Posted by FLORA on January 11, 2002 at 08:04:04:
1.THEME:Management of diarrhoea in children.
OPTIONS:
a.5% dextrose
b.0.9%saline
c.5% dextrose and .45% saline
d.50 ml per kg ORT over 4 hours
e.150 ml per kg ORT over 4 hours
f.150 ml per kg ORT over 24 hours
g.Amoxicillin
h.Trimethoprim-Sulphamethoxazole
i.Anti diarrhoeals
j.Anti emetics
j Lactose free diet
1.8 month old child with h/o diarrhoea 8 episodes in the last 24 hours
2.Child with diarrhoea and vomiting for past 3 days.
3.Child with Shigella dysentery.
4.A bottle fed baby with diarrhoea,urine reducing substance positive
2.THEME:Diagnosis of injury in children(NAI or not)
OPTIONS:
a.Fracture
b.Non accidental injury
c.Accidental injury
d.Normal finding
e.Henoch Schonlein Purpura
f.ITP
g.Leukaemia
h.Sickle cell anaemia
5.10 Y old boy with h/o fall from cycle.o/e lower leg swelling and deformation.
6.8 month old child with large blue patch on the bottom.Father Caucasian, mother- African
7.10 Y old girl brought to the A&E by her stepfather.o/e girl has petechial lesions around her waist and ankles
8.5 y old girl develops sore foot after playing football at her school.GP is concerned about patches of different colours on her lower legs.Otherwise the girl’s examination is normal.
3.THEME:Investigations of wrist fractures
OPTIONS:
a.Isotope Scan
b.Xray wrist AP,lateral with views of scaphoid
c.Refer to Ortho.
d.Xray thumb
e.Plaster cast of wrist
f.Discharge with advice
g.Physiotherapy
9.10 y old boy comes with h/o fall on his hand.Xray of thumb reveals no fracture.
10.12y old comes with h/o fall on his hand.
11.18 y old comes with h/o fall on his hand.Xray wrist reveals impacted fracture lower hand on the left.
4.THEME:Investigations of dyspepsia
OPTIONS:
a.24 hour ambulatory oesophageal ph monitoring
b.Oesophageal manometry
c.Endoscopy
d.Fecal occult blood.
e.No investigation needed at present
f.Helicobacter pylori serology
g.Barium meal
12.50 yr old obese woman with h/o pain in the epigastrium which comes on at night and wakes her up .She also complains of cough and ?water brash.
13.Woman with h/o pain in the stomach after a fundoplication operation
14.woman with long h/o peptic ulcer disease with positive H.pylori.Has not had an xamination for the past 4 yrs, now presents for a check up.
15.36 y old man who has been treating himself for dyspeptic symptoms for several years.
16.A man who has a stressful job presents with history of epigastric pain for past 2 years .He smokes about 20 cigarettes per day
5.THEME:Diagnosis of Antepartum haemorrhage
OPTIONS:
a.Abruptio placenta
b.Placenta praevia
c.Vasa praevia
d.Velamentous insertion
e.Show
f.Ca cervix
g.Trauma
17.21 y old primi with h/o hypertension presents with acute abdominal pain.O/e uterus is tender to palpation and BP-90/40
18.20 Y old primi with h/o painless, bright red vaginal bleed over past 3 hours.o/e fetus transvere lie
19.26 y old in labour with blood and mucus
20.38 y old woman, 4th gravida with h/o blood and mucus.o/e vagina red and ulcerated
21.27 y old primi with h/o post coital bleed
6.THEME:Diagnosis of Head injury(EDH,SDH,mild,moderate)
OPTIONS:
a.Extra dural haematoma
b.Subdural Haematoma
c.Mild head injury
d.Moderate head injury
e.Severe head injury
f.Fracture base of skull
22.45 y old alcoholic with h/o recurrent falls was brought to A&E by his wife in a confused state.
23.23 y old footballer brought to the A&E.Was talking to the paramedics well after injury but subsequently lost consciousness
24.7 y old boy with h/o fall from cycle.Lost consciousness initially but alert, oriented now.Xamination reveals no abnormality.
25.38 yr old man h/o fall.o/e haemotympanum present
26.42 y old man fell down .o/e GCS-13.
7.THEME:Investigations of vaginal bleed
OPTIONS:
a.Endometrial Sampling
b.21 day Progesterone
c.Full blood count
d.Colposcopy
e.D&C
f.Vaginal ultrasound
27.45 y old woman who attained menopause 2 yrs back presents with an episode of vaginal bleed.
28.14 y old girl ,menarche at 12 has been having regular periods so far.Past 4 cycles , she has been having heavy bleed and appears exsanguinated now.
29.West Indian woman 33 y old with h/o menorrhagia and dysmenorrhoea.
30. 23 y old woman on OCP presents with vaginal bleed.
8.THEME:Management of burns
OPTIONS:
a.Escharatomy
b.Intravenous fluids
c.Intubation
d.Aspiration of blisters
e.Deroof blisters
f.Estimation of COHB level
g.Fasciotomy
h.Debridement
i.Cold irrigation
31.Man with full and partial thickness burns from his elbows to hands.
32.Man rescued from burning house with singed nostrils asking for his other family members
33.Man with burns over chest and anterior thigh.
34.Patient presented with scalds with large tense blisters
9.THEME:Mechanism of action of contraceptives(COCPs, IUCD,Mirena coil,POP,vaginal sponge,Depot Progesterone)
OPTIONS:
a.Inhibition of tubal motility
b.Inhibition of ovulation
c.Production of hostile cervical mucus
d.Inhibition of implantation
e.Spermicidal
f.causes miscarriage
35.COCPs
36.IUCD
37.Mirena coil
38.POP
39.Vaginal sponge
40.Depot Progesterone
10.THEME:Management of visual loss(SLE,drusen,cranial arteritis,glaucoma,prolif. retinopathy)
OPTIONS:
a.Eye operation
b.LASER treatment
c.Intraocular Steroids
d.Oral steroids
e.Intravenous steroids.
f.b-blocker drops.
g.No treatment effective
41.68 y old male with 3 month h/o pain and diminished vision in left eye.Pain increases towards evening.Peripheral vision constricted.o/e glaucomatous cupping seen.
42.58 y old male with right sided headache and pain R eye.
43.45 y old diabetic with proliferative retinopathy of right eye. Left eye shows retinal haemmorhage on fundoscopy.
44. 78 y old female with decreased visual acuity.On retinoscopy macula shows pigmentation bilaterally.
45.44y year old woman with h/o SLE has diminished vision .
11.THEME:Management of post menopausal conditions(atrophic vaginitis,prolapse)
OPTIONS:
a.Vaginal oestrogens
b.Cyclical OCPs
c.Continuous OCPs
d.Ring pessary
e.Transdermal oestrogen patch
f.POP
g.Bihosphonates
h.Prevent infection measures
46.78 y old woman sexually active complains of dyspareunia and vaginal dryness.
47.45 y old woman who has attained menopause 2 yrs back complains of weight gain and depression.
48.54 y old woman who has had irregular period for last 3 months c/o flushing, mood swings,weight gain.
49.84 y old woman with 14 issues c/o feeling of something coming down per vaginum
50.32 y old woman with menopausal symptoms,underwent hysterectomy for some pathology.She cannot take oral preparations.
51.53 y old woman who has attained menopause c/o constipation, excess thirst.X Ray shows bone rarefaction.
52 Woman diabetic, post menopausal presents with frequent vaginal and vulval pruritus.
12.THEME:Investigation of acute abdomen(ureteric colic,peptic ulcer rupture,AA,appendicitis,pseudocyst)
OPTIONS:
a.Chest Xray
b.Serum Amylase
c.Abdominal USG
d.Laparotomy
e.Laparoscopy
f.TOE
g.CT
h.Observation only
i.ECG
53.Male with h/o APD (acid peptic disease)presents with 24 hr h/o acute abd pain.o/e board like rigidity abdomen and no bowel sounds.
54.Man with h/o intermittent claudication and IHD presents with tearing pain radiating to back.o/e BP-90/ 40
55.female with h/o pain started in loin.Radiating to groin now.
56.14 Y old boy with h/o abd pain periumbilically.Pain had spread to the Right iliac fossa.Now no pain.o/e mass palpable in right iliac fossa and no pain now.
57.Man with h/o injury to upper abdomen.Now o/e a mass palpable in epigastrium.
13.THEME:Diagnosis of Deafness
OPTIONS:
a.Acoustic Neuroma
b.Noise induced deafness
c.Temporary shift of threshold of hearing
d.AOM with effusion
e.Meniere’s disease
f.Otosclerosis.
g.Adenoids
58.18 year old presents with deafness of 1 day duration after a night out at the local dance club.
59.8 year old girl found to be deaf at a school hearing test.After 1 week mother notices that girl is fine and can hear well.
60.40 y old man with h/o vomiting, vertigo and tinnitus .o/e low sensorineural deafness of left ear.
61.23 y old lactating mother presents with hearing loss.After 9 months post partum ,she can hear well again.
62.40 y old man with family h/o deafness.o/e conductive deafness -left ear.
14.THEME:Investigations of Epilepsy
OPTIONS:
a.CT scan
b.Blood glucose
c.EEG
d.ECG
e.MRI
f.blood levels of anticonvulsant
63.14 y old girl with well controlled epilepsy so far presents with recurring seizures.Dose of Valproate on which the girl is, has been increased several times .Still she has convulsions.
64.8 year old boy with h/o 2 episodes of seizures in his sleep.The seizures start as twitching of mouth followed by generalized convulsions lasting for about 3 mins.He is all right in the morning.
65.12 y old boy with generalized tonic clonic convulsions lasting for about 5 minutes.
66.23 yr old man with h/o diplopia , headache and seizures.
15.THEME:Investigations of stroke
OPTIONS:
a.Blood cultures
b.ECHO
c.Doppler ultrasound of neck
d.CT scn
e.ECG
67.32 Y old woman 1 week after cholecystectomy presents with left sided weakness.o/e she has a murmur precordially and is febrile,temperature being 37.7 deg C.
68.42 yr old woman presents with hemiparesis.Examination reveals a bruit in the neck.
69. 23 y old woman with neck stiffness.No vomiting.Drowsy
16.THEME:Diagnosis of Dementia
OPTIONS:
a.Huntingtons chorea.
b.Alzheimers Dementia
c.Pseudodementia
d.Multi infarct dementia
e.AIDS dementia
70.Commonest dementia in UK.
71.dementia characterized by senile plaques and neurofibrillary tangles.
72.Dementia responsive to anti depressants
73.Family h/o dementia and characterized by early death.
74.Dementia common in hypertensives.
17.THEME:Investigations of Thyroid conditions
OPTIONS:
a.THRH
b.TSH
c.T3 levels
d.No investigation reqd now
e.USG
f.FNAC
75.woman presently taking Thyroxine for Hypothyroidism.Has come for assessment of Thyroid function.
76.13 y old girl with diffuse swelling of thyroid.No symptoms of dysthyroid function.
77.Woman with thyroid swelling, sweating and tremors of hands.
78.32 y old man with swelling on 1 side of Thyroid gland.
79.Man with unilateral swelling of Thyroid.USG shows nodular lesion which is not cystic.
18.THEME:Diagnosis of nerve injury
OPTIONS:
a.Musculocutaneous Nerve
b.Common Peroneal Nerve
c.Sciatic Nerve
d.Axillary nerve.
e.Median Nerve
f.Femoral Nerve
g.Radial Nerve
h.Facial Nerve
i.Glossopharyngeal Nerve
80.Man with h/o fall.Injury to shoulder.o/e region of anaesthesia over the lower part of shoulder.
81.Child with h/o fall.Has injured his arm.Fracture mid shaft of humerus.Presents with wrist drop.
82.Man with h/o injury to lower leg.Restriction of dorsiflexion of Left foot and region of anaesthesia over foot.
83.Man presents with injury to medial epicondyle of humerus.There is region of anaesthesia on dorsum of hand.
84.Man with injury to back of his upper thigh.Weakness of hamstrings.
85.Loss of taste anterior two thirds of tongue.
86.Woman presents with loss of voluntary movements lower part of face.Senstion and movements preserved in the upper part of face.
19.THEME:Diagnosis of chest pain
OPTIONS:
a.Pericarditis
b.Musculoskeletal pain
c.Pneumonia
d.Stable Angina
e.Unstable Angina
f.Myocardial Infarction
87.Patient presents with chest pain related to movement.Post MI
88.Man presents with cough, fever,chest pain , more on inspiration.
89.Woman who used to have chest pain on walking some distance now presents with chest pain even at rest.
90.45 y old diabetic presents with 2 hour h/o central, crushing chest pain.
91.Man presents with chest pain on climbing up the stairs.
20.THEME:Investigations of chest pain/dyspnoea
OPTIONS:
a.V/Q scan
b.ECG
c.Echo
d.Spiral CT
e.Chest X Ray
92.Woman with 3 day h/o cough, sputum and chest pain.
93.Woman on OCP with h/o DVT
94.Man with h/o crushing chest pain.
21.THEMES:Diagnosis of Pneumonia
OPTIONS:
a.Streptococcus pneumoniae
b.Legionella
c.Mycoplasma
d.Pneumocystitis carinii
95.Woman with 3 day h/o cough and purulent sputum.Febrile on examination.
96. 18 y old boy returns home after stay in some country.He presents with fever, cough and diarroeal episodes.
97.Woman presents with fever, cough.Blood examination shows cold agglutinins.
98.IV drug abuser presents with fever, rigor and chills.C XR shows fine, perihilar mottling.
22.THEME:Terminal Care
a.Metronidazole gel.
b.Hyoscine
c.Haloperidol
d.NSAIDS
e.Palliative Xray therapy
f.Lactulose
g.Biphosphonates
99.Woman with Ca breast presents with weeping lesion of breast.
100.Man with Ca bronchus presents with intractable hiccups.
101.Man with excessive salivary and bronchial secretions presents with rattly breathing due to excess secretions.Relatives are concerned.
102.Woman with terminal hepatocellular CA presents with ascites and hep. Encephalopathy.
103.Man with Ca Prostate presents with intractable backache.
104.Woman with Multiple Myeloma presents with thirst,constipation .
23.THEME:Metabolic parameters in Renal conditions
OPTIONS:
a.Haemolytic Uraemic Syndrome
b.CRF
c.Renal Tubular Acidosis
d.Nephrotic Syndrome
e.Acute Glomerular Nephritis
f.SLE
105.Increased urea, inc.creatinine,anaemia, fragmented RBCs,hypertension
106.Inc urea, inc creatinine,hyperkalemia
107.Normal urea,normal creatinine,hyperphosphatemia
108.Proteinuria, hypoalbuminaemia,
109.Hypertension,hematuria
110.Hypertension,glomerular crescents on microscopy
24.THEME:Diagnosis of chronic abdominal conditions(IBD,IBS,Carcinoma.appendiceal mass
OPTIONS:
a.Ulcerative colitis
b.Irritable Bowel Syndrome with diarrhoea
c.Irritable Bowel Syndrome with constipation
d.Sigmoid colon carcinoma
e.Appendiceal mass
f.Diverticular disease
g.Chrons disease
111.72 y old man presenting with confusion.o/e faeces filled in colon.h/o Weight loss,tiredness present.
112.22 y old woman presents with diarrhoea for the past 7 months , she has abdominal pain relieved by passing motion.
113.14 y old boy with h/o pain right iliac fossa.Now there is a mass present on examination.
114.Man presents with h/o bloody diarrhoea and mucus past 6 months.Pathology shows granular mucosa.
25.THEME:Management of backache(IVDP,inj to spine in malignancy,musculosk pain in back)
OPTIONS:
a.Bedrest
b.Traction
c.Surgery
d.Admit in hospital
e.Skeletal metastasis
f.Neurological problem
115.Man who has moved a cupboard in his house some time back presents with h/o backache ever since.
116.Man with sudden h/o lower backache.Now has loss of sensation in his perineum and inability to pass urine.
117.Man with h/o fall yesterday and backache and urinary retention ever since.CXR shows suspicious lesions- 1 in the apex of lung and the other at base.
26.THEME:Epistaxis(Ca maxillary antrum,sepsis post nasal polyp surgery,fracture ethmoid etc)
OPTIONS:
a.Maxillary sinusitis
b.Ca –maxillary antrum
c.Sepsis
d.Fracture ethmoid
e.Fracture nasal bone
f.Allergic rhinitis
g.Vasomotor rhinitis
h.Rhinitis Medicamentosa
118.Woman with 3 month h/o headache, pain over maxillary antrum,epistaxis.Xray of sinus reveals clouded mastoid.
119.Woman presenting with headache,nasal discharge,and blocked nose- 1 week history.Tenderness over maxillary sinus present.
120.11 y old boy with h/o fall.He had epistaxis initially but now only clear fluid dripping from his nostrils.
121.Man who had a nasal polyp surgery a week back now presents to the A&E with epistaxis.
27.THEME:Side effects of drugs-Chloramphenicol,Lithium,Carbamazepine etc
OPTIONS:
a.Aplastic anaemia
b.Check blood levels
c.TFTs
d.LFTs
e.Dexamethasone
122.Chloramphenicol cozes this.
123.Woman with h/o manic depressive illness on Lithium treatment presents with tremors of hand.
124.Woman on Lithium treatment presents with depression, weight gain, cold intolerance and lethargy.
125.Woman with Ca Breast with cerebral metastasis on Carbamazepine treatment for convulsions presents with confusion.
28.THEME:Diagnosis of Leukaemia
OPTIONS:
a.CLL
b.CML
c.ALL
d.Auto immune hemolytic anaemia
e.Myeloproliferative disorder
f.Sickle cell anaemia
g.ITP
h.Haemophilia
126.Elderly person presenting with massive lymphadenopathy and splenomegaly
127.Elderly man with spenomegaly and Philadelphia chromosome positive
128.Woman with antibodies in blood.
29.THEME:Diagnosis of urinary obstruction(BPH,Ca Prostate,clot retention)
OPTIONS:
a.BPH
b.Ca Prostate
c.Clot retention
d.Bladder stone
e.Urethral stricture
129.65 y old man who has been drinking large pints of beer since afternoon now presents to A&E with inability to pass urine.
130.Man wit h/o painless haematuria and weight loss now presents with acute inability to pass urine.
131.Man with h/o wt loss, backache now has progressive difficulty in passing urine
30.THEME:Invest in malignancies
OPTIONS:
a.PSA
b.PAP
c.skeletal survey
d.Thallium scan
e.Technitium scan
f.Abd USG
132.Man with prostatic carcinoma on GnRh analogues now comes for follow up.
133.Man diagnosed as Ca prostate now presents with severe backache
134.Man with Ca Prostate which has spread beyond the capsule now presents with renal failure.
31.Met alkalosis,acidosis,resp alkalosis,acidosis etc
A.Metabolic acidosis
B.Metabolic alkalosis
C.Respiratory acidosis
D.Respiratory alkalosis
E.Hypokalemia
F.Renal failure
135.A man having projectile vomiting due to pyloric stenosis with hypokalemia and base excess
136.A man with villous adenoma of rectum with diarrhoea
137.A man with pulmonary embolism with tacycardia and hypotension and breathlessness
138.A man with pallor,dryskin and anuria
32.THEME:Management of asthma
OPTIONS:
a.Intravenous steroids
b.Short acting B- agonist (inhaled)
c.Short acting b-agonist(nebuliser)
d.Long acting b-agonist
e.Na chromoglycate
f.Leukotriene receptor antagonist
g.inhaled steroids.
h.Theophylline
i.Aminophylline iv
jAvoid smoking
k.Avoid allergens
139.Boy presenting with acute severe asthma to A&E.
140.Boy has diagnosed first time h/o asthma.Comes to u for medication.
141.Man who has nocturnal wheeze inspite of being on twice daily b-agonists
142. 6 y old girl who presents with wheeze when brother plays with his friends cat.
143.3 y old girl whose parents are smokers coughs everytime they smoke.
33.THEME:Management of cancer pain
OPTIONS:
a.TENS
b.NSAIDS
c.Palliative Xray
d.Opiates
e.Calcium supplements
f.Pamidronate
g.HRT
144.Man with Ca prostate c/o backache which prevents him from sleeping.Already on opiates.
145.Woman with Multiple Myeloma oresents with features of hypercalcemia. Xray shows bony rarefaction and this is cozing her great pain.
146.Woman with Ca breast has pain in her elbow.
34.THEME:Management of Shingles
OPTIONS:
a.iv Acyclovir
b.Oral Acyclovir
c.Amitriptyline
d.SSRIs
e.Paracetamol
147.Woman with Ophthalmic Herpes.
148.Boy with Lymphoma has developed Herpes.
149.Woman with Herpetic neuralgia
150.Man with pain along disrtribution of intercostals nerve but no lesion over the region.
35.THEME:Management of meningitis
OPTIONS:
a.Parenteral Penicillin
b.Plasma expansion
c.CT scan
d.Lumbar puncture
e.Sputum for AFB
151. 8 Y old child presents with fever and rash over his whole body.GP is waiting for paediatricians advice.
152.Child with meningitis has been started on Antibiotics.He is still febrile and drowsiness has increased.
153.Woman returned from Pakistan to meet her family at UK presents with meningitis.
154.IV drug abuser has high, fever, headache and vomiting.
36.THEME: Resuscitation-immediate management post trauma
OPTIONS:
a.Splint fracture
b.gain IV access and Intravenous fluids
c.GAIN iv access and Blood transfusion
d.Intubation and ventilation
e.Open airway
f.CT scan
g.Cervical spine immobilization
h.ECG
155.12 y old girl involved in RTA.Vitals stable,breathing is rattly.Resp rate- 30 per min
156.Man involved in RTA.Pale , tachycardia present.PR-120 per min, BP-90/40.thigh deformed and ecchymoses present over it.
157.Woman involved in RTA .Left side shows injury.Cold peripheries.BP-90/?
158.Man in an RTA, brought to A&E.GCS-3
159.Man in RTA brought to A&E with head injury.PR-50 per min and BP-140/96
37.THEME:Complications of Myocardial infarction
OPTIONS:
a.Atrial fibrillation
b.Ventricular tachycardia
c.Chordae tendinae rupture of mitral valve leaflet
d.Ventricular rupture
e.Pericarditis
f.Pulmonary embolism
g.Acute pulmonary oedema
h.heart block
160.Man post MI presents with syncope.HR=40 PER MIN
161.Man post MI presents with palpitations and breathlessness.O/E pulse irregular and rate – 120 per min
162.Man post MI presents with chest pain.Positional variation of pain present.ECG shows saddle like ST elevation in ant leads.
163.Woman post MI presents with syncope. O/e systolic and diastolic murmur audible at apex.
164.Man 1 week post cholecystectomy presents with an MI.4 days after MI he presents with dyspnoea, tachycardia and frothy sputum.
38.Diagnosis - delirium,dementia
OPTIONS:
a.Delirium
b.Late onset Schizophrenia
c.Alzheimers Dementia
d.H.chorea
e.Korsakoff psychosis
f.Psychotic depression
165.Woman who stays alone, looked after by neighbours presents at a shop at 6 o clock in the morning. Neighbours say she has had for the past 2 years slow forgetfulness.
166.Man who has been admitted in the medical ward , on the third day screams at staff and nurses saying that they r going to kill him.
167.Man who has had surgery shouts and screams as he regains consciousness
168.Woman brings her husband to the casualty saying that he has been behaving strangely for the past 3 days.
169.Man hears voices commanding him to risk his life.
39.THEME:Prevention of bleeding-wrist injury in child due to broken glass,wrist inj. in borderline female pt etc,GAIN IV ACCESS
OPTIONS:
a.Apply pressure to site of bleeding
b.gain intravenous access and transfuse fluids
c.gain iv access and immed transfuse blood.
170. 5 yr old child fell on broken glass.Wrist has been slashed by the glass and profuse bleeding from the wound site.Nurses r trying to get an iv access.
171. 20 y old woman who has attempted suicide by slashing her wrists claims that she wants to live no more.
172.Male with suspected splenic injury involed in RTA presents with pallor, tachy and ?BP
40.THEME:Pre operative investigations(Spirometry.,CXR,Angio,ECG,b.sugar,ECHO)
OPTIONS:
a.Spirometry
b.CXR
c.Angiogram
d.ECG-24 hour monitoring.
e.Blood sugar
f.ECHO
173.Woman with h/o COPD needs hysterectomy.CXR reveals no abnormality.
174.Woman with Diabetes needs a laparotomy.
175.Man who has been posted for a cholecystectomy is a known IHD patient.He now has syncope.ECG taken preoperatively shows a LBBB.
176.Man with Rheumatic heart disease has a mid systolic murmur and click on auscultation.Posted for surgery under GA tomorrow.
177.Woman with cough and fever 1 week back has been posted for a sterilization operation tomorrow.
Follow Ups: