Question: A 67 year old man presents to the ED with pain in his left groin. He suddenly collapses and is not able to move or lift his leg. He is on alendronate. What is the diagnosis?
a. Fx of neck of femur
b. Post hip dislocation
c. Fx of shaft of femur
d. Pelvic base fx
e. Peripheral vascular disease
Answer: (a)
Question: A young male met with a RTA and is suspected to have a femur fx. His BP is 90/60mmHg. What is the next immediate action?
a. XR
b. IV fluids
c. Put leg splint
d. Send bloods for investigation
e. US
Answer: (c)
Question: A 70 year old patient presents with cough and SOB. He stopped smoking cigarettes 2yrs ago but has a 50yr smoking hx before quitting. CXR=consolidation and bilateral bihilar lymphadenopathy. What is the best investigation for this patient?
a. LN biopsy
b. Pleural fluid cytology
c. CT
d. MRI
e. US
Answer: (a)
Question: A 27 year old patient met with a RTA. While the NGT is passing, bowel sounds are heard in the chest. CXR shows NGT curls. What is the diagnosis?
a. Diaphragm rupture
b. Aortic rupture
c. Splenic rupture
d. Bowel rupture
e. Liver rupture
Answer: (a)
Question: A 62 year old man diagnosed with T2DM with BMI=33. Lifestyle modifications have failed to control blood sugar. Labs: urea=3.6mmol/l, creatinine=89 umol/l. What is the next appropriate management?
a. Biguanide
b. Sulfonylurea
c. Insulind. Glitazone
e. Sulfonylurea receptor binder
Answer: (a)
Question: A patient presents with progressive dyspnea. He complains of cough, wheeze and a table spoonful of mucopurulent sputum for the last 18 month. Spirometry has been done. FEV1/FVC=2.3/3.6. After taking salbutamol, the ratio=2.4/3.7. What is the most likely diagnosis?
a. Chronic bronchitis
b. Asthma
c. Bronchiectasis
d. Lung fibrosis
e. Sarcoidosis
Answer: (a)
Question: A 62 year old man presents with cough, breathlessness and wheeze. 24% O2, salbutamol and hydrocortisone were given. The symptoms haven’t improved and so nebulized bronchodilator was repeated and IV aminophylline was given. ABG: pH=7.31, RR=32. What is the next appropriate management?
a. Nasal IPPV
b. Intubation and ventilation
c. LABA
d. Doxapram
e. Amoxicillin PO
Answer: (a)
Question: A young girl returns from holidays in Spain. She complains of discharge from her ear and complains of tragal tenderness. Examination: tympanic membrane normal. Aural toilets have been done. What is the next appropriate med?
a. Antibiotic PO
b. Antibiotic IV
c. Steroid PO
d. Steroid drop
e. Antibiotic drop with steroid
Answer: (e)
Question: A 23 year old man sprained his right ankle 6wks ago while playing football. He was tx with a below knee walking cast. On removal of the cast, the patient was noted to have a right foot drop. He has weakness of extensors of the ankle and toes and diminished pinprick sensation over the dorsum of the foot. The ankle jerk is present and the plantar reflex is flexor. What is the most likely cause of the foot drop?
a. Compression of common peroneal nerve
b. Compression of the tibial nerve
c. Compression of the S1 nerve root
d. Rupture of Achilles tendon
e. Tx of the medial collateral lig of the ankle
Answer: (a)
Question: A young man was knocked down during a fight in the waiting room of the ED. He is now unconscious and unresponsive. What is the 1st thing you would do?
a. Turn patient and put in recovery position
b. Put airway
c. Endotracheal intubation
d. Assess GCS
e. Start CPR
Answer: (b)