AMC May 2024 Recalls – Key Exam Insights
- POA 39/52, Os 8cm,st-2,caput.Code comes before head.theatres busy. Management ?
1.lithotomy position
2.ventose
3.cord replace manually
2. 38yrs primi Uneventful delivery, Post partum day1 bleeding + Clotting normal. Cause? 1.amniotic fluid embolism
Q3- 27yrs old post partum 6/52. Withheld breastfeeding 2/52 ago. Think that the baby is an evil.
Father take care of baby now. What to do?
1.ECT
2.serotinine
3.quateipine
4.haloperidol
5.clozapine
Q4- 74 yrs old lady came with depressive symptoms . What to do 1st.
1.CBT
2.start serotinine
3.start respiridone
Q5- A man is bitten by a dog while travelling south east asia. Multiple wounds with bleeding . What ti give ?
1.ARV+ Immunoglobulin
2.ARV
3.immunoglobuline
Q6– syrian refugee had bout of haemoptysis 3 episodes for last 3/12.Now came with cough,sob,haemoptysis again . CXR given . R/S middle lobe ?mass. Dx?
1.TB
2.bronchial ca
Q7-ECG with ST elevations lead 1,avL, V2-V6. Asked initial management .
Q8- 56 yrs old man came with severe chest pain radiated to the jaw . ECG given was normal .trop.I negative . What to do next.
1.reasure and discharge
2.Rpt… E CG and Trop.I
Q9-. Old lady came with severe back pain while opening the widow.fracture +ESR above 100
S.cr slightly high S/E normal. What would be the cause for her fracture .
1.MM
2.oosteoporosis
3.renal osteodystrophy
Q10. Old man came with back pain. Xray sclerotic lesions + Next appropriate investigation .
1.PSA
2.MRI
3. CT
Q11-. Hypoglycaemic attack with LOC. Driving restrictions .
1.no restrictions
2.6/52
Q12-. Pregnant lady who has advanced directive with not to give epidural , asked for epidural on labour with severe pain and distress . Husband and family asked to do as advanced directive .
Now what to do ?
1. Start epidural
2. Discuss with the lady
3. Do not give epidural
Q13. Old lady with myopathy has made an advanced directive of No NG feeding .
Now the pt.can’t talk and swallow . What to do now.
1. Give NG
2. Small oral sips
3. IV fluids
4. Parentral nutrition via central line .
Q14- HF scinario,on examination ,BP 90/60,HR 110,RR 35, elevated JVP,spo2 90/. What examination finding will limit her treatment process ?
1.BP
2.SPO2
3.HR
4.JVP
5.RR
Q15. Young lady came with progressive SOB. No elevated JVP . Cardiac function normal .
B/L coarse creps+ Initial Ix to be done?
1.CXR
2.CT angiogram
3.2D echo
4.pulmonary angio.
Q16. Man with severe MR awaiting MVR.what Ix has to be done prior to the surgery .
MRI heart
Q17. Old man with mild dementia asked for sildenafil.
Q18. 14 yrs old boy, hallucination + social and academic deterioration .cause?
1.drug abuse
2.prodromal psychosis.
Q19-Pt with xray of cervical fracture (suicide hanging c2 fracture was showing)and difficulty of breathing. What will you do
Intubation
Cricothyroidotomy
Tracheostomy
Q20-41gentleman w/ concern about tongue appearance: brown, furry, and bad breath. Tried treating w/ antibacterial mouthwash, no improvement. Takes lansoprazole daily, smokes 20 cigs/day.
1 Diagnosis can be made on clinical grounds, no investigation needed.
2 Swab tongue for bacterial microscopy, culture, sensitivity.
3 Perform punch biopsy of tongue
Q21-.Scenario of boy with constant sneezing and “cold” all year round and worse in winter, (some other pointers to atopy present) asking for what to confirm diagnosis
1. Measure IGE
2. skin prick allergy test
Q22.Picture of a baby with a rash.
4 Months old baby whose Sister also had same rash 1 week ago.
Permethrin cream
Q23.Travel to South ?African country how to prevent from Hookworm infection
Don’t walk with bare foot
A24.A man who is a sheep keeper, undergoing a CT scan for the liver with a mass in the liver, presents with right abdominal pain.has history of smoking The diagnosis :
1.Hydatid cyst
5.hepatic carcinomas
*
Q25.syrian Immigrant 50 Years old with 80 Pack History Smoking , comes with Hemeptysis since(can not remeber Weeks or Months) no Weight loss or fever, Dx?:
Lung CA, TB..
Q26.Barrett’s Esophagus, long-standing patient, on checkup showing high-grade dysplasia. Best Step: Esophagectomy, Endoscopic Ablation, PPI, Review in 3 Months..
Q27.Patient had written Will saying she doesnot want any Tubes, now she comes with stroke she couldot Swallow, can not talk,
1.central line insertion and give parenteral feeding
2.NG feeding
3Gasrostomy feeding
Q28.patient with trauma to the Eye with Hyphema, you arranged for referral to Opthamogfoist, but it take time, what to in this time?
1.Eye shield
2.Timolol eye drop
Q29.laceration wound in the digit, which anathesia to use for surgical repair:
1.1% Lidocaine Only
2.Lidocaine with adrenaline
3.0.25% Bupivacaine
4.bupivacaine wrist block
Q30.Patient with prolong hypertension history comes with sever Chest paain Radiating to the Back BP: 140/110, HR 100(can’t remember exactly)
1.MI
2.Pulmonary embolism
3.Dissecting descnedning aortioc aneurysm…
Q31.Female with history of histerectomy (long stems)atropic vaginitis
1. Oral estrogen
2. Topical estrogen
3.
Q32.Young man working in garend yesterday , now comes with sever Backpain, Neuro Exam. Normal, what to do?
Paracetol
Lumbar Xrat
MRI Spine
Q33.Orbital fracture
Q34.young Lady has hitory of migraine what is the most suitable contraceptive method?
Q35.Question with vertigo no tinnitus no hearing loss there is a spontaneous eye movement or something.
1.BPPV
2.Vestibular neuritis
Q36. Woman comes to ED ECG- Prolong QT syndrome there is a white color tablets in the bag 1. Amitryptiline
Q37. Mine worker with cough and fever X-ray with pleural effusion blood streaks 1.Mesothelioma
2024/05/09
Q38=MR regurgitation scenario. What to do before going for surgery, TEE was already done and severity was already measured
TEE, MRI heart, dobutamine Stress echo(Look for pul htn n reversible ischemia)
Q39-A case of woman with h/o b/l salpingectomy for contraception and now presenting with complain of sever menorrhagia uss showed multiple submucosal fibroids, with endometrial thickness of 10mm HB low. What to do? Hysteroacopic myomectomy, d and C, cocps ,IUCD
Q40-53 years old 1 year Post menopausal coming with wrist fragility fracture apart from wrist fracture management what will you do that will improve her well being??
Advise HRT, BMD, do wrist splint, give vit d
Q41-Woman with BMI 30 vitally stable coming especially for cocps but bothother has h/o of thrombophelia What will you do??
Advise OCP as pt wish, give pop, give implants do thrombophelia screening
Q42-Which is the most imp risk factors for endometrial cancer in post menupousal women
Nulliparaty
Advance age
Obesity
Q43-Pt alcholic 10 sd/day presents with distressing vertigo that make him bed ridden ass with tinitus, vomiting but no hearing loss, on exam there was horizontal vertigo more on right side with diplopia, but unable to fix his eye on doing rapid rotational nystagmus
Alcoholic cerebellar degeneration
Vestibular nystagmus
Bpvv
Q44-Pt h/o URTI presents with sudden onset of weakness bed bond involve distal muscle more no sensory levels, absent reflex but can be easily induced cause, no sensory level
Acute pllolynuropathy
Mysthenia
MND
Q45-57 year old man experiencing weakness of pelvic n shoulder girdle and wasting of muscles. CK is normal no rash on exam Dx?
Polymyositis as there were symmetrical muscle weakness
dermatomyositis,
inclusion body myositis,
polymyalgia rheumatica no wasting
Q46-Typical scenario of globe fracture via speedy tennis ball all of its symptoms there soft globe no reflex etc most immidiate step
Apply eye sheild
Q47-Pt presents with typical senecrio of pul edema that is acute onset n hemodynamically unstable with raised jvp b/l crackels hypotensive etc, which of the following will be ass with difficulty in resuscitation
B/l pulmonary crackels
Inc jvp
Hypotension
Dec spo2 88
Q48-19 years old women collapse while in dancing centre n when regain consciousness she describe only dizziness prior syncopy on examination her BP was 140/80 siting and 110/60 standing, pulse 100, spo2 ,ECG was normal most imp step will be
teach her how she can cope her syncope
Echo
Fluticasone
Q49-Middle age man, running marathon, sudden LOC, GCS 12/15. Stable. Cold sponging started I. Field, Brought into ED, agitated, difficult to manage. Temperatura raise upto 40, no apparent closed trauma, no other exmination finding mentioned, GCS drop 9/15. What next?
A. Endotracheal intubation
B. IV paracetamol heat stroke
C. CT
Pack with ice underarm n cold sponging
Q50-2 months child presenting with UTI symptoms and was given cephalexin after taking it for 3 days parents bring him again irritable crying, tacvhypnea, tacchycardia grunting sounds and lower abd pain on palpation What to do? Continue cephalexin,
give oral trimethoprim, .
Iv genta
IV Cepphalaxin
Q51-Pt taking a tide presents presented with confusion disorientation labs given only hyponatremia there,Asking initial step?
Fluid restriction,
hypertonic bolus 3% saline,
normal saline
Q52-75 year old man no comorbid other then BPH for which had undergone turp and sent for biopsy. A biopsy showed a tumor involving less than 5% What to do now?
Radiotherapy,
Reassure him n do f/u
hormonal therapy,
radical prostatectomy
Q53-Female pt presented with severe tenderness of both shoulder n pelvic girdle, no rash esr 60 treatment?
Prednisone
Q54-Young diabetic, hypothyroidis presenting with 10 kg weight lost, generalized weakness, inc urine frequency Not taking meds properly for that. Labs were given. HbA1C was 9% and TSH was high normalcortisol asking for cause of her symptoms
Cushing
Thyroid dysfunction
Uncontrolled diabetes
Q55-10 years old girls with type 1 diabetes do regular blood glucose monitoring but forget to take it on today’s appointment when ask Abt her control she satisfied the doctor but when HbA1c can out it was 9%what is the cause of high hba1c
Expired strips
Wrong use of strips
Have taking high carbohydrates 1 week before test
Expire insulin
Q56-Pt with back pain aggrevated on rest put resolved on walk, no other systemic signs, x-ray given most appropriate step in addition to brufen.
Physiotherapy, infliximab, methotrexate.
Q57-Sheep farmer and smoker. H/oelenoma excision presents with uss pic in pict there was multiple hyperdense mass best investigate???
HIDA Scan
Uss guided biopsy
CT guided biopsy
Triphesic ct
Q58-Old age have hip replacement presents with abd distention and pain x-ray showed multiple dialated bowel loops no air fluid level, on exam there was fecal impectionwhat is the initial step
Rectal tube
NG tube
I/v fluid
Enema
Q59- Patient had sore throat for which amoxicillin given but after 4 days pt presents with widespread Maculopapular rash, what is underlying cause
Delayed hypersensitivity
Serum sickness
Anaphylaxis
Urtecaria
Q60- Patient on 35mg risedronate presenting with 2,3 crush fractures with 3 months of use only Whats next?
Continue same,
stop this and start bisphosphonate, stop this and start strontium ranelate
Q61- Lidocaine, bupivacane question but doses were wrong I chose lidocain 1% as dose was correct
Q62-. Residents n one staff of old age home are vaccinated regularly for influenza virus. 3 people got fever, cough with in 3 days, Two more of them got infected today. Which organism is responsible? Streptococcus pneumoniae, leoginella, influenza virus
Q63-Pt presents with 1L vaginal blood lose she is tacchycardia normal b.pn sqts baby heart rate 155 which is the most imp clinical features that can help in diagnosis
Fetal engagement, maternal Bp, maternal pulse, fetal heart rate, uterine contractions
Q64-. Son with old age father came to ED and said he no longer wants to take care of the father what to do?
Social work review,
admit father to psycho geriatric mental health
Urgently arrange for old age home facility
Send him home with son
Send nurse for asst at home
Q65- Case of quinsy. Patient is coming with drooling and uvula deviated. Im penicillin given after 4 hours patient develops stridor and breathlessness what to do?
Endotracheal intubation, Im adrenaline, iv adrenaline, antibiotic
Q66-Adult was bought by her mother complain of he keep in his Rome don’t like to talk anyone don’t like to go to school but school grades are very good no h/o hallucination sleep all day but remains awake at night, what will u prescribe
Risperidone not bipolar
Fluxiteine not depression
Mirtazepine cycle reverse
Clonazepam no psychosis no hallucinations
Stupid drug name n I select it
Q67-68 years old with symptoms of dementia they were asking which thing will help to reach diagnosis
Family history of dementia
Pin rolling tremors
Disorientation
Auditory hallucinations
Q68-School children assaulted a 10 yr boy and they called him weirdo when he taken to hospital he had bruses on chest consistent with adult the boy was all ok ur next step
Call child protection
Call parents for consent to proceed
Condels the child as he ia fearfull
Start management
Q69-Old men with dementia n now in love with other pt attandent mms is 23/25 wants sildenafil for erectile dysfunction
Prescribe it
Do mental state exem
Do sat of capacity of taking decision
Q70-Pregnant lady who has advanced directive with not to give epidural, asked for epidural on labour with severe pain and distress. Husband and family asked to do as advanced directive.
Now what to do?
1. Start epidural
Follow advance directive as said by family
2. Discuss with the lady
3. Do not give epidural
Q71. Old lady with stroke has made an advanced directive of No NG feeding. Now the pt having swallowing weakness his family members want to put NG at all cost What to do now.
1. Give NG
2. Small oral sips
3. IV fluids
4. Parentral nutrition via central line.
.
Q72-Code comes before head.theatres busy. Most imp step of Management?
1.lithotomy position
2.ventose
3.cord replace manually
Q73– 27yrs old post partum 6/52.Withheld breastfeeding 2/52 ago. Think that the baby is an evil. Father take care of baby now.
What to do?
1.ECT
2.serotinine
3.quateipine
4.haloperidol
5.clozapine
Q74– syrian refugee had bout of haemoptysis 3 episodes for last 3/12. Now came with cough,sob, haemoptysis weight lost CXR given R/S middle lobe cavity with air fluid level ?mass.
Dx?
1.TB
2.bronchial ca
Q74-Pt with typical picture of graves disease but no TRAB only peroxidase antibidies I go for radio scan
Q75- In pregnancy I mark relapse of previous panic attacks as she has h/o panic attacks n this time she also presented to go with panic attack with inc b.p pulse n r/r, n her husband also complain of her suffocating feeling during night
I mark amylase for pancreatitis
As they have ask which investigation reach the diagnosis
Q76- I go for mipropion as yellow crusted lesion was there on baby body, bec I don’t know whether scabies cause Maculopapular rash like that in whole body when such small baby can’t itch, there was no history of URTI so viral was r/o, 4 weeks persistent rash
I think so I have made mistake
Q77-One more pt with CRF EGFR <25% taking both iron n Omeprazole but still not getting his anemia corrected which is the best investigation for diagnosis the problem
Serum erythropoietin
Bonearrw
Q78-2 ND post opp i go for UTI not endometriosis as lochia was normal not fouel smelling, although she has no urinary complain and urine was passed but have lower abd pain…
It was clearly written lochia red color scant no fouel smelling
Q79-For popliteal anuresyum for only 2cm I go for CT angio although there is no indication for CT as he was asymptomatic, other option were related to PAD in was written his pulses were normal
Q80-Ferritin for restless syndrome 🙂
Bloody campylobactor no bloody ecoli
I mark cholengitis havnt mark billiary stricture although 4 days history of pain
Billiary strictre presents with pruritus there was no history of that
N ampullary cancer are painless with abd mass called Charcot triangle but his abd was painfull
