Question: A 7 year old girl is brought by her mother with bright red staining of her underpants. She also gives a hx that her daughter recently started taking horse riding lessons. What is the single most appropriate next action?
a. Local exam
b. Exam under GA
c. Continue regular child care
d. Inform child protection services
e. Coag profile
Answer: (b)
Question: A 7 day baby whose birth weight was 3.5 kg and now is 3 kg. What is the most appropriate next step?
a. Check child protection register
b. Nutritional assessment
c. Skeletal survey
d. Continue regular child care
e. Inform police
Answer: (d)
Question: A 6 year old child fell on his nose 2 days ago. His parents have now brought him with difficulty in breathing. Examination: fever, nasal bones are straight. What is the single most likely diagnosis?
a. Nasal polyp
b. Septal hematoma
c. Septal abscess
d. Deviated nasal septum
e. Fx nose
Answer: (c)
Question: A 12 year old patient came to the OPD with complaints of fever, malaise, weight loss, anorexia and productive cough. Examination: temperature=39C, pulse=100 bpm. His mother says that he has a hx of recurrent chest infections and he is not thriving well. What is the single most likely causative organism?
a. Pneumococcal pneumonia
b. Staphylococcus
c. Mycobacterium TB
d. Pseudomonas
e. PCP
Answer: (d)
Question: A 3 year old child brought by his mother. Examination: bruises on the buttocks. Mother also gives hx of runny nose 2 weeks ago. What is the single most appropriate next action?
a. Check child protection register
b. Coag profile
c. Skeletal survey
d. Continue regular child care
e. Inform police
Answer: (b)
Question: A 4 year old is brought to the ED by ambulance. His mother reports that he has been unwell with a sore throat for 8h. He is sitting on his mother’s knee and is tolerating an oxygen mask but looks unwell. He has constant noisy breathing and he is drooling saliva. His temp=39C. What is the most important diagnosis?
a. Acute asthma
b. Bronchiolitis
c. Croup
d. Epiglottitis
e. Tonsillitis
Answer: (d)
Question: A patient with terminal cancer is being treated with chemo and develops tingling and numbness of the fingertips of both arms. What is the single most likely cause of the symptoms?
a. Bone mets to cervical vertebrae
b. Post-chemo neuropathy
c. Hyponatremia
d. Hypocalcemia
Answer: (b)
Question: An 80 year man has a permanent catheter. Catheter specimen urine found lots of e-coli. What is the single most appropriate management as he wants to attend his daughter’s wedding next week?
a. Change the catheter
b. Prolonged antibiotics
c. Bladder wash
d. Repeat MSU after wedding
e. Reassure
Answer: (a)
Question: A 35 year old male typist who suffered a scaphoid fx was treated with a scaphoid cast. After 2 weeks when the cast was removed for a review XR, it was found that he had problems in moving the thumb, index and middle fingers. What would you suggest as the management for the recent prb?
a. Release of flexor retinaculum
b. Release of common flexor sheath
c. Release of palmar sheath
d. Ulnar nerve release
e. Fasciotomy
Answer: (a)
Question: A patient on insulin is booked in for a hernia operation. What is the most appropriate management of insulin?
a. Give insulin and saline pre-op
b. Stop insulin for the duration of the op
c. Give IV insulin + dextrose + saline pre-op
d. Give insulin as usual pre-op
e. None
Answer: (c)