Question: A 27 year old lady after C-section developed epigastric pain after 8h. What is the appropriate investigation?
a. ABG
b. Coag profile
c. Liver enzyme
d. Liver biopsy
Answer: (c)
Question: A 35 year old woman presents with visual problems. CT brain reveals pituitary tumor. What is the single most likely defect?
a. Homonymous hemianopia
b. Homonymous upper quadrantanopia
c. Bitemporal hemianopia
d. Cortical blindness
e. Homonymous lower quadrantanopia
Answer: (c)
Question: A 45 year old heroin addict was involved in a car crash and is now paraplegic. During the 1st week of hospital stay he cried everyday because he couldn’t remember the accident. What is the most likely diagnosis?
a. PTSD
b. Severe depression
c. Organic brain damage
Answer: (c)
Question: A patient with Type 1 DM has a fundus showing micro-aneurysm and hard exudate. What is the single most likely diagnosis?
a. Macular degeneration
b. Hypertensive retinopathy
c. MS
d. Diabetic background
e. Proliferative DM retinopathy
Answer: (d)
Question: A 62 year old man has multiple liver mets due to adenocarcinoma with an unknown primary. He is deeply jaundiced and has ascites with edema upto the buttocks. He is now drowsy and his family are worried that he is not drinking enough.
His meds include: haloperidol 1.5mg, lactulose 10 ml. Bloods taken 3d ago: electrolytes normal, urea=6.5mmol/l, creatinine=89 umol/l, calcium=2.04mmol/l, albumin=17g/L, total bilirubin=189 mmol/l.
What is the single most appropriate management of his fluid intake?
a. Albumin infusion
b. Crystalloids IV
c. Crystalloids SC
d. Fluids via NGT
e. Fluids PO
Answer: (a)
Question: A 2 year old with atrophy of the buttocks, distended abdomen with frequent offensive smelly stool. Choose the single most likely investigation?
a. Upper GI endoscopy
b. Endomysial/alpha gliadin antibody
c. Sweat test
d. Colonoscopy
e. Stool culture
Answer: (b)
Question: A 78 year old woman is brought to the hospital complaining of back pain and is referred to the surgeon. She has been saying that her mother is due to visit her today and that somebody must have broken her lower back as she is in agony. Labs: creatinine=295 mmol/l, calcium=3.03mmol/l.
Which investigation is most likely to lead to a diagnosis?
a. US KUB
b. XR Spine
c. IVU
d. Bence-Jones Protein
e. Mental state exam
Answer: (d)
Question: A 40 year old woman presents with dysphagia. Examination: febrile with erythema and middle neck swelling. What is the best management strategy?
a. IV antibiotics and drainage
b. Antipyretics
c. XR neck
d. Endoscopic diverticulectomy
e. I&D
Answer: (a)
Question: A young lady presents with gradually worsening headaches, visual disturbance, and lack of energy. MRI shows a 15mm tumor in the pituitary fossa. What is the tx of choice?
a. Radiotherapy
b. Octreotide
c. Reassurance and f/u after 6m
d. Surgery
e. Chemotherapy
Answer: (d)
Question: A man with dementia has an ulcerative lesion on his forehead. He wants it removed so ‘it can help improve his memory’. Wife says he is not fit to give consent. What will you do?
a. Get letter signed from the GP
b. Get letter signed from the wife
c. Get letter signed from the patient
d. Refer to psychiatrist to assess the mental capacity to give consent
Answer: (d)