25 SEQs from past pmdc theory paper - 29 june 2009

1) A man of 40 years with drooping of eyelids presented to Medical OPD with complains of difficulty in swallowing towards the end of the meal intake and severe musde weakness few minutes after the start of exercise.
a)from which disorder the man is suffering? b) what is the course of this disorder? C) Which drug is effective In this disorder?
[hide]2) A young man sustained injury to the chest in a road accident.Effective ventilation was compromised by a large flail segment of the thoracic wall. His investigations showed: Arterial PCO2~ 60 mmHg (40 mmHg) Arterial PO2~ 65 mmHg (95 mmHg) Arterial pH 7.25 (7.4) Arterial bicarbonate 25 mmol/L (24 mmol/L) •) a)Which disorder the young man developed7 b)explain the compensatory mechanisms initiated in the man to correct the disorder?

3) Enlist SIX clinical uses of sympathomimetic drugs with one drug example for each use.

4) An 8 year old school going chlid had severe bacterial pharyngitis, which was treated by the familv physician. Alter 3 weeks, he developed fever, migratory polyarthritis and carditis.

a) Name the condition and the causative organism. b) Name ONE other sequel of this type of pharyngis and the type of hypersensitivity involved.

5)A woman of 35 years old was diagnosed to have Carpal Tunnel Syndrome. Give Its anatomical basis. Which factors predispose to this condition?what are the symptoms of this disease?

6)A 2 year old girl who has cough and difficulty in breathing is brought to a basic Health Unit. On examination her respiratory rate is 65 breaths / min and she has chest In-drawing.

a) What question would you ask from the mother? b) What examination would you perform in this patient according to IMCI Guidelines?c) If the child does not have any danger sign how would you classify and treat her?

7)A 1 year old boy has high grade fever and sore throat for one day, He develops generalized tonic clonic seizure which last for five minutes. His elder brother also has similar episode when he was 9 months old.. a)what is the most likely diagnosis? B)how would you manage this child? C)what is the prognosis of this condition? .

8)A 37 year old man presents with four months history of having loose motions with blood and mucous. He has not responded to repeated courses of antibiotics and metronidazole. He has also developed backache and polyarthralgia. There is no history of significant weight loss..

a) What is the most likely diagnosis? B) list TWO relevant investigations with likely abnormalities c) briefly outline the treatment.

9）A 52 year old clerk Who had myocardial infarction two months earlier presents with shortness of breath on exertion.. He is also woken up at night with severe shortness of breath and bouts of cough. a) What is the most likely diagnosis b) list Five Important principal signs to be looked for c) list TWo most relevant Investigations to make the diagnosis[/hide]

 

Re: SEQs from past pmdc theory papers

10）A 33 year old lady who is known to have mitral stenosis and regurgitation presents with sudden onset weakness of left half of body.her pulse is irregularly irregular.

A)what is the most likely cause of her paralysis? b) Name ONE deffinitive test to confirm the neurological problem c) Name ONE deffinitive Investigation to look for the likely cardiac problem d) How would YOU prevent further stroke In this lady

11）A 15 year old girl is brought to emergency with vomitting, shock and pain abdomen. She is having rapid breathing. She is afebrile, her chest is clinically clear and there Is no abdominal rigidity. Her laboratory results shows; Blood Glucose 18 mmol/L Sodlum 131 mmol/L Potassium 5.8. mmol/L Bicarbonate 08 mmol/L pH (Arterial Blood) 6.9

a)what is the most likely diagnosis ?b)what acid base abnormality is present? c) outline briefly the management

12)A 48 year old man under treatment for hypotension comes to the clinic for follow-up visit.Blood pressure is well controlled with diurerics.Examination shows bilaterally palpable kidneys.His urea and creatinine are slightly elevated.his elder brother is also being treated for hypertension and renal disease.
a)what is the most likely diagnosis? b)which investigation is required to confirm the diagnosis?c)list the likely renal complications
[hide]13）A 40 year old patient presents to you with grouped vesicles and blisters in a band like distribution on the right side of his chest.he has a history of pain in the same region,three days prior to eruption.
a)what is your diagnosis?justify your diagnosis. b)how will you treat this patient?

14)A boy 19 years of age comes to you with severe pain in the throat on right side with fever and dysphagia for one day.On examination his saliva is drooling from right angle of mouth.He is unable to open his mouth properly.throat examination shows swollen and congested right tonsil and anterior pillar.
a)what is the most probable diagnosis?
b)how will you treat the case?

15)A 9 years old boy presents with burning,itching and thick ropey discharge from the eyes.The symptoms get aggravated in summer season and respond well to medication.
a)what is the probable diagnosis?
b)what is the aetiology of the disease?
c)what are the treatment options?

16)A 26 years old P2+O presented with severe abdominal pain and attacks of faintness.Last menstrual period(LMP)was unsure.Her pulse was 110/minutes and blood pressure was 90/60 mmHG.
A)WHAT IS THE MOST LIKELY DIAGNOSIS?
B)HOW WILL YOU MANAGE HER?

17)A 40 year old lady has presented with pain in right hypochondrium with radiation to right shoulder and jaundice with temperature.
a)what is your appropriate investigation plan?
b)what are the treatment options for bile duct stones?

18)A young lady with multinodular goiter has been advised surgery for cosmetic reasons.Give the steps of operation for subtotal thyroidectomy?

19)A 25 year old man is planned for anorectal surgery under spinal anaesthesia.
a)what is the most appropriate site for injection and why?
b)Enlist the complications of spinal aneasthesia

20)A 36 year old primigravida is followed up at the health centre and referred to the hospital antenatal clinic at 37 weeks of gestation.On abdominal examination the size of the uterus corresponds to the dates and the head was not engaged but instead felt in the fundus with a longitudinal lie.
a)what is the most likely presentation in this case?
b)what would you like to do before you allow this patient to deliver vaginally?Mention Two.
c)Mention Three complications to this fetus that can occur during delivery.

21）A patient weighing 60 kg has sustained burn of face and scalp,upper chest front and both upper limbs
a)what is the percentage of burn area?
b)what is the calculation of fluid for first 24 hours?
c)what is the escharotomy?

22)A 45 year old lady with carcinoma of breast had undergone modified radical mastectomy on right side and has been advised chemotherapy treatment.
a)what is the broad classification of broad chemotherapeutic agents”?
b)what are the complication of chemotherapy?

23)Healthcare is at cross-roads,as regards the ideal model of healthcare
a)list the four the major differences between the conventional Medical model of healthcare and Engels biopsychosocial model of healthcare.
b)Which model of healthcare will you prefer to use in your clinical practice?Justify your choice by Highlighting briefly the advantages that your choice carries.

24)As a doctor working in a remote village of Pakistan with no reproductive Health facilities,You notice that a number of new borns delivered by traditional birth attendants are dying within a week after developing spasm of body ,jerks,arching of the back refusal to take mother feed and eventually difficulty in breathing.
a)what would be the most likely cause of these deaths?
b)what preventive steps would you put into place to stop these deaths?

25)A 29 Years old Housewife present with feeling fatigue and lethargy in the morning that improves as the day passes for the last three months.she feels that she can no longer cope with ‘Heavy-workload’ at home and that she is unable to enjoy her sex-life.Her appetite is reduced and tends to wake up repeatedly at night after fearful dreams.She feels that this could be a ;punishment ‘for the thousands of sins that she has committed.
She states that her symptoms started just after she recovered from a prolonged fever and that did not respond to antibiotics.and that she feels better after taking –rest.
a) List Four clinical conditions that you will consider in the differential diagnosis ;choosing also the most probable /likely diagnosis.
b) Name TWO drugs that she is likely to respond with their doses
c) What would you tell the patient and family about the nature of patients illness[/hide]

 

Salam dr watson. thank u very much.
u are very helpful. may ALLAH bless you.ameen.

 

only thanks to me.i uploaded it on orkut pmdc community!

 

ok credit for this goes to u only ! be happy ..cheers

 

thank you!

 

thanks a lot....

 

thanks

 

thnkxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

 

thanks bro....great job

 

thank you guys

 

drwatson can u solve the scenarios?

 

thanks

 

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can anyone plz te; me te answers

 

Number 10 is embolism infarction of the brain where an embolus is dislodged from heart and carried to the brain causing ischemic stroke


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CT IS THE BEST INITIAL to rule out hemorrhagic stroke as both ischemic and hemorrhagic stroke present similarly , ct is must to differentiate before initiating therapy . However MRI. Is the most accurate for ischemic strokes


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Transthoracic echocardiogram/ transesophageal echocardiogram is the best initial and confirmatory test to see thrombus in heart


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Further attacks can be prevented through anti coagulant therapy such as warfarin for 6 weeks and heparin in the first 5-6 days


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Question number 11 is DKA( diabetic keto acidosis) young patient with rapid breathing pattern high glucose level and increased anion gap. start IV fluids Normal saline with Insulin Regular , and infuse potassium.