Question 1 : Scenario of vomiting due to molar pregnancy, urine ketone positive, next step?

A. Serum electrolytes

B. Giving IV fluids

C. Ondansetron wafer

Question 2: Pic of 3 days old boy without abnormalities with vaginal delivery, asking mx?

1. reassure 2. Herpes 3. Streptococcal 4. Strep

Mother has no infection and I choose reassurance

Question 3 : 19 years old girl with bilirubin only increase. Total other LFT including GGT is normal. History of jaundice  after fasting to lose weight. She went to party and drank alcohol  and came to Gp with slight jaundice with LFT done. Mx?

1. Gilbert

2. unconjugated bilirubin

3.genetics

4.usg

Question 4:  23 years old woman came to GP and told that she is hassarment in her laptop one organization is tracing her files and they want to give a danger to her . she also hears their voices from that organization talking about her for 6 months. Dx?

1 delusion

2. schizophrenia

3. schizoaffective

4.paranoid

5.delusion

Question 5: Mother brings her daughter 17 years old girl complaining about her daughter is afraid of her daughter of swallowing difficulty of food in the throat. Her daughter has BMI 17 and no suicidal thoughts, no self-harm , no sexual abused in childhood ,no other complaints—asking management for daughter?

1.family therapy

2 dialectal

3. progressive relaxation therapy

4.Exposure to solid food

Question 6:  50 years old man with smoking history for 20 years. He changed color changes his fingers sometime .Not talking about joint specificity, no headache asking dx?

1. dermatomyositis – I choose 1

2. Berger disease

3. RA

4 Polymyositis

5. polymyalgia rheumatica

Question 7 : The 39 years old man found to have unconscious and treated in ER and him regain consciousness and shouted and said that he will gives lessons to his wife and abusive to wife. His wife has applied away from him and against him for domestic violence and they have 2 children. Most appropriate mx?

a. Inform police

b. Admit under medical tribunal

c. Inform child protection service

question 8: One lady came to GP and said that there is one drug is allergy to her during hospitalization and she heard the nurse talking drug…

1. fill incident form

2. complaint in proper channel

Question 9: 16 years old boy doesn’t want to go to school and locked himself in room, no change in sleep and eating ,school grade is declining and don’t talk to parents-Points for dx?

a. Loosening of association –I choose

b. Don’t talk to parents

Question 10 : Asking about associations for using mercury amalgam and cancer?

a. cross sectional

look for case control study

No randomized and no cohort study in options

Question 11: 50 years old came with Malena. OGDS done, no bleeding vessels H.Pylori test positive and now stable Asking appropriate mx?

1 triple regime

2. endoscopic ablation

3. adrenaline injection

4. octeriotide infusion

Question12: Thyroid nodule 3 cm, FNAC done – TSH is normal with left psammoma bodiesfound and right side is normal next . patient is discomforting and breathlessness appropriate plan for this patient.

a. Radioiodine scan

b. Left thyroidectomy—I choose this because patient telling symptom

c. Total thyroidectomy

d. Radiotherapy

Question 13 : Patient is symptoms Sjogren syndrome  with dry eyes and already given eye drop and asking long term mx?

1.Hydroxychloroquine

Question 14 : inferior wall MI with BP 80/90 asking initial mx?

1 N/S infusion – I chose

2.dopamine

3. dobutamine

4. adrenaline

Question 15 : Patient is on post-partum 3 days and 2 times seizures and already given IV midazolam , no underlying epilepsy and nothing about seizures .Now BP is 150/100,Now talking about obstetric history of Preeclampsia ,nothing history of pregnancy given. Asking mx?

1. labetalol

2. MGSo4

3. Nifedipine

4. Hydralazine

Question 16: Primi gravida CTG given early acceleration uterine contraction is same as 5hours vg length 3 cm FHR is normal 140 . cerxi good effacement Asking next step?

1. Oxytocin

2. PG

3. CTG

If bishop score < 6: PG

If bishop score >6: oxytocin or amniotomy

I choose 1

Question 17 : Indications for LSCS?

Question 18: 39 years old lady with labor pain LOP position Cx 1cm  meconium stanning Fetal scalp sampling acidosis ?

Question 19 : BP 80/50, PR 120,Asking Blood volume loss percentage?

a. >45—I choose

b. >20

c. >40

Actual PR >120 is better for choose for this

Depends upon other parameters/vitals

Question 20:  estimating blood loss (ATLS classification),HR was 124,BP was ok,lying(~110/70),BP sitting/standing low (MAP<65).What would be the minimum amount of blood loss by patient?

– 10%

– 20%

– 30%

– 45%

– >45%

Question 21: After doing of needle aspiration of pneumothorax —the patient becomes BP 80/60 and breathlessness, Dullness on left side of the chest ,trachea shifted .Asking appropriate step?

A .Needle aspiration

b. Chest x ray

c. USG

d. Thoracotomy and chest tube on affected side —I choose this

question 22: Pregnancy 14 week came to check AN, Previous history of macrosomia and gestation DM and first pregnancy has h/o of shoulder dystocia, Appropriate advice to patient?

a. OGTT in early pregnancy – I choose this

b .OGTT in 28 weeks

question 23:Patient has burn on abdomen and thigh  for arm already given analgesia – what additional want to give ?

a. Silver sulphasalazine

b. Airway patent

c. Normal saline

Look for Hartmann solution

Question 25 : Patient has mouth and genital ulcer several time and now came for eye pic given, fundoscopy done. Anterior uveitis was present ,asking Tx ?

1.oral prednisolone 2. Topical prednisolone 3.chramphnicol

Question 26 : eye pic given, patient has trauma and fundoscopy done, no abnormalities. No infection& pain. Not sudden onset No itchy. Already given topical antihistamine asking appropriate management.

 1. Timolol 2. Acetazolamide 3. Pilocarpine

Question 27 : Infertility, regular menstrual cycle 28-day cycle and need to check ovulation?

1.testeroaterone

2. Progesterone on day 21

3. Estrogen on day 1 4 and 17

4.FSH and LH (I choose 2)

Question 28: thrombocytopenia with bleeding ,asking mx ?

1. Immunoglobulin(I choose it)

2. Platelet  transfusion

3. Steroid

4. blood transfusion

Question 29 : One patient came with abdominal pain after taking alcohol and vomiting after giving analgesic and doing USG which was normal. What is the initial Mx?

1.NG (I choose this)

2. IV normal saline

3.antibioctis

Question 30 : child old boy doesn’t talk, playing alone, arranged toys, development is normal. Asking dx?

1. Asperger 
2.  ODD
3.  ADHH

Question 31: One patient after accident. Came to ER, Tongue is bleeding , maxilla and mandibles fracture on both side and can’t open mouth and already orophygeal tube inserted but still breathlessness S02 is  92% and appropriate mx ?

1 endotracheal incubation

2.naso incubation

3.tracheostomy

4. Cricothyrotomy

5. Percutaneous tracheostomy with oxygen (I choose 5)

Question 32: Patient 17 years old boy  collapse and history of cardiac death in father .after this good and normal. Initial test is ?

 1.ECG

2 Echo

3.chest x ray

Question 33: 9 years old child with SVT  given , BP stable. Initial mx?

 1.Vasoval maneuver (I choose this )

2.adenosine

3. Amiodarone

4. Metoprolol

Question 34 : A 52 yrs old man history of colon screening with no symptoms. His brother has colon  cancer at 60 years. Colon Cancer screening ?

 1.FOBT now

 2. colonoscopy  now

3. yearly colonoscopy

Question 35: A 39 yrs,  old and history of  colon cancer in her father 49 and his aunty 60 years. Screening ?

1.colonosovpy 39 years (I choose )

2. Colonoscopy now

3. FOBT

4.5 years colonoscopy

Question 36: Aortic aneurysm 3.5 cm to 4.9 cm within 1yrs ,male patient. Mx?

 1.semiurgent

2. urgently

3. yearly USG

4. 6 monthly USG

Question 37: Wilms tumor, mother noticed 3 years old child that mass on left side of abdomen  while bathing?

Question 38: Headache on frontal head but before headache flickering light on eyes. Not responsible to Paracetamol .sensation like migration, bank type character. Dx?

1. Migraine

Question 39: 3-month-old baby picture on abdomen given maybe hemangioma three portions, propranolol given 3 days after birth.Mother does not want to give anymore. Appropriate mx?

1.Review 6 months

2.surgery

3. Topical b blocker

Question 40: Patient has TIA, aspirin was given total  Cholesterol was  5.6 , Carotid stenosis 30 % on right. Mx?

1.Dipyrimole

2. cloudlet

 3. Endarterectomy

4. Rosuvastatin

Question 41: Pregnancy 14 weeks, shortness of Breath, Chest pain sudden onset 3 days ago. No history of travelling. Ecg shows sinus tachycardia ,vital signs normal. Mx.?

 1.ctpa

 2.USG Doppler

 3.chest x ray

4. d – dimers

Question 42: Patient  on warfarin have symptoms of PE due to DVT , already given enoxaparin. Mx?

1. increase dose enoxaparin

 2. Stop enoxaparin  and warfarin

3. increase dose warfarin and stop enoxaparin

4. Change apixaban  (I choose this cause it’s  from 2023 and first aid .answer is this one)

Question 43: Patient smoking history 20 years ,hemoptysis , weight loss , night sweat , no fever. He is an  immigrant 10 years ago from Vietnam , auscultation shows  chest crackle on both upper lobes. Dx?

 1.Tuberculosis

 2. lung cancer

 3. Pneumonia

 4. Fibrosis

Question 44:Patient has non- Hodgkin and chemotherapy given 1 years back. Now came to GP for breathlessness. On examination crackles were heard. Chest x ray done and showed hilar infiltration. No chest x-ray  given and no signs of ca lung  option and no fever or no  flu signs or no mention of pneumonia.

 1.pcp

Question 45: One pic given of lipid deposition on leg ,not itchy & no pain, yellowish deposition that is already mentioning  50 years has hypertension hyperlipidemia, no fever,  no weight loss , ask cause of this? 

 1. Tb

2. Hyperlipidemia

 3.scc

 4.melanoma

Question 46: Patient already taken venlafaxine  for 2 years or 3 years with schizophrenia complaints about he can’t control his legs and symptoms are controlled.Mx?

 1. Propranolol

2. Stop venlafaxine

3.change to  Clozapine

 4 .baclofen 10 mg

5. Bromocriptine

Question 47: Patients came to ER fatigue BP 80/60, lab shows  low sodium , k high, creatinine was Normal,  hco3 was  normal. Dx?

         1.Pituitary deficiency

   2. Hyperaldosteronism

   3. SIADH

Question 48: patient taken ACEi , bb blocker,  furosemide   and got back pain so recently taken naproxen. lab  values were given : k high, Cr little high ,  Na low 120,  cause?

1. ACEi

naproxen

      3. bb blocker

       4. Furosemide ( I choose naproxen. Cause  I suspect  Whipple)

Question 49:  50yrs  male patient got sudden onset back pain, can’t move , limited movement. Asking appropriate mx?

1. MRI???

2.anagisia

3. Opioids

There is no red flag therefore go with pain mangement

Question 50: Patient got back pain from gardening, x ray lumbar was given normal, no compression fractures.  Appropriate mx ?

1. Bed rest

2. Mobile and analgesic

 3. MRI

Question 51: 60 yrs., old female has  vaginal redness and pic was given, no bleeding per vagina ,no itching . Treatment?

1. Topical steroid

 2. Ketoconazole cream : candidiasis

3. Vg pessary

Dd: Lichen sclerosis: topical steroid  /atrophic vaginitis : estrogen cream /vg pessary

Question 52: chlamydia positive and with symptoms. Mx?

 1. Azithromycin  

 2. Ceftriaxone

3. Doxycycline  for 7 days

Question 53: 20 yrs old man came for bloating, Diarrhea & sometimes constipation. brother and sister got celiac  disease . So he did coeliac serology and it was negative  He is not avoiding special food gluten. Next investigation?

1. iron studies( I choose this)

 2. Upper GI scope (not sure)

3. Cp

????

Question 54: 15 years came to GP with menorrhagia last month and now again  menorrhagia. Asking initial test?

1. Cp( I choose )

2. Coagulation profile

3. Hemophilia factors

Question 55: 25 years old lady come  to GP with  lower abdominal pain during menstrual period with regular menstrual cycle .Prevention of pain for lower abdominal pain ?

1.mefanamic

2.coc

3.progesrtone only  pill

Question 56: An eye  pic was given , melanoma in eye.( same pic AMC  website has ). Mx.?

1. Refer plastic surgeon

2. excision

3. Punch biopsy

?????not sure

Question 57: Back picture given ; melanoma was there . mx ?

1. Wider excision

 2. Punch biopsy

 3. Surgery

4. Excision

Question 58: ⁠ ⁠Maybe ARDS question(wheezing all over the chest, opaque patches all over the lung in CXR), which antibiotics?

1.amoxicillin/clavulanate

 2.ceftriaxone

3.TMPSMX

Question 59: Registrar takes drugs from cupboard, as an intern what’s next do?

a. Report to coordinator of intern training

        b. Talk to registrar to consult his problem with his senior

???not sure

question 60: A man was transferred from ICU due to overdose of drug. He’s renowned self-made man. Recently divorced by wife because she felt emotional abuse. He assessed her as ungrateful, and suspicious of her purpose. Now he is finding medical chief who treated him, and registrar to sue them. No self-harm. What’s his problem?

a. Borderline disorder : chaotic relationships, labile mood, impulsivity ,self-harm, inner emptiness

b. Narcissistic  disorder

question 61: ⁠ ⁠Foreign body sensation in the eye, no visible foreign body, but corneal scratch on slit lamp. What’s management?

1.chlroramphenicol: corneal abrasion

 5.⁠ ⁠Tropicamide

Question 62: Middle-aged women, no WL, no History  of breast cancer, Tennis ball injury in her breast, in ivx axillary nerve  involvement, LN in axillary area tender and swollen of 4 cm , 10 years ago she did a surgery about fibroadenoma, what’s the likely cause?

1- fat necrosis

2 -breast cancer

3- fibrocystic changes

Question 63: Man trying to conceive, when he did semen analysis, he found morphology normal ,volume low ,motility low .What is the likely cause of infertility? One of the indicant of sperm analysis?

1.morphology

2. volume

3. motility

Question 64: Man treated  by clozapine, had sore throat and  fever, what is the next appropriate invx?

1 .FBC ( agranulocytosis associated with clozapine)

2 .CXR

3 .swab tests

4. US

5 .electrolytes

Question 65: Teenager 13 yo was doing great, suddenly 6 months ago he begins drop school, the mother is stressed about that, the child pass all day gaming with his friends, he doesn’t feel that his friends are better than him, he doesn’t eat with his parents anymore. Dg?

1. normal pubertal development

2. ASD

3. internet gaming addiction

Question 66: Dr wants to evaluate mercury amalgam(risk factor) effect and dementia (disease), what is the type of study ?

1 .case control

2 .cohort

3 .RCT : efficacy

4 .cross sectional: prevalence

Question 67: A  man travel for hiking in Victoria ,pain in 2-3 MTP  joints, swollen knee joint, T 38 c , presented in the ED, What’s the most likely diagnostic ?

1 .Ross River fever

2. Parvovirus B19: aplastic anemia ,slapped cheek ,flu like prodrome

3. reactive arthritis : conjunctivitis, uteritis & uvetis (reiter syndrome )

4. Rheumatoid arthritis(PIP, elbow ,knee etc

Question 68: A Man without any history, presented with worsening respiratory distress O2 saturation at the admission Po2 92%  placed on Hudson mask 8L then it worsens to 86% What’s the next most appropriate step in his oxygenation?

1- Hudson mask (normal face mask)15L

2- Nonrebreather mask 15L

3- Intubation and ventilation

4- Hudson Venturi mask 15L

Question 69: Stable patient at first came for Left subclavian Catheter placed, then develop respiratory distress with Engorged neck veins, Dull percussion, severe distress. Mx?

1.Large bore canula thorastomy

2.Intubation

3.Needle decompression

????not sure

Question 70: Drowsiness, history of heroin abuse, Low bp, Pinpoint pupil?

Opioids overdose : naloxone

Question 71: A Man with lung cancer, treated surgically +RT repeated Cxr normal,

Presented with wrist flexion impaired (median )and numbness on palmar surface of the 5th finger(ulnar) , cause ?

1.Paraneoplastic mononeuropathy

2.Brachial plexus injury

3.Cervical spondylosis

Questions 72: WL 6kg ,in 1months Erythema nodosum picture, TB scenario, lung crackles in the upper left lobe, Vietnam, no smoking history, fever. Dx?

1.Sarcoidosis

2.TB

3.Lung cancer

Question 73: Mother had history of coeliac disease symptoms, gluten free diet , came to the ED worried about her son serology negative what to do to rule out the underlying condition?

1.Small bowel biopsy: when px is consuming gluten

2.HlADQ8

3.Iron Studies

4.FBC

Question 74: Male patient treated with Methotrexate and hydroxychloroquine for RA came with his wife worry about his risk on conception what to advice?

1.Stop hydroxychloroquine and methotrexate

2.Stop Metho and continue hydroxy

3.Continue same regimen

Question 75: Male treated with venlafaxine for severe depression, came bcs he has hypomanic symptoms and started with olanzapine what to do next ?

1.Stop venlafaxine may be ???

2.Haloperidol(antipsychotics can use in manic episode )

3.Tacrolimus

4. Indapamide

Look for taper the venlafaxine

Question 76: Long history back pain 3 days Naproxen now has glomerulonephritis, renal failure, high urea, low grade fever, Hyponatremia .What’s the most likely cause of this presentation ?

1.Acute exacerbation of glomerulonephritis

2.Naproxen

3.Pyelonephritis

Question 77: Endoscopy found ongoing bleeding ulcer and rapid test HP came positive. What’s the most appropriate immediate management ?

a. Triple therapy

b. Intravenous Omeprazole

c. Endoscopic Ablation d. Endoscopic Injection of epinephrine

Question 78: 0.5 cm stone in renal pelvis? Uric acid was elevated. Mx?

A. Hydrochlorothiazide

B. Allopurinol

C.ESWL( for 5-10mm or 0.5-1.0cm )

Question 79: Pt with upper GI bleeding, resuscitated but minor bleeding from the ulcer but bleeding arteries not located. H pylori positive.Mx?

1.triple therapy

2.epinephrine

3.Banding

question 80 : ⁠ ⁠Elderly with painful knee, aspiration done. Temperature elevated. Next action ?

a. Ultrasound of the  knee

B. X ray

C. Refer to ED assuming septic arthritis