46. 7 year old boy bitten by bat. Father worried. What to do?

1. Monitorandtxaccordingly

2. Antibioti3

3. Tetanus 4

4. Postexposurerabies 5

5. of the aorta

    

   47. Another irritable infant (how many months?) with umbilical hernia. What to do next? A. Refertosurgery
   B. SendtoED

   48. Mother found a swelling on one side of the baby’s neck while bathing him. It was hard but painless Head tilted towards the swelling. What’s the dx?

   A. Cystic Hygroma (Opposite side)

   B. SCMtumor(sternocleidomastoidtumor)

   C. Thyroglossalcyst D. EctopicThyroid

   49. Another child swelling of scrotum. Not painful. Scrotum could be felt separately. Went til penis and perineum. What’s the dx?

   1. Edema

   2. Epididymitis

   3. Testiculartorsion

   50. Bat Bite. Patient stable. Next step?
   A. RabiesVaccine
   B. ObservechildinERfirstanysymptomsdeveloping

   51. Clinical scenario of HOCM what will you do next all stable now A. Referpatienttocardiology
   B. Admitandobserve
   C. Dischargewithnoreferrals

   52. ECG given. Looked like 2 PVCs in couplet ECG.

   53. CXR of chest showing pneumonia in the left middle lobe – CXR was to identify the diagnosis.

   54. Pt comes with right iliac fossa pain. USG done and stone of 5 mm seen at the junction. What to do next?

   55. ER doctor was drinking till morning. What will you do? A. InformAHPRA
   B. InformERhead

   56. Girl came to get a prescription for her boyfriend. What to do? Verbal consent over the phone?

   57. Internal hemorrhoids (Given a picture). Management?

   58. Pregnant 36 weeks with her child. Got chicken pox. Lady doesn’t remember if she is immune. Management?

   A. Checkserology

   59. One question with a woman all history of TB, chest x ray and sputum culture done. What more?

   A. Sputumcytology
   B. Mantoux
   C. Interferongammareleaseassay D. Isolate

   60. Another with pleural effusion and 6 months symptoms of difficulty breathing. What next?

   1. Bronchoscopytoo

   2. needlethoracocentesis

      CA Lung?
      Needle thoracentesis —– pleural fluid examination with Light criteria

   61. Primi in active labour for 12 hours, caput + moulding + Station +1, active pushing for 1 hour, contractions reduced. Next step?

   A. Oxytocin
   B. Assisteddelivery(iffullydilated)(forcepsnotventouse)

   C. LSCS

   62. A 55-year-old man has been on warfarin for AF for the past 3 months. He presented with an incarcerated inguinal hernia and was booked for emergent surgery. Warfarin was stopped and fresh frozen plasma was given. Which one of the following is the time to resume warfarin therapy?

   A. 12hourspost-op(within24hours)
   B. 48hourspost-op
   C. Immediatelyafterrecoveryfromanesthesia D. 5dayspost-op

   64.Old man hearing progressive deterioration.Given the audiogram .Asking for which type of deafness?

   65.AF ECG was given ,Management?

   66.Another ECG given .Digoxin toxicity.Management?

   67.A man with a pin in the forearm and elbow, weakness on extension and tenderness on palpation on the extensors. What investigation should you do next.
   X ray
   Nothing more

   MRI
   Poly pharmacy.

   68. Old man with Alzheimer presents with urinary incontinence.

   69. Pre orbital (Periorbital?) cellulitis can not open the eye and thin yellow discharge and fever. What ab is needed?

   70. 18 month old child presented with a tonic clonic seizure which was controlled with lorazepam. Temp 39, tachy, confused, 3 days ago. Diarrhea and vomiting preceded investigation showing sodium 119, K 4, Cl 85 and bicarb 18. Asking what to do to confirm dx

   1. LP
   2.Blood culture 3.stool exam 4.CXR

   71. A long scenario about a patient on warfarin, previously URTI receiving multiple AB treatments now ( dont remember for what) on CT abdomen large mass appeared in anterior abdomen. No fever just abdominal pain.
   1.psoas abscess

   2.rectus sheath hematoma (?h/o URTI, cough reflex) 3.ureteral stone

   72. A man with RTA GCS 6/15 has long heavy bearded bp 100/75 RR9 SaO 88, asking initial step to do
   1.shaving beard to ensure mask ventilation
   2.100% O2 mask venti immediately

   3.CT 4.IV fluid

   73. A 7 day baby presented with bilious vomiting feeding intermittently no fever vitals stable asking what to do initially?
   1.USS abdomen
   2.Ba enema and follow through

   3. Xray abdomen

   74. An elderly female 80yr urine exam shows 20wbc and culture e coli but no symptoms what to do?
   1.Discharge with po trimethoprim
   2.nothing

   3.IV ceftriaxone

   75. A 33 wk pregnant lady presented with vaginal bleeding and abdominal pain, abdomen tender moderately, her BP 145/90 urine dipstick with ++protein, ++RBC she has previous hx of preterm labor due to PEC. asking which one precludes (make impossible) tocolysis?
   1.PEC
   2.vaginal bleeding
   3.UTI

   76. A case of skin mass excise dwith clear margin so  f2mm then biopsy returned back with melanoma of 0.6mm thickness. What to do
   1. Further excision
   2.routine follow up

   77.A young pregnant lady 8wk comes to you concerned about thrombosis risk. Her mother has PE history and her sister also has repeated DVT history. Which one is mostly to use for screening her?
   1.screening thrombophilia

   2. Lupus anticoagulants test 3. Doppler USS of legs

   78. Patient with poker playing (gambling?) asking what about appropriate initial treatment

   1.insight psychotherapy 2.CBT
   3.supportive psychotherapy 4.sertraline

   79.Parents concerned about their 8yr old childs behavior. Child with isolation doesn’t prefer to play with his peers just playing with one of peers, difficulties controlling him in school, tantrums, normal language, normal eye contact, but in his room all dolls are parallel locating. Making sudden screaming occasionally at different times. Asking dx

   1. ADHD

   2.Autism spectrum disorder

   3.tourette sx

   80.AF ECG 80 yr old patient coming for routine control has GFR 35, cr high other investigation normal, bp 145/90, pr 88 irregularly irregular. No signs of HF. DM2 on multiple drugs (asprin, atova, metformin) asking what to give
   1. Metoprolol

   2.rivaroxaban

   3.warfarin 4.digoxin

   81.A 55 yr old DM female BMI presented for a control visit regarding her cellulitis in the leg. She mentioned that this is her 4th cellulitis event in the same leg. She is well now, healed cellulitis both legs with varicosities but no chronic venous insufficiency signs but between toes there is tinea infections. Asking what is the major factor causing her problem

   1. Obesity 2.varicose vein 3.DM
   4.alcohol

   82.Child with impetigo. Ceph prescribed. Asking school exclusion

   24H after AB

   83.A patient working as a manager in company with delaying in works, work studies postponed, and difficulties in organizing works with poor concentration. All started after an event (dont remember ) before 3 months. Asking what you look for to support dx.

   1. Increased forgetfulness

   2. Anxious and fidgeting appearance

   84.A child with URTI and then symptoms of rheumatic heart disease. Arthritis, murmur fever asking what to do confirm
   1. Blood culture
   2.ASO titre

   3.echo

   85. Another long scenario about cryptogenic organizing pneumonia with masson bodies asking for treatment?
   1.dexamethasone
   2.ciprofloxacine

   3.doxycycline

   86.Mother came with child for vaccination, complains she has sleep disturbance due to frequent crying of baby and husband is not supportive at all. Despite this she is able to do work and interact with colleagues as usual
   1. Send a nurse to home for assessment

   2. Refer to marital relationship counsel 3. Sleep hygiene

   87. . 53yr old female with breast mass mammo done, dense breast tissue, USS showing cystic lesion. What to do next?
   1. FNAC
   2. TRU CUT BX

   3.follow up after 6 wks 4. Mastectomy

   88. 62. A 55-year-old man has been on warfarin for AF for the past 3 months. He presented with an incarcerated inguinal hernia and was booked for emergent surgery. Warfarin was stopped and fresh frozen plasma was given. Which one of the following is the time to resume warfarin therapy?

   1. 12hourspost-op

   2. 48hourspost-op

   3. Immediatelyafterrecoveryfromanesthesia

   4. 5dayspost-op

   5. WhenINRislessthan1.8again

   89. .Old man hearing progressive deterioration.Given the audiogram .Asking for which type of deafness?

   90. .AF ECG was given ,Management?

   91.Another ECG given .Digoxin toxicity.Management?

   92.A man with a pin in the forearm and elbow, weakness on extension and tenderness on palpation on the extensors. What investigation should you do next.
   X ray
   Nothing more

   MRI
   Poly pharmacy.

   93. You are seeing a patient of your colleague, prescribed thyroxine without checking

   TFTs. She had weight gain and lethargy, but no other indication for hypothyroidism.

   Tell the patient she was treated wrongly Report to AHPRA
   Talk to colleague when he returns from holiday Take patient under your care

   94. question of an old man with lots of meds with dizziness and syncope what should b

   stopped first in their medications

   Digoxin Spironolactone B Blocker
   Ace Inhibitor

   95 .Old patients with fractures admitted in the hospital then delirium (asked: 1. What is the cause 2. What to give)

   1. Lorazepam ( if patient has liver failure) 2. Diazepam

   3. Haloperdol

   96. A man with midline mass 1 cm asking what important to support diagnosis

   A. Tongue extrusion

   B. Xray
   C. USG of mass

   DX Thyroglossal cyst

   97. A renal pelvis stone 2cm asking Mx

   A. PCNL
   B. ESWL
   C. analgesic and discharge

   98.. Patient for cellulitis treated with cefazolin, then picture given after 3 days of Tx, macular drug reaction on trunk, asking the cefazolin stopped which one not good for pt in the future?

   A. All cephalosporins
   B. All penicillins and cephalosporins C. Just cefazolin
   D. Clindamycin

   99. Patient can’t see in left eye for 4days which she noticed after hurt on a table what’s the cause
   A.Viterous hemorrhage- (floaters, no flashes,visual loss )
   B.Retinal detachment- (Floaters, flashes, reduced vision)

   C.CRVO
   D.Macular degeneration

   100. DM pt with sudden painless loss of vision before 3 days asking the most probable cause?

   A. Retinal Detachment
   B. Vitreous Hemorrhage – In Proliferative retinopathy in DM more common C. CRAO