SEPT 01 PLAB-1 EMQs

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Posted by jnt-ANAT on September 20, 2001 at 11:39:56:


SEPTEMBER 2001 PLABPART-1 EXAM
OPTH
a-eye washing
b-intraocular pressure
c-floureiscence stain
d-eye secretion swap culture
e-dactrocyst drainage
f-x ray of orbit
1---Blefarospasm, photophobia(?) when a gardener trimming
2---a pt p/w metal pieces to his eyes
3--- Headache, reduced vision in one eye(vomiting?,dilated pupil?)

a-do nothing
b-steroids
c-laser photocoagulation
d-pilocarpine
e-lens transplantation
-eye surgery
4---HT sudden visual reduction, red optic disc
5--- an elderly 80 yr old has some black spots on macula and vision reduction
6---vision reduction,ESR is high and elderly

LOC

a-diffuse brain damage
b-cerebral haematoma
c-extradural haematoma
d-subdural haematoma
e-temporal linear fracture
f-subarachnoid haematoma
g-epilepsy
h-depression
7---motorist with cascate has an accident—no localisation sign, bilateral plantar reflex-upgoing
8---Rugby player has had a blow to his head,. And lost his consciousness then he was fine. And in the house his wife found him unconsciousness
9---an elderly person, falling several times in last few weeks—he is well now(?)
10--- 47 yrs old man p/w suddenly starting severe headache, neck stiffness,loss of consciousness
11--- a pt p/w incontinance and drowsiness after some contractions

a-electrolyte and urate
b-lying and sitting BP
c-eeg
d-ambulatory ecg
e-rest ecg
f-laparotomy
g-urine analysis
h-chest x ray
i-blood glucose
j-ct
12---when a pt. gets up mornings ,falling down and become unconsciousness—most descriptive invest.?
13---a pt. everyday several times for few wks loss of consciousness without warning(?) and regain his consciousness in 2 min
14---a pt with severe abd. pain radiating to the back, BP:90/50 and still falling down
15---a pt with GCS:3 dilated pupils nonreactant

PSYCH

a-acute confusional state
b-dementia
c-Depression
d-Schiophrenia
e-posttraumatic stress disorder
f-hypomania
g-Korsakoff`s synd
16---80yrs old person taking some drugs(?), p/w agitation,disorientation in time and place
17---a high speed car driving—stopped by police.he is still speaking very fast in police station
18---A Kosovian person is always afraid of being killed, fear of a war and p/w agitation and stress—
19---a young lady lost his desire for everthing and lost her appetite, she wants to die.

a-tricyclics
b-fluexhetine
c-councelling
d-couple therapy
e-marital therapy
f-ECT
g-psychiatric surgery
h-lithium
i-carbamazepole
20---a dentist can cope with his work and life but there is lack of confidence
21---A young lady despite on antidepressant treatment, doesn`t eat or drink anything,loss of weight
22---a mother recently delivered a baby. Her first baby died. She is hiding her baby and believed that her husband will kill the baby
23---a pt comes with feeling low and depressive symptoms who had disinhibition,hyperactive, feeling very high before. Antidepressants didn`t help.
DRUGS
a-opioid overdose
b-opioid withdrawal
c-triclics intox


24--- a pt-agitated, dilated pupils(?),tremor. she demand her tablets which are not prescribed recently
25---a pt. p/w resp. rate: 6/min, drowsy, small pupil,non-reactant to light—


GIS

a-chest x ray
b-abd US
c-amylase level
d-brain CT
d-barium enema
e-laparotomy
f-stool culture
g-blood culture
h-bulk laxatives
i-stimulant laxatives
j-colonoscopy
k-sigmoidoscopy
26---a pt with severe epigastrium pain and tenderness, hypotension(?) resussitation in progress
27---After a cholecystectomy operation, a pt with hypotension,severe epigastrium pain radiating to back
28---After an abd. operation, a pt. p/w subfebril fever,distension(?),tenderness, constipation, no bowel sound
29---a pt comes with diarrhea and abdominal pain following a meal—stool culture, blood culture
30---after morphine abuse(?) a pt p/w constipation

a-candidiasis
b-Ebstain-barr
c-diffuse esophagial spasm
d-achalasia
e-esoph. Ca
f-pharyngeal pouch
g-barret`s esoph

31--- a known HIV(+) patient p/w pain in swallowing and some lesion in the mouth. The underlying tissue is red when the lesion is taken off
32---a pt comes with dysphagia for solids for 5 yrs and now p/w regurgitation(?) when he eats, it relieves a few hrs after meal
33--- 65 yrs old male p/w weight loss, difficulty in swallowing solid
34--- a pt p/w intermittent dysphagia for both solids and liquids and chest pain.no weight loss(?)
35--- a patient with difficulty in swallowing , filling defect,
36---a pt with regurgitations symptoms, associated with ca


a-chr. Pancreatitis
b-acute Pancreatitis
c-duodenal ulcer
d-gastric ulcer
e-gallstones

37--- a pt. with ALT and gamma GT are high and jaindice is found
38---a pt with gastric disturbances, relieved by eating
39---a pt has got some complaints just after eating something
40---cause recurrent infections,colic pains(?)

SCROTAL MASS

a-acute epidydimoorchitis
b-chr epididimoorchitis
c-Hydrocele
d-Varicocele
e-Teratoma
f-Seminoma
g-testis torsion
h-lymphoma
i-TB

41---a pt with swelling in testis,13 cm on US, removed, histologically cystic, smooth linear epithelium
42---a pt p/w severe testicular pain after massive exercise, operated, testis(?) colour was is blue
43---a pt p/w testicular pain and fever 2 wks after URTI, mass is separated from testis
44---a 23 yr old patient p/w scrotal mass,operated, and septal structure(?) and some surely malignant cells are found
45---a pt with scrotal mass, which is separated from testis, operated and histologically caseiting granuloma is found


METABOLISMA AND ENDOCRIN

a-familial hypercholesterolemia IIa
b-familial hypertrigliseridemia
c-obesite
d-diabetes
e-alcoholism(?)
46---13 yrs old female(?)—high cholesterol level(11.2) , tendon xantoma is found
47---a child(7 yrs old) with high level (7.1) triglyseridaemia
48---a pt (45 yr old) with both cholesterol(7.1) and triglyseride(3.1)-high

a-prolactin level
b-skull x ray
c-statin
d-fish oil
e-insulin
f-calcium level
g-carbimazole
h-proparanolol
49---a pt. p/w diplopia(?),weight gain,libido decreasing
50---a pt p/w angina,in blood test hypercholesterolemia is found..
51--- after thyroid surgery, a pt p/w numbness, perioral paraesthesia(?)
52---a pregnant woman p/w tachycardia,tremor, itching,sweating

CARDIAC and HYPERTENSION
a-alcohol reduction
b-b-blockers
c-ACE inhibitors
d-Stop smoking
e-exercise
f-digoxin
g-frusemide
h-thiazides
i-cardioversion(?)
j-amiodarone
k-partial myotomy
l-morphin iv
m-mannitol
n-surgical ablation

53---a pt with HT=160/95 mmhg, he consume 50 U/week –management?
54---a pt with HT –200/140 frusemide was given but HT still persists
55---a pt with oedema in the legs who takes frusemide but there is still oedema and dyspnoea
56---in close relatives, death when they are in their 40`ies. In echocardiography of that patient-subarachnoid thickness is found
57---a pt. in his childhood he had some feverish disease and took prednisolone(?) for 6 wks now p/w murmurs, finger swelling(?), subfebril
58--- a pt with crushing chest pain lasting 30 min
59---a pt with narrow complex tachycardia, adenosine has been given, but still there is tachycardia—next step?

NEXT STEP IN CARDIO
a-Echocardiography
b-ambulatory ecg
c-rest ecg
d-chest x ray
e-pacing
f-cardiac enzymes
g-drug toxicity
h-angiogram
i-eeg
60---a pt has got cardiac valve diseases for a long time now p/w JVP increase, dyspnoea, oeadema
61---everyday afternoon a pt –suffer from 2 hrs chest pain when working
62---Paradoxal pulse(?), QRS amplitude is low in all leads(maybe P2 and JVP is increased)—(following a viral inf(?)
63---a pt with lead II,III,aVF-ST elevation, pulse rate: 30/min
64---a young man found dead by his wife on ECG MI was found( maybe dilated pupils no reaction)- next step?


OBS&GYNE
a-Chlamidya
b-Gonorrhea
c-Syphilis
d-human papilloma virus

65---a woman with slight jaundice,deep dysparenue,pelvic and hepatic adhesion,fibroids(?)
66---cervical lesion, inflammatory, precancerous(?) or granulomatous

a-transvaginal us
b-cervical os exam
c-laparotomy
d-colposcopic examination(?)
e-abdominal US
f-lupus factor
g-fibroid studying(?)
67--- a lady doesn`t have menstruation for 7 wks,p/w vag. bleeding, cervical os is closed
68---a pregnant p/w bleeding, (us by GP :fetus is normal)
69 ---a pt with severe right lower abd. pain, pregnancy test(+), but no fetus in uterus(?)
70---a lady had DVT and 3 times miscarriage at 12, 14 and 13 wks and some fibroid tissue(?) or uterus tenderness
71---a woman p/w termination at 14 wks and at the moment ,at 20 wks, there is miscarriage
72---2 wks after delivery, there is still bleeding and uterus tenderness

INFECTION
a-toxoplasma gondi
b-candidiasis
c-CMV(?)
d-Syphilis
e-chlamidya
73---a pt with known HIV(+) p/w headache and confusion ,some neurological signs(?)
74---young man, lymphadenopathy,fever, dysuria, urethral lesion(?)

a-amoxicilline
b-cotrimaxozole
c-anti-tb drugs
d-corticosteroids
e-clarithromycin

75---a pt with cough , fever,had several influenza inf, CXR-lung lower lobe consolidation—tx ?
76--- a pt with known HIV(+) –Chest x ray-bilateral diffuse alveolar shadows—tx?
77---A pt student is getting fever,diarhhea(?) his friends has similar symptoms-tx?
78--- Pakistani man comes with cough, weight loss, sweating


WRIST TRAUMA

a-consult immediately to orthopediciant
b-correct and put in a cast
c-bandage and discharge
d-bandage and rewiev in hospital
e-x rays
f-x rays(including scaphoid wiev)
79---a pt with wrist injury-x-rays have been done, which are normal. There is slight swelling and pain
80---a pt p/w fell on outstretched hand
81---a pt fell on hand p/w swollen and tender wrist, movement are painful. X ray shows effusion(?)

UROLOGY

a-abd US
b-urine test
c-micturation cystogram
d-IVP
e-mefenamic acid
f-frusemide
g-thiazides
h-gentamycine
i-prednisolone(?)
j-amoxycilline(?)

82--- a child with a mass on abdominal palpation and haematuria(?)
83--- a congenital anomaly at the entrance of ureters to the bladder
84---a pt with severe loin pain radiating to scrotum
85---an agent which is toxic on renal system


a-polycsytic renal
b-UTI
c-renal colic
d-renal stones
e-Renal clear cell ca
f-bladder ca
g-PAN
h-IgA nephropathy
i-poststreptococcal glomerulonephritis

86---a lady with painless haematuria ,HT(?). Her both uncle and mother died from renal problems
87--- a pt with HT and skin nodules—PAN
88---a pt with renal involvement and haematuria after a viral infection(?)
89--- a pt. with haematuria and proteinuria(?) 2 wks after URTI
90--- an elderly person p/w weight loss,haematuria, anaemia(?) and a mass on abdominal palpation
91---a smoker for long years, weight loss- assocaiated with?

a-ACE inh
b-Decrease insulin dose
c-increase insulin dose
d-thiazides
e-b-blockers
f-frusemide
92---a pt with transplanted kidney-cret:700
93---a pt with renal disease( creat:700)DM,and HT(?)
94---a pt with a transplanted kidney p/w creatinine: 700
95---a pt. with renal disease(creatinine:700) p/w legs oedema,proteinuria

LUNG MANAGEMENT

a-pleural biopsy
b-V/C scan
c-chest x ray
d-echocardiography
e-medianoscopy
f-bronchoscopy
g-sputum culture
h-sputum EZN

Most descriptive investigations:
96---a man who has been worked as boil…(?) for 20 yrs p/w dyspnoea and pleurisy –most descriptive investigation?
97---a pt 40 yr smoker, weight loss, fullness in his chest
98--- Pakistani man comes with cough, weight loss, sweating
99---after an abdominal surgery, dyspnea, chest pain

DIAGNOSIS

a-sarcoidosis
b-COPD
c-allergic asthma(?)
100---(?)wheezing, PaO2 is low, Pa CO2 is high
101---bilateral hilar opacities, ACE is high – diagnosis?

a-analgesia
b-chest drain
c-chest bandage
d-do nothing(?)
101--- a pt with last 2 ribs are fractured but there is no dyspnea or pneumothorax
102--- a pt. after trauma p/w tranverse fracture on sternum no other signs or vital sings
103---Apical pneumothorax on x ray,dyspnea but otherwise normal

BREAST CA

a-Hypercalcemia
b-Metastasis
c-cord compression
d-femur head fracture(?)
e-DM(?)
f-lymphoedema

104--- pt with breast ca-p/w thirsty,polyuria , polydipsia,tiredness—
105--- after breast surgery for ca,arm swelling(maybe legs too)
106--- after breast surgery for ca,headache, dysphasia(?)diplopia(?)
107---a pt with breast ca p/w back pain, leg pain, sphincter disturbances

NONACCIDENTAL INJURY

a-accidental trauma
b-normal sign
c-sexual abuse
d-physical abuse
e-neglect
f-ITP

108 ---a newborn baby with some black spots on the buttock, whose parents- one is white man and the other black women
109--- 8 yrs old girl, recently started horse- riding course p/w bleeding in urination and dysuria but urine investigation is normal , pre-pubertal exam is normal, abdominal exam is normal(?)
110---a child with poor hjyenic conditions and ear wax
111---a child with some bruises on the hands after her parents hold, epistaxis

ANATOMICAL SITES OF NECK LUMPS:

a-cervical rib
b-thyroglossal cyst
c-bronchial cyst
d-lymph node
e-thyroid gland(?)
f-subclavian aneurysm
112---posterior part of the neck, full-filling image
113---between hyoid and … structure—thyroglossal cyst
114--- in front of sternoclaudomastoid muscle, placed deeply
115---at the base of anterior triangle(?) pulsatile mass

BURNS

a-iv line
b-nasopharyngeal airway
c-oropharyngeal airway
d-endotracheal intubation
116---10% burns of a child`s body and dehydration
117---burns of nose and face,breathing difficulty(?)

DEVELOPMENTAL STEPS

a-one week
b-2 weeks(?)
c-6 weeks
d-3 months
e-6 months
f-9 months
g-1 yr
h-2 yr
i-3 yr
j-4 yr

118--- copies circle, can say 4 words,
119---smiles responsively, Head lags
120---can walk 4 steps upstairs
121---holds head up at 45° when prone, vocalise

ANATOMIC LOCALISATION OF MS

a-optic disc
b-optic nerve
c-optic radiation
d-cerebellum

122---a pt with MS p/w blurred vision,optic disc pale
123---a pt with MS p/w intension tremor,ataxia


IMMUNISATION

a-hep A immunisation
b-hep B immunglobulin
c-hep B vaccine
d-leptospirosis
e-leishmaniasis(?)
124---sea shell products
125---sawage workers-immunisation
126--- swimmers
127---health stuff who are related with blood products-immunisation
128--- it is done to prevent esp. Hepatic Ca—hep B vaccine

EAR

a-ear wax
b-varicella zoster
c-trigeminal nevralgia
d-temporal petrosal fracture
129---a pt.had a blow to his head during a fight p/w hearing loss
130---a pt. withpoor hjyenic condition p/w hearing loss
131---pain on one side of face, and blisters in the ear

RHEUMATOLOGY

a-transient synovitis
b-septic arthritis
c-slipped femoral epiphysis
d-JRA
e-Felty`s synd
f-gout
g-myeloma
132---a pt with all movements are restricted, he is better now and there isn`t any complaints
133---a child , hip abduction is limited
134--- a child with fever and all movement are restricted
135---RF(-), fever(?), swollen fingers(?)
136---RA with infections and splenomegaly,Hepatomegaly(?)
137---a pt postop, serum uric acid increase,first metacarpal pain
138---a pt with backache,ESR is high

ANAEMIA

a-chr.blood loss
b-RA
c-pernicious anaemia
d-haemolysis
e-B-thalessemia
f-alcoholism
g-sickle cell anaemia

139---MCV:85 Hb :9.1 ret:<1% ESR is high
140---Ret:9%,MCV:82 Hb:7.5
141---Ret:1%,MCV:85 Hb:7.2
142---MCV:106,ret:<1%,Hgb:9.2 smear: target cells
143---a black child,MCV:72, Hgb:8.6,ret:6


NOSE BLEEDING

a-anterior pack
b-posterior pack
c-anterior pack and posterior pack
d-electrocother
e-surgery
144--- there is just blood clotting in the nostrils bleeding has stopped
145---a pt with nose bleeding , on exam vascular damage is found, there is still some leakage

ANOTHER

a-central venous line
b-intraosseos fluid injection
c-fresh frozen plasma
146---a pt on anticoagulant , INR is high p/w deep anaemia(?) or bleeding
147---13 yr old girl with severe dehydration—despite every effort no success for iv line—central venous line
148---2 yr old girl with severe dehydration—despite every effort no success for iv line


OTHERS
149---headache,papillaedema—ct of the brain
150---(?)a known diabetic young person p/w perspiration, fell down from the sofa( or exercise?)—hypoglycemia
151---Calf tenderness,mild fever,swelling—heparin
152---Papiledema,neausea, vomiting—mannitol
153---one question on stroke( the answer was stroke)



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