PFMSG FORUM

[drwatson]

Theme: 1: Diagnosis of Rectal pain
Rpt; July-2002/Jan-2003/Jullly-2003/Jan-2004

Options
A. Fissure in Ano
B. Fistula in Ano
C. Hemorrhoids
D. Proctalgia fugax
E. Perianal Haematoma
F. CA rectum
G. Crohn’s disease
H. Ulcerative colitis
I. Ischemic Colitis
J. Diverticulitis
K.

1. A 22-year-old female patient with occasional shooting rectal pain which comes intermittently & is so intense that she can not control crying. Examination & Sigmoidoscopy was normal
2. A 50-year-old man has come to you with increasing diarrhoea and bleeding per rectum. On sigmoidoscopy there was an ulcer found 10-cm from the anus (no h/o change of bowel habit was mentioned)
3. A 25-year-old female comes to you with pain while defecation and occasional blood on toilet paper. Pain was so severe that the rectal examination was not possible
4. A 31-year-old female comes to you with the complaint of intense pain on defecation. On Examination a pink/ purple colored mass at anus was found, which is mildly tender. This started 2-months ago after her first child birth.


Theme: 2 Diagnosis Of Injury
Rpt; Jan-2004
Options
A. Liver.
B. Pancreas
C. Spleen.
D. Aorta
E. Kidney
F. Urethra
G. Uterus
H. Ureter
5. A man sitting in a passenger seat and the car is hit from the left side in an RTA. He is complaining of pain in the left side. There is bruising of that side.
6. A patient involved in an RTA comes to A&E complaining of pain in upper abdomen and breathlessness. On x-ray the nasogastric tube is seen coiled up in the chest region?
7. A driver of the car was hit in a RTA on right side. He developed shock which organ is injured.
8. A woman had met with an RTA in the car she was driving. She went and hit to the windscreen and now she developed epigastric pain. Which organ is injured?
9. A man had met with an RTA and he developed shock and bruising of the flanks, which organ was injured
10. A man had fallen from a scaffolding astride, he developed pain and swelling in the scrotum. Which organ is injured

Theme: 3 Mechanism of child diseases
Repeat; March-2003
Options
A. Surfactant deficiency
B. Alpha-1-antitrpsin deficiency
C. Infection
D. Chloride channel defect
E- Allergy
F- Immune defect
G- Viral titer
11. Respiratory distress syndrome in Premature birth
12. Cystic fibrosis
13. Bronchiolitis
14. Lady has past h/o of recurrent jaundice as a child, now develops emphysema.
15. Asthma



Theme: 4 Transmission of infection
Rpt; July 2001

Options
A. Animal-human transmission
B. Blood borne
C. Carrier state
D. Close community contact
E. Exposure to air conditioning
F. Faecal-oral
G. Fomite transmission
H. Not infectious or contagious
I. Sexually transmitted
J. Skin to skin contact


Instruction
For each patient described below, choose the SINGLE most likely route of infection from the above list of options. Each option may be used once, more that once, or not at all.
17. An 18-year-old university student develops meningococcal meningitis in his first week of term.
18. A 28-year-old man is found to be Hepatitis-C positive on serological testing.
19. A 15-year-old boy develops scabies after returning from a school camping holiday.
20. A 44-year-old man develops a feverish illness, which on blood culture proves to be salmonella typhi.
21. A pregnant woman contracts toxoplasmosis.



Theme: 5 Management Plan for Burns
Rpt; July-2001/March-2002/Sept-2002

Options:
A. Referral to burns unit
B. IV opioid
C. Dressing
D. Wound debridement
E. Wound irrigation
F. Escharotomy
G. Anesthesia & intubation
H. IV fluids resuscitation
I. Reassure and advise
J. Ice packs
K.


22. A middle aged man rescued from burning building. On Examination; burns on face & anterior chest with soot in pharynx & singed nasal hairs. He is asking about his other family members.
23. Little boy tipped off a cup of tea over his chest and shoulders is irritable, crying, not allowing examination. Scalds are noted involving less than 3 percent of surface area.
24. A 45-year-old electrician sustains contact electrical burns to his dominant hand. There are full thickness burns to pulp of his fingers and movement of the hand is painful. He has had appropriate analgesia complaining of pain.
25. Adult man with 40 percent hot water burns/scalds over trunk and legs. Has had appropriate analgesia.
26. An adult male slept while sunbathing comes with generalized pigmentation and irritation. He is otherwise well.


Theme: 6 Management of psychosis
Rpt; July 2001
Options
A. Alternative housing
B. Clozapine
C. Depot antipsychotic medication
D. Detain under the Mental Health Act
E. Education
F. Electroconvulsive therapy (ECT)
G. Family therapy
H. Hospital hostel
I. Monoamine oxidase (MAO) inhibitor
J. Oral antipsychotic medication
K. Rehabilitation ward
L. Risk management strategy
M. Tricyclic antidepressant
N. Voluntary inpatient admission
28. A 28-year-old man has been detained in hospital and is being treated for paranoid schizophrenia with depot anti-psychotic medication. He had stabbed his mother in the hand with a screwdriver. He is now symptom free and ready to be discharged home to live with his mother, who is worried.
29. A 26-year-old woman with established schizophrenia since age 15 lives with her very supportive parents, but has never fully recovered. She has been on a range of appropriate medication in adequate dosage since diagnosis.
30. An 89-year-old woman presents with a three-week history of not eating and not sleeping. She is convinced that she is about to be investigated by the government for spying, which is not the case. She refuses to eat or drink and her physical state is deteriorating. She is agreeable to treatment.
31. An 80-year-old man has a paranoid psychosis and mild cognitive decline. He is hard of hearing and says his neighbors are killing his chattels, but the authority has already announced that there is an outburst of some disease due to which cows are dying. He is continuously observing the neighbors by binoculars.
32. A 64-year-old man with eight admissions to hospital in the last five years is again brought to hospital by his son. It is known that he always stops taking his antipsychotic tablets a home. His wife died 6 months ago & he has been depressed and threatening to kill himself and refused any treatment.


Theme: 7 Diagnosis of confusion
Rpt; sept-2001

Options
A. Alzheimer’s disease
B. Anaemia
C. Carcinomatosis
D. Cerebral tumour
E. Delirium tremens
F. Delusional depression
G. Drug toxicity
H. Electrolyte imbalance
I. Heart failure
J. Hyper pyrexia
K. Hypoglycemia
L. Hypomania
M. Hypotension
N. Infection toxicity
O. Post ictal state
P. Schizophrenia
Q. Subdural Hematoma
R. Temporal arteritis

For each patient described below, choose the SINGLE most likely cause from the above list of options. Each option may be used once, more than once, or not at all.
33. A 37-year-old alcoholic found wondering in a park. His partner says he has had a number of falls recently and in A&E the pt is confused. Blood glucose is normal.
34. A 40-year-old chronic alcoholic, who lives alone, is brought into the Accident and Emergency Department having been found confused at home after a fall. He complains of a headache.
35. A 76-year-old woman has become tired and confused following an influenza like illness. She is also breathless, with signs of consolidation of the left lung base.
36. An 18-year-old previously well student is in his first year at university. He has been brought into the Accident and Emergency Department in an agitated, deluded and disorientated state.
37. A 50-year-old man presents with a flight of ideas, which are rambling and disinhibited. He is distractible confused and overactive.


Theme: 8 Chest pain/breathlessness
Rpt; July-2002/Jan-203/July-2003

Options
A. Pulmonary embolism
B. Myocardial Infarction
C. Pneumonia
D. Pleural effusion
E. Spontaneous Pneumothorax
F. Tension Pneumothorax
G. Ruptured esophagus
H. Ruptured bronchus
I. Aortic stenosis
J. GERD
K. Hydropneumothorax
L. Emphysema


38. Temp: 37oC
Pulse= 110 bpm
BP= 130/80
JVP =raised
Trachea =deviated
Chest hyper resonant

39. Temp: 37oc
Pulse= 110 bpm
BP= 130/80
JVP =raised
ECG=T wave inversion in lead III

40. Temp:37oc
Pulse= 110 bpm
BP= 130/80
JVP = Normal
ECG=Q wave in lead v1-v3 MI

41. Temp: 37oc
Pulse= 110 bpm
BP= 130/80
JVP =Normal
Chest =Crackles at the base

42. Temp=38oc
Pulse= 110
BP= 130/80
JVP =Normal
Chest =Dullness on percussion


Theme: 9 Chest medicine

Options
A- Bronchopneumonia
B- Lobar pneumonia
C- Pulmonary Embolism
D- Tension pneumothorax
E- Simple pneumothorax
F- Myocardial Infraction
G- Congestive cardiac failure
H-Foreign body

43. Trachea deviated to left
Breath sound reduced on left
Dull percussion
44. Trachea central
Dullness from base to midzone
45. Trachea central
Dullness at the apex
46. Trachea deviated to right
Dullness to the right too
47. Trachea central
Basal crackles

Theme: 10 Management of Epistaxis
Rpt; Jan-2003
Options
A. Vitamin K
B. Reassure
C. Neomycin cream
D. Verapamil
E. Fresh Frozen Plasma
F. Anterior nasal Pack
G. Posterior nasal pack
H. Pinching of nose

48. A man who came to A&E with epistaxis, bleeding from nose, INR-9 and who is on Warfarin for valvular heart disease
49. Girl has come with slight bleeding from anterior part of nose by the time she reaches A&E bleeding has stopped. This was first ever episode. Reassure
49. A 13 yr. old girl with epistaxis but when she reaches hospital the bleeding stopped and there was only crusting & redness.
50. A 50-year-old male came with bleeding from nose, BP-230/110. His circulatory system has been stabilized, nose anterior packing done? but he continues to bleed


Theme: 11 Incontinence
Rpt; Nov-2001/Nov-2003
Options
A- Detrusor instability
B- Uterovaginal Fistula
C- Pelvic floor muscle weakness
D- Prolapse
E-



52. A 48-year-old woman 2-weeks after hysterectomy develops incontinence
53. A 34-year-old mother of 2 healthy children complains of incontinence when she coughs or sneezes
54. An 82-year-old confused woman in a nursing home is noted by the care assistants to wet the bed frequently. She has a three-year history of transient ischaemic attacks and has recently developed a left hemiparesis


Theme: 12 Menorrhagia

Options
A. Hysterectomy
B. Cervical resection
C. Polypectomy
D. Myomectomy
E. COCP
F. Mirena coil
G. IUCD
H. Diathermy
I. Mefenamic acid

55. Pt with h/o 2 abortions with regular heavy periods with irregular uterus.
56. A 45-years-old with c/o unacceptably heavy bleeding
57. Pt presents with heavy bleeding + passage of clots on first 2 days of menstruation has normal duration of bleed and BP is 140-90.. previously controlled by POP
58. Lady presents with mucus + post coital discharge. Cervix & vaginal smear was normal. Vagina was red & sore
59. A 13-year-old girl complains of severe menorrhagia (7-days) & pain.


Theme: 13 Diagnosis of Infection / PUO
Rpt; Jan-2003
Options
A. Tuberculosis
B. Lymphoma
C. Brucellosis
D. Plasmodium Falciparum
E. Plasmodium Ovale
F. Plasmodium Vivax
G.
H.
60. An 18-year-old boy has come back from Mexico after working in a farm there & now has fever with splenomegaly
61. A man with haemoptysis cough and fever
62. Woman returned from Zambia now had night sweats and cervical lymph node enlargement
63. A patient comes back from Ghana and presets with fever rigors and fits?


Theme: 14 Renal Imaging
Rpt; Nov-2003/July-2002
Options
A. Renal nuclear scan
B. Cystoscopy
C. Abdominal x ray
D. IVU
E. Serum ca
F. Serum phosphate count
G. Parathyroid level
H. Urine cystine
I. Urine oxalate count
J. 24 hr urine
K. Ultrasound
L. Urine culture
M. Nephrostomy
65. A pt with bilateral hydronephrosis passes clots of blood. IVU already done.
66. A pt with loin pain and hematuria
67. A patient with right loin pain & pyrexia. recent IVU showed Right hydronephrosis. Next investigation that may help in the management?
68. A pt with dysuria, dribbling and night frequency. On x ray nothing. On IVU bilateral hydronephrosis
69. A 70-year-old male presents with backache. He has peripheral vascular disease and radiographs reveled bilateral renal calculi.


Theme: 15 Natural H/O syncope/dizziness
Rpt; April-2001
Options:
A- Vertibro-Basilar Disorder
B-
C-
D-
E-
F-
71. Patient experience vertigo, and straded to the left when she tried to walk straight.
72. A 55-year-old female presents with increased dizziness on getting up from bed. She also falls down especially in the early morning.
73. A 50-year-old male comes with the complaint of giddiness and vertigo. He says that the surroundings are spinning around him. On examination, nystagmus +ve.
74. A 35+-year-old female patient complaints of giddiness manifestations on moving her head.



Theme: 16 Ear treatment

Options
A. Oral acyclovir
B. Flucloxacillin
C. Immediate referral
D. Routine referral
E. Sedate
F. Diclofenac sodium
75. Patient with vesicles in the ear
76. Diabetic patient with a boil or something like this in the ear (dont remember)
77. A middle aged pt after syringing of ear came to A&E with acute ear pain
78. A 55-year-old patient with chronic ear problem. On examination he is scarred, ear drum and a white mass visible?



Theme: 17 Hoarseness

Options:
A. CA larynx,
B. CA right main bronchus,
C. CA left main bronchus,
D. Intubation granuloma
E. Vocal cord nodules.
F. Ca thyroid
G. Nodules in larynx
H. Functional dysphonia
I. Myxedema

80. A elderly man with swelling in front of neck, hoarseness, inspiration and expiration wheeze, hoarseness, and loss of appetite & weight.
81. A school teacher with hoarseness, On Laryngoscopy, well circurmcsized nodules.
82. a patient has just recovered from a terminal illness during which he had to be intubated for 3-weeks and ventilated for three months, he was given or he is being given amitriptyline, develops hoarseness thereafter



Theme: 18 ENDOCRINOLOGY

Options
A- Thyrotoxicosis
B- Type 1 diabetes
C- Type 2 diabetes
D- Coons syndrome
E-
F-
83. A patient with sweating, palpitations and atrial fibrillation had some urinary symptoms and hypertension
84. A patient with BMI 34 had some diabetic and urinary symptoms
85. Patient had BMI of 32 with some urinary symptoms and peer breath smell




Theme: 19 Mechanism of Disease

Options
A. Acquired Coagulation Disorder
B. Inherited Coagulation Disorder
C. Vit K Deficiency
D. Vessel Wall Defect
E. Abnormality of platelet aggregation
F. DIC
G. Inherited platelet disorder
87. A lady with bleeding from various sites
88. A boy with rashes on ext surfaces
89. A boy with hemarthrosis
90. A boy with purpuric patches on the back (HSP)
91. A pt with pyelonephritis with hypotension bleeding from gums and also bleed spots over body.


Theme: 20 Non accidental injury

Options
A. CBC and coagulation profile
B. Skeletal survey
C. Look for blue sclera
D. No investigation
E. Nutritional history
F. Renal nuclear scan
G. CT Scan
H. Abdominal x-ray
I. IVU
91. A boy who has black eye and petechiae of various ages
92. A boy with bronchitis and multiple broken ribs
93. A boy with recurrent fractures ...father has deafness
94. A child lives with his foster mother and has his height and weight at 3rd centile
95. A baby with ruptured frenulum...
96. A baby with bleeding spots in retina..



Theme: 21 Anemia

Options
A- Oral Iron
B- Blood Transfusion
C- Inj. Transcobalamin
D- I.M Fe
E-
F-

97. Young 8yr vegetarian boy presents with 7G Hb, with microcytosis
98. Pregnant 34 wk, has HB 10G/dl had been taking oral FE & Folic acid thru out pregnancy
99. Terminal ca stomach pt. whose Hb has dropped from 11 to 7 in last 1 month


Theme: 22 Diagnosis of Dementia

A- Alzheimer
B- HIV
C- Huntington’s Chorea
D- Parkinsonism
E- Space occupying lesion
F- Vascular Dementia

101- A 55-year-old progressively forgetful, loses temper. No history of trauma.
102- A 74-year-old weakness in arm recovered after few days, short-term memory loss. Similar episode 2 years back
103- 34 yr old memory loss, right hand involuntary movements, family history
104- Hemophiliac who received several transfusions presents with memory loss. He is on ATT
105- Chronic schizophrenic pin rolling movements, forgetfulness



Theme: 23 Depression

Options:
A- Anxiety and depression
B- Major depression
C- Psychotic depression
D- Post natal depression
E- Seasonal depression
F- Cyclothymic depression
G- Dysthymia

106- A mother 1 week after delivery developed depression weight loss and felling to kill her baby. has thoughts of harming baby.
107- Pt has lost appetite, sleep problems, suicide thoughts
108- Pt with sleep disturbance, palpitations, with alternating mood swings.
109- Pt with depression every winter


Theme: 24 Psychiatry

A- Refer to medical team
B- OPD referral to psychiatry
C- Urgent referral to psychiatry
D- Admit with consent
E- Refer to social worker
F- Detain under regulations

110. A pt with 17 tabs of Paracetamol
111. A pt who wanted to jump of a bridge....and says he is alright.
112. A pt with multiple lacerations that doesn’t need suturing. She had several such visits to emergency previously.
113. Man found aimlessly around the park brought to the A&E by ambulance team. His neighbors informed that his GP had called on him yesterday. No history can be obtained from the patient.
114. A 45-year-old male chronic alcoholic wants to give up.



Theme: 25 Gastroesophageal Reflux disease
Rpt; July-2003
Options
A- Review medication
B- Fundoplication
C-Antacids
D- H2 blockers
E- Proton pump inhibitors
F- Repeated endoscopic evaluations
G- Reassurance
H- Triple therapy

115. A 50-year-old man with Barrett-esophagitis, on esophagoscopy and biopsy shows no CA
116. A Patient of rheumatoid arthritis on NSAID for knee pain. He developed ulcers & symptoms of dyspepsia
117. Pregnant woman with dyspepsia
118. A female who has symptoms of GERD despite PPI's, H2 antagonist still had acid reflux from pH studies. -Fundoplication
119. Patient with symptoms of acid reflux for first time. PPI


Theme: 26 RIF Pain in women

Options:
A. Ectopic
B. Bleeding corpus Luteum
C. Appendicitis
D. Torsion of ovarian cyst
E. Ruptured ovarian cyst
F. Spontaneous abortion
G. Uncomplicated normal pregnancy
H. PID
120. Female with 10wks amenorrhoea, C/0 sever right sided pain
121. Female with 12wks am, c/o pain in RIF with no bleeding PV
122. Female with 8wks came to A&E with 4 month ammonirrhea, pain right side lower abdomen with bleeding PV, when abdomina is pressed she feels very much pain and also her uterus is a little bit tender & bulky temperature of 38celcius.
123.10wks amenorrhea, c/o pain in RIF, o/e fluid in the pouch of Douglas
124- female tender in RIF, temp 38

Theme: 27Pain management

Options
A- NSAIDS
B- Morphine IM
C- Morphine SC
D- Paracetamol
E- Diclofenac sodium
F- Ibuprofen
G-

125. A pt with ca esophagus
126. A pt with unilateral headache and dyspepsia
127. A pt with pseudo gout



Theme- 28 : Diagnosis of pelvic mass
Rpt;-July 2002 / Nov 2002
Options
A. Endometriosis
B. Dermoid cyst
C. Ovarian carcinoma
D. Tubo-ovarian abscess
E. PID
F. Endometrial Ca
G. Ectopic Pregnancy
H. UTI
128. A 50-year-old woman presents with lower abdominal mass more to the left side. USG shows solid and cystic areas and fluid in the pouch of Douglas.
129. A pregnant lady is found to have a mass with complex solid and cystic echo patterns during a routine USG at 16 weeks.
130. A lady presents with history of dysmenorrhea. O/e there is tenderness in pouch of Douglas. USG shows cystic lesion with numerous echogenic substances.
131. A sexually active female presents with dysuria, frequency and hematuria.
132. A 35-year-old woman is being treated for PID and seems to be recovering. After a few days develops high temp. USG shows a cystic mass.


Theme: 29 Ascites
Rpt;-Jan-2004
Options
A- Congestive Cardiac failure
B- Hepatitis B
C- Hepatitis C
D- Carcinomatous Peritonei
E- Bacterial peritonitis
F- Tuberculosis
133. A man had ascites and secondaries in liver.
134. A man with cardiomegaly and ascites (transudate)
135. A man ascites (transudate) with chronic liver disease.
136. a lady with ascitic fluid with neutrophils.
137 Immigrant from India developing exudative ascites and loss of weight.


Theme: 30 Complications Breast CA
Rpt;-Sept-2001/March-2002
Options
A. Pathological fracture
B. Cerebral metastases
C. Hypocalcemia
D. Hypercalcemia
E. Lymphedema
F. Spinal cord compression
G. Pleural effusion
H. Liver metastasis
I. Peritoneal recurrence
J. Local recurrence
K. Diabetes mellitus
L. .Lymphangitis carcinomatosis

138. Female with breast CA 3 yrs back, was treated with mastectomy & lymph node clearance on the left side, presents with a swollen right arm & decreased hand movements.
139. A 35-year-old female treated one year ago for breast CA presents with 2-day history of confusion. She is drowsy and disoriented. Her husband reports that she had been complaining of severe thirst for past week.
140. A 45-year-old women treated 3-year ago for breast carcinoma presented with back pain, lack of sensation in legs. She says that even after evacuation she feels that her bladder is full. She has been constipated for last 24-hrs.
141. A 43 year old woman treated 2-years ago for breast carcinoma present with confusion, headache and vomiting.On examination she is drowsy but has no focal neurolo0gical sings. She dose have diplopia.. O/E, papilledema present.
142. A lady Presents with fall and features of fracture femur.


Theme: 31 CNS diagnosis

Options
A. Alzheimer's dementia
B. Alcoholic dementia
C. Huntington’s chorea
D. Creutzfeldt-Jakob’s disease
E. Pick's disease
F. Lewy body dementia
G. Multi infarct dementia
H. HIV
I. Frontotemporal dementia
143.A 40-year-old lady with right handed involuntary writhing movement with strong family history
144.A 55-year-old man with no previous history of disease brought to A&E by his wife who says that he has become progressively more forgetful tend to lose his temper and emotionally labile
145.A 77-year-old man with weakness in his arm and leg from which he recovered within few days with short term memory loss has extensor plantar response. He has similar episodes 2 years ago and became unable to identify objects and make proper judgments

Them: 32 The diagnosis of neurological complaints
Rpt;-May-2001
Option
A 24 hour Holter monitor
B EE
C ECG
D Random glucose
E CT scan
FMRI
G lateral cervical spine radiograph
H chest x ray
I. ESR
146. A 16 year old girl suddenly collapses after standing for a while. Her limbs are flaccid and she is not incontinent. Following 30 seconds she recovers fully.
147. An 82-year-old lady has 5 episodes of loss of consciousness with on convulsion.
148. A 50-year-old male wakes up with tingling sensation and numbness in his right hand. This is accompanies by slurring of speech which recover following about four hour.
149. 30-year-old woman is found unconscious in front of television.


Theme: 33 Management of CVS cases
Rpt: July-2001
Options
A. Aminophylline
B. (ACE) inhibitors
C. Aspirin
D. Atropine
E. Beta blocker
F. Buccal nitrate
G. Calcium antagonist
H. Cardiac pacing
I. Cardiopulmonary resuscitation
J. Cardioversion
K. Diuretic
L. Intravenous noradrenaline
M. Nebulized Salbutamol
N. Thrombolysis
150. A 60-year-old man with a one and a half hour history of chest pain has an electrocardiogram (ECG). Showing an acute anterior myocardial infarction. Aspirin and analgesia have already been given to the patient.
151. A 60-year-old man had a proven myocardial infarction a month ago. He is re-admitted to hospital with acute breathlessness and basal crackles.
152. A 60-year-old man had a proven myocardial infarction a week ago. He feels faint and has a pulse rate of 36 beats/minute

Theme: 34 investigation for cystitis ?????
Rpt; July-2001
Options
A Computed tomography (CT) scan
B Creatinine clearance
C Cystoscopy
D Isotope scan
E Mid stream mine culture in three Months
F Mid stream urine culture
G Monthly mid stream urine culture
H Ultrasound of kidneys and Bladder
164. An 18-year-old woman became sexually active one month ago. She has had frequency of micturition, dysuria and one episode of hematuria.
165. A 70-year-old man with poor stream, dribbling develops dysuria and frequency of micturition. Urine testing reveals microscopic hematuria but no growth on culture.
166. A previously un investigated 25-year-old woman has he third attack of frequency of micturition and dysuria. Midstream urine culture grows E. coli on each occasion.
167. A 25-year-old man has his first proven episode or urinary tract infection (UTI). The intravenous urogram (IVU) is normal



Miscellaneous

153. A pt with increased cell conts and gangrene of the feet
154. A pt with Alzheimer’s had lost conscious with incontinence of urine-EEG
155. A pt with h/o diarrhea , anal tags
156. A male with drooping eyelids, SOB, cough. chest x-ray findings were given. a mass was present in the apex of the right lung,
157. Baby with anorexia and dribbling and high temperature ...my answer was appendicitis but dont know that it can b bronchiolitis as well?
158. A 60-year-old male patient, with a previous history of pain in calves and decreased pulses in the leg, has suddenly developed pain in the back and BP decreases with increase pulse rate.
159. Gangrene of the toe with b glucose 9-- dm
160. Fasting glucose 6.5 - Impaired Glucoe tolerance test
161. A 65 old lady had loc when examined has systolic and diastolic murmur- valvular heart disease.
162. An 18-year-old girl is doing her exam and is very stressed. She has missed her last period. Her pregnancy test is negative. She complains of three months history of generalized abdominal pain and bloating.
163.a pt who develops depression almost year long and with recurrence.
164. there was a theme about invest of pulmonary embolism in preg lady. options were V/Q scan and High contrast CT . ..... spiral ct was not in options but I went for ct as it was emergency presentation

*Diagnosis of abd & pelvic injuries ???

*Recollect other themes like one CVS theme with systolic diastolic murmur, diabetes type 1, type 2 , investigation of infectious diseases, CNS theme which had glioma etc in options, rhamatology theme, syncope

ANSWERS

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