AMC MCQ Recalls NOVEMBER 2020

Even though we had a tough year battling COVID-19, we have also achieved an incredible milestone for science with the development of vaccine reported to be ready in near future. All hope is not lost for those who has been staying positive and testing negative. Likewise, AMC MCQ Examination is a tough battle we ought to fight for a medical career in Australia, we know how painful it is. There is a great demand for past recalls and we are here working with some of the best candidates to fill in the gap. Let us help you in getting your career off to a great start. Moving on to a new stage in life can be a challenging process. We wish you the best of luck in all of your future endeavors, you will be great!

Australian Medical Council (AMC) MCQ Recalls NOVEMBER 2020 compilation

Trachoma recall. About 7 cases with 20 something contact in 240 community. How will you manage?
A. antibiotics drops to contacts
B. antibiotics drops to community
C. treatment of cases
D. treatment of contacts
E. treat whole community

Woman migrain with aura what contraception?
Mirena

computed tomography scanning of a patient’s head within 2 hours of a newly acquired epidural hematoma should reveal which of the following?
a A normal brain
b A lens-shaped density over the frontal lobe
c forgot

A pt with chronic depression on serteraline not responding to tx, what to do?
A. Add quetiapine
B. Add bzd
C. Add lithium

Which of the following clinical feature is helpful to differentiate Lewy body dementia from Alzheimer’s disease?
a. Parkinsonism
b. Persistent short term memory loss
c. Deterioration of social skills
d. Taking longer to do routine tasks
e. Forgetting well-known people or places

A teenager girl with history of excessive exercise and workout. She weighed 27kg before. Now she binges eats but then purges and does excessive exercise. Her current weight is 32kg. Ht is 162cm. Age was 16 years. What will you find in examination?
a) tachycardia
b) ankle edema
c) vitiligo
d) hyperthermia

A 55-year-old male presented with inguinal lymph nodes swelling.Biopsy of the node was taken wand was found to be squamous cell carcinoma.Where could be the most likely primary tumour?
a. Kidney
b. Breast
c. Lung
d. Rectum
e. Prostate

Female 42yr old , normal but very high BMI, regular periods, partner semen analysis normal. What is the cause for subfertility,
a. Pelvic adhesion
b. Submucosal fibroids
c. Endometriosis
d. PCOS
e. Adenomyosis

A woman with high bmi irregullar mense came because of infertility, first thing to check?
Partner sperm analysis
Sono
Lapa

A 33 year old woman presents with a 2 cm painful breast mass which she has noticed a week ago. What is the most common diagnosis?

1. Breast cancer
2. Fibroadenoma
3. Mammary duct ectasia
4. Fat necrosis
5. Mammary dysplasia

ventriculoperitoneal shunt placement for hydrocephalus. gait and cognition improved. next day complain headache. unable to walk. new symptoms?
a. Chemical meningitis
b. Subdural hematoma
c. Epidural hematoma

A pt with crohn’s dis. needed colectomy but was annoyed and said that she wants her previous dr and no other doctor is like him, dx?
Borderline pd

need albuterol daily, especially exercise, and has coughing that awaken her from sleep about twice a week. treatment?
a. Short-acting, inhaled β-agonists, as needed
b. Daily leukotriene modifier with short-acting β-agonist

A 43yo woman a year ago had done breast sono without atypic features, now the cyst was bigger and biopsied and malignancy was reported, she was angry that why didnt they do biopsy last year to knw its malignancy, what to do!!?
Tell her it was a simple cyst amd there has been no indication of bx last year
Tell her your previous dr was wrong

young boy has intermittent watery diarrhea, nausea, belching, and abdominal pain. weight is less than the fifth percentile for his age. diagnosis?
a. CBC and differential
b. ESR

woman with cough and chest pain for 2 months. complains of coughing up hair. the CXR reveals a mediastinal mass. clinical scenario?
a. Thymoma
b. Hodgkin disease

child with fever of unknown etiology. urine specimen shows grew E coli with a colony count of 2000. true about the sampled urine?
It has a specific gravity of 1.008.
It is from a bag attached to the perineum of an uncircumcised boy. (exact option)

boy cramping abdominal pain and a rash back of his legs and buttocks. you diagnose Henoch-Schönlein, or anaphylactoid, purpura. other finding likely to have?
chronic renal failure?

75 yo woman, sudden onset of right-sided weakness and slurred speech. dense hemiplegia of the R upper and lower extremities. Aspirin has been given. next step?
Immediate intravenous unfractionated heparin
Immediate thrombolytic therapy

Recall of girl pickin her eyebrows because she feels tense if she doesn’t do it, dx?
Ocd

Let me summerize:
psa> 20 or metastatic => androgen deprivation therapy or orchidecgomy

Psa> 20 and spinal mets=> androgen deprivation therapy or radiotherapy of mets location
Locally advanced T3b (seminal vesicle or capsule)=> External beam radiotherapy for prostate cancer (EBRT)

Psa<10 even doubled, without comorbidity, and foci found in bx <10% or one out of 12=> active survillence

Psa doubled, life expectancy<10yrs=> watchful waiting

Psa doubled but under 10, foci<10% with lower urinary tract sx=> radical prostatectomy

14 year old comes to you with a 3 month history of loose stools associated with abdominal pain. On physical examination, she is noticed to have anal excoriations. No anaemia / passage of blood in stools. History of pin worm infestation at the age of 3 present for which she was treated. Her ESR is 70. The most likely diagnosis is ?
a. Crohn’s disease
b. Giardiasis
c. Campylobacter
d. Clostridium perfringens
e. Pseudomembranous

Child with vtach ecg presents with diziness tx?
Adenosin
Amiodarone
Valsalva maneuvre

Woman with flische clip on both sides presents with meneorrhagia what to do?
Mirena

A pt was perscribed sertralin because of anxiety, she said her anxiety was better but not completely gone, what to do?
Continue the same dose
Increase the dose
Decrease the dose
Add another antidepressant
Add bzd

young woman who is interested in starting COC pills. risks associated with COC use?
Users of COC pills have an increased risk of ovarian cancer.
Users of COC pills have an increased risk of endometrial cancer.

A pt with chronic depression on serteraline not responding to tx, what to do?
Add quetiapine
Add bzd
Add lithium

patient complains of fever and sore throat for several days. the patient is febrile and has inspiratory stridor. best course of action?
a. Begin outpatient treatment with ampicillin
b. Culture throat for β-hemolytic streptococci

infant normal weight, but with an enlarged head. heart rate is 75 beats per minute and the temperature is 35°C. large anterior and posterior fontanelles. result?
Congenital hypothyroidism
Congenital megacolon (Hirschsprung disease) ??

A pt came with tia sx (visual loss and loss of sensory of half the body) for 30minutes, regular pulse, he had no sx now. How to reach the definite dx?
Eeg
Ct
Carotid doppler
Mri
Echo

woman has noted bilateral thin serous discharge from her breasts. there seems to be no mass associated with it. statements to tell the patient?
a. Intermittent thin or milky discharge can be physiologic.
b. Expressible nipple discharge is an indication for open biopsy.

6 yo boy difficulty breathing. 1-week history of fever, congestion, and cough. diffuse rales noted on auscultation, pulses are weak and thready. increasingly somnolent. method?
a. Internal jugular central line
b. Femoral vein central line

A test was performed to assess depression for a lady with anhedonia and insomnia, the test would be negative and normal if the score was under 5 out of 15. Woman’s score was 4. Th Q mentioned that the ppv of the test is low. What to do?
Tell her that she is depressed ans start tx
Admit her
Take a full history and assessment

A woman came with abortion complaint in ph/ex cervical os was open and placenta and blood was seen in os, what to do inotially?
D&c
Evacuate the remained parts of placenta
Pelvic sono
Laparotomy

A pt with chest discomfort for an hour and he was ok now, ecg and trop were normal, what to do?
Serial check of ecg and trop

An ecg with st elevation on leads 2 ,3 and avf and chest discomfort and…, what causes the symptoms of the pt?
Unstable angina
Posterior mi

true regarding benign prostatic hyperplasia (BPH)?
a/ Initial management of BPH is transurethral resection of the prostate.
b/ Indications for surgery is urinary retention refractory to medical therapy and recurrent UTI

Severe hypoglycemic attack resolved with sugar goven by wife, driving restriction?
Not allowed to drive for 6w

Mild swelling under the nipple. quarter-sized area of breast tissue under the left nipple that is not tender and has no discharge. Tanner stage 3. best action?
a. CT scan of the pituitary
b. Measurement of serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH)

daughter has a 3-day history of subjective fever, hoarseness, and a bad barking cough. you would expect to find?
a. A temperature greater than 38.9°C
b. Expiratory stridor

A test was performed to assess depression for a lady with anhedonia and insomnia, the test would be negative and normal if the score was under 5 out of 15. Woman’s score was 4. Th Q mentioned that the ppv of the test is low. What to do?
Tell her that she is depressed ans start tx
Admit her
Take a full history and assessment

Two dka Qs with lots of lab data=> tx => n/s
Insulin
Resenium or sth
⚠️Read dka

A 5day infant with scanty yellow bilateral eye discharge and not ill from 24hrs before,organism?
Gonorrhea
Staph
Chlamidiya

Prostate cancer Q, metastasis to seminal vesicles only, psa 14, tx?
Ebrt
Prostatectomy
Androgen depriviation

patient with alcohol abuse problem. drinks because he continually recounts stressful memories from being from a car accident which occured 5 years ago. medication?
a Bupropion
b Sertraline

a 16-year-old boy is struck on the side of the head by a bottle thrown by a friend .he becomes stuporous & is unresponsive to painful stimuli. ECG reveals no arrhythmias. he has venous distention & absent pulsations of the retinal vasculature. best explanation?
seizure disorder? forgot other option

a 33-year-old healthy nonsmoking man presents with 8 weeks chronic cough. antitussives, bronchodilator & azithromycin did not help. symptoms are worse when he lies down for sleep & when he drinks caffeine or alcohol. diagnosis?
GERD

A pregnant lady in 2nd trim, came with postcoital bleedin in ph/e we see ectropion and a laceration, what to do?
Co test
Lbc
Visit postpartum

Same old recall, pt has many diseases, in 2 years ahead which of the following would increase risk of MI?
Previous Angina
Htn
Bmi
High chol

Pt came to us as a gp and complained about her surgeon (for cosmetic and plastic surgery) that he told her that you might die under anaesthesia and the surgery is dangerous for you amd she was scared. She was angry why the surgeon had scared her off! Wtd?
Report surgeon to ethics committee
Tell her the surgeon was right

A pt needed a sugery for canal stenosis, he came to us as a gp and complained that the physiotherapist told her that the surgeon that we suggested to her had a high failure and errors in surgery and was scared to go to the surgeon, what to do?
Call the physiotherapist and tell him why did you make such comments
Tell the pt that choosing the surgeon is part of our job and physiotherapist has no role in it
Tell pt to go to surgeon and talk to him about his concenrns
Report the surgeon

A pt needed a sugery for canal stenosis, he came to us as a gp and complained that the physiotherapist told her that the surgeon that we suggested to her had a high failure and errors in surgery and was scared to go to the surgeon, what to do?
Call the physiotherapist and tell him why did you make such comments
Tell the pt that choosing the surgeon is part of our job and physiotherapist has no role in it
Tell pt to go to surgeon and talk to him about his concenrns
Report the surgeon

A 17yo teenager who was an exemplary student before, came with drop in grades and used drugs what is dx?
Depression
Drug abuse
Borderline

A pt with constant pain in epigastrium and nausea and vomiting, initial management?
Check lipase
Abdomen xray
Abdomen Ct
Abdomen sono

A young girl come with an epigastric pain started some hours ago. There is no special position or something to reduce her pain. Serum lipase, amylase and sonography are normal. Whats the diagnose?

A) cholecystitis
B) pancreatitis
C)esophigitis
D) acute coronery syndrome

an 8-year-old boy presents with a 2-year history of intermittent vomiting, dysphagia, and epigastric pain. history significant for eczema & peanut allergy. biopsy reveals many eosinophils. treatment?
a/ Corticosteroids
b/ Prolonged acid blockade

a 45-year-old woman who had two normal pregnancies 15 and 18 years ago presents with the complaint of amenorrhea for 7 months. After exclusion of pregnancy, next test?
a/ Hysterosalpingogram
b/ Endometrial biopsy

a case of syphilis. Secondary stage?
a/ Macular rash over the hands and feet
b/ gumma
c/ Optic nerve atrophy and generalized paresis

patient had unprotected intercourse with a partner later found to have chronic hepatitis B. in testing your patient, which serologic markers would be the first to appear?
a/ Hepatitis B surface antigen (HBsAg)
b/ Hepatitis B core antigen (HBcAg)

A 36-year-old woman complains of worsening weakness. she has 5/5 strength in her bilateral upper and lower extremities distally but 3/5 strength proximally. sensory examination and reflexes are normal. there is a red confluent macular rash on her eyelids. diagnosis?
Myasthenia gravis ??

a 26-year-old woman with “slipped disk” was sent home without surgery. acute herniation of an intervertebral disk will require emergency surgery in which of the following circumstances?
The disk is laterally herniated at C7.
The disk is causing radicular pain.
Forgot other option

a 67-year-old woman had a tremor 12 years ago. Her condition deteriorated until she cannot carry out her basic daily activities. High frequency stimulation of which of the following brain structures is most likely to improve her symptoms?
a. Globus pallidus, medulla, parietal lobe ??

a 52-year-old man has auditory and visual hallucinations. His thought process is normal. drug toxicology screen is positive for marijuana . diagnosis?
a. Substance/medication induced psychotic disorder
b. Schizophrenia

a patient with a solid malignancy is discussing the risks of chemotherapy with his oncologist. what is the primary toxicity of doxorubicin (Adriamycin)?
a Cardiomyopathy

a 70-year-old man with unresectable carcinoma of the lung has executed a valid living will that prohibits the use of feeding tube in the setting of terminal illness. patient stops eating altogether. Patient’s wife insists on enteral feeding . most appropriate course of action?
a. Respect the wife’s wishes as a reliable surrogate decision maker.

a 53-year-old postmenopausal woman, G3P3, presents with urinary leakage 6 weeks in duration. Most appropriate first step?
a/ Urinalysis and culture
b/ Urethral pressure profiles

a 20-year-old woman presents with condyloma. Pap smear returns showing ASCUS. reflex HPV typing showed no high-risk HPV. viral types responsible for the patient’s condyloma?
a/ HPV type 11
b/ HPV type 16

a 34-year-old woman with flushed face, chest pain, shortness of breath, and dizziness. her temperature is 38’C BP is 85/50 mm Hg, HR is 125 b/m, and RR is 26 b/m. diagnosis?
a/ Hypovolemic shock
b/ Neurogenic shock
c/ Septic shock
d/ Spinal shock

a 24-year-old G2P0+1 in her 2nd trimester presents with vaginal spotting for the past day. Her vital signs are HR of 76 b/m, BP of 120/65 mm Hg, respiratory rate (RR) of 16 b/m, and temp 37.1°C. likely condition?
a/ Ectopic pregnancy
b/ Placenta previa

a patient presents with her last menstrual period 4 weeks ago. she denies any symptoms such as nausea, fatigue, urinary frequency, or breast tenderness. she thinks she is pregnant. actions?
a/ No action is needed because the patient is asymptomatic, has not missed her period, and cannot be pregnant.
b/ Order a serum quantitative pregnancy test.

an 84-year-old woman develops confusion and agitation after surgery for hip fracture. her current medications include intravenous fentanyl , lorazepam , DVT prophylaxis & ciprofloxacin. actions that best manage this patient’s delirium?
a/ Increase lorazepam to more effective dose, repeat urinalysis. ?

a 26-year-old woman presents complaining of dyspnea on exertion and bilateral pleuritic chest pain with a recent 14kg weight loss. she reports occasional intravenous drug use . chest radiograph reveals bilateral interstitial infiltrates and no cardiomegaly. diagnosis?
a/ Pulmonary edema
b/ Pneumocystis jiroveci pneumonia

which of the following conditions is considered an anxiety disorder?
a/ Obsessive-compulsive disorder
b/ Conversion disorder

a 72-year-old woman presents with pruritus for the past 6 weeks. she has lost 9kg of weight & has noticed diminished appetite. previously been healthy & takes no medications. she appears fatigued & shows mild temporal muscle wasting. next step?
a/ Topical corticosteroids
b/ Oral antihistamines

a 2-year-old child with 2 episodes of a brief, shrill cry followed by a prolonged expiration and apnea. No previous chronic medical problems. child without unexpected physical examination findings. Diagnosis?
a/ Seizure disorder
b/ Drug ingestion

a young infant is noted to have developed constipation over the past week, & then facial diplegia & difficulty sucking & swallowing. most likely culprit in this child?
a/ Infantile spinal muscular atrophy
b/ Myasthenia gravis

a 16-month-old male child is being raised in a home environment characterized by both verbal & physical aggression toward the child & his siblings. likely psychiatric disorders of child in his early school years?
a/ Conduct disorder
b/ Schizophrenia

a 53-year-old man presents with a fungating mass in the sigmoid colon; biopsy is consistent with adenocarcinoma. a CEA level is fourfold greater than normal. Which of the following is the appropriate use of this test?
a/ As an indication for neoadjuvant chemotherapy
b/ As an indication for postoperative radiation therapy

a 72-year-old woman presents with left temporal hemorrhage and swelling. localization of encephalitis to the medial temporal or orbital frontal regions of the brain is most consistent with which of the following?
a/ Treponema pallidum
b/ Varicella zoster virus

a 35-year-old right-handed construction worker presents with complaints of nocturnal numbness & pain involving the right hand . there is some atrophy of the thenar eminence. Tinel sign is positive. Diagnosis?
a/ Carpal tunnel syndrome
b/ De Quervain tenosynovitis

a 20-year-old woman presents with abdominal pain reveals that she was sexually assaulted at a party 3 weeks ago by a male friend whom she recently started dating. her abdominal & pelvic examinations are normal. best management to offer this patient?
a/ Counsel patient to sue male friend.
b/ Provide an antidepressant.

17 yrs. old previously healthy boy presented with 1-day Hx of vomiting, lethargy, impaired consciousness. On examination severe dehydration. Labs given RBS-22 mmol/l, PH=7.1, HCO3= 8, K+=5.6, and some more. Next immediate management?
a. N saline
b. Ca Gluconate
c. NaHCO3
d. Ca Resonium

DKA question with metabolic acidosis. Asking next management after fluid resuscitation?
a. Insulin
b. NaHCO3
c. Resonium

Patient with tangentiallity, asking about what he most likely has
A. Dissociation
B. Depersonalisation
C. Depression
D. Disorganised behaviour

Patient present with symptoms of depression and anxiety. You prescribe sertraline 50 mg. after two months during review pat say he has only mild improvement. Mangement?
a. Increase sertraline dose
b. Continue same dose for another 8 weeks
c. Change to another drug
d. Add benzodiazepine

BMI chart given. A 12-year-old child with BMI 25. Asking about his weight interpretation from chart. (it was between 95th and 97th percentile.
a. Underweight
b. Overweight.
c. Obese
d. Morbid obese
e. Normal

42 yrs. old women. Comes with infertility for 14 months. Never pregnant before. Pelvic USS was normal. BMI high. Asking next step?
a. Partner sperm analysis
b. Ovum donation
c. laparoscopy
D. Ovulation induction

A 43yo woman a year ago had done breast USS reported as cystic lesion without suspicious lesions. Now came with increasing size of lump since few months and biopsy report as malignant. She was angry and ask why they didn’t do biopsy last year to know its malignancy, what to do?
a. Tell her it was a simple cyst and there has been no indication of bx last year.
b. Tell her I can’t answer that until I consult a specialist in that field.
c. The malignancy is probably not related to the cyst.

A girl picking her eyebrows because she feels tense if she doesn’t do it, dx?
a. OCD
B. Impulse control disorder

8-year-old Child with dizziness. Hemodynamically stable. ventricular tachycardia ecg. tx?
a. Adenosine
b. Amiodarone
c. Valsalva maneuver
d. DC cardioversion

31 yr old lady. Has two children and underwent filshie clip sterilization on both sides. Having regular cycles with heavy periods. Most appropriate management?
a. Levenogestral IUD
b. Hysterectomy
c. Artery embolisation

Patient with major depressive disorder treated with sertraline for 4 months without any improvement? Next
a. Dothiepin
b. Venlafaxine
c. Na valproate
d. Lithium

70 yr old patient came complaining of episode of difficulty in speaking and heaviness o the right side of the body few days back, which resolved spontaneously in 30 mins. What is the most appropriate investgation?
a. ECG
b. CT brain
c. Carotid doppler
d. ECHO
e. MRI

A 75 yr old lady came with anhedonia and insomnia. She was assessed with Geriatric Depression Scale, a screening tool used to diagnose depression in elderly. The test would be negative and normal if the score was under 5 out of 15. The test has 70% sensitivity and 90% specificity. PPV 50%, NPV 90%. Woman’s score was 4. What to do?
a. Start antidepressant
b. Admit.
c. Further assessment with detailed history
d. Repeat the test in 3 months.
e. Reassure her she has no depression.

15-year-old boy living in street present with laceration to his arm during a fight. During history he disclose that he says that he is bisexual and has multiple sexual partners and ask for STI screening. What will you do next?
a. Inform parents
b. Inform child protection authority
c. Educate him about safe sex

A sex worker came for a sexual health check up. What will you ask to guide management
A. Number of partners
B. Injecting drug use
C. Sex of partners
D. Use of condom

14-week pregnant lady came with mild vaginal bleeding. At 12 weeks she underwent USS as part of 1st trimester screening which showed grade 4 placenta previa. Her blood results showed risk of trisomy 21- 120/10,000 and trisomy 18- 200/100000 (can’t remember the exact figures). Asking what Is the indication to perform USS at this presentation.
a. To see if the fetus is still alive
b. To find the cause of bleeding
c. To assess the fetal anomalies

32-week pregnant lady came with 800ml blood loss and severe abdominal pain. Fundus is tender and SFH 36 cm. fetal heart sounds not heard. Patient has tachycardia and hypotension. After fluid resuscitation what’s next?
a. Amniotomy
b. Em LSCS
c. USS
d. Prostaglandins

10-week pregnant lady came with vaginal bleeding. OE os open and some fetal tissue is seen in the os. After gaining IV access whats next?
a. Cross match
b. D&C
c. Remove the retained products at os
d. USS

A pt with chest discomfort for an hour and he was ok now, ecg and trop were normal, what to do?
a. repeat ecg and trop
b. continuous ECG monitoring
c. reassure and send home
d. angiography

An ecg with st elevation on leads 2 ,3 and avf and chest discomfort and…, what causes the symptoms of the pt?
a. Posterior MI
b. Unstable angina
c. Pericarditis

A 27 yr old pregnant lady never had cervical screening test, present with post coital bleeding in 2nd trimester. On speculum examination cx ectropion and a laceration found, what to do?
a. Co test
b. Take smaple for LBC
c. To HPV DNA
d. Do cervical screening postpartum
e. Take a biopsy from ulcer

Patient planned for total hip replacement and when patient ask about the complications of the surgery, surgeon got irritated and told her extensive list of complications including can die due to anesthesia. Now patient got scared and thinking about not going for surgery. As the GP what will you do?
a. Refer to different surgeon.
b. Refer to anesthetist to discuss the anesthetic complications.
c. Report surgeon to APHRA
d. Call the surgeon and ask him to apologise to the patient

A pt needed a sugery for spinal canal stenosis, he came to us as a gp and complained that the physiotherapist told her that the surgeon that we suggested to her had a high failure and errors in surgery and was scared to go to the surgeon, what to do?
a. Call the physiotherapist and tell him why did you make such comments
b. Tell the pt that choosing the surgeon is part of our job and physiotherapist has no role in it
c. Tell pt to go to surgeon and talk to him about his concenrns
d. Report the surgeon

A pt with constant pain in epigastrium and nausea and vomiting, what will help with diagnosis ?
a.Check lipase
b.Abdomen xray
c.Abdomen Ct
d.Abdomen USS

A 15 yr old boy presented with headache nausea vomiting neck stiffness and rash, what to do asap?
a. LP
b. Blood culture
c. Meningococcal pcr
d. CT

22-year-old pregnant woman with breech presentation. Going for elective CS. bmi=20, no risk factors, no pmh, what to give for prevention of dvt?
a. hydration
b. graduate compression stockings
c. heparin
d. enoxaparin

Postpartum mother scenario, awake all night, not letting to take her child away afraid of swapping and stealing her baby, checking everything in the room. wanted to go back home, what to do?
a. Admit in psychiatry ward
b. Discharge her
c. Diazepam
d. Olanzapine
e. Sertraline

A pt with melena went through endoscopy, a duodenal ulcer was seen in bx H. pylori diagnosed and triple therapy given. what to do for follow up?
a. Urea breath test in 6 weeks
b. Repeat endoscopy in 6 weeks
c. H. pylori serology

66 yr dental assistant who resigned from job due to issues at work place following behaving inappropriately in a workplace get together. He is a chronic alcoholic. His wife says he is forgetful and say the same thing he just said. On examination he is unable to perform fist palm side test (Luria’s test) and has broad base gait. What is the diagnosis
a. Alzhimers disease
b. Mercury toxicity
c. Depression
d. Alcohol induced cognitive degeneration

Patient came with palpitations, weight loss, diarrhea. O/E lid lag, exophthalmos. Labs show low TSH, High t3 and t4. Anti TPO antibodies, anti-thyroglobulin antibodies and anti-thyrotrophin receptor antibody titers were given. Asking what is the most consisting finding of the diagnosis.
a. Anti TPO antibodies
b. anti-thyroglobulin antibodies
c. anti-thyrotrophin receptor antibody
d. lid lag
e. exopthalmos

Patient on multiple drugs presented with angiooedema- asking cause

1. Ramipril
2. HCTZ
3. Amoxy

DM and HT Patient came with painless sudden onset vision loss in R eye. Fundoscopy.
a. CRAO
b. CRVO
c. Hypertensive retinopathy

Case of a female patient who has painful heavy bleeding on first 3 days of menstrual cycle. USG and other investigations were normal. Cause of infertility ( no mention of hirsuitism, heavy bleed or finding on inv)
A. Adenomysosis
B. Endometriosis
C. Male
D. PCOS

Gdm diagnosed in third trimester. OGTT slightly above normal. Treatment
A. Dietitian
B. Metformin
C. Do HBA1C
C. Repeat glucose tolerance

Pregnant woman at 8 weeks or close. Cousin had cri du chat. Wants diagnostic test for chromosomal abnormalities
A. Nuchal at 12 weeks
B. Chorionic villus sampling at 10 weeks
C. Combined first trimester screening
D. Amniocentesis at 16 weeks

1. fundocopy of papilloedema . patient hypertensive, diabetic. Asked cause
   A. raised ICP
   B. systemic hypertension
   C. DM

patient with swelling under angle of mouth, tender on swallowing, asked diagnosis ?
A. salivary gland tumor
B thyroglossal duct cyst
C parotid swelling
D submandibular calculus

patient with meningitis, neck stiffness, asked next inv?
A blood culture
B CT
C lumbar puncture

child with meningitis , non blanching rash on trunk , high temp , asked next inv?
A blood culture
B pcr HSV
C pcr meningococcus

DKA scenario, metabolic acidosis , asked next management ?
A NS
B insulin
C calcium gluconate

RA scenario, anti ccp positive, dsdna negative , asked diagnoiss
A. RA
B. sle
C. osteoarthritis

patient taking Dothiepin, presenting with several symptoms. What symptom will lead to diagnosis ?
A. intracranial hemorrhage
B. Cardiac arrhythmias

2 year old child. Healthy but has diarrhoea of up to 5 motions of undigested food particles. Likes fruit juices and vegetables but also drinks some milk.
A. Anti-gliadin antibodies
B. Stop fruit juices
C. Lactose intolerance
D. Gluten intolerant
No toddler’s diarrhoea in the options

Patient with a drug eluting stent on Clopidogrel and neck of fermur fracture

1. Give platelets and do surgery
2. Stop clop 7 days before
3. Proceed to surgery

Child with BMI above 85% and parents overweight
A. BMI will be normal at puberty
B. Initial goal is to maintain current weight
C. Child takes after his parents

One q in which one medical studen assaulted during roatation in psychiatry unit..now discussing with registrar that he feel stressed out thinking of going that ward again.what registerar should suggest.
1.encourge to go same
ward nd complete rotation
2.write letter to change ward
3.send for PTSD rx
4.suggest to join student support groups

7 years old boy h/o nocturnal enueresis going for camping. Best management
A. Impramine
B. Alarm
C. Don’t go
D. Reduce fluids before sleep
E. Nasal desmopressin

16 year old wresting player with skin lesions
Molluscum contagiosum

A 8 yr old girl with a nontender lymph node on lateral of her neck, grown in size in a year, attached to underlying structures but the skin moved easily on it, what is dx?

1. Toxo
2. Cat scratch dis
3. Lymphoma
4. Adenitis
5. Thyroglossal cyst

Schizophrenia 15yr child comes with mom and thinks someone is poisoning his food and he is checking many times if there is poison in his body- looks in the mirror quite often
A. OCD
B. Prodromal schizo
C. Body dysmorphic

Vaginal delivery total 12hrs time and 3rd stage 70mins
1wks later breast feeding stooped due to cracked nipple. Now vaginal bleeding. Cause?

1. Effect of weaning
   2.Endometriosis
2. Retained product Of conception

An ecg with diffuse ST elevation in multiple leads and chest pain after a heavy meal
a. Posterior MI
b. Unstable angina
c. Acute Pericarditis
d. Oesophagitis

an infant presented with viral pneumonia symptoms. O/E child is not ill. air entry equal and few B/L ronchi and crepts. xray like this one. asked diagnosis
a. upper lobe pneumonia
b. total anomalous pulmonary venous return
c. congenital emphysema
d. upper lobe collapse
e. enlarged thymus

Patient has had some episodes of angina and is a smoker with multiple cormobidities, in 2 years ahead which of the following would increase risk of MI?
A. Previous Angina
B. Htn
C. Bmi
D. High cholesterol
E. Smoking

After a negative mammography, the patient requests further info on accuracy of the test ( handbook questions)
A. NPPV

Young man involved in a fight. Has a tender swelling behind his ear. Otherwise normal. What next
A. I&D
B. I&D and close the window
C. Follow up the next day

Patient with a prescription of diazepam and Oxycodone from interstate. Comes in after hours and wants diazepam prescription to push him until he can see his Dr. what to do
A. Refuse
B. Give short term dose of Oxycodone only
C. Give Diazepam
D. Check prescription shopping info

62 yo lady with one year recurrent pain in left illiac fosa. Swelling medial to the inguinal ligament.No GIT symptoms. Pain on internal rotation of the hip
A. Femoral hernia
B. Psoas abcess