Posted by P.H. on January 10, 2002 at 11:04:42:
Theme 1. Shock
septic-gm 朧e septicaemia
cardiogenic
hypovolemic
anaphylaxis
1)boy comes with swollen lips after eating peanuts
2) pt had an accident and fracture of pelvis and femur ,b.p. 100/70 p =90
3)pt had an m.i. and then is in shock now
4)pt post op has fever ,warm extremeties
Theme 2. EPISTAXIS
anterior nasal packing
post nasal packing
Neomycin cream
pinching of the nose
reassurance
vit k
ffp
ice pack on the nase
5) patient on warfarin , comes with you with nose bleeds inr is 9
6)boy has come with slight bleeding from nose .some crusts seen in nose
7) pt has come with a b.p. of 230/110 and bleeding from nose , his circulatory system has been stabilised and nose ant. packing done ?but he continues to bleed
8) girl has come with slight bleeding from ant part of nose . by the time she reaches a-e bleeding has stopped
Theme 3. FRACTURES OF WRIST JOINT
x -ray of wrist scaphoid view
refer to ortho doctor immediately
bandage and discharge
isotope scan
9) boy fell from tree now has come with painful wrist x- ray taken was normal
10) pt had a fall x- ray shows perilunate fracture .
11) patient had a fall x ray normal ? tenderness in anatomical snuff box
12) pt had a fall -x ray showed displacement of the radia
Theme 4. RELATION TO OBESITY
obstuctive sleep apnoea
type 1 dm
type 2 dm
alcholol
cushings
hypothyroidism
13) wt loss would help night sleep and this condition and improve family relations
14) wt loss would even help to stop the medications
15) stop of this would help in wt loss and vitamin deficiency
16) surgery in this condition would help in wt loss and improve this condition
Theme 5. DELAYED MILESTONE
fragile x syndrome
tay-sachs disease
bacterial meningitis
hypothyroidim
prematurity
duchennes muscular atrophy
Fetus alcohol syndrome
17) a 4 yrs old boy can write his name and draw a circle and square; he walks with a lordosis and he cannot run.
18) boy of 3 yrs of age, has delayed milestones his uncle and brother also have this condition
19) girl can sort out cube 4 9 and is 97 percentile for her weight, but her head circumference is lower than normal
20) a six months old child, can smile, but has head lag ---- ( cant remember the whole q)
21) child was normal but then delayed miletones after a fever
Theme 6. PSYCHIATRIC MANAGEMENT HOW CAN YOU HELP THESE PATIENTS
methadone
propanolol
diazepam
acomprosate
zopiclone
risperidone
amitryptilline
Re-breath back the air (something like that)
22). A girl has oral numbness and limb paraetheses after an argument with her friend
23) patient a heroin addict - now in ward in withdrawal wants u to help him
24) patient an alcholic now has been detoxified feel that he wants to remain off it but is scare he may relapse
25) female with s-s of pain in chest 朤ightness ,feeling like dying and sinking feeling ,wants some medication for her condition.
26) patient has to go for an interview has sweaty palms and palpitations asks for your help.
27) patient having restlessness, pacing up and down after death of her husband with difficulty in falling asleep .
Theme 7. DIAGNOSIS OF PSYCHIATRIC DISORDERS
Post-traumatic disorder
Post naltal-psychosis
though -broadcasting ,
insertion ,echo ( 3 separate choices)
Hallucination
Illusion
paranoid delusions
Judgement
Insight
low mood
flight of ideas
28) patient keeps on talking to you ?non stop and jumps from one topic to another
29) patient after the birth of her child feels sad and does not want to feed the baby
30) patient has the believe that terrists is planning an attack (something like that).
31) a old woman has been admitted and feels that the staff of the hospital knows what she is thinking all the time.
32) patient who lost her husband is sad now and avoids eye contact
33). A man has psychiatric problem and he knows that he need a treatment
Theme 8 VOMITTING IN PREGNANCY
hyperemesis gravidum
hydatid form mole
cholecystitis
Chloecystic pregancy
Brain tumour
pre eclampsia
migraine
34) 12 weeks pregnant woman has been continuously vomiting , comes with a furred tongue and signs of dehydration
35) A 14 weeks pregnant woman comes to you with severe vomiting , u.s of uterus shows absence of f.h.s. and the uterine is 18 weeks to date.
36) patient comes to u with severe vomitting ,diziness and photohobia ?she is in the 34 week ,she tells you that she had these symptoms since 14 weeks and o/e her pulse rate is 60 /min
37) A pregnant woman had a nauseous and vomit since week 18 and these symptoms have got worse since two weeks and she is anorexic, vomiting and slightly jaundice.
Theme 9. NERVE INJURY
axillary
musculocutaneous
radial
ulnar
common peroneal nerve
sciatic
38) patient has history of fracture shoulder now has decreased sensation on the lateral aspect of the deltoid muscle
39) patient had fracture of fibula or at level of fibula and now lost his dorsreflex and sensation loss on the lateral side of his low leg.
40) patient had fracture of medial epicondly and now come with decreased sensation of 5th and 4 th finger
41) patient has some fracture of humer and comes with s/s/ of wrist drop
42) old man had a fall and fracture or dislocation of hip now has weakness in his hamstring.
Theme 10. PAIN RELIEF
Purlpurine
radio therapy
tens
im diamorphine
nsaids
paracetamol
prednisolone
physiotheraphy
home exercise
im steroids in joint
43) patient with ca prostate and now has 2 aries to back with severe pain , no nsaids, morphine has helped ?wants to continue his work
44) patient with ca lung with 2 aries now has come with an unilateral swollen arm , all other medications have failed ( ie nsaids ?morphine )
45) 50 yr old woman has come with painful shoulder joint and hip joint
46) 30 yr old busy executive has got pain on lateral aspect of thigh . he shows no improvement with nsaids . x ray taken was normal
47) a man is on Fresmide and got pain in his joint
Theme 11. MECHANISM OF ABORTION
immunological
genetic
anatomical
endocrine
Drug-induced
48 ) patient having 6 abortions in mid trimester
49 ) patient having some problem with the deformed child (She married her cousin)
50) patient has recurrent abortions, is obese and hirsutism.
Theme 12. INVESTIGATION OF LEG ULCERS
pyoderma gangeroneusm
bowens disese
venous stasis
arteriography
Melanoma biopsy
51) patient having pain on walking. His leg and foot are pale and with the 5th digit blackened
52) patient with diarrhoea and abdominal pain had a small round (with central necrotic tissue)
53) female fat obese and having edema of leg now has a small ulcer on medial aspect of her ankle.
54) 60 yrs old man with a pigmented skin lesion on his shin.
Theme 13. HEAD PATHOLOGY
Intra-cerebral haematoma
brain stem injury
Extradual haematoma
Subdual haematoma (SDH)
acute SDH
Chronic SDH
vertibo basilar ischaemia
migraine
depressed fracture of skull
Sub-rchnoid Haemorrhage
55) motor cyclist with accident is brought to casualty with head injury. gcs is 3 and his blood pressure is 180/100 and heart rate of 56/min and his pupil is dilated and sluggish to light.
56) young male 27 after a heavy bout of alcholol feell down on the road and then got up n walked home . His wife found him on the floor and cannot rouse.
57) 67 yrs old man had recent falls, became agitated and confused.
58) A old lady has dizziness and vertigo and walking reeling to one side.
59) Female has come to a-e with vomiting and severe pain in the back of the head
60) patient hit on the head with a hammer, now comes with vomiting
61) a young man fell over and there is injury on his temple scalp (I think he is alert)
Theme 14. DIAGNOSTIC TESTS ON LOSS OF VISON
MRI temporal lobe
MRI pituatory
MRI occipital lobe
Doppler carotid artery
ESR
62) patient comes with repeated h/o/ loss of vision in one eye and it improves after a few hours
63) patient with bitemporal hemianopia and increaes in shoe size.
64) patient has come with vomiting and upper quadranopia (not sure of the full question )
65) patient having pain while brushing her hair and now comes with loss of vision in one eye
Theme 15. MANAGEMENT OF INJURIES
laparatomy
refer to surgeon
admit and observe
give iv fluids 1 litre in 30 mins
iv fluids 2 litres in 30 mins
reassurance and send home
66) boy has come with injury by fall on handle of cycle and had got pain and tenderness in left upper side of abdomen. u.s of spleen shows a small sized haematoma in the splenic capsule
67) patient with being hit by a ball comes with severe pain in epigastrium
68) patient was stabbed in a fight and now comes with his omentum ( or omentocele outside in the umblical area). His blood pressure is 110/70 and heart rate 80.
69) patient with h/o/ fall has come with tenderness in left side of abdomen and fracture of 2 right sided ribs. patient in shock
70) Patient had (some sort of injury), after 2 litres of fluid iv, his bp is low and hr higher.
Theme 16. MANAGEMENT investigation OF SEIZURES
Start anti-convulsants
reassurance
anxiolytic treatment
vulvar surgery
e.e.g.
e.c.g.
I.V. glucose
71) A 50 yrs old man had hemoptysis and cough for some time and now come with a first fit.
72) 8 year old girl falls down in the assembly. She is pale and loss consciousness for 1 min. She often falls in dentist visit.
73) boy has period of breathholding spells where he becomes blue and loss consciousness. This happens when he is separating from his parents.
74) 30 year old female has 2-3 episodes of falling down, she also has got a loud murmur in inspiration
75) 50 yrs old woman has episodes of unconsciousness starting in the left thumb and then going to whole body. she loses consciousness
76) A 10 yrs old boy behaves strangely (cannot remember exactly), and his teacher says that he is not concentrating at the moment.
77) A young man has some kind of fit (it is a long Q), his heart rate drop down to 50/min
78) a young boy has fit, he is a DM, his blood glucose is 2mmol.
Theme 17. HAEMETEMESIS
malleroy weiss tear
alcholic cirrhosis
gastric erosion
peptic ulcer
duodenal ulcer
divertuiculosis
Benign gastric ulcer
78) patient 55 has been drinking 15 units/ day now comes with massive hemetemesis
79) patient comes with massive hemesis after eating a lot and a bout of alcholol
80) patient suffering from r.a. comes with vommiting with streaks of blood
81) a 50 years old manager (some sort) had epigastric discomfort for some time and his stool is tarry. He is otherwise normal.
Theme 18. MANAGEMENT OF DRUG SIDE-EFFECTS
drug serum levels
thyroid function tests
liver function tests
sr. prolactin levels
urea and electrolytes
82) patient on lithium now comes to you with tremors of hand
83) patient on lithium now comes with wt gain, slow down
84) patient on phenytion for epilepsy now comes with dizziness , blurred vision and ataxia
85) male patient on phenothiazines now comes with a painful breasts
86) A man take overdose of his Aspri. He is conscious (did not mention how much and when)
Theme 19. HEARING PROBLEM
ototoicity
tilt test (b.p.v)
salicylate levels
fracture petrous temporal bone
wax in ears
acoustic neuroma
Blast injury
87) patient on gentamycin comes with ringing of ears
88) patient with some pathology of ear comes with tinnitus and it worsens with movement. the test for it is by lowering the patient
89) patient took some treatment for his should pain and now comes with tininitus
90) A boy was hit and fell and hit somewhere behind his ear and now comes with difficulty in hearing and tinnitus
91) vagarant comes to a-e with diminished hearing particularly after a show.
92) A patient who is anesthetic to his cornea reflex has a diminished hearing. CT showed a widened ear cannal.
Theme 20. HOW WOULD YOU HELP THIS LADY
home redecoration
advice on posture
neck collar
review the dose of anti hypertension
review the dose of anti diabetics
rearrange home
93) lady on asprin 朾endofloridazole 7.5 mg comes to you with repeated falls while trying to get out of bed
94) lady on various medicatio one of them which id glibenclaimede come to you with sweating and altered consiousness
95) lady 85 year old lives alone, fell down while trying to put up her curtains. This has occurred on another same occasion.
Theme 21. ANAL CONDITiONS
anal haematoma
ischaemis colitis
proctalis fugalis
ca rectum
sq cell ca of anus
chrons~{!/~}
ulcerative colitis
anal fissure
96) patient comes to you a young woman with electric pain in the rectum
97) young girl with h/o/ constipation cannot pass stools. PR is impossible because of the pain.
98) a young woman has constipation and painless fresh blood after defecation
99). A woman of 29 of age has diarrahoea and colic abdominal pain with tags in her anal exam
Theme 22. DIAGNOSIS OF RECTAL CONDITIONS
Rectal haematoma
Carcinoma of rectum
Ischaemia colitis
Ulcerative colitis
Crohns disease
100) 50 year old patient with diarrahea and pain in abdomen
101) on proctosigmoidscopy an ulcer is found 10 cm from the rectum
102) patient has come with pain while defacating . o/e anl cushions are found which are purple in color
103) patient comes with h/o/ fever and diarrhoea on biopsy granuloma found
Theme 23 CONTRACEPTION ( BELIEVE ME THE WOREST!)
abstinence
mirena coil
9 nothistone
o.c. pills
progestrone only pills
IUCD
depot preparations depot vera
tubal ligation
Vasectomy
rhytm method
withdrawal
ovulation testing
Condom
Diaphram
104) A 47 year old woman with 9 month h/o amenhorea now comes wanting to have contraception. She says that her husband is not reliable with condoms and she does not want chemicals in her body
105) A 26 yrs old lady with irregular periods of 24 to 40 day variations, she does not want children for the next two years. She comes to you saying she wants a natural method of contraception
106) 37 yrs old lady with 2 children and a hectic life style comes to you for contraceptoin. She wants reliable method since she was pregnant when she was on the oral combined contraceptive last time.
107) lady 26 year old .2 kids the youngest 6 months says she wants to be sterilised. She has separated from her husband and she does not want to put weight on since the oral combined contraception did before.
Theme 24. INVESTIGATIONS FOR FEVER
pl. 杤ivax梖alciparum- ovale
lumbar puncture
lymes seology
brucellosis
108) patient returned from zambia now has fever with rigors and fits
109) young girl with fever, ash and neck stiffness
110) 18 yr old boy has come back from mexico after working in a farm there and now has fever with spleomegaly
111) girl went out in the forest for walk now has a tick bite and has fever at the moment
112) surgical conditions what is the rx
Theme 25. MANAGEMENT OF POST-OPERATION
Cathoclamin
Dopmine
laprotomy
antibiotics
wide excision of affected tissue
percutaneous drainage
Insert stent
Excision of the dead tissue
113) A middle aged woman had operation on the perforated ~{!-!-~}. She has been unwell since the operation. She has difficulties in breathing. Despite of the full support from the high independent unit, her Po2 is 6.
114) patient post acute pancreatic attack has on c.t. scan have non-enhanced ~{!-~}.behind the tail of pancreas.
115) girl post chiken pox gets blue discoloration of skin after scratching ,it is spreading at the moment .
Theme 25. NATURE OF ANAEMIA
Folate deficieny
B12
Iorn deficiency
Sickle cell
B-thalassaemia trait
G-6PD
Hereditary spherocytosis
116) A boy brought hb 8, unconjugate bilirubin 120 mother says that anaemia is hereditary in the family
117) A Greek boy brought by mother says that he looks pale inspite of being normal
118) patient with severe menhorrgia and tired
119). A four year old boy has been having funny dietary pattern. He likes cheese and drinks 2 litres of milk a day. He looks pale and otherwise normal.
Theme 26. DYSPHAGIA
achalsia
Pill Striture
barrets
ca esophagus
post caricoid cancer
Phar Pouch
120) a 34 yrs aged plump woman has difficult in swallowing food, particularly after drinking alcohol and in the night.
121). A young girl (cannot remember this Q)
122). 45 yrs old man, he has difficulties in swallowing the food to start with, but the rest of the swallow is normal. He does not have regurgitation.
123). This Q is about a man has difficult in swallowing, and there is lump in his throat.
124) patient having difficluty in swallowing specially liquids ( did not mention about weight loss)
Theme 27. CERVICAL PATHOLOGY
cervical smear
cervical biopsy
colposcopy
125) young patient gets post coital bleeding. Speculum shows cervical epitopic
126) patient attend clinic because of CIN 1
127) patient with cin2 what will you do now
THEME 28. RESPIRATORY DISESE ---- this was given in an value form emq with clinical findings ?ecg and chest xray and temp given in serial order
pneumonia
p.e.
pulmonry edema
rupture of esophagus
m.i
pneumothorax
128) pt with fever ?basal consolidation and ecg normal
129) patient with surgical emphysema ( cant remebber the rest --for me this was enough >>)
130) patient with breathlessness and absent markings on chest x ray
131) patient with severe pin in chest and q waves in v 3
132) pt with severe pain in chest and q waves in v 1 to v3
Theme 28.Diagnosis of chest pain
Occupational asthma
Pneumothorax
Arotic dissection
Interstitial ~{!-~}
PE
133) A carpenter has chronic breathlessness, he does not smoke. He becomes normal when he goes away for holidays.
134). A woman has cough. On examination she has crept on her lung base. (not exactly)
135). 50 year old patient comes with severe pain in chest and now has breathlessness and difficult in breathing ecg shows gallop rhythm
136). A 50 yrs old man had severe chest pain under the sternal. He late had hemiparesis.
Theme 29. ASTHMA IN CHILDREN
Peak flow diary
Spirometry
Exercise test
No need investigation
CXR
137) a young girl has 2 episodes of breathless so far and she is on short acting broch-dialator and now she is fine. mother had eczema.
138) boy comes with sudden breathless and trachea deviated to the left -pneumothorax
139). A girl in the A&E, she is too breathless to have her peak flow checked.
140). A boy has asthma, and he is given some short acting dialator inhaler. His parents don~{!/~}t know when he should use it.
Theme 30. ANATOMY OF RENAL FAILURE
Bladder
Prostate
Parpilla
Medllary
Interstitum
Ureter
Renal artery
Cortex
141). A woman has not pass her urine for many hours (not exactly), on examination there is mass on super pubic
142). A old man has difficult in passing urine and drippling for long time
143). A woman of sickle cell disease has not passed urine for many hours
144). A woman has protein urine and oedema
145). Patient with hypertension and small kidney on one side
Theme 31. INVESTIGATION OF HEMATURIA
Ultra sound
Microscopy and sedimentation
Anti-strep. Trite
Cretinine
IVU
Urine osmolarity
146). A man came with haematuria, he says this runs in the family
147). A boy has fever, oliguriaand oedema.
148). A 56 yrs old woman had operation on her uterine cancer years ago now comes with haematuria
149) A man has been unwell for long time, now comes with hypertension and haematuria (cannot remember exactly, but sounded like he has got DM to me)
Theme 32 DIAGNOSIS OF HEMATURIA
Bladder cancer
HSP
SLE
Polystic kidney
150). A smoker with painless haematuria
151). A 40 yrs old woman has haematuria. She has got non-blanching purpura on her legs and back. (it is obviously HSP, but never come cross with somebody who is 40!!)
152). A man with haematuia, his father or somebody has got it.
Theme 33. Management of cardiac patients
Nitrates
B-bloker
AEC
Surgic intervention
Valve replacement
153). A patient has angina and he is on nitrates. He is having pains once a week although he has been taking his medication
154). A old woman has pains in her chest, angiograph shows 3 severe anterosclerotic lesions.
155). 65 old woman, has murmur and palpitation~{!-~}..(cannot remember)
Theme 34. Diagnostic tests for breast lump
FNA
Ultra sound
Mammagraph
Discharge cytosis
CT scan of the spine
X-ray of the spine
Duct-graphy
156). A young 24 yrs old woman with a breast lump. She has other lumps in the out quarter of her breast.
157). A young woman with a breast lump that varies in size according to her mense
158). 56 yrs old woman has blood stained nipple discharge. The discharge is from a solitary duct. Ultra sound and mammagraphy show normal
159). 48 yrs old woman has a breast lump in the upper out quarter of her breast. Mommagraph showed a solid lump.
160). A old woman had breast cancer which was operated a few years ago, now she has numbness on her chest.
Theme 35. Diagnosis of gastrienterology findings
Campy. Diarrhoea
Gastroenteritis
UTI
Carcinoma Colon
Acute appendititis
Salmonllia infection
161). A young boy has fever, nausea and vomiting for 24 hours
162). A pregnant teacher has diarrhoea and vomiting. The children with her all had same symptoms
163). A young boy has bloody diarrhoea and vomiting for one day
Theme 36. PREPARATION FOR PRE-OPERATION
ECG
CXR
FBC
Blood glucose
Angiography
CT
164). A old patient is due for his ~{!-~}. Operation. He has palpitation~{!-~}..
165). A woman due for her operation, she is amenarrhgic and tired
Theme 37. Bites and Stings
thick and thin blood film
lyme disease serology
leptospirosis serology
hep A serology
hep B serology
skin swab test
skin prick test
165). 28 yo policeman is brought to A&E after bitten by a drug addict while thef catch. There is a deep wound at his right hand.
166). 16 yo girl after forest walking, she had to remove an insect form her leg, now present with red raised ulcer.
167). 52 yo businessman present with fever and rigor after coming back form 10 days meeting at Zambia
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