Infection at which of these site will cause enlargement of the preauricular LN

- skin of lower eyelid

- inner side of cheek
- ear pinna
- submandibular gland
A lady twisted her ankle and afterwords could feel pain and difficulty in walking. There's tenderness
just below lateral malleolus. What is the structure affected?
- anterior talo-fibular ligament
- deltoid ligament
- calceneo-fibular ligament
A man was subjected to head trauma during an RTA. After the accident clear fluid was seen coming
through the external auditory meatus. What is the source of the fluid?
- CSF
- endolymph from inner ear
A man had a strong blow to his face during fight. There's periorbital ecchymosis, and enophthalmos.
The most likely fractured bone is
- maxillary
- fronatal
- ethmoid
- mastoid
A manual worker had a sudden feeling of giving away and pain in the elbow region during using his
screwdriver. There was tenderness and bluish discolouration just below the cubital fossa. The tendpon
most likelty ruptured is:
- biceps
- brachiradialis
- triceps
- supraspinatus
A 30 year old lady developped epilepsy for three years after her mother died. Her boyfriend says she
has seizures everyday despite treatment. He also feels that she is able to talk sometimes during the
attack. What is the required investigation?
- video eeg
- serum calcium
- ct brain
- mri brain
A man is being admitted for an eleelctive hemicolectomy. When is the time for giving prophylactic
antibiotics?
- At induction of anaesthesia (OHCM says 30 minutes before surgery)
- 24 hours before surgery
- 6 hours before surgery
- no need
An old man who has dementia was admitted with suspected intestinal obstruction and had laparotomy
which he did not survive from. He had hemicolectomy but no histroy could be elicited from the patient

about the reason. At autopsy, the pathology of the liver describes various nodules at the surface of the
liver just below the capsule showing central unmblication. These lesions are:
- Secondaries
- Hepatoma
- Haemangioma
The pathology report of colonic tissue describes chronic mucosal inflammation and mucosa at some
parts are invaginating through the muscular layer until reaching serosa. These lesions describe:
- Diveticulosis
- Crohn's disease
- UC
A patient had recently had MI. He now has moderate depression. The best drug for him would be:
- Sertraline
- Imipramine
- Olanzapine
The ideal time over which citalopram can be withdrawn is:
- 6 weeks (all SSRI except fluoxetine should be withdrawn over 6 weeks, source Passmed)
- 6 months
- 4 weeks
- 2 months
A preganant woman who is RH- gave birth to a boy who's Rh+. The latest time she can be given the
anti-Rh antibody is:
- 72 hours
- 6 hours
- 24 hours
- 4 days
A 30 year-old lady has a long history of dysphagia to solids. She has nocturnal cough. She is presenting
with worsening of dysphagia and regurgitation of stale fluid. The likely diagnosis is:
- oesophageal stricture
- pharyngeal pouch
- GORD.
- oesophageal cancer
A patient with cancer is on oral morphine 60 mg bid. Patient can no longer tolerate oral medication.
What is the best altenative?
- SC morphine 60 mg/day
- morphine pump
- hydromorphine syrup
The first line treatment for hay fever is:
- Local antihistaminics
- Oral antihistaminica
- Local steroids.
_ Inhaled steroids

A young man presents with 2 days history of sticky secretion blocking his eyes. On examination there
are is conjunctival injection. What is your advice to patient.
- Wash his eyes regualrly with water. (Source is NHS patient info)
- Antibiotic eye drops
- Steroid eye drops
A pregnant lady at 34 weeks at check up. Hb 111 gm/L MCV
- Nothing.
- Folate
- Oral iron

96. What would you prescribe?

A new born is seen to be cyanosed. SpO2 without oxygen is 70%. This noenate has:
- TOF
-VSD
-ASD
-PDA
An old man with long histroy of recurrent pain at his leg is seen to have a nodule on his helix. This is
propably:
- Gout
- BCC
-SCC
A 17 year old female has 1ry amenorrhoea and recurrent abdominal pains and swelling in the
suprapubic area every month or so. She has
- Haematocolpos
- Premature ovarian failure
- PCOS
A 14 year old girl has not developped 2ry sexual characters. This is likely due:
- constitutional
- PCOS
- Ovarian failure
An old man had CVS and is bid ridden. He chokes on eating or drinking. The best method to deliver
nutrition is:
- Percutaneous endoscopic gastrostomy
- Jejunostomy
- Nasogastric tube
- TPN
Parents of a 6 year-old boy are complaining that he wets his bed every night. What is the treatment of
choice
Alarm
Bladder training
Fluid restriction
Oxybutinin

A young man from Ghana presents with anaemia and abdominal pain. He says that the pains recur with
any mild infection he develops. This is likely due to
Sickle cell anaemia
G6PD def
Thalasaemia
An old man with suspected oesophageal cancer. The best mothod to ensure diagnosis is:
Flexible endoscopy
Rigid oesophagoscopy
Barium swallow
The histopathology report of the biopsy from the lower oesophageal mucosa describes intestinal
metaplasia in the form of columna r epithelium. This is called
-Barret's oesophagus
-Plummer Vinson Syndrome
A man has SVC obstruction due to lung cancer. The best initial treatment is:
- Dexamethasone
- Diuretics
- Vascular stenting
An old lady who is heavy smoker is presenting with 4 month history of progressive dyspnoea and
weight loss. He chest X ray shows generalised opacification of the left hemithorax (this was the
expression I am sure). The best option for management is:
- Chest CT
- Pleural fluid aspiration
- Antibiotics
A pateint with end-stage lung cancer with less than 4 week expected survival. He is complaining of
progressive dyspnea and CXR shows moderate effusion. The best next step is:
- Aspiration
- Thoracoscopy and pleurodesis
- Chest tube
A 3 (or may be 6) year old girl is brough by her parents due to pallor. She was previously fine without
any history of illnesses. She has low Hb and low MCV. The likely cause to this is:
- Nutritional
- Beta thalesaemia major
A mother who has long histroy of hearing problem is asking you how she can assess the hearing of her
2-day old child. You tell her:
- Brainstem auditory response
- Distraction test
- Tuning fork test
- Audiometry
A man is being admitted for an open fracture of the femur following RTA. During the induction of
anaesthesia the BP drops to 60/40 and HR is 130 bpm. The likely explanation is:

- fat embolism
- severe bleeding
- reaction to anaesthetic
A young man has a long history of gastric discomfort. Stool antigen for H-pylori is negative. No
improvement is seen after 4 (or may be 2 weeks). What's nest step:
- Upper GI endoscopy
- Continue treatment
- Urea breath test
A 62 year old lady who was not sexually active for a long period is presenting with dyspareunia and
bleeding post coital. Best treatment:
- Vaginal oestrogen
- HRT
- OCP
- Tranexamic acid
A 6 year old child is diagnosed with meningeococcal meningitis type C. He has a 6 month old brother
who received the meningitis b. Who should receive rifampicin prophylaxis. (I don't remember the
options and even my answer)
- Parents and infant
- Infant
- Patient, infant, hospital staff
- No body
A 65 year old whose BMI is 21 was doing a checkup fasting blood glucose was 7.1 mmol/L. What's
next step?
Repeat test
Life style modification
Metformin
Oral hypoglycaemics
Inslulin
A woman is complain of vaginal discharge which is whitish and has foul odour. The pH of the
discharge is > 4.5. The causative organism is
Gardenella
Trichomonas
Candida
Chlamydia
A man with IHD and depression is controlled on SSRI, aspirin and nitrates? (no beta blocker). He's
complaining of sexual dysfuntion. Likely cause is:
SSRIs
Cardiac condition
Angina drugs
A patient was diagnosed with pulmonary embolism (may be AF?)and is prescribed warfarin. Target
INR should be:
2-3
1.5-2.5

2.5-3.5
1-2
3-4
A middle age person has long history of GORD and a hiatus hernia proved by chest CT is complaining
of hoarseness of voice. Next step?
Gastrology referral
ENT referral
Young man is complaining of shortness of breath, abdominal pain, and dysuria.
PH 7.2
PCO2 low
PO2 normal
What's the next investigation
Capillary blood glucose
Urine analysis
Ultrasound abdomen
A patient with DM is controlled on gliclazide. He will undergo elective endoscopy. What should be
done regarding diabetic management (not sure about the stem or the choices)
Withhold oral drugs night before
Give insulin, glucose and potassium during procedure
A patient developed focal weakness and headache due to brain secondaries and was started on
dexamethasone. He now has poluria, thirst and his random blood glucose is very high. What should be
done:
Give insulin
Give oral hypoglycaemic drugs
Stop dexamethasone
A researcher divides patients with breast cancer into two groups and give each group one type of drug
and follows the two groups to see if the disease course in modified in any of the groups. Type of this
study:
Controlled study
Prospective cohort
Retrospective cohort
Case control
Case series

Questions related to ethics/professionalism:

There's a question about the minimum age a person can be assumed to have the capacity to consent.
(The GMC guidance states it is 16 years). Choices were: 14 15 16 18
Another one about a patient with terminal cancer on morphine who asks you to help him end his life.
Several choices on how to do that by different drugs but there's a choice that says: you tell him this not
possible but assure him that there are effective ways to deal with pain. ( euthanasia is illegal in the UK)

The 14 yr old girl who asks for oral contraception. This question is similar to a sample question on the
GMC website but with a twist. Here the boyfriend is a school teacher. Option were to prescribe, just
refuse, call parents, report to police, report to local safeguards. Answer should be one of the last 2.
Then the very recurrent question of a man with dementia who has a nodule on his scalp that he wants to
remove to improve memory and his daughter refuses surgery. (So you refer patient to psychiatry to
asses capabilitily to consent)
Not sure if this belongs to the category but it looked new. A patient who just had a TIA. Regarding
driving what should he do:
Don't inform DVLA but only goes back to driving after the specified period. (The correct answer
according to OHCM, and the period is a month)
Refrain completely
Only drive when accompanied
Resume normally
Inform DVLA