Q 1: You are intern, patient wishes you to witness her will in the presence of lawyer?
a. witness will
b. refuse witness
c. asks surgical register if he can do it
d. asks the patient if he is happy with intern witnessing will
e. seeks legal advice
Q 2. Annular Skin lesion on face (looks figure 8) on face. It has scaly on the border,
itchy looks like Erythema – Annulare but resembles ring worm. Treatment?
b) 1 % Hydrocortisone
c) Prednisolone
a) Topical Clotrimazole
Q 3: Patient presented who had osteoarthritis presented with a swelling on his knee
(there is visible small irregular opacity (Radio opalescent), at the edge adjacent
joint space. It is red, hot, tender no other systemic manifestations. What are you
likely to see on the microscope?
a)mono Sodium urate crystals
b) Calcium pyrophosphate crystals
c) Staph Aureus
Q 4: Hypothyroid patient on medication( one Thyroxin and ? warfarin) found
inconclusive at home. Blood result CK 1100(it was very high), low BP, there was
slightly increased Troponin. decreased RR. What causes her presentation?
a) Myxedema coma
b) Polymyositis
c) Hematoma
d) Myocardial infarction
Q 5. A man who has joint arthritis, on ants-pain. After he developed his joint
problems, Patient Isolated himself from club and social activities, wake up early in
morning, his sleep is disturbed and not interested in anything anymore. What is this?
- Schizophrenia
- Somatization
- Major depressive disorder
Q 6. Hbale 7.2 had recent Acute coronary syndrome. On metformin. What to add?
1. Uraglutide
2. EMPA
Q 7: Lady tried lifestyle modifications and drug therapy for weight loss. No
response. She has BMI 32. Next?
- Bupropion
b. naltrexone
c. Bariatric
d. Keto diet
one question on Complex regional pain syndrome
Atrial fibrillation ECG + stable patient next mx?
Q 8: Stab injury to chest perforating wound = tension pneumothorax = unstable pt
next mx?
Intubation
IC tube
wound closure
Q 9: 40 weeks primigravida vaginal bleeding following intercourse , uterus tender , hard, FHR shows brady next step?
Labor induction
obstetric scan
Q 10: 18 weeks primigravida headache bp 180/ 110, urine analysis done. what is the next thing to do?
Serum creatinine
ocular fundoscopy
CT
liver functions
Q 11: 55 yrs old pt came for prostate ca screening what to do?
(No option was there telling discuss pros and cons of PSA and urine analysis )
PSA
DRE
uss
do Nothing
Q 12: Antenatal genetic screening 12 wk scan nuchal thickeness detected ,cvs shows 46xy, ANC parameters normal, done what is the next Ox to do ?
Second trimester screening,
routine anc
tertiary care center scan
Q 13: Breast cancer surveillance , around 5 qs about breast lump , nipple discharge, atypical ductal hyperplasia.
Q 14: 50 yrs. male abdominal distension, altered bowel habits, Constipation , diarrhea evaluated with colonoscopy 12 month ago all normal , came with same symptoms
Again. Mx?
Psy referral
stool culture ova study
colonoscopy
Q 15: 34 yrs obese heavy smorker alcohol consumption , bmi 32 request for cocp , mostly considered factor prior prescription?
smoking / obesity/ alcohol
Q 16: A junior college asks from junior doctor to get a photograph of a patient s leg
lesion, what do u do.?
Take the photo for him,
ask pts consent and take photos,
refuse the request
Q 17: you get caught a Marijuana consuming doctor in the interval while seeing pts in the
clinic, clinic also knew his situation as he recently separated from his marriage ,
what can you do?
Talk and ask to stop
Inform Aphra
Inform clinic supervisor
Q 18: Marijuana addicted mother delivered a healthy baby , refuses rehabilitation most
concerning thing before discharge ?
Indoor marijuana inhalation
Mothers’ drowsiness following inhalation
Baby’s feeding
One question on Celiac disease
Q 19: Shcizo pt, symptoms controlled in RV with RX, but agitated, restless, what to do?
Q 20: A traveler going climbing , previous hx of high-altitude symptoms , what to do?
Dexamethasone
prednisone
Acetazolamide
Q 21: Fallen outstretched hand, Young pt initial xray wrist normal, pain and bruising later dorsal surface of hand Where is the fracture?
Q 22: Osteoporosis pt elderly fallen outstretched hand no other sym, xray distal radial
fracture displaced .what do u give other than orthopedic intervention?
vit d
ca supplement
vit b
Q 23: Stocking type neuropathy on bilateral lower limb up to ankle
Cause?
Alcohol
DM
vit b deficiency
one question on Foot drop causes
Q 24: Hemolytic anemia = pallor and jaundice, no hepatosplenomegaly cause??
Megaloblastic anemia
Q 25: abdominal pain of 2nd trimester pregnancy tender right-side abdomen, other
Normal. Dx?
Appendicitis
luteal cyst rupture
ectopic
Q 26: Atypical pneumonia xray chest, of a child
Refugee polio vaccination 4 yrs child had 3 does, what to do?
Q 27: 22 yrs travel to Thailand for 6 weks, after 4 weeks comes with fever, headache,
abdominal pain. Dx?
Dengue/ hepatitis A/ HIV/ Typhoid
Q 28: A child 3 yrs with cough, fever, abdominal pain, no chest finding on examination.
Chest with bilateral hazy infiltrates. Cause
1. Pneumococcus pneumonia
2.H. Influenzas
3.S. Aureus.
4. Mycoplasma Pneumonia
Q 29. A pregnant primi who was treated for GBS uti with oral Amoxicillin at 27 weeks.
What next?
a) GBS Swab test at 34 -36 eke
b) C / S
c)Give Ampicillin intrapartum
Q 30. History was 50 yr old woman, with itching for 6 months and progressively
increasing, no discharge, constant now, she’s regularly been getting her periods,
they’ just gotten heavy in the last few months, lasting for 10 days and on exam
there is only redness, (even in the picture only redness) next treatment?
1. Oral estrogen
2. Topical prednisolone
3. Clotrimazole
4. Vaginal pessary
5.Vaginal douching
Q 31. Swollen red tender knee overnight. Know comorbidities. Aspiration done what
will be seen
1. urate crystals
2. hydroxy appetite crystals
3. pyrophosphate crystal
4. gram + cocci
Q 33: A young adult woman thrown out of the family house with mood changes ‘feeling
down’ and ‘feeling great’. Comes in agitated, mentions she cuts herself to calm
down, people are frightened of her and she hit her mother recently. What’s the
diagnosis?
– Borderline personality disorder
– Bipolar disorder
– Antisocial disorder
Q 34: 15-year-old female came into the clinic 28 weeks pregnant for ANC Says the father of the baby is her 30-year-old Uncle and Asks you to keep it confidential. What the baby do you do?
– Notify child protection services
– respect her wishes
– call her parents
– discuss with both mother and Father of the child
Q 35: A young male child (can’t remember the age) comes in with facial swelling, legend proteinuria (++++). What investigation is to be done. What initial next investigation to be done?
Can’t remember the options
Q 36: A 13-year-old female just started menses; mother mentions easy bruises.
Menstruates heavily for up to 10 days. What investigation to to do establish diagnosis?
-Factor IX assay
– VWF assay
– FBC
Q 37: A child 3 yrs with cough, fever, abdominal pain, no chest finding on examination.
Chest with bilateral hazy infiltrates. Cause ?
1. Pneumococcus/ pneumonia
2. H. Influenza
3. S. Aureus.
4.Mycoplasma Pneumonia .
Q 38. History was 50 yr old woman, with itching for 6 months and progressively
increasing, no discharge, constant now, she’s regularly been getting her periods,
they’ just gotten heavy in the last few months, lasting for 10 days and on exam
there is only redness, (even in the picture only redness) next treatment ?
1. Oral estrogen
2. Topical prednisolone
3. Clotrimazole
4. Vaginal pessary
5. Vaginal douching
Q 39: Gp is doing a study 200 examined with per for bacteria 170 pcr positive and hva
bacteria 2 pcr negative and have bacteria, 25 pcr negative and dont have bacteria 3
per negative and don’t have bacteria?
2/170-
2/200-
3/25-
Q 40. Man with cough and sputum. Antibiotic started. Fever Pain increase with
coughing. Diagnosis?
a. Lung abscess : fever + productive sputum + no pain on coughing
b. Pleural effusion
c. Empyema: fever + pain on coughing
Q 41. Breast CA pt with Metastasis of femur. Pain treatment?
1. Chemotherapy
2. Eternal beam Radiotherapy – it can treat localise mets
3. Brachytherapy
Q 42: A young adult woman thrown out of the family house with mood changes ‘feeling
down’ and ‘feeling great’. Comes in agitated, mentions she cuts herself to calm
down, people are frightened of her and she hit her mother recently. What’s the
diagnosis?
– Borderline personality disorder
– Bipolar disorder
– Antisocial disorder
Lymphogranuloma venereum case
Molloscum contagiosum case
Q 43: Baby died, social worker consoling parents, who next to inform?
1. Funeral director
2. coroner
3. medical director
4. gp
Q 44: 18yo on OCPs, LMP 4w ago, presented with RIF pain, initial test
1. Beta hcg
2. wcc
3. urine test
4. ultrasound
Aboriginal pregnant at 12w Hbsag -,Anti hbs +,Vdrl + What to do?
1. Benzyl Pencillin
2. tx for hep b
3. rpt serology
Q 45: hcv vertical transmission, best way to check if there was vertical transmission
1. Hcv load on delivery
2. hcv pcr of baby
Look for the option AntiBody at 18months
Q 46: 35weeker delivered, otherwise normal baby, immunization?
1. Give hep b as scheduled
2. delay hep b up to “term age”
3. delay hep b for 4 weeks
Q 47: twin preg at 16weeks, di-di. Prev had normal vaginal delivery with no complications, this pregnancy unremarkable, what to advise?
1. Admission at 36w
2. caesarean section
3. start oral iron
Q 48: Di/di- Dichorionic-Diamniotic twins 36 weeker, ruptured membranes, everything else normal, initial investigation?
1. Speculum
2. US
3. swabs
4. blood tests
Q 49: Study design to find the source of food infection.
Cross section
Ecological
Case control
RCT
Cohort
Q 50. Picture of patient underwent cataract surgery presented with anterior chamber
pus accumulation what is the diagnosis?
Dx: Hypopyon
Q 51: No contraction fetal movement for 24 hrs 2. Picture of CTG was normal Heart rate between 120 -150 of a Pregnant lady 39wks gestation presented with decreased fetal
I guess she was also very busy and didn’t count . what is the next step?
something like that Reassure
Q 52: Picture of ECG for a patient showing Irregular Irregular rhythm heart Rate
120-140 No features of heart failure no Chest pain or syncope, what is the next
step?
Cardioversion
metoprolol
warfarin
Picture of adult patient with lobar Pneumonia asking about the organism
Q53: Picture a ct chest with cavitation of patient with history of renal transplant on
immunosuppressive drugs presented with fever loss of weight and appetite,
asking about how to diagnose?
Sputum culture,
legionella serology,
fungus serology
Dx: Aspergillus
Q54: immigrant patient with history of loss of weight, night sweats and fever for
one month, how to diagnose?
Q55 . female patient had RTA and sustained pelvis fracture after resuscitation what
to do?
There was an option for applying pelvic binder
Q 56: Two scenarios regarding spleen injury one was patient had abdominal trauma
during sport and sustained Lowe left abdominal pain and he was vitally stable
BP 110/70, PR was 80 what investigations to do?
CT abdomen
Q 57: Young male following high velocity motor vehicle accident, complaining of abdominal pain, BP 85/60 Hmm, PR 120? GCS 12.What is the most appropriate next step of management?
– transfuse 1 pack O negative blood
– IV normal saline 1 L bolus
-Laparotomy
– CT abdomen
Q 58: Middle aged Alcoholic patient presented with chronic abdominal pain for
three months on examination he has what is the next investigation
normal lipase and amylase high conjugated Bilirubin. next step?
-CT-Abdomen
Q 59: Woman hyperthyroidism on carbimazole, but biochemically hyperthyroid
planning a pregnancy, what to do?
1. Shift to PTU
2. Thyroidectomy
3. radioactive iodine
Q 60: Perforated diverticulitis, patient unwell, given IV + antibiotics, management:
1. Observation
2. Colostomy
3. Lap lavage
4. bowel resection
points
Q 61: 65yo woman with fam hx breast ca, 3 mo history of breast lump 2cm, last mammogram 3 months ago normal, what next to order?
– FNAC
– Mammogram
– Ultrasound
– advise pt to do self-breast exam
– re-examine in 3 months
Q 62: Patient presented to ED bec of fever and throat complaints, you noted a
peritonsillar abscess. When you started examining his throat, he became overly
anxious and scared, what to do initially?
– intubate
– iv fluids
– breathe into brown paper bag to relax
Q 63: There was also a question on infantile spasms, mother was worried that 3-month
baby had “jackknife” seizures + blank stare, otherwise well on exam, no fevers.
1. Absence
2. infantile spasms
3. febrile seizures
Q 64: First line investigation for achalasia
1. Barium swallow
2. Manometry
Q 64: A middle-aged man on warfarin developed retroperitoneal hematoma hid INR
is checked and is 5 after stopping warfarin What to do?
1.give prothrombin complex conc+ FFP
2. give FFP
3. Give vitamin k
4 . Do nothing
Q 65.A patient presents with recurrent headaches and has a family history of brain tumors.Laboratory results show respiratory alkalosis with the following data: oxygen saturation is normal, PaO2 is 95 mmHg, PaCO2 is 27 mmHg, and pH is 7.48. What is the most appropriate next step in management?
A. Order a brain MRI
B. Refer for psychiatric evaluation
C. Start oxygen therapy
D. Schedule a follow-up appointment in one month
E. Initiate carbonic anhydrase inhibitors
Q 66: How to diagnose the cause of the condition strep pneumonia related effusion in
5-year-old girl?
1.X-ray given ,high fever
2. serum pneumococcal per
3. Blood culture
4. Pleural aspirate
Q 67:female (age not mentioned) presented with complain of prolong menstrual
period and heavy blood loss ,what is most appropriate Tx?
A.cocp
B.iucd
c.mefanemic acid
d.transemic acid
e.northisteron
Q 68: 17 years old schoolgirl with complain of prolong irregular menstrual periods
and heavy blood loss,most appropriate tx?
a.cocp
b.iucd
c.mefanemic acid
d.pop
e.mirena
Q 69:32 years female presented with complain of heavy menstrual periods ,US
:uterine thickness >14mm,Most appropriate tx?
a.cocp
b.pop
c.mirena
d.mefanemic acid
e.iucd
Q 70:A mother brings in her 12-year-old child for screening due to a family history of
familial hypercholesterolemia. The child’s grandfather has recently been
diagnosed with this condition, and there is a significant presence of premature
heart diseases in the extended family. Considering this detailed clinical context,
what is the most appropriate course of action?
-Perform a comprehensive lipid profile assessment for the child.
-Extend the screening to encompass the entire family.
-Direct specific screening efforts towards thedaughter.
-Clearly communicate that the daughter is presently ineligible for screening.
-Refer both the mother and the child for genetic testing to ascertain familial
hypercholesterolemia risk.
8 episodes of repeated ear discharge, notably green in
Q 71. A 4-year-old Aboriginal child with a history of grommet insertion for recurrent
otitis media presents with 8 episodes of repeated ear discharge, notably green in
color. What is the most likely causative organism responsible for this recurrent
ear infection?
Streptococcus
Staphylococcus
Mycoplasma
Pseudomonas
Hemophilus influenzae
Q 72: 5-year-old girl her mother works as a prostitute the child was put in a
foster care but her mother keeps visiting her or something ,, the foster care nurse
noticed that the girl has erratic sexual behavior with one of her friends in the
care, what to do next?
Inform CPS
Psychological support
Talk to the mother
Q73. A middle-aged man came to GP for regular checkup after the consultation he
asked the GP to prescribe him anti HTN medicine because his medication is
about to finish in 2 days and he tried to contact his regular doctor and wasn’t
possible to reach him, what to do?
-advice the patient to contact his doctor
-Prescribe the drug
-Advise him to contact the online Prescription services
Q74: young male came for insurance checkup and was found to have + protein in
his urine what to do?
-Abd us
-Biopsy
-24 hrs urine collection
-Repeat the test after strenuous exercise
-S.cr
Q75:12 years old girl has on and off abd pain, no dysuria or frequency urine
culture revealed E.coli, what to do?
There were 3 options for oral anti biotics
Repeat the test thrimo
Q76 :pregnant lady has genital warts what to do?
There was no option for cryotherapy
Leave it till delivery
Q 77: a pregnant lady on her 36 wks Gestation, had GBS positive result at 12 wks
and received 5 days penicillin what to do next?
-Intrapartum ABx
-Treat her Newborn
-Do nothing at all
-other medications
Q 78: recall question patient was on hydrochlorothiazide and perindopril and
presented with fatigue what possible compilation led to her
presentation?
Q 79: an old male patient presented with severe left iliac fossa pain was
diagnosed with ruptured diverticulitis after resuscitation what is the next step?
Laparoscopic something
Laparotomy
Conservative
Q 80: Female came for contraception use she is post-partum for 2 weeks and
developed mastitis, on her antenatal care records there was a note written ” not
for contraception use” her husband don’t agree for the use of the contraception,
what is your advice?
4 options involved the husband in decision making
Tell the patient that using contraception is your choice and prescribe her the ocp
asked him to contact his psychiatrist he refused. what to do?
Override him and contact his psychiatrist
I don’t remember the other options
