June 2013 Recalls

7/25/2019 June 2013 Recalls

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June 2013 recalls

1. Patient is taking doxycycline, complaints of nausea

indigestion abdominal pain, what adice gien

a add an antacid

b add an antiemetic

c take doxycycline before meals

d take doxycycline after meals

2. ! woman has electric pains at her face that start at her "aw

and radiate towards her forehead.her corneal re#exes are

normal.what is the diagnosis

a. atypical facial pain

b. trigeminal neuralgia

c. $emporomandibular "oint dysfunction

3 ! schi%ophrenic man complains that he can hear oices

talking about him and telling him to end his life by cutting his

throat. &e only hears them when he wakes up from sleep and

not at other times. what type of hallucinations is he haing'

a. (ommand

b. )inesthetic

c. &ypnagogic

d. &ypnapompic



* man 2+ -!/ !- presents with hoarseness of oice wd

swollen ocal card, his 45 32 and smokes 2062+ cigrettes per

day, what to adice him

a stop smoking

b wt loss

+ pregnant woman is diagnosed to hae osteoarthritis, what isthe choice of drug

a paracetamol

b steroids

c nsaid

7 patient wakes up with slurred speech and right sided

weakness, ct shows cerebral infarct ,what to gie

a aspirin

b alteplase

c warfarin

d clopidogril

8 a man after 45 presneted with sudden breathlessnnes n

dyspnea, on chest examination he had scattered pansytolic

murmur all oer the precarduim,,,,,what is the nextinestigation that will lead to diagnosis



a ecg

b echo

c ct chest

9.lady 8 wks pregnant omiting fr 3 wks on oral antiemetic n i

#uids, not tolerating things orally..and she is still omiiting, next

step

a termination of pregnancy

b i: antiemetics

c parentral nutrition

d i: hydrocortisone

; 80 yr old man presented with muscle weakness and inabilty

to climb the stairs, inestigation shows (P) ery raised , -/

1+ mm hour<...diagnosis

a polymyositis

b polymyalgia rheumatica

( reactie arthritis

10 lady with breast cancer hae done axillary lymph nodes

clearance then deelops arm swelling after bee sting

a lymphedema

b cellulitis



c hypersensitiity reaction

d =>$

11 pt underwent hip surgery later presents with shortness of

breath chest pain etc etc

a pulmonary embolism

12 ! 7yr old boy presented with constant bed wetting, urine

incontinence also in daytime, what is the most appropriatemanagement

a enuresis alarm

b desmopressin

c behaioural therapy.

13 ! boy with sudden chest pain while playing football ..initial

inestigation

a ct chest

b chest xray

c !?s

d /pirometery

1* ! boy after a surgery presented with a high random blood

sugar ....which went to normal afterwards...reason of his raised

blood glucose



a normal stress reaction

b =)!

c =4

1+ ! 2yr old boy presented with gradual swelling of feet een

his feeding has been poor recently, he has gained weight with

dark urine..what is the single most appropriate inestigation...

a serum albumin

b calcium

c urea n creatinine,

d glucose

17 a @uestion was about a patient who worries a lot oer

closing locks and doors

a (=

18 21 yr old girl looking unkempt, agitated n nerous looking

nutritionally malnourished comes to the hospital asking for pain

killer for her abdominal pain....what could she be misusing...

! alcohol

heroine

( cocaine

= A/=

19 18 yr old lady presents with worm in ear. /he is ery

agitated and anxious<.next step

! remoe under !



alcohol drops

( suction

= forceps

1; ! young man 3+ yrs was brought by his wife who claimed

that his behaiour has changed, on examination, there was loss

of recent memory and wife says patient does not take too much

alcohol, he keeps talking to himself and says he wants to help

the world...what is the lightly diagnosis,

a delirium tremens

b early onset dementia

20 0ld man, known case of (= presents with bruises on

forearm n face

! non6accidental in"ury

21 Pt from a building on Bre, unconscious , no eidence of

burns or external in"ury C soot

! 100 prcnt 2 entilation

2 by mask.

( hyperbaric oxygen

= intubation

22 ! pt presents with +0D partial thickness burns,

management

! i: luid calculated from the time of arrial at the hospital

i: #uids calculated from the time of burn

( no i: #uids

23 @uestion on statistics,<<the percent of people who were

screened for disease and results were negatiet but deeloped

the disease later



! false negatie

2* another statistics @uestion about absolute and relatie risk

2+ pregant lady with p bleeding os is closed

! threatened abortion

ineetible miscarriage

( missed miscarriage

2+ a young girl presented with lower abd pain, and bleeding per

aginum, on examination she appered shocked with rigid

abdomen.. what is the next most diagnostic inestigation! ct, abd

xray erect n supine,

( u:s abd

27 one @uestion lady was<lady with abruptio placenta and still

bleeding...what inestigation to do to Bnd out the cause

! clotting proBle

u:s abdomen

( ct scan abd

= =6 dimer

28 a @uestion about urinary incontinence in post6menopausal

women<urinary culture was sterile .. next step

! antibiotics

topical oestrogen

( systemic oestrogens

29 patient with anaphylactic shock< what to choose

! i: adrenaline

i:m adrenaline



( s:c adrenaline

2; patient with anaphylactic shock dose of adrenaline

! 0.+ ml of 1E1000 adrenaline

0.+ ml of 1E10000 adrenaline

( 1 ml of 1E+00 adrenaline

30 patient presents with haemoptysis he had tonsillectomy 8

days back<.next step

! packing

oral antibiotics and discharge

( admit and parentral antibiotics

31 patient with P5= on treatment now has lower abd pain n

rigidity n uncomfortable pelic exam . 3; c temp.

! F/

!bd G6ray erect and supine

( (t scan abd

32 female with history of P5= now presents with abd pain, p

bleeding and shock, management'

! laparotomy

33 a @uestion about treatment of P5=

3* @uestion on which drug causes Parkinson like symptoms

(hlorproma%ine

3+ a child presented with a rash mom applied tc cream but

didnHt improe what other medication will u add

! corticosteroid, systemic

antifungal,

( antibacterial



= corticosteroid, topical

- combination of a and b

37 a man presented with cellulitis and swelling and was started

on #ucloxacillin what other medication will you add

! ancomycin

penicillin

( metronida%ole

= ceftriaxone

38 patient on antihypertensie drugs has hyperkalemia<.whatantihypertencie caused it..

! ramipril

losartan

( bendro#umethia%ide

39 old lady drowsy her relaties want to take her home and

gie ben%odia%apines at home asking about routes

a oral

b i:

c i:m

d rectal

3; patient presents with right hypochondrium pain <inestigations shows a big gall stone <<management

a lap cholecystectomy

b nothing

c low fat deit

d ursodeoxycholic acid



*0 @uestion about thining of heart septal walls<<.dilated

cardiomyopathy

*1 a @ues on congenital heart disease <.something like a child

had a machinery murmer which disappeared later

! sd

asd

( pda

*2 a man with prosthetic heart ale underwent hemicolectomy

and after some days he complains of left hypochondrial pain,

feer and has a systolic murmur, what is the next inestigationto ascertain the cause of the heart failure,,,

a ct scan

b blood culture,

c echo

d chesy xray

*3 a man had a $! and presented with engorged neck ein,

trachea was central, chest examination is

resonant......diagnosis

! tension pneumothorax

simple pneumothorax

( cardiac tamponade

** Patient with exercise induced asthma. !lready on salbutamol

n steroid inhalers, now has to wake up at night for inhaler. &ow

will u manage...

! /od chromoglycate

A!!

( /teroid



*+ ! patient with progressie dyspnea and 1 tablespoon full of

mucopurulent sputum for last 19 months. e: fc 8.1 n 7.2 n

after salbutamol 8.2 n 7.3 <<diagnosis'

! (hronic bronchitis

ronchiectasis

( !sthma

*7 egarding hernia surgery what would delay the surgery

! diastolic P below ;0

=>$ two yrs ago( 45 2 months ago

= (ontrolled !

- controlled asthma

*8 lady presents with itching around breast, pus drains from a

nipple<.had similar episode before

! duct papilloma

b duct ectasia

c breast abscess

d periductal mastitis

*9 $here was one @uestion /troke patient taking aspirin n has

heumatoid arthritis can?t tolerate pain. &eHs taking senna for

constipation<what to gie to reliee pain'''

*; man presents with history of ingestion of 2+ tabs of

paracetamol 10 hours ago<..next step

! check leels

I acetyl acetylcystine

+0 pt with cerical A!=, sore throat, treated with antibiotics,presented with rash



! erythema multiformae

/teen6 Johnson syndrome

( erythema marginatum

+1 ! female, pregnant returns from /udan, present with

intermittent feer, rigors, sei%ures <diagnosis

! 4alaria

brucellosis

+2 ! patient returns from holiday, presents with pus discharge

from external ear but normal tympanic membrane, treatment! gentamyin drop

oral antibiotics

( steroids

+3 37 yrs old presents with painless hematuria and also

proteinuria 3 plus<..5nestigation E

! .!bd usg

. (ystoscopy

( renogram

+* Patient with mued hearing and fullness of pressure in ear,

tinnitus n ertigo

! menniers disease

acoustic neuroma

( acute labrynthitis

++ an old lady in a nursing home while eating had sudden

dysphagia and presents Kith drooling of salia...next step

! arium swallow

ct chest,



( endoscopy

= laryngoscopy

+7 polycythaemiaE itching after a hot bath L(lassicalM

+8 a patients suNers from a pointing tremor which resoles

when he doesnHt moe his hand

! binign positional tremor

+9 ne @uestion was on 5$P

+; +3 yr old patient, spleen palpable upto the umbilicus<.&

low<K( high<platelet low<<..! (4A

70 Pt with $5! history, recent memory problems<< cause''

! 4ulti infarct dementia

picks disease

( temporofrontal dementia

71 a man has reducible hernia below the inguinal ring, with

cough impulse present

! =irect

5ndirect

( emoral

72 ! 7yr old boy fell on an outstretched hand while playing,feels tender at the elbow but otherwise is well,,,,,,

! spiraal fracture

green stick fratcure,

( compound fracture

= supracondylar fracture



73 a 70 yr old woman presented with radial fracture, had colles

and suprocondlar fracture in past what other test is re@uired to

detect her possibility of haing the same problem later,,,

! dexa scan

b mri

c nuclear bone scan

7* Pt on some drugs presents with coarse tremor, what was the

underlying cause of his symptoms,

a lithium

b dia%epam

c halopaidol

7* ill looking kid wih epiglottitis< drooling slia<. immediate

management

! call anesthetisc of intubation

gie 0xygen

( gie antibiotics

= -I$ examination

7+ ! patient with normal proBle, but only !P$$ prolonged

! haemophilia

77 elow knee cast<<Io dorsi#exion of foot< nere

inolement''

! tibial nere

sciatic nere

( common peroneal nere

78 ! 22 year old woman was brought by her boyfriend with

multiple superBcial lacerations. there are scars of old cuts on



her forearms. she is distressed because he wants to end the

relationship. she denies trying to end her life.

a. !cute psychosis

b. borderline personality disorder

c. /eere depression

d. /chi%oid personality

79 patient presents with watery diarrhoea, abdominal pain n

abdominal bloating with a history of trael....cause

! campylobacter giardiasis

( e.coli

= typhoid

7; posterior gastric ulcer, which perforated, where will the #uid

accumulate in the peritoneal caity

a. Aeft paracolic gutter

b. Pelic caity

c lesser sac

d. Fnder the diaphragm

- retroperitoneal

80 al child presented with upper respiratory tract infection, andlater deeloped feer, seere earache, moderate tonsillitis and

the tympanic memebreane is dull..what is the likely

diagnosis,......

! acute otitis media

otitis externa

( glue ear



81 Patient with treated (! breast with no nodal inolement,

now has sei%ures<.. n ct scan there are localised mets<..

! /urgery

=examethasone

82Pt with a persistent lesion on upper part of pinna

! asal cell ca

/@uamous cell cal

( )eratocanthoma

83 !n old lady called for an ambulance for an acute chest painshe has a history of =4 and &$I and was a excessie smoker ,

Paramedics mentioned that she was oerweight. /he collapsed

and died in the ambulance car. Khat is the most likely cause of

her death

! Pulmonary embolism

myocardial infarctin

( /troke

= (ardiac arrythemia

8* (P= patient<. Kith !s<..Ph 8.2<..Po2 low<..Pco2 high

! I5PP>

Aaba

( 2 2*D

= 2 100D

8+ a man with acute exacerbation of (P=, patient was gien

2*percent oxygen<.. what is the next line of action,

a 29 percent oxgyen

b nebuli%ed salbutamol,



c non inasie mechanical entilation

87 a child who had mumps three days ago n later presented

with scrotal pain n swelling<

! analgesia n adice

scrotal support

( antibiotics

88 a man presented pain and discomfort in anal region<

examination shows a purplish swelling at the anal area..what is

the managemaent...

! incision n drainage

incision and drainage plus antibiotics

( reasuure

= analgesia

89 a 3+yr old man presented with haematuria, abdominal

swelling and has a P of 1;0:1*0, what is the most diagnosticinestigation,

! cystoscopy

usg abd

( ct scan

8; ! woman + days after an obstructed labour presents with

pain n swelling of one leg. :e the leg has blue mottling n iscold. =iagnosis'

! =>$

post phlebitis syndrome

( -mbolus

90 Patient with pain and swelling in left leg and thigh upto the

leel of inguinal ligament<leel of occlusion '''



! emoropopliteal artery

left (ommon iliac artery

( !orto iliacartery

91 7 month old hild with sei%ures and "erking limbs

! infantile spasms

/A

( breath holding splls

92 patient was in"ected with contrast for imaging...what to use

to protect kidneys

! normalsaline

93 10D burns on chest of child<next sep

! i: morphine

dressng

( i:#uids

d oralmorphine

9* 30 yr old man with dirty wound on foot<.he got in"ured

while working in soil<his last tetnus accine was at school

! tt plus immunoglobulin.

tt only

( immunoglobolins only

9+ a 8 yr boy has a wound on his foot<.no past history of

immuni%ation as parents were scared that child might catch

some disease<now the wound has been cleaned<next step

! reassure

tetnus toxod only

( $etnus immunoglobulinns only



= full course of tt and immunoglobulins

- ull course of =P$

97 a@uestion about ambiguous genetalia<some alues of Ia

and ) were gien

! (ongenital adrenal hyperplasia

98 little baby with 80D oxygenation

! !sd

>sd

( Pda

= $of

- coarctation of aorta

9; blood Blm shows occasional spherocytes <.next

inestigation

a direct coombs test

b bone marrow exam

c indirect comb test

;0 20 yr old girl<..with amenorrhea<.and 45 of 1* and she

thinks she still has to loss weight

! anorexia nerosa

anorexia bulimia

;1 1*yr old girl with amoneorrhoea and short stature

! turners syndrome

P(s

( premature oarian failure



;2 patient is unresponsie and cyanosed <<.Brst step

! check airway

recoery position

( chest compressions

;3 Pt who remembered his date of birth and place but

disoriented in time place person.

! !l%heimer

rontal temporal dementia

( Aewy body dementia

= (J=

- ascular dementia

;* Pt after 3 days of 45 with pansystolic murmer<<cause''

! upture of papillary muscle

entricular aneurysm

( pericarditis

d pericardial eNusion

;+ pt with higk leel of potassium, how to manage

! insulinC dextro

only insulin( only dextrose

;7 lady 10 week pregnant,<how to check iability of pregnecy

! transaginal ultrasound

abdominal u:s

( t scan abd



;8 a lady with depression has a bag full of medicines..presents

with coarse tremors <which drug caused her symptom

! lithium

thyroxine

( amitriptyline

;9 7 week old baby presented with omiting, mother claims

that there was no bile<.what diagnostic inestigation to do'

! c scan

barium studies( u:s abdomen

;; a patient with Bndings of<<.asting blood glucose 7

mmok:l amd ogtt 10 mmol:l , diagnosis'''

! 5mpaired glucose tolerance

=iabetes insipidus

( $ype 1 diabetes

= $ype 2 diabetes

100 a patient experiences rotational ertigo eery time he

moes his head on the bed from one side to the other, what

inestigation is important.....

! hallpikestest

ct scan brain

101 which of the following will be aNected by a%ithromycin...

! cocp,

iucd,

( pop

= mirena.



102 a patient with coeliac disease from birth now as an adult

presented with some abd symptoms, the biopsy shows

inBltration of the gastric epithelium by lymphocytes.....the likely

diagnosis,

! lymphoma

dierticular disease

103 a man is moderately depressed and is a known case of 45,

what medication will u gie'

a citalopram,

b amitirptyline

c imipramine

10* a patient with illous adenoma<presents with diarrhoea,

what electrolyte imbalance would u Bnd'

! hypernatremia

hypokalemia

( hyperkalemia

= hypocalcemia

10+! 1* year old boy who was preiously well and immunised

two years ago against 4eningococcus roup ( has been

diagnosed with 4eningococcus roup /epticaemia. &e did

not re@uire resuscitation. &e lies with his family which consists

of his mother, father, and six6week6old breast fed brother, whoare well at the moment. &e attends a local secondary day

school. Khat is the single most appropriate contact:group of

contacts to receie ifampicin prophylaxis'

!. Iobody

. $he six week old brother

(. $he six week old brother and both parents =. $he six week

old brother, both parents and attending doctors and nurses



-. $he six week old brother, both parents, attending doctors,

nurses and school pupils

107 a man post cholesctomy presented with "aundice, feer

and dark urine..what is the single most diagnisticinestigation....

! -(P,

!= F/

( ($ scan

= mrcp

108 the following are associated with barret Os esophagitis'

! columnar metaplasia,

s@uamous metaplasia

( columnar dysplasia

= s@uamous dysplasia

109 a person with glioblastoma taking dexa for long time had

h:o repeated fall<.cause

! adrenal insuciency

10; $here was a @uestion about 7+yr man who is on

dexamathasone and had a surgery, during and after the

surgery the blood glucose was around 18 to 1; mmol:l...what

will u gie to pt,,,,

! insulin,

oral hypgoglycemic,

( remoe dexamethasone

110 an alcoholic had yellow colour ascitic #uid<cause

! alcoholic hepatitis

decompensated cirrhosis



c $

111 Question about pregnant woman coming with &b 10.7

<..29 weeks of gestation, what will u do

! eso*

reassure this is physiological

( blood transfusion

112 a man presented with haemoptysis, weight loss, and on

chest xray has scattered caiation, whats the most appropriate

important inestigation,,,

! acid fast bacilli

ct scan

113 a @uestion about treatment of anal Bstula

! otox in"

=ilatation of anal sphincter

( lay open the Bstula

= defunctioning colostomy

11*a lady with Brm smooth breast lump in outer @uadrant ,fnac

done results show borderline benign changes'

/uspicious<<,next step

! mammography

F/g

( core biopsy

( excision biopsy

11+ 2 yr old girl with smooth lump in breast, with family

history of ca of breast asking about initial inestigation

! ultrasound



fnac

( core biopsy

= excision biopsy

117 ! woman with breast ca presented with omitting abd

pain,confusion. Khat is the likely diagnosis....

! hypercalcemia,

hypocalcemia

( ,intestinal obstruction

118 @uestion about a patient who takes 120mg slow releasemorphine which has been increased to 200 mg to control his

pain along with oral morphine' $he @uestion was what to gie

him now and the options were something like

a. 5ncrease slow release morphine dose

b. entanyl transcutaneous patch

c. replace morphine with oral hydromorphone

d. eplace morphine with oxycodone

e subcutaneous morphine

119 lady painting the wall n then hits her head n gets a

laceration presented with headache and omiting<.choice of

inestigation

! ct scan

carbonmonoxide leels

( !s

= glucose leels

11; a @uestion about an old lady in a care home, presents with

itching <.cause

! /cabies



120 ! @uestion about patient haig petechie,,,,some lab alues

were gien ,,,,

! 5$P

factor + deBciency

120 old woman haing decrease ision cannot see properly at

night she een changed her glasses @uite a few times but no

eNect. normal pupil and cornea. diagnosis'

! cataract

glaucoma

( retinal detachment

121 2+ yr old woman with pain right hypochondrium and

"aundice. /he wasn?t feeling well for a few days n has anorexia.

$ender &( but no hepatomegally. 5nestigation'

! >iral screen

Aft

( u:s abdomen

122 a man undergoes a pneumonectomy, and after the

surgery, inestigations shows hyponatremia...what could be the

cause of the biochemical changes....

! remoal of hormonall actie tumor,

excess dextrose

( excess colloid

123 a @uestion on transdermal granulomas at ileocoecal

"unction<diagnosis

! crohn disease

ulceratie colitis



12* a woman presenting some pain in the back and sensory

loss<5 think there was a mass at A26A3 leel

! spinal cord compression

12+ a @ues on post chemo neuropathy

127 man presents with purulent and sticky eye, what treatment

to oNer''

! topical antibiotic

topical steroids

( reassure and adice on cleanliness128 ! woman brought his husband saying she wants the thing

on his forehead to be remoed and that when is remoed it will

improe his thinking...what will u do....

! assess his mental capability to refuse treatment

sent to the psychiatrist to assess her mental capacity to

refuse treatment

129 ! man presented with massie abdominal distension and

dribbling of urine.....his underpants are wet and smells of

ammonium...what will u do for him.

! /uprapubic catheter,

urethral catheri%ation etc

12; was a @uestion about a lady who presented with multiple

shallow ulcers on the labia ma"ora........herpes simplex

130 ! pt with persistent worrying for few months, palpitaions,

waking her at night,

! enerali%ed anxiety syndrome

131 a @uestion on ad"ustment order was there

132 a @uestion about palpable left supraclaicularmass<.diagnosis



! gastric (!

133 mechanism of #uid accumulation in a patient with lier

disease.

! cirhosis,

portal hypertension

13* a guy who has seeral coniction and has been imprisoned

for seeral times, break ups with his family and does not

contact his children,,,what personality disorder,,,,

! borderline personality disorder,

dissocial personality disorder

( schi%otypial

13+ during antinatal isits, the followng routine test are done

after hepatis b and hi

! rubella and syphilis,

b syphilis and toxoplasmosis

( hepatic c and e

137 Pt. with seere diarrhoea. Khat 4etabolic abnormality will

b ther

! metabolic acidosis

metabolic alkalosis

138 Pt with eclampsia. 5: mgso* and hydrala%ine started.

!nother Bt.

! 4gso* bolus

dia%epam

139 @uestion on chronic fatigue syndrome



13; a pt wit hemetamesis haing h:o long term use of aspirin

and other drug66666666now present with seere epigastric pain

whats the management

! oral antacids

b i: ppi

c oral ppi

1*0 (ontraception for Bbroid uterus with distorted uterine

caity

! implanon

cocp

( pop

1*1 Pt haing history of expansile mass in abdomen now

presents with shock<.next step inmanagement

! ie #uids slowly to bring P to ;0

ie #uids rapidly to bring P to 120.

( F/ abd

1*2 ! boy with temper tantrum , apnea and screaming

! breath holding spells

1*3 a girl who had an accident presents with hard tender

breast swelling

! fat necrosis

!/ $&-/- !- -(!AA/ / $&- 5I 5/ 5$ P!$(&<./$5AA 5

KFA= /! = $&F& !AA -(!AA/ !I= &!>- !

$&F& -!= $&- $P5(/ !$ A-!/$ <<.-(!AA/ !-

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June 2013 Recalls

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