, so bone scan: confirmed pubic
bone fr management:
a- bed rest 2 wks
b- mobilize as tolerated
c- bed rest for 6 months
6- homeless middle aged female, picture of rash over wrist , this rash on both wrists and groin ,
ttt:
a- cortisone cream
b- tar
c- benzyl benzoate
7- child , bite by black snake on his finger, what is initial management:
a- crepe bandage from finger to axilla
b- antivenom acc to body wt
c- immediate transfer to hospital
8- 18 yrs old , football player, asthma on fluticasone, picture of gynecomastia, cause:
abcd-

fluticasone
kleinfilter
normal puberty
anabolic steroids

9- two scenario of git bleeding, one colonoscopy not reaching past hepatic flexure, other needing
3 units packed RBCs daily ------- capsule endoscopy
10- child 4 yrs old, xray of lt pleural effusion rising to axilla, fever, exam: equal air entry , no
adv sounds, diagnosis:
a- pleural aspiration
b- blood culture
c- ct chest
10- picture of old female with red swelling in upper neck ? parotid? Causing spasm of neck
muscles and jaw muscles with difficulty in mastication:
a- parotitis
b- cervical abscess
11- female 8 yrs with forearm fracture , urine dipstick done after managing fa fr in the evening
++, on followup dipstick repeated few days later in the morning and was negative, diagnosis:
a- due to her trauma
b- orthostatic prtnuria
c- nephritic
12- female 10 yrs , otherwise healthy with no ss, no illness, dipstick ptn + what to do to reach
diagnosis:
a- renal biopsy
b- s creat, BUN
c- sequential urinary ptn over 12 hrs
13- 4 yrs child, generalized convulsions for 5 min, on exam htn , ptnuria +++ , hematuria +++,
after managing bl pr next:
a- low ptn , low salt, high cho diet
b- high ptn ,
14- 4 yrs old, 2 yrs history of recurrent abd pain and vomiting each attack lasting 12 hrs, last
attack felt in lt flank , urine analysis and culture negative , how to reach diagnosis:
a- small intestine meal and followthrough
b- us during the attack
c- s creat and BUN , electrolytes
15- child with attack of asthma , not relieved by 6 puffs of salbut what next?
Another puffs of salbutamol

16- adult with long history of dysphagia , more after certain types of food lasting for few days ,
also history of asthma, endoscopy done: multiple constrictions , diagnosis:
a- eosinophilic esophagitis
b- achalasia
c- ca esophagus
17- picture of swelling in supraclavicular fossa, present for past 12 ms , not changing in size,
soft, non tender diagnosis:
a- lymph node
b- lipoma
18- old age female with nausea, vomiting, abd pain , constipation, tenderness rt iliac fossa,
xray given of ----- caecal volvulus
19- pt on selegiline for long period , recently started sertraline for depressed mood,
developed abd pain , diarrhea , management:
a- stop sertraline
b- stop selegiline
c- stop both
20- pt came co of attacks of fading colors in the sky , staring look to the sky , when doing
MRI brain , wheres pathology:
a- medial temporal lobe
b- parietal lobe
c- frontal lobe
21- manual worker with history of rt hand weakness for few hrs resolved spontaneously,
similar attack 2 wks ago, after exam and giving aspirin:
a- go to work after 6 ms
b- Donot work until cleared by ur gp
22- manual worker with swelling of whole rt ul compared to the other side after heavy work
by saw machine:
a- Muscle sprain
b- Subclavian vein thrombosis
23- young male, small cyst in lt testicle, not bothering him, above testis , testis no, other side
no , uscystic , next:
a- Tumor markers

b- Surgery
c- Review in 3 ms
24- female , pg 18 wks , sudden frontal headache, bp 80/60, pulse 90, on exam: confused and
drowsy, heart normal what inv:
a- Mri
b- Us
c- Echo
25- female , menopause, starting HRT, least to resolve with ttt:
a- Depression
b- Insomnia
c- Hot flushes
26- female 52yrs, menopause , bleeding for 24 hrs after sex, no sex in previous 2 yrs, no pain
or discomfort during sex, diagnosis:
a- Atrophic vaginitis
b- Ca cervix
c- Ca endometrium
27- female , 13 yrs away from home 8ms ago, rape 3 ms ago, coming for termination of
pregnancy, who to inform:
a- Parents
b- Police
c- Sexual assault services
28- female, vaginal bleeding after 8 wks of amenorrhea, urine pregnancy test positive,obese:
so pelvic ex difficult, next to diagnose ectopic pregnancy:
a- Quantitative bhcg
b- Transvaginal us
c- Trans abd us
29- female , vaginal bl after 8 wks of amenorrhea, urine preg test positive, what in history is
dangerous:
a- Bl clots
b- Shoulder tip pain
30- female , pap smear result as follows: atypical cells, inflammatory cells, normal endocx
cells, candida hyphae, whats next:

abcd-

Repeat after 1 m
Repeat after ttt of candida
Colposcopy
Cone biopsy

31- female , pap result showing LSIL CIN 1, next:

Repeat pap after 1 yr
32- adult female , mentally retarded brought by mother with menorrhagia, failed several trial
of oral pills dt non-cmpliance:
a- Copper IUD
b- Mirena
c- Implanon
33- male ,coming for ankle sprain, smoker , what to screen, 22yrs old :
abcd-

HTN
Testicular tumor
DM
Cholesterol

34- female ,25 yrs , 2 SD alcohol per day , planning to conceive in the future, ur advice:
a- Stop alcohol immediately
b- Limit alcohol to 1 SD per day
c- Holiday of alcohol 2 days per wk
35- female, 25 yrs , smoker, planning to conceive, doesnot want to stop smoking, the most
likely risk:
a- Premature labour
b- IUGR
36- female 36 yrs , obese , attack of dizziness and lightheadedness in gym, came to u, pulse
35 , ECG of sinus bradycardia, next:
abcd-

Thyroid function test

Oxygen
Atropine
Pace maker

37- some ecgs difficult

Recalls 17-10

1.Pt with diabetic foot admitted at the hospital,1-cm ulcer on the 5th toe, with purulent
discharge and erythema on the dorsum of the foot. After debridment
oral amoxicillin-clavulnate
Ivticarcillin-clavulate
2 21- year-old o ,

ought

othe . Does t o k, does t talk

u h,a hedo ia,

He was good at high-school

Citalopram
Risperidone
3.pic of scabies, asking Rx
4.red eye, decreased visual acuity, normal pupil response
Irits

keratitis

angle-closure glaucoma

5.young girl usually stays at home,and sees some friend there. When going out , she
experiences distressed palpitation, Dx
Agrophobia

social phobia

5. a child with slightly delayed speaking, interested in math and computer game, doenst talk
u h , de eased e e o ta t,
Asperger

autism

9.relateive risk of progression of IHD not taking aspirin among smokers

Aspirin(+) group 1 patient 99healthy
Apirin(-) grouo 2 patient 98 healthy
100% 200%

2%

1%

10.patient with malaise,fatigue

Western blot
HIV test
Elisa +
False positive
Repeat the test after some time
11.a man with recurrent anal abcess, cause?
Crohn

anal fistula

12. a boy with many episodes of staphylococcus areusabcess and scars on tonsil
x-linkedagammaglobulinemia
and all other inherited diseases

13. patient on CCB and sertraline, after increasing dosage of sertraline, pt experience
palpitation
What is the cause?
Sertraline
Drug interaction
13.many cases on bowel obstruction,mostly asked about causes
14.3 cases that cxray was given asking about the Rx. It seems we should study obstructive and
restrictive pulmonary diseases more
15.pt with pancytopenia and back pain and night sweat and weight loss
Multiple myeloma acute leukemia
16. a colleague is becoming increasingly forgetful, also occasionally disoriented, what to do?
Inform registration authority
Talk to him first
Inform head of the hospital

17.4 test on screening methods for DM , Breast cancer , BP, prostate cancer
18. what is more suggestive of blow-out fx of orbital rim?
Diplopia in upward gaze
Diplopia in direct gaze
19.child with head trauma some days ago, mother is a nurse, asks you to do CT scan
20.recent episode jaundice, rise in transaminase ultrasound: dilatation of CBD, cholelithiasis
ha e ot de ted. I thi k pt did t ha e a do i al pai
ERCP CT scan MRCP

Recalls from Bangalore 2015 October

1)The test we should do before starting infliximab therapy:
Quantiferon TB
2) AN 8 year old girl performing well at school,told by schoolteacher to mother that imitating
sexual act in playground,mother tells you this in consultation,what do you do?
a) tell mother you have to notify child protection agencies as there are chances of sexual abuse
b) evaluate for precocious puberty
3) what contraception will you use for a woman with migraine+hirustism+acne ?
a) oestrogen plus cyproterone acetate

B) oestrogen plus drospirenone

c) depot mpa
4) what is the benefit of using the yasmin contraceptive pill?
a) least dosage of oestrogen
b) causes weight gain
c) prevents acne
5) a woman forgot to take first two active pills of her ocp cycle,had sex the next two days and
presents to you, what is your advice?
a) take two pills together and continue next in 12 hours
b) take levonorgestrel one now and 12 hours later
c) discontinue and do pregnancy test
c)use condoms
6)a very vahue qs about cns:
Atypical left sided chest pain radiating to back with left sided leg weakness with bilateral thigh
tenderness ,what investigation will you do?
a)emg
b)ct pelvis
c)mri
d)blood culture
e)lumbar puncture
7)by the time a child starts kindergarden at three years:what skills must he have mastered?
a)speaking sentences fluently
b)kicking a football
8)two viral bronchiolitis question just treatment : oxygen,other options
antibiotics,antiviral,steroids

9) a child with asthma,what bedside test will you do?

a) peak flow spirometry
10)the question you will ask to check reliability of an rct of two new drugs:which has better
efficacy?
A) were equivalent doses of drug used?
b) which year was it done?
c) which country was it conducted in?
11)a second trimester woman comes with lower abdominal pain,performed appendicectomy
ten years back,what could be the cause?
a) torsion of cyst
b)uti
c)red degeneration
12)old recall: a patient comes for admission ,fights with nurse,asks for private room and wine
and accommodation for dog,tell you that you will understand because your status is not like the
nurses,what personality disorder?
a) schizotypal
b)narcissistic
13)restraining a person with severe abdominal pain due to acute pancreatitis,after security has
arrived
a)oral benzodiazepine
b) im haloperidol
c)iv diazepam
14)a drug peddler complaintis of delusions,thoughts of violence,lack of interest,what drug?
a)olanzepine
b)lithium
c)diazepam

15) a patient ,i think in 60s,living alone,competent,competent,tells advance directive,do not

resuscitate,she falls ill and loses consciousness,children want everything to be done
a) do as children say
b)take matter to family court
c)talk to state court
16)a patient on polypharmacy,started on verapamil two weeks ago,develops
headache,nausea,palpitation,cause?
a) verapamil
17)A patient 52 years ,how often screened for diabetes?
a) ever y three year fasting bgl
b)screen now
c) every three years hba1c
18) indicator of familial hypercholesterolaemia
a) tendinous xanthomas
19)an xray: i think dissection of thoracic aorta
t o e gs: o e a h th ia, do t e e

e se o d o e

21)a woman 38years comes for breast cancer screening following her best friend diagnosed
with breast ca
a) tell her no screening required till 50 years
b) refer for counselling
22)a boy 13 years,constantly at fifth percentile for height ,tells you he is shortest in class,what
will you tell him?
a) something is seriously wrong with you,you have to be fully evaluated
b) you will achieve mid parental height
23)a child with recurrent ear discharge,referred ear pain,with painless cervical lyph node
enlargement,how can you find cause?

a) do idl
b)clean discharge and view with otoscope
c) gram stain and c/s of discharge

Recalls of 16th October Istanbul

1. The picture of muloscom and the days that the patient must be excluded from school was
asked o eed to e lusio
2. The young male had a history of mumps and is consuming some drugs and now he has found
to have severely disturbed semen analysis with severely decreased sperm count. What is the
easo fo this o ditio sulfasalazi
. Whi h stud

a fi d a asso iatio

. Whi h stud

a fi d the easo fo

et ee HTN a d MI oho t
e

ases of sal u ella ase o t ol

5. Which study can find a relationship between "the number of moles" a person have and
de elop e t of ela o a I used to e ag eed ith oho t, ut that ste
as ot o plet
and didnt say the number of moles. I think if the number of moles is the factor, you can do a
case control that is cheaper and easier than cohort
6. The farmer with history of colectomy for colon cancer. Now have RUG pain. The US of liver
as depi ted It as a solutel a etastasis so e little solid depositio , o sti . The ost
important differential diagnosis in options was hydatid cyst
7. Four years old boy have nocturnal enuresis, but throughout day is dry. He dosnt have any
a o alit i histo a d e a eassu e the
8. The CXR of a patient with dyspnea and hematuria. The X ray had bilateral hilar LAP, that was
o e p o i e t i o e side. The i estigatio as asked se u Cal iu . ACE a d a tou
test were not included in options.

9. The picture of 6 months old baby with a mass in scrotom that was there from birth and is
increasing in size. The i estigatio as asked The pi tu e as i gui al he ia a d I hose U
of scrutom.
10. An old patient with malaise and weight loss and general LAP and anemia and
th o o tope ia a d l pho utosis a d eut ope ia i la s. What is the t eat e t I did t
remember the treatment of CLL and I chose radiotherapy, but unfortunately, I dont remember
the other options.
11. The homeless disturbed patient brought by police with delusion of he is followed to be
killed because of X rated CDs. What is your first manage e t ask ollate al histo f o
police
. The CF of HV e i gitis ith RBCs. What is the
to prevent it from progression to encephalitis

a age e t I hose a

lo i i o de

13. The young footbal player that collapesed in game and returend to consiousness after 5
i utes aso agal
. The ase of eosi ophili eosophagitis. Whats the t eat e t I hose fluti aso e. Meth l
prednisolon was in options too.
. The patie t ith GI leedi g a d o
endoscopy
. Pi tu e of Colles f ea tu e. Whe

al olo os op a d uppe e dos op apsule

ou e ie it

eeks late

. You g patie t afte a URTI de eloped he atu ia a d p otei u ia. Wahts the diag osis
IgA nephropathy. PSGN was in options too
18. Cilhd with intermitent abdominal and flank pain which everytime lasts for 12 hours. Renal
sto e ad uled out. What is the i estigatio of hoi e uppe GI se ies a d follo th ough
19. child with attack of asthma , not relieved by 6 puffs of salbut what next
Another puffs of salbutamol
20. Patient that is a manual worker with TIA (temporary paressis of upper limb) dont work
until the GP allowed, or dont work for 6 months
21. Patient with swelling in front of tragus and driblling CT
22. Picture of old woman in nursery home with redness and swelling of parotid poor hygiene

23. Woman 35 years old with secondary amenorrhea and high FSH and LH, She dont want to
concieve HRT
24. Postmenopausal woman with normal pop smear and painless postcoital bleeding
endometrial cancer
25. Young woman without family history of breast cancer and normal examination, is concerned
about breasr cancer reassure
26. Pregnant woman in 39 week presentes with 200 cc vaginal bleeding that has stoped and
physical exam is normal. Uterous is soft, BP and Us is ok send her home untill the next visit.
Other option was admission
. P eg a t patie t ith a ide t a d s pto es of pla e tal a uptio
chose normal salin in 6 hours. Other option was cross match

ith sho k I

29. Patient addmited for elective hysterectomy has low Calcium. She had a history of thyroid
su ge IV al iu . Othe optio s e e it D a d al iu o al
. Pi tu e of
reassurance

ela o a i lo e lid plasti su ge . Othe optio s e e iothe ap a

13/10 Istanbul
1. Case of cecal volulus with xray dx asker
2- I have got only one case from hb.. shoulder dislocation
3- photo of old woman with red parotid
Bad oral hygiene
4- plenty psychatrics.. the woman says unconnected phrases like.. the sky is red my
meal is potatoes.. asking wt is this actually i didn't find a suitable answer
5- woman severely depressed wtbis the indication for ect.. i choose suicidal idea
6- mobiz 2 ecg tx

7- i got 3 other ecgs quite tough

8- child xray with lobar pn tx
9- xray of sarcoidosis with hematurea ix
S.ca
Ct abd
10- best predictor of obesity
Bmi
Waist circumference
Waist / hip ratio
Mid arm circumference
I marked c
11- man smoke 20 cig, bl.pres.150/90 , cholestrol 7.7 , worst facter leading to death in
five yr
I choosed chol
12- sudany 3 m child came for vaccine what else will check
13- woman with lethargy
Microcytic an., high ca, low albumin, high total protein, ix?
I marked s.electrophoresis!!!
14- man cMe to donate hos kidney what in history u will find
His wife convinced him
Hx of other alrusim
B
15- woman with cervical abscess
Anthology pic Dx?
16- case of leg swelling, redness, diabetic temp 37 , tx
Lmwh
Ab
Warf
A
17 - same with high temp ix
Bl culture

18 - same case with abrasion between 4th and 5th toe ix

Swab
Bl culture
I went to bl. Culture again..???
19- child with monthly asthma
Best for prevention
SCG
Fluticason
Salbutamol
Salmetrol/ fluticason
I choosed d!!!
20- child 4 yrs with two yr abd pain on off u can feel a mass on rt hypochondrium
Wilms
Vesico uretric reflux
I choosed b
21- parotic swelling with dribling ix
Ct
22- preg with hx of 20 ml bleeding then again 50 ml bleeding wt to do first
Cross match
Us
Pv exam
A
23- preg with accident, low bl. Pressure no bleeding, tender uterus first to do
2 l ns over six hrs
Cross match
Aminotomy
Cs
I choosed b.. six hr is long time
24- 35 yr read in magazin about celebrities making operations for breast coz of ca breat,
no f hx
Reassure
25- 75 yr old woman wt will u screen
Fbs
Cbc
Mamogram
Pap

A
26- atypical cells on pap with candida
Repeat after 1 m
After 6 m
After 1 yr
After tx of candida
I choosed c right answer maybe d
27- pat with renal failure got uti tx
Gentam
Nitrofurantion
Trimethop
I selected c!!!
28 - man with pain in his second toe for 3 yrs with deformity
Appropriate shoes
Surgery
B
29- farmer with rt hypochondriak pian, hx of hemicolectomy, us provided ix
Hydated serology
Biopsy
Ct
C
30- pt with depression 2 yr on tx, well controled
Make the dose on alternate days and discontinue
Discontinue over 2 wks gradually
Try new drug
B
31- woman with offensive discharge with clue cell
31 woman with itchyness and red vagina
Choosed see hyphy
32- wiman with sudden continuous pain in maxillary area with redess dx?
Herpes
Trigeminal n
Varecilla
C??? Not sure
33 muloscum pic adking exclusion

34- 3 yr child got pertusis, family got ab prophylaxis but not his 5 m old sis who is
completed her vacc, wt is ur advice
Booster vac to whole fam
Booster to the 5 m baby
Noooooo option for ab to the sis
35- parents got a new born wt is ur advice
dtpa to parents
dtpa to parents and grands
Fluenza vacc
B
36- 25 yr old girl, came for flow up visit her 2 yrs ago chlamedia screen n, no sex for the
past two yrs why will u screen for chlamedia??
Asyptomatic
Cause infertility
B
37- secondary amenorrhea wiman 2 yrs
Lh, fsh above n. , E low, prolactine 250
Not intersested in concieving
Pop
Menopausal hormons
Coc
B
38- woman secondary amenorrhea two yrs, E n, lh sfh, testosteron, prolactine all n ,
cause?
Pcos,
Pitw. Adenoma
Idiopathic hypothalamic dysfunction
C
39- male with 19 milon / ml sperm, 40% motility, 60% abn
Prengnacy will not affected
Pregn is unlikly
B!!!
40- woman with child 3 yrs ago cannot concieve , no contraceptives, regular cycles, mid
cycle sex,, cause
Abn sperm count
Tubal pathology
Long leutial phace
Bad timing of sex

I choosed b... although many may say sperm count

41- worse combination of ab on renak function
I choosed genta and cefaclor
42- hypertensive man on ace, diuretics and another drug, presented with high jvp, leg
edema, basal cripitation tx adked
I choose digoxin
Don't remember
43- the woman with frequent falls last one on mole, can remember, wt wilk help u to dx
Witness
Eeg
B
44- young man asking risk of melanima
Bcc
Melanoma in cousin
Sunburn in child
Hx of out door work in early 20
I choose d.. maybe c..
45- 40 yr woman came for precolecystectomy visit, she had thyrodectomy 5 yrs ago her
ix showed
Low ca 1.9
Low vit d
Tx
Iv ca... she is asym
Oral ca
Calcitonin
I choosed c...
46- asthmatic child wth attack, took 3 boluses of 4 puffes of salb his o2 is better 95%
but still irritable
Bebulizatin by atrovent
Others...
I went to iv hydrocortison
47- after epidural anasthesia feotal ht rate decreaded to 70 then gradually back to n. Wt
to do nxt
.... don't remember....
I chose iv fluid, ***

48- woman came to u saying her son is abusing her like beating her, she think he is
drug dealer...
It ur obligations to calk the police
Admit her son to hospital
Refer her to refuge shelter
C maybe
49- xray of smalk bowel obst dx asked
Adhision
50- pat with sudden severe epigastric pain, vomiting, hx of gastric ligation next ix
Barrium swalkow
Ct
No chest xry
I think she got perforation... i choosed ct barrium cannot be used if there's perfo. Ct is
not a good option too
51- old pat with fecal impaction...
When u have 150 recall doing them in short time it's not easy to remember
52- pat with bl. Pres 150/95 , tiredness and wife say he snoors.. ix
Sleep study i choose
53- again alomost tge same story but no snoring, ix again.... may be i am wrong
54- child with recurrent dizzeness vertigo every month.. wt to do
Eeg
Ct
Reassure it will be gone
55- obese woman felt a mass in groin, on exam mass below and lat to pubic tubercle
non reduceable
Us
Biopsy
Surgery
56- heavy smoker came and willing to quite smoking, next important
Advice her about the benifits of quitting
Nicotine replacement therapy
Make a plan to stop smoking
I choose c??
16 ot tiland

1. Pic of cervical mass- esophageal or thyroid cancer

2.Anal pic
-external haemorroids
-internal haemorroids
-pilonidal abscess
-abscess
3. Pic of child scrotum
4. Black lesion in eye- Mx
5. delirium drug of choice
6. Brest mass ix- excisional biopsy
7. Greenish discharge from brest ectacia
8. parkinsonism case
9. Alzeimer case
10. Ecg of MI
11. Prevention of asthma
12. Causative organism of infection causing green discharge of vagina
13. Pitutary tumour in pregnant woman
-surgery
-review
-radiotherapy
14. Drug choice of children in pneumonia
-amox
-penicillin
-fluclox
15. Abdominal trauma, may be spleen rupture
-saline 2L
-usg
-ct
16. Case of false +ve- ELISA for HIV
17. Pt with buttock pain and radiating pain
-spinal canal stenosis
- L4-L5
-other- vascular
18. # tibia realignment, next is debriment
19. No more ECG
20. Vietnamese pt with fatigue/ malaise
- malaria
-dengue
-filariasis
21. Case of TIA
22. Case of sex between an old age male and nurse
-inform board
-private room
-make a complain
-inform male family
23. Pt gave a gold watch to dr.

-dont accept such a gift

- decline the gift
-accept
24. Pt with wish for organ donation, family agree. After senior physician confirmation of brain
death what to
do?
-donation service contact
-family meeting
-resuscitation service
-hospital lawyer
26. Recurrent attact of gout, which indicate need of long tx?
-PUA
-punched out lesion
-RF
27. Case of WPW and drug choice
28. Huntington senerio
29. Lewy body dementia
30. Lady with milky discharge from breast with tubal ligation, tx?
-bromocryptine
-OCP
-others
31. Drug of choice of vomiting in pregnancy
32. Pregnant- postnatal with lochia comefor contraception
-POP
-combined
-others
33. Pt afraid of brest ca, 33 yr old, no family hx
-reassure
-surgical reff
-BRCA 1
34. Ejection systolic murmur
-AS
-others
35. Child pain in knee, localized pain in upper tibia
-septic arthritis
-osteomyelitis
-cancer
-others
36. Pt with OA of knee, tx
-paracetamol
-indomethacin
-meloxicom
-glucosamine
-chondroitin sulphate
37. A lot of qs of antibiotic as a drug of choice
38. A case of clamydia asking drug of choice

39. pls concentrate on arrangement of investigations regarding

-scrotal swelling
-hernia
-masses in neck
40. Pls do the fluid mx specially post operatively
41. All normal values were given
42. Post TICA (total knee replacement) pt oliguria. Us-> bladder->20 ml
-IV saline
-oral fluid
-other
17 oct
1- melanoma pic what is management?
2- pneumonia treatment in a child
3- two elders have sex in a nursery home
4- prostate cancer screening his father die for prostate cancer
5- umbilical redness in child what is treatment
6-48hours after birth the child develops jaundice what is treatment
7- teenage inappropriate sexual Act in school
8- 8 week pregnancy previously well cervix closed with minimal bleeding I choose threatened
abortion
9-studey of diabetes in Australia 1-cohor2case cantorol3- RCT
10-Man staying in subway coffee with extended hands and not talking not movement and not
giving any
response what is the cause I forget options but it was new
11- p.t after MI admitted to ccu and after successful treatmen he was very happy for high
technology and
well trained nurse,doctors what is the cause
Regression suppressive12-40 y old man comes with weakness in left hand and soulder then he developed paraplegia?
Sryngomalia
Motor nouron lesion subacute combile degeneration
13- case of 10 month child his parent see him funny movement ather investigation normal I
choose eeg
14- case of febrile convulstion what is the treatment
15-2 cases of plural effustion with x.ray
16- pancreatic psoudosyst ask diagnosis CT given
1737 yrs. old woman with secondary amenorrhea, normal BMI, FSH: 55, LH: 54, oestradiol: 77,
Prolactin:
very high treatment asked
18- another question also fsh,lh, tsh and proctin are all high treatment
19 case of RUQ pain treatment (lap choleceystecomy
20- Pt with long standing back pain, no Rx at all, xray show bamboo spine, Treatment
21 Picture of para umblical hernia in 5 yrs child
22-55y old man after return from Bali after short holiday of 5 days with his wife presents with
Fever, chill,
abdominal pain, malaise and jaundice

Hep.A
23-couple not conceive 2 years and she had regular mense what is the couse
24-pic of bells palsy treatment (pridnisolone )
25 Old lady with Hx of rectal prolapsed now she wet her bed what is the couse her vagina
normal only
atrophic
26pregnant after Motor car accident she is now pulse80 bl pr 80/50 and tender on abdomen what
to do I
choose u/s
27-p.t with paraesophgeal hernia going to surgery but he took clopidogril for 6 months dou to
infarction
what to do I selected stop clo 7 days the preceed surgy
30- one was child developed juandice and low wight , after 8 months.. mother says he is alright
and she only
says he takes food and solid , every thng was nrml with child,,
options were,, feed on cow milk,, second was admit and observe his diet
c. was continue breast feed
31-man who is has faced gun point some days before , now presents with insomnia, and he has
some night
dreams like this and not conscious at work whats best to prescribe
a. altrozepam
b. resperidone
c. olanzapine

Bilal Recalls
1)got 1 case statics , (u know 2009 and 2010) ask to count the prevelence of BMI
2 )got 2 cases , one is wilms tumor (accidental abdominal mass in the bath noticed by mother)
other
neuroblastoma i think, with head mri
3) man , 40 cigarettes a day , typical case of lung cancer ,x-ray given
4) i ecg i think it was pulmonary embolism (not sure ) , 1 week ago arrived after a flight for 15
hours
5)the man with bags in the police , options like collateral information , and admit, i went for
admissions,
know many others with collateral infos
6)bronchspasm after general anasthesia
7) renal scarring -DSMA
8) photo of red leg(line-like) , after trauma , i went for cellulitis, although now i think it could be
DVT
,,,,,,,,,,

9) x ray , and malignant cells in CARDIOCENTESIS !!! new one ! i chose CT next
10 ) pap with candida infection , repeat after treating candida
11) most increasing psycho disease , dementia / schizo
12) after parathyroidectomy tingling around the mouth , dx or cause ? chose tetany .
13 )football player , collapsed
14) most likely investigate to define the cause of persistant proteinura in a child , options like
renal biopsy
and creatinine with electrolytes, i went for biopsy , not sure !
15 ) case with labs, dx is MM (and back pain)
16) family histroy of down syndrome in pregnant 16 wks, wut to do

Engy Magdy Recalls 17.october 2015

1st, cvs questions:
ecg, hyperkalemia asking treatment : a- iv calcium chloride b. iv insulin c. glucose and insulin
2- ecg , complete heart block was hard patient was on spironolactone, digoxin, ace inhibitor
treatment asked?
a- stop digoxin b. stop ace c. permanant peacemaker d. stop spironolactone
3- ecg, young patient 31 years old presented with lightheadeness after excersise, palipitations and
shortness
of breath choose which strip of ecg : a. af strip b. heart block c. ventricular tachy d-atrial fluter.
no svt ecg
4- ecg of ventricular tachycardia hard one , patient bp 135/80, pulse 100 asked treatment a- dc bamidarone
c- adenosine
5- ecg of a young patient with some symptoms dont remember but it as identify ecg it was WPW
hard one as
well "find delta wave"
6- ecg of MI of a patient in a tertiary hospital after recussitation best: a- angiography b7- history of a 21 sportive girl has syncope and history her father died young maybe 28 years old
after
recussitation next: a- echo b- ctpa
8- pt after 4 days of stroke with right leg weakness , bp 178/92, on asprin 100 mg ,lightheadness
and ecg
shows ST elevations. management? a- acei b- metoprol c- GTN patch d- frusemide e- another
antihypertensive
9- pt on renal dialysis he is normotensive in dialysis but after dialysis he is hypertensive mx:
aantihypertensive
b- frusemide before dialysis
10- young female with unilateral renal artery stenosis with hypertension mx: a- acei b- beta
blocker ccalcium
chanel blocker d- frusemide
11- a case of anterior mi with st elevations asking mx: a- reteplase b- heparin
pt with history of travel since 7 days from thiland, now shortness of breath, left chest pain, temp
38c and

pain increases with cough and inspiration" new" a- peumonia b- pulmonary embolism c- acute
pericarditis dmyocardial
infarction
13- after mva, pt with wide mediastinum lost aortic kuncle bp 120/75, pulse 100 best
investigation: atranesophageal
echo b- tarnscutenous echo c- ct angio d- ecg
satatistics and epidemology questions:
study for vit d defficency in ur comunity: a- cross sectional b- case study c- cohort d- case series
15- you as a gp wasnt to make a study as there are 3 cases of salmonella in your area of practice
what is
important to do? a- compare healthy ppl food with others diseased b- take detailed food history
from patients
at your practice
16- calculate increase in relative risk where in 100 person took asprin 1 only had stroke and in
100 without
asprin 2 had stroke: a- 1% b-2% c-100% d- 200%
17- cvs chart risk in a smoker 48 years 6 total cholesterol and 1 HDL. bp 140/85.... chart given
easy a-1016% b-> 30 % c-5-10 %
peadiatrics questions:
what is considered a delay in a child 12 months: a- doesnt say understandable words b- doesnt
understand no
c- cant walk unsupported
19- what is considered a serious dangerous delay in a 4 years child: a- cant cloth himself b- cant
draw a face
c- cant ride a two wheeled bicycle d- cant stabilize on one foot 5 seconds
20- a 3rd day jaundice where bilruin is 410 mx: a- phototherapy b- blood transfusion c- blood
exchange dreassure
21-.child 13 months completed his immunisation now fever 39c and petache and lethargy mx: aceftrixone
b- blood culture c- send to hospital
child son of a refuge came uncomplited polio vaccine he used to take oral form what to do: agive iv polio
and continue his immunization b- start from begining c- dont give vaccine
24- a case of basal creptitation with tracheal tag , temp 39c, cough mx a- iv penicillin bflucloxacillin cneubilzed
adrenalin
25- pt with abdominal pain he is 4 years old , pain reccurent for last 2 years , last attack was in
left flank inv:
a- us during attack b- micturating cystogram c- erect and supine xray d- small intestine meal and
follow eelectrolytes
and urea , creatinine
26- a preterm baby born 33 weeks, had respiratory distress due to hylaine disease and needed
40% oxygen in
a tube or something like that then oxygen requirment is need to increase till 80% of oxygen to let
oxygen

saturation 90% what is the cause of deterioration of the case? a- congenital heart disease bpneumonia cseptecimea
d- pneumothorax pictures:
pic of a painless lump in neck since years , slightly change in size over years in a young male alipoma blymph
node c- lymphoma
28- pic of acromioclavicular dislocation pic of hand book asking identify
29- pic of handbook of thyroglossal cyst but didnt mention that it said moves aith swallowing up
and down
asked for investiagtion: a- fnac b- ultrasound c- xray d- mri e- ct
30- pic of red eye after cataract sugery was very red conjunctiva, irregular iris, small hyopoyon
cause: aacute
irirtis b- hyphema c- hypoyoin d- acute glucoma 31- another eye question but without picture: a
lady
had severe photophbia left eye and visual acuity was 6/12 in that eye , pupil is reactive to light
cause: akeratitis
b- acute glucoma c- uveitis
32- Ct scan of abdomen of pseudopancreatic cyst pic of hb asking diagnosis
33- ct scan of abdomen of liver with dark red circle on edge was big one, history was 56 female
had sudden
right upper pain then last 12 hours then resolved diagnosis: a- simple cyst b- hydat cyst chepatocellular
carcinoma d- hemanigioma
34- ct scan of brain of cereberal tumor puc from hand book just asked diagnosis easy
35- pic of small bowel obstruction xray: history lady 60 years old had appedicectomy when she
was 20 years
old now having ldopa and carpidopa , has constipation, for two days. cause of constipation asigmoid
vulvulos b- adhesion obstruction c- pseudo-obstruction due to caridopa and l dopa
pschaitry:
36- patient feels there are funny games arround going on and there is someone who will harm
him cause he
win a promotion and he mentioned to police there is terrible think he expect is coming in coming
days : aidea
of reference b- delusional c- delairment d- schizotypal personality
37- pt 34 with long history of abbusing and recently caught in assult . he behaves in a bad way:
a- antisocial
personality b- conduct disorder c- borderline personality
38- female recently breakdown her relation which was short duration, was refured to pscyhaitrist
last year
cuz of bad attitude at work, depressed mood now a- schizotypal personality b- paranoid
personality cborderline
personality d- shcizoid personality e- schizoaffective
39- pt agitated in hospital he used to dring alcohol he is uncontrolable by security: a- im
haloperidole bthiamine
c- iv diazepam d- iv midazolam

40- lady postpartam 3rd day, told nurses from 2 days she is afraid about her child and needs to
keep him in
the room next day seen whole night moving arround moving objects spereading some pecticides
on floor.
examonation, agitated, palpitations, temp 37.5 intital important investigation"new" a- blood
culture b- fbc curine
drug screen d- ct
41- 62 years old man 3 months begun to forget it is progressive lost interest in hobbies
recently, bad money manangement hypertensive and well controled on acei. diagnosis: avascular demintia
b- alzhimer dementia c- lewy-bowdy dem d- fronto-temporal infarction e- depression
42- which is area responisble for coping and drawing objects: a- dominant parietal lobe bnondominant
parietal lobe c- temporal lobe d- frontal lobe e- occiptial lobe
43- man staring in sky and see fading in sky which is responsible for that: a- medial temporal
lobe b- parietal
lobe c- frontal lobe
44- pt was in hospital and falled had tibial fracture then after discharge came after a week
agitated and
blaming doctors they let him fall, he was not hit on head and many saw this next: a- talk to him
about his
attitude b- check for special frintal lobe testing c- ct
45- patient on fluxetine for depression and nifedipine for htn. one month ago fluxetine dose was
increased,
now pilpitations, and sinus tachycardia, bp 135/75 cause: a- drug ieraction b- nifidepine cfluxetine toxicity
d- neuroplastic malig. syndrome
46- another question asking about drug side effect and benzodiazepaim toxicity cant remember it
47- case of newly discovered mainia case of lady her husband brought her to you old scenario
treatment no
lithuim or na valproate a- olanzapine b- setraline c- duazipame 48- story of well controlled pt on
setraline for
depression but had some abdominal troubles lately ttt: a- change to another ssri b- change to nsri
cclonazipame
49- chinese student came from 4 month he was free before he came now presents for loose
diarrhea
noctournal 2-3 times since he came, his exams is soon ttt. "new" a- muscle relaxants bantidepressent i think
sssri c- lactose free diet d- fat free diet e- another thing about diet moudulation
50- scenario of insomina 6 months after her husband died she is tired and had same symptoms
after her death
of her sone last year afraid to sleep in home in dark darkness a- tenezapam b- clompizem comiga 3 ity
37- pt 34 with long history of abbusing and recently caught in assult . he behaves in a bad way:
a- antisocial
personality b- conduct disorder c- borderline personality

38- female recently breakdown her relation which was short duration, was refured to pscyhaitrist
last year
cuz of bad attitude at work, depressed mood now a- schizotypal personality b- paranoid
personality cborderline
personality d- shcizoid personality e- schizoaffective
39- pt agitated in hospital he used to dring alcohol he is uncontrolable by security: a- im
haloperidole bthiamine
c- iv diazepam d- iv midazolam
40- lady postpartam 3rd day, told nurses from 2 days she is afraid about her child and needs to
keep him in
the room next day seen whole night moving arround moving objects spereading some pecticides
on floor.
examonation, agitated, palpitations, temp 37.5 intital important investigation"new" a- blood
culture b- fbc curine
drug screen d- ct
41- 62 years old man 3 months begun to forget it is progressive lost interest in hobbies recently,
bad money
manangement hypertensive and well controled on acei. diagnosis: a-vascular demintia balzhimer dementia
c- lewy-bowdy dem d- fronto-temporal infarction e- depression
42- which is area responisble for coping and drawing objects: a- dominant parietal lobe bnondominant
parietal lobe c- temporal lobe d- frontal lobe e- occiptial lobe
43- man staring in sky and see fading in sky which is responsible for that: a- medial temporal
lobe b- parietal
lobe c- frontal lobe
44- pt was in hospital and falled had tibial fracture then after discharge came after a week
agitated and
blaming doctors they let him fall, he was not hit on head and many saw this next: a- talk to him
about his
attitude b- check for special frintal lobe testing c- ct
45- patient on fluxetine for depression and nifedipine for htn. one month ago fluxetine dose was
increased,
now pilpitations, and sinus tachycardia, bp 135/75 cause: a- drug ieraction b- nifidepine cfluxetine toxicity
d- neuroplastic malig. syndrome
46- another question asking about drug side effect and benzodiazepaim toxicity cant remember it
47- case of newly discovered mainia case of lady her husband brought her to you old scenario
treatment no
lithuim or na valproate a- olanzapine b- setraline c- duazipame
48- story of well controlled pt on setraline for depression but had some abdominal troubles lately
ttt: achange
to another ssri b- change to nsri c- clonazipame
49- chinese student came from 4 month he was free before he came now presents for loose
diarrhea

noctournal 2-3 times since he came, his exams is soon ttt. "new" a- muscle relaxants bantidepressent i think
sssri c- lactose free diet d- fat free diet e- another thing about diet moudulation
50- scenario of insomina 6 months after her husband died she is tired and had same symptoms
after her death
of her sone last year afraid to sleep in home in dark darkness a- tenezapam b- clompizem comiga 3
51- pt for ect and refuses whike agitated she refuse to eat for days ur action: a- consent from her
son bconsent
from mental instution c- ect regardless her will as she needs it 52- another question about
agitation a
deliruim case ttt: a- iv midazolam b- im haloperidol c- iv diazepam
53- a senario of pt on antipsychotic got some side side effects which i felt are mild no fever , no
rigidity but
asked why he had them he was on diazepam as well a- neuroleptic malignant syndrome bantipscyhotic cbenzodiazepam
toxicty
ethics:
54- pt his mother is newly diagnosed case of alzhimer's disease she lives alone , she feels she is
fine doesnt
want medication she denies any thinking or memory troubles. her son says his mother is
functioning well
and they dont care about her well being and dont care about her taking medication ur action: asend her
nurse daily for drug adminstration b- admit to nursing home c- say she must take her medicine as
long as she
lives alone "tell her son so" d- respect their will
55- indogenous woman came for her son vacc 4th month was very fast no eye contact want to
finish
immunization and go what will u do? a- observe her attitude next visit b- child protection
authorty c- send
nurse to inspect home
56- a woman her husband beats her alot but she refuses to leave him and to talk to police ur
action: a- find
her a shelter b- disscuss with her the future impact of such abuse c- call police
57- 14 years old girl came to you with her mother she was examined alone she asked for
chlamydial testing
then after one week results appear it was negative her mother called to ask u about her girl ur
response: a- u
cant tell her anything about her girl b- ask her to come with her girl for next appointment c- say
you can
discolse with only the girl d- say results didnt appear yet
screening:
58- question of why do we screen chalmydia in a girl 16 years old recently begun sex: a- cuz it
causes

infertility b- asymptomatic in males c- asymptomatic in females 59- a young female 32 was

worried about
breast cancer as ber friend had it on examination she is normal no family history no risk factors
ur action: amanography
now b- reassure no need for more investigation c- advise self examination
60-61,62 cancer cervix screening i advise do it well it came in different ways will try to
remember hopefully
: 60- female had atypical cells on pap smear + endothelial cells and +ve candida: a- pap after a
month b- pap
after a year c- pap after candida treatment d- colposcopy
61- 37 lady with CIN1 on pap smear past pap was normal what to do now: a- repeat pap after a
year bcolposcopy
c- conization d- repeat after 6 months
62- 21 years old first pap showed CIN1 on pap smear your action: a- repeat after 6 months bcolposcopy cconization
d- LLEZT e- repeat in one year
63- a 21 years old man to your clinic for checkup no strick family history what to screen for: afbs b- HTN
c- full blood count d- cholesterol
64- a case of lady for cancer breast screening she was 48 years no risk factors normal on
examination: amamo
now b- begin mamography at 50 years
GIT Questions:
65- a nursing lady chronic constipation and uses laxituves present in emergency department as
severe colic
no flatlus since 12 hours, rectal examinal is free. diagnosis: a- fecal impaction b- sigmoid volvuls
cpseudovstruction
66- a lady came from travel had right upper quadrant pain, temp 38.4 , dark urine sclera
icteric best next step a- us b- ercp and decompression c- xray d- surgery
67- pt recent mi and on asprin and clopidogreal, with third episode of cholycestitis attack and us
revels thick
wall of gall bladder he is on fluids and antibiotic what is best to do now a- continue antibiotics
bpercutaneous
cholystectomy c- surgery
68- nuring patient with 3 days of diarrhea then fecal incontinence what is next: a- colonscop brectal
examination c- stool culture and senstivity d- enema e- xray
69- a case of melena with negative edoscopy and coloscopy next a- capsule edoscopy b- ct cxray 70- 25 ypt
used to has asthma since ge was a child has gerd on esomperszole 20 mg, he feels he has troubles
with
swallowing certain types of food. on endoscopy it showed mid eccentric stricture with
eosinophilic
oesphagitis. next a- give gaszoin b- double dose of ppi c- give mythlepridnisolone oral d- give
inhaled
flucitazone 71-

urology
72- child never dry in bed 4 years old dipstick normal, no growth next a: reassure mother bdespmorssin cbed
alarm
73- diabetic lady with unhealable ulcer came for changing over it. had urine and fbs test, lab
shows fbc
normal urine culture exclusive ecoli 0.1x106 growth no wbcs treatment a- immediate ecoli
treatment b- not
active treatment c- urine alkalnization 72- ymale urgency urnie culture is negative for growth
otherwise well
ttt a- anticholenergic agents b- prazosin c- bladder training d- pelvic floor training
orthopedics:
73- pt with pain in upwards and rotating her arm. history of mild trauma. what is investigation
after xray: act
b- mri c- aspiration
74- pt for hip replacement. regarding dvt prevention apart from decopmrtions in operation for
prevention of
dvt and post operative LMWH what shall u do: a- lmwh for 7 days post opperative b- warfarin
one month cwarfarin
3 months d- one month on a frug not sure of its name rabgason!
7 6- that question of mobilize as tolerated about fracture cant remember the stem
77- guy with left hip problem with a stick how to use it: a- stick in right and move left with stick
b- stick in
right and move stick with right c- stick in left and move with right leg d- stick on left side and
move with left
leg e- use it with both legs
infectious:
78- farmer, with fever, hepatomegaly and lymphadenopathy, malaise no rash all lab elevated ggt,
alt, ast, alp
a- brucellosis b- q fever c- lyme d- cholysectitis 79- pt with diarrhea he is a student works at a
resturant what
is advice: a- school exclusion b- vaccation from work till diarrhea subsides
80- pic of atypical pnemonia say patches on chest xray with fever cough, ttt a- doxycycline bcefrixone
neuro: was tough
81- pt 60 years old, with some shoulder pain. felt asleep infront of tv yesterday and in the
morning presents
with more pain on shoulders, on examination, shoulder movements r painful, abduction is painful
and sligh
sensation reduction on upper arm, has elbow extension and wrist weekness and low sensation in
outer
forearm.used to be a football player had multiple past neck injuries,cause: a-brachial plexus
injury b- radial
nerve injury c- ulnar nerve injury d- median nerve injury e- axillary nerve injury
82- 50 y pt with urinary incontenance,sensation below inguinal ligamint is impaired, weakness of
legs since

days a felxed legs, muscle tone is normal, planter reflexes are equivocal, tendon reflex
exagerated, cause: alumbar
disc comprssion b- thoracic disc compression c- cauda equinea d- peripheral neuropathy
83- question about right foot drop and small muscles of hand weakness someothers.... a- vit b12
defficency
b- mri c- anticholengeric drug d- nerve conduction
84- optic neuritis scenario asked investigation a- mri b- lumbar puncture c- ct
emergency and postoperative:
85- postcholestectomy, oliguria though on 1.5 l he has 200 ml urine what to do to discover cause:
a- fluid
challenge test as descriped b- urea and creatinine and electrolytes c- blood culture d- full blood
count
86- dyspnea post operative after 5 days asked investigation a- ecg b- xray d- ctpa 87- another
senario gave
abg pic was like ph 7.3, po2 33, pco2 low bicarbonate 21 what is next investigation a- ctpa b- ecg
c- d dimer
not sure cant recall it properly
gynaobs :wasnt good
88- lady in labour primigravida now head +2 cx 2 cm intact membranes everything normal after
4 hours u
examin her again what if u found shall make u decide cs: a- cx 2 cm and nothing changed b- cx 3
cm and but
head still +2 c- 5cm cx , +1 head, occipotoposteior position and intact membranes d- 9 cm cx ,
+1 head,
oocipitopostior position and intact membranes c- fulky dilated +1 head, occipitoposterior and
ruptured
membranes
89- 25 years old lady, in 16 weeks has family history of down syndrome, past antenatal r fine,
her fundal is i
think slightly higher cant remember 12 or something, what is next a- amniocentesis b- bhcg c- us
d- maternal
serum screening
90- that recall of positive preg. at home presenting with bleeding after ammenorrhea for 6 weeks
endometrium 12 mm cyst in ovary no fluid in doglas pouch, cause a- complete abortion b- false
preg. test cincomplete
abortion d-ectopic preg test
91- senario of 6 weeks bleeding after positive preg. test in chemists , excitation cervix test is
negative, obese,
best next a- transvaginal us b- quantitative bhcg c- abdominal ultrasound
92- scenario of pain seems to be mid cyclic lasting for 3 days and happened from 4 weeks before
pain cause:
a- ovulation b- endometriosis
93- lady with post coital bleeding used to have wart with virus four years ago last pap from 2
years was
normal, she is one year after menopause bleeding continued for 12 hours, had no sex last 2 years,
cause of

bleeding a- ca cervix b- cancer endometrium c- follicular activation d- atrophic vaginitis

94- female found positive for gonorrhea pcr what to do a- ceftroxine b- send for treatment
counselling
vaccinations:
95- nurse had needle brick , hepatitis b surfuce ag positive next: a- immunoglobulins blamivudine cimmunoglobuluins
and vaccinate d- vaccinate e- nothing send her four counselling
96- man had lacerated wound he had similar wound last 5 weeks he took tetanous toxoid,
unknown
vcaccination, what is best regarding tetanous prophylaxis: a- give immunoglobulins and tetanus
toxoid bimmunoglobulins
c- tetanous toxoid d- penicillin 5 days
others:
97- hemochromatosis scenario he had a complication cant remember exat stem 98- a lymph node
in
subtonsillar are in a heavy smoker make for 30 year it is painless a- metastatic cancer bnasopharynx cancer
99- investigation asked in a heavy smoker and he was exposed to asbestotes xray showes plueral
plaques ,
hyperinflated chest fve1 50 a- bronchoscopy b- ct c- plureal biopsy
100- inconclusive cancer in parotid by fnca next: a- biopsy salivary gland b- ct c- mri 101irritable sudanese
child lab given all high alp, bilruibin silightly high, low vit d very low, cause of his iiritability aalp b- vit d
c- bilrubin
102- baby doesnt cry alot 10 days on examination systemic murmer but other wise normal next:
1- reassure
he has normal heart 2- refel to pediatric doctor 3- immediate ecg 4- hospital admission
103- most common cause of low milk production 1- low fluid intake 2- less adequet baby
feeding 3- baby
not put on breast feeding frequently
104- 16 years old girl just begun sex her partner uses condoms what to do a- pcr for chalmydia bpap smear
c- refere to social worker
105- school counselling other than safe sex a- skin cancer b- alcohol
106- asperger's disease was easy repetitive and no language delay
107- a case asking about higher cvs risk in a lady her bmi 25 and cholest. 5.5, smoker 10 cig/day
a- body
weight b-total cholesterol c- smoking
108- a lady with systemic lupus with rash arthralgia.... with nsiads what shall u add ahydroxycholquione bcyclosporn
c- sulphasalazine d- methotrexate
109- lady smoker and pregnant tried to quit but couldnt what to do? a- non nictoine chewing gum
bbuspirone
c- nicotine replacement therapy
110- treatment of pneumothorax 25% ...... tube drain

111- best cbt in depression a- problem solving. others cant remember

112- treatment of postpartum fever in a lady allergic to amoxacillin avancomycin+metronidazole+
gentamycin b- fluclocacilin+ vancomycin c- ceftrixone+ gentamycin d- metronidazole+
vancomycin egentamycin+
metronidazole
113- hydrops fetalis suspection what to do a- fetal scalp testing b- amniocenteisis
114- headach after accident a young guy he was in a motorcycle wearing hemlet after 3 weeks asubdural
hge b- extradural hge c- subarachnoide hge d- intracranial hge
115- small boy with head trauma 6 years old vomited once now fine , best a- admit and observe
neurological
changes b- ct c- discharge and come. back if complicated
116- what is the cause of a high head of fetus in a primigravida: a- placenta previa bmacrosomnia ccontracted
pelvis
117- a homosexul his partner is hiv positive his elisa -ve and westorblot negative but have
maliase
lymphadenopathy, hepatomegaly next a- repeat elisa b- EBV serology
118- painless hematurina after dipstick best investigation a- cystoscopy b- us c- xray
119- child has hematuria ++and proteniuria +++ persistant what is best investigation to know ots
cause arenal
biopsy b- serum electrolytes and urea, creatinine
120- 6 years old child with mild urticaria after bite of an insect clear chest ttt a- im adrenaline
bprednisolone
c- oral parmethrin
121- inscisional hernia from past surgery best to be examined by a- cough while sleeping bcough while
standing c- lying down and raising shoulders up
122- pic of a diabetic ulcer after swab and blood culture with pus inside askingafter treating with
antibiotic
what is next? a- xray
123- prophylaxis in a child with valvular disease not allergic to drugs will do tonsillectomy aamoxacillin bvancomycin
c- flucolxacilin
124- a case had vomiting asked investigation but i cant remember i think pyloric stenosis inve
125- a girl with delayed puberty with pubic hair what is important to ask about? a- when was her
breast
development b- growth surpt
126- a lady who care about animals was bitten by a bat after a swab what is most important intial
a- wash the
woundy b- rabies immunization c- antibotics
127- a 45 year lady prsent with painful upper outer firm mass in her right brest diagnosis afibroadenoma bbreast
cyst c- breast cancer

128- most common cause of postpartum fever she had small vaginal cut unsutured during normal
labour abreast
engorgment b- infection of uneffected wound
129- man with high cervical injury bp 80/50 pulse 50 initial a- colloid fluids b- tredenberg
position catropib
iv 130- hypercalcuria and hypercalcemia in an old female asked the cause a- osteolytic metastatic
bhyperparathyrodism
c- renal failure
131- that recall of headache that of pitutuitary apoplexy in a pregnant lady asking investigation
a-ct b- mri
132- a question with lab and very high esr and normocytic normochromic anemia in a male a
case of
multiple myloma
133- a lady feeling tiredness and sonoring. obese. hypertensive what to examine to know cause
of her
tiredeness a- sleep study
oct 17th recalls
MVA patient with 96% saturation on room air, finding it hard to breath b/c of intractable pain
and taking
shallow breaths due to pain, multiple bilateral rib injuries, ct provided showing small
hemothorax on rt side
what is the immediate treatment to help him breath
Intubation
Morphine
Chest strapping
Underwater seal
Pt wit infertility on sulphasalazine and past hx of methotrexate and mumps>>> old recall
Hb Pic of molluscum in child >>asking for exclusion
Old recall of microgynon 30 and continuing pain and want to conceive after 12 months
Mentally challenged girl brought by mother asking for contraception trial of OCP didnt work
well options
had mirena , implanon, ablation,
Old recall of vaccination for grandma whose daughter is expecting a baby
Question about meningococcal prophylaxis where friend of child had spent night at their place
and was later
diagnosed to have meningococcemia. Valid Options included ceftriaxone orally
MMR vaccination if childs mother had egg allergy
MMR vaccination if child had history of perioral swelling after eating egg
Pt tested positive after triple therapy on urea breath test what is the cause.. options included
resistance to
antibiotic amoxicillin , low yield of urea breath test
Study to find out association btw HTN and MI
Mother came to clinic who has a drug addict son violent towards mother what will you do
options included
a) call police b) call son and talk to him c) ask lady to call police D) give her address of womens
shelter

Pt on clopidogrel weeks after coronary stenting presents with fracture femur , how will you
proceed
Regarding repair
Case of pericarditis
Ecg of hyperkalemia K 6.5 asking for management
Old patient with prostatism collapses in bathroom cause >>> stroke, vaso vagal syncope
Athelete collapses on ground returns to play after 30 min cause vaso vagal , cardiac arythmia
Ecg of mobitz type two ECG on polypharmacy asking what to do options included stop digoxin ,
pacemaker
Two questions about pneumonia
Influenza case asking management
Pregnant lady with measles presents within 24 hours of rash asking management options
included do nothing
, administer immunoglobulin , trace contacts
3 years old Child develops pertusis has a five moth old sibling nothing mentioned about
completely
immunized asking for management
Scenario of brucellosis about diagnosis ( organism)
Jaundice in a full term healthy baby feeding well developed after one week asking for causes
conjugated
was 120 total bilirubin 240
Another scenario of neonatal jaundice with bilirubin 410 asking for management options
included exchange
transfusion , photo therapy , discharge
ECG of STEMI presented within two hours asking for mangemt options included aspirin
,morphine ,
coronary angio ,tPa

SEJAL PRAJAPATI RECALLS

SUMAIRA FURQAN OCT. RECALL

CHANDANI KANSAL OCT RECALLS

REMY BEKHIT OCT RECALLL

AHMED HESHAM OCT RECALLS

LATE POSTED SEP. RECALLS

Sept 2015
1. Hb 1.10
2. Hb 1.16
3. Hb 1.22
4.hb 2.029
5. ECG on stemi nect? PCI
6. ECG on palpitations looked like psvt
7. Abdominal xray on small bowel obstruction with clear valvulae connivantes and prior history
of op adhesions
8. Melanoma pic
9. Patient with history of stroke. What advice will you give? do t go to o k until cleared by
gp
10. A child with urti. Urinalysis done at that time showed rbc positive. Urinalysis repeated 2
weeks later showed rbc still positive but no casts? IgA nephropathy
11. Acute angle glaucoma scenario within 3 hours iv acetazolamide
12.Eclamptic patient. After calling for help. What next? - clear airway
13. Child with severe pneumonia symptoms. Mx iv fluclox
14. Asthma inhaled preventer in children
15. Asthma drug to be used prior to exercise
16. Agitated patient in ED. What to give? IM halo or Iv mida?
17. Best treatment for IBS SSRI
18. Best treatment for PMS SSRI
19. Pregnant lady with mother who is a diabetic. When to do OGTT? 20 weeks

20. Mentally retarded girl contraception Mirena

21. Woman with onset of menopause at 55 having pv bleed - endomentrial ca
21. Ectopic pregnancy scenario
22. What to monitor in patient on olanzepine? Lipids and fbs
23. Most important factor in a research? A. Randomization b placebo c random pick
24.Jaundice in a neonate after 24 hrs
25. Viral meningitis management- analgesia and observation
26. Cherry red spot on fundoscopy. Mx?
27 Upper GI endoscopy normal. What next? Capsule
28. LSIL on pap. Mx? Repeat in 12 months
29. Bronchiolitis scenario.Mx? iv fluids and o2
30. Gleason 4 prostate ca management?
31. Child with fall. No LOC no headache or vomiting. Mx?
32. Meningitis scenario of baby with rash. Mx? IM penicillin
33. Patient with prior history of foot amputation. RBS abnormal. Normal BP, lipid control, non
smoker. Asked which is the most imp factor in preventing amputation of other leg? Meticulous
foot care, strict rbs control
34. Old patient with agitation. Most likely diagnosis? A delirium b depression c dementia
35. Brachial nerve injury
36. Man with neck swelling. Which will be best to diagnose the lesion? A fnac b usg
37. Best to diagnose swelling in front of tragus? Fnac
38 Painful breast lump in a perimenopausal moman? Breast cyst
39. Best investigation for cancer head of pancreas? CT
40 Patient with sudden collapse. Father died at a young age due to cardiac problem. What is
the best ix for diagnosis? - Read on cardiomyopathy echo

41 Ankylosing spondylitis patient. Not responsive to nsaids. Next? Infliximab

42. Patient after a flight had SOB. Best ix? Ctpa
43. Same as above. Mx asked? SC enoxaparin
44. Cerebral mets question from hb
45. Mx of hypocalcaemia IV calcium
46. Cause of cleft lip? Genetics
47. How to calculate relative risk. Study the topic.
48. Asbestosis scenario. Xray now and 5 years
49. Scenario of toxic megacolon. Diagnosis asked.
50. Least relieved on hrt? Depression
51. ECG on complete heart block. Management asked?
52. Drug combo causing hyperkalaemia. A aspirin and amio b frusemide and amio
53. Patient with bilateral chronic OA now presents with numbness below the knee. Which other
clinical finding will be present? loss of sensation in the lateral side of the leg
54. Coeliac disease scenario. Asked for bets investigation small bowel biopsy
55. Solid ovarian mass 6cm. Teratoma
56. Cause of sterile pyuria with haematuria renal tb
57. Best ix to diagnose in a patient with facial swelling and neck swelling in a patient who had
just removed central venous line? Ct chest with contrast or cxr
58. Mx of severe depression? Setraline and haloperidol
59. Female with menopausal sx under 1 year. Experienced cessation of menopausal symptoms
and pv bleed. Cause return of follicular activity
60. Best management for OSA
61. Diagnosis of OSA Sleep study
62. 3 salmonella cases in your gp practice. Which study to do? Case series

63. Patient on clopidogrel requiring emergency op. Management asked?

64. Patient on venlafaxine develops pressured speech, euphoria. Mx? Add na valp, add
olanzepine
65 Post op patient with oliguria. ix to diagnose? USG
66. Hb 2.076
67. Breast cancer screening
68. Colon cancer screening
69. Prostate cancer screening high false positive rate
70.male with sperm count 19 million, 40 motility and 65% abnormal sperm. What to tell
patient? A. Spontaneous pregnancy is unlikely. B No chances for pregnancy.
71. 31-year-old woman G2P1 previous pregnancy was complicated with placental abruption at
34 weeks. next best step in management in addition to routine antenatal care?
Ad it to the hospital afte
I

eeks.

eased i o a d foli a id supple e tatio .

Serial CTGs from 34 week

72. Serotonin syndrome diagnosis.
73 Serotonin syndrome management. Stop both drugs
74. A 30 yr old computer softwer programmer with hx of 3y outdoor work, with no FH of
melanoma came for melanoma screening .wats the risk factor ?
A. melanoma in cousin
b. sunburn in child
c. BCC in family
d,hx of outdoor working
75. Child with 48 hours rhinorrhea and lots of abscence among his classmates dt influenza-LIKE
illnesses asking best to de?
check influenza

7 days off school

wear a face mask
oseltamivir
give vaccine
76.football player suddenly feel acute moderate pain in his right knee while playing, after
hours the pain bubsided but effusion expanded,after some days when the pain and swelling
were setteled, some times he feels his leg is giving away and some other times his knee is
locked DX?
A)antcruiciatelig injury
b)med menscial lig
c)medmenscial +ligamentous lesion
d)fracture patella
77. Young man after a quarrel had a fracture of floor of eye what is the more consistent
symptom with that
A- conjunctival hge
B-can't open the mouth completely
C- loss of sensation in the skin around
D- reduce the visual acuity
78. boy hit to coffee table while playing, presents with epistaxis, lip nd mcosal bleeds, thigh
with bruises, no petachie, no hepatomegaly
a. ITP
B. Vwd
c. factor 8
79. 60. mother present with her boy complaining persistant bleeding after tripping with a
coffee table..what is the treatmnet of this condition?
a)steroid

b)IgG
C)platelate
80 Most common cause of neurological defect in newborn if the mother is on
1 Anticonvulsants
2 Antipsychotics
3 Marijuana
4 opioids
81. 70. Ma
og a of a east . a old o e ith o al east examination. She had a
history of trauma on chest 10 years ago with bruising in the breast ?What will u do?
a.reassure
b.Percutaneous core biopsy
c.FNAC
d.repeat mammo after 6 months

Youssef recall 17 september2015

1.old women 50 yrs living with her son son has some psychological problem his is violent to his
mom the mom to the doc and asking help what to do next??
a. erge her to call the police b.reffer her to consultation support

2.pt came after break up with his girl fried he was sitted some psychological problem when he
was kid after ur assessment he looks came and normal but he says he kill his previous girl friend
a.inform police

3.pt feeling worthless anhedonia he say life is worthless

a. consult expectation and consultancy

4.50 yrs old positional vertigo while examination u realize u realize nystegmus few sec after
vertigo when doc handseek
a.vertibibasilar necrosis b. acusticneuritisc c. acute labyrinthitis

5.50 yrs old women having pain in both knee and slight separation within joint no xray given
what next treatment
a. paracetamol b. naproxane c. aspirine

6 .girl came bmi 13 long senerio 1st thing going her

a. breast development

7.women came 2dary ammenorrhoea for 2yrs 25 yrs old having 1 kid asking cause of 2ndy
ammenorrhoea all physical exam normal
a. premature hormonal therapy

8.12month amenorrhoea already 1 kids all lab r normal except prolectine 170 nprmal range 40 60 doesnot have any galactorrhoea she wants to conceivewhatur initial mx?
a. bromocriptinb.clomiphencithate c gonadotropine

9. 9 years oldchild95 percentile mom is concern doc found all family mem fatty
a. change after puberty b. strick diet

10.pt 25 yrs old he came pain in the eye eye became red at the pain time complain pain on
urination from 2 weeks
a. trachomoneasis b. chlamydia c. gonnorrhoead.herpes

11.ct of head of 75 yrs old man in man complaining recurrent headache and worst in the
morning long scenario?
a.SAHb.brain abscess c.intracranialhaemorrhage d, epidural

12. 5o yrsoldasking about recurrent blurring of vision for few days what the most imp cause
a. gaint cell arteritis

13.pic of hb femoral hernia

14.all electrolyte r normal except k :7 mx :i/v calcium gluconate

15.an agitated old women ed how to sedetade:i/m halo

16.ecg hyperkalemia rx:i/v calcium gluconate

17.dm type 1 came dry sclera , dry mouth u did finger prick test 22 mmol ketone in urine initial
test to strat mx:
a.blood sugar b.blood culture c. k leve
no urine test in the option

18.hb qus:glenohumeral dislocation

19 .18 yea old gi ls she sa s he fathe

in street what ur advise?

itte he

thats h she lea es of ho e a d sta

a. refer her to homeless services

20.a kid try to sexual intercourse in school: child abuse

21.A man called gp transfer his and his family file to another gp :tell him everyone has to come
and consent

22.A mother calledgp to her daughter result :not tell her

23. seretine syndrome scenario

.A ouple a e
to do?

ale

s old ha i g

st i teste le does t othe hi

aski g

hat e t

a. usg .b. tumer marker

25.A mother brought her child 6 weeks old left testis is not palpable asking for what to do?
Surgical refer

26.what tha most teratogenic???

a. alcohol.b.morphin.c.diazepam.d.ectasy

27.pt was in prison came u said his parent replace by aliens asking what diseases?
Schizophrenia

28.21 yrsA girl went for party whole day after that she feel tinging 40degree tem many
eu ologi al p o le do t e e e hat the ause?
a. ectasy no remember other option

29.A young man 28 yrold he was treated 8 yrs ago DVT after a car accident now coming gastric
operation what ur mx?/
a. warferineb.clopid.c.enoxaperine for 10 days d. enoxaparine for 1 month

30.dopc lec in the school 6 to 9 yrskid ??

a. sunscreenb.increase physical activity

31.Ct of abdomen pt on multidrug and warfarin :haematoma

32.what the indication of delirium severity??

a. unable to remember his idendityb.unbale he is doctor c .repeat 2 out of 5 after 3 min

33. 65 yrs he came because of forgetfulness bp well control and he taking statin only asking his
the cause of forgetfulness??
a.delerium vascular

.PT ou g suffe i g p og essi e d sphagia a d t eated PPI

g still s pto do t elie e
and on cheek red throat and narrow in esophagous severe case of GERD may be
a.increase dose b. gastrograffinc.change to another PPI

35.Pt taking some type of SSRI cant mood sweeing next mx? Add lithium

36.A man came together with his wife methotrexate and hydroxyl choroqune she want to
conceive what next?
a.stophydrooxy and continue metho

37.A case of HOCM 25 yrs old man syncopy asking mx?

a. stress test b .ECHO test

38 .old man syncopy in toilet ;dx micturition syncope

.athlet ha i g palpitatio put hi

u confirm??? Echo test

holte

a hi e do t e e

hole

e HOCM ho

40.GIRL DEVELOP pain every month all r normal pain 3 to 4 days every month
a.mullarian agenesis

41.A women suffering anuresis till age of 13 yrs , other sis same problem before all lab test
normal what could be cause??
a.VUR B .hoarse shoe shape kidney

42.Aboy 4 yr old having aneuris at night day time ok asking initial mx????
a. bed time alarming b.not remember

43. A child came after camping having nausea vomiting diarrhea slight blood in the stool asking
about the cause????
a.acute GF b.AINc.IGanefropathyd.DIC

44.5 Days after surgerical procedure in leg there is a swelling and pain what the reason??
a.infection

45. 25 yrs old lady came withGreen tooth pest like discharge and nipple inversion what dx?
a. paget b. duct ectesia

46.saterday night palsy scenario old recall radial nerve

47.trigeminal nerve ingury what happen????

a.unable to move jaw b. unable to move tongue c.parasthesia of affected site

48.A child was funny movement and spasm ?infantile spasm

49.What the most common cause of infection of gall bladder?

A. staphyloauriusb.E Coli

50.6 week pregnant betahcg high small bleelingoss close on palpation uterus and abdomen r
normal what the cause??
a. threatened abortion b. ectopic prg c. iniviatable abortion.

51.hb; hip dislocation

52.Middle age man after falling pain radiated to back AST was slightly increase and lipase was
increase ??acute pancreatitis

53.1cm bladder stone what to Mx????a.increase fluid b. ESWL C.other option not remember

54.55 yr old women having small lump in upper part of breast all exam normal what to do
next???
a.mamography

55. 55 yrs old women 4cm cyst in overy her last paps smear was normal whats next??
a. tumer marker b. D and C c. other option not remember

56.women came asking for OCP she having occational headache what imp to ask her????
a. any f/h/o b.stress increase ur headache c.visual disturbance accompanihg headache d.not
remember

57.def of prevalence?
A new cases

58.child having measles in ur clinic after 3 hour u realize

a.u have to ask everyone stay and take the vaccination against measles
b.vaccinate only the stuff c.inform the medical board about this

59. bacterialvaginosis asking the mx//////??? No tracing

60.elisa positive and western blot was negative?? False positive

61. vaginal ulceration asking about the cause?herpes simplex

62. 64 yrs old teacher start neglecting and forgetting and also auditory hallucination what imp
to ask ???
a.h/o of schizophrenia in family

63. women collect rubbish and her son brought her after full cheek up she was feeling dishonor
what imp to investigate???

Blood test electrolyte blood culture not no exactly

64.asking about prophylaxis of dengue fever???

A 500mg doxycycline b. vaccination c. not remember d. ware long sleeve

65. middleageXray left lower lobe of lung absent pt 4 to 5 cigarrate a day exam. rhonchi and
crepitation x ray shows fluid asking dx????
a.IHD b copd c

66. A doc find there is too many case chlamydia in his area???
a.trace contact

67.Pt came prostate dis his brother also suffer 55 yrs he is now 52 yras what next to do???
a.DREb.PSAc.not option in both

68.pic of old man was brownish patch in his face no change long time what to do next??
a.local excision b.deep excision c.review in 12 months

69.small bowel obstruction Xray asking mx?

a.nasogastric decompression

70.common cause of SBO??

a.sigmoid volvulus

71.ct of left iliac artery occlusion asking mx??

a.warferin b. heparin c, clopid d. aspirine

72.one case of cholilithiasis (without jaundice)and one case of cholangitis (with jaundice)

73.operation of calcified gall bladder H/O MI how to operated??? Percutenious laparoscopy

s old o

a.digoxin

ide

s ho to

??? Ma

e VT do t gi e ECG

75.pt was everything normal slight decresena what the mx?

a.arragena tab slow release every 6 hour.b. noi/v option not remember the other option
76. a case of bullemia nervosa BMI 24.5 asing best inv?
A full blood examination b. electrolyte

77.a women came binge drinking on weekened asking for advice ?a.advice her safe way of
drinking b. stop immediately

78.A Xrayfracture glenohumeral joint and clavicle middle age man asking mx??? A.surgery b.
reduction

79.TYPE2 DM typical feature of cellulitis allergy to penicillin asking mx?

Ceftriaxone no option of fluclox
80.A person anaphylactic shock after eating rsturent what most imp to advice him??
a.strick diet b.keepepipen with u

81.A pt taking warfarin prednisone and now taking tramadol .after taking tramadol he suffer
haematuria what the cause?
Drug interection

82.what the most imp mx of ear infection??

a.antibiotic

83.a case of RSV virus inf

84. herpesinf in child

85.meningitis feature in kid what inv next?

LP

86.mother came her son sleept over his frd place and after 3 days sons frd develop meningitis
now what prophylaxis

87. female came with jaundice lethargy and hepatspllenomegally asking about the cause????
a.thalassamia minor b.G6PDHD C,hereditarysherocytosis

88.typical scenario of CML

89.feature of microcytic anaemia and reticulocyte count 5% especting more in bllodtest ??

a. spherocyte

90. typical pic of CMV in child

91 .post traumatic depression

92.pt of chons diseases pic show bowel obstruction asking about mx?
a. decompression

93. pt came with lethargy palpitation visual gaze may be thyrotoxicosis

94.after MVA pt came with leg swollen and pulse less asking about next mx?
a. faciotomyb.heparine c. ct angiogram

95.mother came with her chid 5 month old she said she wake up 4 or 5 times at night to feed
her baby child 50 percentile and looks normal ????

a. give dummy at night b. changing her feeding procedure

96.pt came h/o t8 fracture now he feeling parasthesia ,numbness his peripheral limb what the
cause???
a. multiplesclerosisb. Disc compression

97.2 case of syringomylia

98.pt came after taking 10 tab of temazepam all examination normal asking psychology come
she want to leave before psychiatry came what next??

a. involuntary admission
99.pt taking too many drug and he took 10 gmparacetamol came in clinic after doing
paracetamollevel its normal what to do next?
Observe

100. pt came with diarrhea stool culture negative blood test show low hb and normocytic
anaemianext inv?????

Warm and paracytecheekup

101.pt taking triple antibiotic asking for the cause of diarrhea?? Clostridium deffecele

102.80 yrs old women she came say want to go mountain climb himalay her MMSE 23what
next??advise her she not feet to go

103.a pt came after stroke he want to drive ?inform RTA

104. apt having stent now need to major operation INR 1.2 what to do before opetation
a.i/v heparine

105.a case of ITP test give low platelet

106. typical Feature of ADHD asking most imp to ask

107.farmer was fever haemoptysis hepatomegaly no rash

a. bruselosis b. q fever c hydatid diseases

108. a guy came hittedcriket ball in eye asking and decrease visual acuatity what to do ????

a.hyperboric o2

109.pt before antrysellute 3 times ?

mannerism

110. pt after trauma suddenly find cyst over his kidney what next?
Aspiration

111.Keratoacanthoma hb pic

112.doc prescribepcm to the pt who is suffering from constipation u came out to know nurse
prescribe codein with paracetamol not asking you what ur reaction???
a. call the nurse board

113. child 86%o2 concentration asking about the 1st? give o2

114.2 brown spot on her foot unchangeable long time all leb test r normal asking about next???
No further examination