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 Middle aged man presents with pain from sole to great toe of right foot, which awakes him from his sleep. O/E: inflammation from sole to great toe, non tender, active and passive movements are painless and free. No sensory loss, SLR- positive 30 degree. Pedal pulses normal. No h/o dm/gout/arthritis. Reflexes are normal. What investigation is most important for diagnosis? a) Serum urate b) MRI lumbar spine c) FBE d) angiography e) usg  10 year old boy who has recent onset of enuresis. the doctor calls his parents for assessment. they have separated for 3 months. In the interview father tells you that he is intending to hide assets from his ex wife even before the divorce.what should you do? A. inform the mother B. do nothing C. inform registrar at the family court D. Tell father it is because of him

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the boy was affected E. Inform police  3 questions on epidemiology about research methods (not exactly but similar to-) *increase report cases of childhood cancer d/t waste production from a factory in river. Which study? A- RCT B- Cohort C- Case-control D- Cross-sectional *You are a doctor in a hospital and want to do research about the outcome of babies born to diabetic mothers and want to compare the result with the babies born to non- diabetic mothers. Which study will be the best study? a) Cross sectional study b) Cohort study c)Case control study d) Randomized control trial e)Case study Mother booked an appointment for daughter for some

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leg pain or something. but she couldn’t attend with her. Daughter after the examination asks to be tested for chlamydia. you took a swab and the result was negative. Second day mother called and asked about the results of her daughter.what to do a)tell the mother that test for chlamydia was negative b) tell her no test was performed c)tell her to ask her daughter to make an appointment d) Ask the mother and daughter to come together for appointment e)ask her daughter to call for the results 18 yr old girl presents with malaise, tiredness for mnths. on labs, hb 8, microcytic hypochromic, inr 1.5, calcium 1.9. what’s the inv to reach the diagnosis. (Many labs were given) 1.hb electrophoresis 2.antigliadin antibodies 3.iron studies 4.serum electrolytes some girl having 1 year daughter come to you to consulting about meningococcal vaccine. her

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neighbor(cousin) lost her 4 month baby even though getting the vaccine. so she wants to know about vaccine option a.her daughter's age is apt to get viral meningitis b. the best way to protect meninogcoccus is get the vaccine

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c.the neigbor's case is unlucky bcz the vaccine's efficiency is close to 100% d.the most prevelent orgarnism is type c meningococcus 2 years Child with abdominal symptoms and vomiting and high fever, there is abdominal tenderness also, giving CXR of left lung effusion asking about investigation to reach the diagnosis A.. Blood culture B.. Urine microscopy and culture C.. Pneumococcal pcr D.. Pleural fluid aspirate Pneumonia 3.lady presented with pain and tenderness supraorbital was diagnosed to have sinusitis, she has fever and then she developed neck stiffness, LP revealed polymorphonucleocytes. what is the diagnosis : A.Frontal sinusitis B.Meningeococcal meningitis C. Pneumococcal meningitis D.Stretococal meningitis - Gram+ve diplococci

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complication from sinusitis 4.Old man came with his wife. she complains that he gets confused sometimes and has stopped reading news paper. He still drives, sometimes at night. mmse 26/ .what are you gonna do about it? a- Cease driving at night b-Repeat mmse after 3 months c-MRi of brain d-advice to do more mental and physical activities e. assess him for treatable demential conditions. 5 A farmer not doing well, had recent losses, cant eat or sleep. He wants to commit sucide and end it all .He is not accepting that he is depressed and says that its just because of his financial problems that he is feeling like this. What does it reflect? a) Denial b) Ration alisation C)suprresi on

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18 th^ august Melboune 2018  Female admitted, overdosed on indapamid , was admitted and not able to sleep despite benzodiazepam. Now nurse found her staring at the ceiling and other times agitated. Cause? A. Dementi a B. Delirium C. Depression D. Catatonia  what is the least affect from lead poisoning A.neurological abnormalities B.Abdominal pain C.Liver abnormalities D.Behavioral problems

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 old man in a nursing home...nurse complains he s masturbating frequently...he is widow.rest he is fine wat next n controlled on his htn medications(bt no drug mentioned in qs).what's most appropriate next a.No change in medications b.give antipshycotic c.give anxiolytic  Baby with hematuria, urea creatinine normal, had similar episode before which resolved within 48 hrs. Now prot 1+ rbc 4+ dx? Iga neph Acute psgn HSP Nephrotic syndrom Hemorrhagic cystitis

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 11.14 years old boy begin soiling his pants his mother was concerned before 4 month he suffered from abdominal pain and diarrhea but she doesn't know if associated with weight loss?? A constipation with soiling B sexual abuse  Regarding hierarchy study,which is the least effective study? A.case report B.case control C. cohort D.RCT

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 Pt with cough and breathlessness, on many drugs ,X-ray done shows interstitial lung disease ,cause : Amiodar one Rosiglita zone Ramipril  Preg lady antinatal visit with anemia Hb 9 Mcv low from range, taking multivitamins already what adv :

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Iron infusion Green leafy vegetable Hb electrophoresi s 16.a lady her boyfriend left her. She feels sad for long time bored at times. Can't manage her anger sometimes. Now angry as many course of antidepressants didn't work. Now sleeps and eats well. what in history will help? A.unemployment for 6 months. b.alcohol abuse. C.repeated self harm 18. ..Syphilis rpr qs... pt had rpr 0 at beginning then 1: then aft 6 months and now 1:2 Also mentioned were some tpha and some antibodies which were both positive at 6 months and at present...qs was asking wat does this mean Pt has had syphilis 6 months back Pt has syphilis now

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Pt had syphilis one year back .A lady came in abdominal pain. Hx of cholecystectomy and prostetic valve for which she is on warfarin. INR 5. BP 120/80, HR 80. CT scan given. Looks like distented bladded with irregular border a. Suprapubic chateter b. Urinary chateter c. IV Vit K

. A 72 yrs old woman presents with confusion and O/E she was found to be afebrile and nothing abnormal was detected. She has an ulcer on the lower part of her leg, which has been treated by the community nurse for several months. What will assist in the diagnosis? a. Urine test b.Swab of the wound c.Blood culture d.CT scan e.Lumbar puncture  Child has diarrhea + for 4 days, mother doesn't mind until the child develops a limp and stops walking, then

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she brings the child to you. Pain and tenderness in left hip. No fever. Diagnosis? A.transient tenosynovitis B.Septic arthritis C. Slipped femoral capital epiphysis  image like this.55yr male,smoker,h/o surgery for ca oesophagus;swelling in the lateral neck fro 3 weeks,non tender,smooth,sof,free ffrom overlying skin.oropharyngealexamination normal.whts Dx? a.branchial cyst- b.pleomorphic adenoma of parotid- c.submandibular duct stone d.metastasis  Patient with flank pain that radiates into the groin. Abd CT found 2cm stone in upper pole of the kidney. What to do? A.extracorporeal lithotripsy B.Wait to pass it by himself

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C. Alfa blockator and wait

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D.PCNL

7.hyperkalemia in ECG shows A.flat t wave B.U wave C.Wide QRS

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7.32 weeks pregnant lady's child got varicella. Was tested earlier to have no immunity against varicella. What to do now? (No option for check ig) A.Do u/s b.Give zoster Ig c.Give Acyclovir d.Give Varicella Zoster vaccine JM infection in pregnancy

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8.. in a community survey is being conducted for 200 people.

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Following data 2009 2010 Bp >145/85 45 50 Fbs values I forgot High cholesterol Calculate incidence of bp in 2010 A. b. 5 c. 0 d. 25 c. 50 A patient was sent on a stess leave after employer finds him using cocaine. The patient admits using cocaine and also has memory impairment, agitation and is also irritable, what is the next step a. urine drug screen b.collateral history from employer

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c. history of sexual abuse d.past history of drug use Lawyer who is a perfectionist, recently fall in performance after miscarriage, affect sleeping, crying, can’t concentrate her work and problem with husband. don’t want to take medicine coz it might be habit forming. what is suitable management at this stage? a) CBT b) SSRI c) Interpersonal therapy (better for interrelationship problems) d) Diazepam Depression a lady in 22 week of pregnancy, came with fever, and abdominal pain in right quadrant and nausea, she has a history of appendectomy, what is the likely diagnosis? a. Ectopic pregnancy b. Abortion c. Red degeneration d. Corpus luteal cyst e. Ovarian torsion Young male complaining of pain in groin after lifting a heavy object. By exam no Lump but US revealed 1cm defect in inguinal ring with fat

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herniation. But No visible lump. What to do next? a- open laparotomy mesh b- laparoscopic repair c- check again if lump appears

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up to 10 cm (laparoscopic) more than 10 cm (open mash repair) Hereditary sphero scenario. Cause of abd pain A. Renal stone. Gall stones. Splenic enlargement  A 32 or 37 week pregnant patient present with right iliac fossa pain. She vomited twice. There was no abdominal tenderness or rigidity,. What is the cause of her pain 1.acute appendicitis? 2.intraabodominal adhesion

3. red degeneration of unrecognized fibroid 4- Placental abruption  pregnant woman 10 weeks starts to have pain in the right iliac fossa specially when she stands up or cough she had appendectomy when she was 12 year old , No rebound tenderness and guarding. wts most likely the diagnosis a. Round ligament pain b.Complex ovarian cyst c. Unrupture Ectopic pregnancy d.Intestinal obstruction

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Q182432- Pregnant patient present with RLQ pain in 22 week. She vomited twice, NO abdominal tenderness or rigidity. She has past history of appendectomy, when she was 19 years old. What is the cause of pain? A.Intraabdominal adhesion B.red generation of unrecognized fibroid C. round ligament strain D.Cholecystitis E.Adnexal Torsion

- rosetta an 18 years opd lady is on ocp. presented with first time seizure. She had muscle twitching for last 4 years.now started on sodium valproate.advice about driving? A.cant drive 3 months. B.cant drive 6 months C.cant drive 1 year D.cant drive 2 yrs E.cant apply for license 2-which modality of treatment is most useful for nasopharyngeal CA? A.chemotherapy B.radiotherapy C.surgery

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D.harmonal therapy E.immunotherap y 3-NNT is the number of people that must be treated? A.according to sample size B. to make study valid C. from sample population D. to get 1 positive outcome

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E. to get 1 adverse outcome 13 yr old boy, stealing , swearing, destructing furniture, violent towards teachers and classmates, diagnosis A- ODD B-conduct disorder C- borderline One stat question, asking to calculate the false negative rate of chalmydia (sorry I don’t remember d values) my abs was 2/172 6 year old child presenting with abdominal pain, vomiting , no diarrhoea and dehydrated, glucose high, wat is d initial investigation A-ABG B- HBA1c C- urine ketone 16 yr old girl staying with parents came for routine checkup , states dat she s abt to start sex life soon ,apart frm advice regarding safe sex and contraception wat to advises A- chlamydia 6 monthly B- Pap smear frm age of 25

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C- Pap now Every 5 years, until 69yo, from 70-74 if last 2 was normal, no anymore. Pharmaceutical company approaches u with results of comparison between 2 drugs for hyper cholesterolrmia, wat is d important question u wil ask A- wether same dose of dugs wer used B- wether 2 grp s contained d same no of people C- how did u equalize d dietary factors -a man concerned with his counting rituals, is on d verge of expulsion frm his job due to his lateness and impaired work performance, asking for d most appropriate immediate management along with relaxation technique A- exposure and response prevention B- citalopram C- olanzapine D- diazepam OCD, Exposure and response therapy OCPD SSRI 2-old lady living alone ,her son has been taking care of her health issues, wen

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