Professional Documents
Culture Documents
4.
A
man
had
a
trip
to
West
Indies
and
comes
back
with
pain
in
both
ears.
What
is
the
most
appropriate
management?
a. Urgent
referral
b. IM
gentamicin
c. Oral
amoxicillin
d. Routine
referral
to
ENT
e. Reassure
5. A
6
year
old
boy
who
travelled
from
New
york
to
united
kingdom
with
a
fever.
He
presents
to
hospital
in
the
united
kingdom
with
night
sweats.
On
examination
he
has
splenomegaly
and
his
temperature
36.4.
What
is
the
single
most
likely
diagnosis?
A. Tuberclosis
B. Lymphoma
C. Brucelosis
D. Sarcoidosis
E. Malaria
6.
A
50
year
old
man
presents
with
pain
in
his
right
ear.
On
examination
there
are
blisters
in
the
ear.
What
is
the
most
likely
cause?
a. Herpes
simplex
b. Acute
otitis
media
c. Acute
otitis
externa
d. Herpes
zoster
e. H.
influenza
7.
A
male
aged
80
years
wakes
up
in
the
morning
with
testicular
pain.
What
is
the
most
appropriate
management?
11.
A
30
year
old
lady
who
takes
combined
oral
contraception
pupils
develops
chest
infection
and
she
wants
to
amoxicillin
for
7
days.
What
is
the
single
most
appropriate
advice
for
her?
15.
A
30
years
old
post
op
surgical
patient
comes
complains
of
sudden
onset
of
chest
pain
and
shortness
of
breath.
What’s
the
most
definitive
investigation?
a. CTPA
b. Ventilation
perfusion
scan
c. D
dimer
d. Pulmonary
angiogram
e. Doppler
ultrasound
16.
A
45
year
old
patient
presents
with
COPD
and
has
worked
in
an
asbestos
company.
He
now
has
shortness
of
breath
and
pleural
effusion.
How
would
diagnose
the
fluids?
a. Chest
drain
b. Antibiotics
c. CT
scan
of
the
chest
d. Oxygen
e. Pleural
effusion
17.
A
7
year
old
lady
ingested
her
sister’s
methadone
by
mistake
and
was
found
unconscious.
He
was
given
naloxone
and
regained
consciousness.
Half
an
hour
later,
his
GCS
dropped
down
to
11/15.
What
is
the
cause
of
the
2nd
unconscious
episode?
a. Naloxone
metabolises
faster
than
methadone
b. He
took
something
else
apart
from
naloxone
c. Naloxone
is
a
partial
agonist
d. Naloxone
works
better
in
an
adult
e. Metabolism
of
naloxone
in
adult
is
low
18.
A
45
year
male
had
mechanical
injury
to
his
arm.
The
X-‐ray
is
normal.
What
will
you
advise?
a. High
arm
sling
for
2-‐3days
b. Broad
arm
sling
c. Plaster
cast
d. Analgesia
ad
bed
rest
e. Analgesia
only
19.
An
elderly
man
fell
in
the
garden.
On
examination,
there
is
a
murmur.
What
is
the
most
appropriate
investigation?
a. ABG
b. ECG
c. ECHO
d. Chest
X-‐ray
e. Hb
20.
A
45
year
old
man
was
involved
in
a
fight
and
sustained
an
injury
to
his
right
ear.
He
has
bleeding,
ringing
and
deafness
in
his
right
ear.
What
is
the
most
appropriate
investigation?
a. CT
head
b. Otoscopy
c. X-‐ray
d. MRI
scan
e. Refer
to
the
outpatient
clinic
21.
A
45
year
old
man
was
trapped
under
a
rock
for
4
hours.
He
then
presents
with
red
urine
and
renal
failure.
What
is
the
most
appropriate
treatment?
a. Urgent
dialysis
b. Fluid
challenge
c. Glucose
and
insulin
d. Dobutamin
e. Antibiotics
22.
A
30
year
lady
was
found
to
have
inflammatory
changes
on
routine
cervical
smear.
What
is
the
most
appropriate
action?
a. Do
colposcopy
b. Repeat
smear
in
6
months
c. Reassure
24.
A
45
year
old
homosexual
who
has
multiple
partners
presents
with
urethral
discharge.
He
describes
a
transiet
painless
ulcer
few
weeks
back.
What
is
the
single
most
appropriate
diagnostic
investigation?
A. Ulcer
swabs
and
culture
B. Buccal
mucosa
swab
C. PCR
for
antigen
D. Antibodies
to
treponema
pallidum
E. Biopsy
of
the
ulcer
25.
A
40
year
old
man
is
seen
with
a
hematoma
over
the
mastoid
after
being
involved
in
a
fight.
Which
bone
is
fractured?
a. Parietal
b. Temporal
c. Sphenoidal
d. Mandibular
e. Occipital
26.
A
15
year
old
female
presents
with
colicky
pain
in
the
pelvis
region
since
1
year
ago
which
has
now
increased.
The
pain
is
in
the
right
iliac
fossa.
What
is
the
diagnosis?
a. Ovarian
torsion
b. Twisted
ovarian
cyst
c. Appendicitis
d. Ovarian
cancer
e. Endometriosis
27.
A
30
year
old
lady
had
blood
film
which
shows
a
picture
of
anaemia
with
spherocytes.
What
will
you
do?
a.
Indirect
Coomb’s
test
b.
Bone
marrow
examination
c.
Measure
serum
ferritin
d.
Bilirubin
e.
Direct
Coomb’s
test
28.
A
45
year
old
man
presents
with
pain,
loss
of
sense
and
reflexes
on
both
legs.
Where
is
the
lesion?
a. Aorta
b. External
iliac
c. Internal
iliac
d. Common
iliac
e. Femoral
29.
A
45
year
old
man
presents
with
eye
pain
and
semi
dilated
pupil.
What
is
the
single
diagnosis?
a.
Closed
angle
glaucoma
b.
Open
angle
glaucoma
c.
Uveitis
d.
Iritis
e.
Central
retinal
artery
30.
A
40
year
old
lady
patient
with
rheumatoid
arthritis
presents
with
redness
in
the
lateral
side
of
the
eye.
The
vision
is
normal.
What
is
the
diagnosis?
a. Uveitis
b. Cataracts
c. Posterior
uveitis
d. Glaucoma
e. Central
retinal
vein
occlusion
31.
A
35
year
old
female
presents
with
5
percent
full
thickness
burns.
What
is
the
most
appropriate?
What
will
you
do?
a. Reassure
b. IV
fluids
c. Fresh
frozen
plasma
d. Do
not
give
fluids
e. IV
fluids
32.
A
40
year
old
woman
with
diabetes
mellitus
has
high
ferritin
levels.
What
cancer
is
she
predisposed
to?
a. Liver
carcinoma
b. Lung
carcinoma
c. Renal
carcinoma
d. Intestinal
carcinoma
e. Pancrease
carcinoma
33.
A
30
year
old
female
is
afraid
of
developing
appendicitis.
What
risk
factor
is
likely
to
increase
the
risk
of
ectopic
pegnancy?
a. Chlamydial
infection
b. PCOS
c. Smoking
e. Cervical ectroprion
39.
A
70
year
old
man
with
known
prostrate
cancer
which
has
grown
outside
the
capsule
presents
with
increasing
confusion.
He
also
has
high
urea
and
creatinine.
What
do
you
do
next?
a. IVU
b. Furosemide
c. Ultrasound
scan
d. MSU
e. Cystoscopy
40.
A
child
of
10
years
has
positive
anti-‐hepatitis
A
IgE
and
is
hepatitis
C
IgE
negative.
What
do
you
check
to
confirm
the
diagnosis?
a. Hepatitis
B
antigen
b. Hepatitis
A
IgG
c. PCR
for
hepatitis
C
d. Envelope
hepatitis
C
antigen
e. Surface
antigen
41.
A
20
year
old
man
presents
with
syphilis
ulcers.
What
investigation
will
you
do?
a.
Antibody
for
treponema
b.
Antigen
for
treponema
c.
PCR
for
treponema
d.
Swab
from
lesions
e.
Syphillis
antigen
42.
A
30
year
male
adult
had
sex
with
a
female
adult
and
developed
a
painless
ulcer.
What
is
the
diagnosis?
a. Primary
syphilis
b. Herpes
simplex
c. Secondary
syphillis
d. Erythema
multiforme
e. Drug
related
43.
A
40
year
old
woman
presents
with
very
painful
ulcers
on
her
vulva.
She
recently
changed
her
partner.
What
is
the
single
most
likely
cause?
a. Syphilis
b. Herpes
simplex
c. Herpes
zoster
d. Erythema
multiforme
e. Chlamydia
infection
44.
A
45
year
old
man
patient
developed
infected
peritonitis
after
an
appendicectomy
for
perforated
gangrenous
appedicitis.
What
analgesia
will
you
give?
a. Morphine
IM
b. Diclofenac
PR
c. Paracetamol
PO
d. Patient
control
analgesia
e. Diamorphine
IM
45.
A
12
year
old
boy
who
is
asthmatic
child
fell
off
the
bicycle
and
sustained
a
fracture
of
the
tibia
and
fibula.
His
GCS
is
15/15.
What
is
the
most
appropriate
analgesia
to
give?
a. Apirin
b. Paracetamol
c. Opiods
d. NSAID’s
e. Patient
controlled
analgesia
(PCA)
46.
A
65
year
menopausal
woman
presents
with
recurrent
UTI
and
a
little
bleeding
PV.
Transvaginal
ultrasound
scan
was
normal.
What
is
the
appropriate
management?
a. Hormonal
replacement
b. Vaginal
oestrogen
c. Vaginal
lubricant
d. Combined
contraception
e. Progetserone
only
pill
47.
A
70
year
old
man
has
lung
cancer
and
is
confused.
There
is
also
decreased
sodium
on
blood
testing.
Examination
is
normal.
What
is
the
diagnosis?
a. SIADH
b. Fluid
overload
c. Cushing
syndrome
d. Phaechromocytoma
e. Parathyroid
hormone
48.
A
40
year
old
female
on
sodium
valproate
5mg
twice
daily
for
epilepsy
has
been
getting
attacks
more
frequently
than
usual.
On
examination
she
has
mild
obesity.
What
is
the
most
appropriate
management?
a. Increase
the
dose
b. Change
the
medication
c. Review
the
dose
d. Check
the
serum
drug
levels
e. Add
a
second
drug
49.
An
alcoholic
with
history
of
major
drinking
wants
to
quit.
He
doesn’t
want
to
get
unpleasant
feeling.
He
has
no
liver
damage.
What
is
the
most
appropriate
management?
a. Give
disulfiram
and
ask
him
to
come
back
later
b. Reduce
drinking
and
go
to
the
GP
c. Ask
him
to
stop
drinking
d. Refer
to
self
help
group
e. Acamprosate
50.
A
60
year
old
lady
presents
with
ovarian
carcinoma.
Which
lymph
drainage
is
involved?
a. Internal
iliac
lymph
nodes
b. Paraortic
lymph
nodes
c. External
iliac
lymph
nodes
d. Deep
inguinal
lymph
nodes
e. Superficial
lymph
nodes
51.
A
female
of
74
years
presents
with
repeated
falls.
She
is
diabetic,
hypertensive
and
is
on
medication
for
diabetes.
She
is
also
on
bendroflumethiazide
and
some
other
drug.
What
is
the
next
investigation?
a. Ambulatory
ECG
b. ECHO
c. Tilt
table
BP
d. Carotid
angiography
e. Standing
and
lying
blood
pressure
52.
A
74
year
old
male
who
is
a
known
diabetic
presents
with
falls.
He
is
on
the
following
medication;
aspirin,
diclofenac,
glibenclamide
and
metformin.
What
is
the
most
appropriate
investigation?
a. Ambulatory
ECG
b. ECHO
c. Carotid
angiography
d. Blood
glucose
e.
Standing
and
lying
blood
pressure
53.
A
24
year
old
woman
whose
last
menstrual
period
was
6-‐8
weeks
ago
presents
with
sudden
onset
of
right
sided
iliac
fossa
pain.
What
is
the
most
likely
diagnosis?
a. Miscarriage
b. Ectopic
pregnancy
c. Ovarian
cyst
d. Torsion
of
ovarian
cyst
e. Pelvic
inflammatory
disease
54.
A
15
year
old
female
presents
with
right
iliac
fossa
pain
every
4-‐
8weeks
which
is
very
severe
in
recent
weeks.
What
is
the
most
likely
diagnosis?
a. Miscarriage
b. Ectopic
pregnancy
c. Ovarian
cyst
d. Torsion
of
ovarian
cyst
e. Pelvic
inflammatory
disease
55.
A
19
year
old
presents
with
per
vaginal
bleeding.
She
was
treated
for
Chlamydia
in
the
past.
She
has
6
weeks
of
amenorrhea.
Pregnancy
test
is
positive.
What
is
the
most
appropriate
investigation?
a. Pregnancy
test
b. Transvaginal
ultrasound
scan
c. Serum
beta
HCG
d. Laparascopy
e. Laparotomy
56.
A
35
year
old
woman
with
5
children
presents
with
right
upper
quadrant
pain.
She
also
has
fever
and
vomiting.
3
years
ago,
she
had
intermittent
pain
in
the
right
upper
quadrant.
What
is
the
most
appropriate
management?
a. Ultrasound
scan
b. Midstream
urine
c. Intravenous
urogram
d. Laparoscopy
e. Retrograde
pyelography
57.
A
3
month
old
child
collapses
and
was
resuscitated
and
is
now
well.
His
parents
are
asking
how
to
do
CPR
in
case
it
happens
again.
a. 5:1
with
mouth
and
nose
together
b. 5:1
with
just
mouth,
nose
pinched
c. 15:2
with
mouth
plus
nose
d. 15:2
with
mouth,
pinch
nose
e. 30:2
with
one
hand
58.
A
45
year
old
man
has
been
withdrawn
recently
and
feels
that
he
is
responsible
for
the
floods
in
Thailand.
What
is
the
likely
diagnosis?
a. Schizophrenia
b. Depression
c. Schophrenia
d. Anxiety
e. Mania
59.
A
man
fell
off
his
roof
from
a
4m
height.
He
was
stable
and
answering
questions.
Suddenly,
he
became
unconscious.
On
auscultation,
there
is
decreased
air
entry
on
the
right
side
of
his
chest.
What
is
the
most
appropriate
investigation?
a. CT
scan
b. IV
fluids
c. Thoracocentesis
d. Chest
X-‐ray
e. MRI
brain
60.
An
8
year
old
girl
fell
down
and
fainted
at
the
school
assembly.
She
went
pale
and
light
headed.
What
is
the
most
likely
diagnosis?
a. Decreased
blood
sugar
b. Vasovagal
syncope
c. Anxiety
d. Arrhythmia
e. Heat
stroke
61.
A
7
year
old
boy
with
epilepsy
is
admitted
to
hospital
and
is
presently
on
valproate.
He
has
a
seizure
in
the
night.
What
is
the
initial
investigation?
a. Check
drug
seum
b. CT
head
c. EEG
d. ECG
e. MRI
scan
of
the
brain
62.
A
20
year
old
female
presents
with
palpitations.
On
examination,
there
is
no
abnormality
and
pulse
is
regular.
What
is
the
singe
most
diagnosis?
a. Sinus
tachycardia
b. VT
c. SVT
d. AF
e. Atrial
flutter
63.
A
38
year
old
woman
presents
with
pruritus
for
5
years.
What
is
the
most
appropriate
investigation?
a. FBC
b. Serum
amylase
c. Anti-‐mitochondrial
antibodies
d. Liver
ultrasound
scan
e. Liver
function
tests
64.
A
45
year
old
man
recently
returned
from
Malaysia.
For
the
past
2
days,
he
has
developed
fever
and
upper
right
quadrant
pain
and
jaundice.
What
is
the
most
appropriate
investigation?
a. CT
abdomen
b. Hepatitis
screen
c. Serum
amylase
d. Ultrasound
scan
of
the
abdomen
e. Liver
function
tests
65.
A
22
year
old
man
presents
with
bilateral
facial
swelling.
What
is
the
most
likely
diagnosis?
a. Parotid
calculi
b. Submandibular
calculi
c. Lympadenopathy
d. TB
adenitis
e. Mumps
66.
A
6
week
old
girl
with
pyloric
stenosis
presents
with
vomiting.
What
is
the
most
appropriate
test?
a. Calcium
b. Potassium
c. Sodium
d. HCl
e. Magnesium
67.
A
15
year
old
boy
has
had
his
sebaceous
cyst
removed.
He
is
a
known
asthmatic.
What
is
the
most
appropriate
management?
a. Paracetamol
b. NSAID’s
c. Morphine
d. Codeine
e. Aspirin
68.
A
50
year
old
man
presents
with
sudden
loss
of
vision
in
his
right
eye.
On
fundoscopy,
there
are
hard
exudates
and
flame
shaped
hemorrhages.
What
is
the
most
likely
diagnosis?
a. Central
retinal
vein
occlusion
b. Central
retinal
vein
artery
c. Retinal
detachment
d. Optic
neuritis
e. Branch
of
retinal
artery
occlusion
69.
A
40
year
old
lady
while
walking
at
home
develop
sudden
onset
of
vomiting
and
loss
of
consciousness.
In
accident
and
emergency
department
her
GCS
is
5/15.
Initially
she
lost
consciousness
and
later
she
was
ok
with
GCS
15/15.
What
is
the
single
most
appropriate
investigation?
She
had
a
laceration
to
her
temple
area
A. CT
scan
of
the
head
B. Facial
X-‐ray
C. MRI
brain
D. No
investigation
E.
Skull
X-‐ray
70.
A
23
year
old
lady
who
is
pregnant
presents
with
hypertension
in
her
pregnancy.
She
has
history
of
recurrent
UTI
as
a
child.
What
is
the
most
likely
cause
of
her
hypertension?
a. Pregnancy
induced
hypertension
b. Kidney
damage
c. Essential
hypertension
d. Pre-‐eclampsia
e. Diabetes
71.
A
45
year
old
lady
was
found
to
have
CIN
2
on
routine
test.
What
is
the
most
appropriate
next
step?
a. Smear
b. Colposcopy
c. Cervical
biopsy
d. Transvaginal
ultrasound
scan
e. Endometrial
carcinoma
72.
A
67
year
old
lady
presents
with
tingling
and
numbness
in
the
index
and
middle
finger.
Tinnel
test
is
negative.
What
is
the
most
appropriate
investigation?
a. Blood
glucose
b. CT
spine
c. Spine
X-‐ray
d. MRI
spine
e. Hormone
levels
73.
A
50
year
old
man
wakes
up
in
the
morning
with
food
on
the
pillow.
What
is
the
most
likely
cause?
a. GERD
b. Pharyngeal
pouch
c. Laryngeal
cancer
d. Facial
nerve
palsy
e. Nocturnal
vomiting
74.
A
3
year
old
boy
develops
haematuria
2
weeks
after
upper
respiratory
tract
infection.
What
is
the
single
most
likely
diagnosis?
A. Post-‐streptococcal
glomerulonephritis
B. Ig
A
nephropathy
C. Chronic
pyelonephritis
D. Urinary
tract
infection
E. Bladder
tumour
75.
A
23
year
old
lady
presents
with
shortness
of
breath
and
light
headedness.
She
has
vitiligo
and
raised
MCV.
What
is
the
most
likely
diagnosis?
a. Hypothyroidism
b. Pernicious
anemia
c. Phenytoin
side
effects
d. Iron
deficiency
anaemia
e. Folate
deficiency
76.
A
56
year
old
man
who
has
never
smoked
presents
with
regurgitation
of
food
when
lying
down.
He
also
has
hoarseness
of
voice
for
few
months.
Who
do
you
refer
to?
a. ENT
surgeon
b. GIT
surgeon
c. General
surgeon
d. Voice
therapist
e. Speech
therapist
77.
A
43
year
old
pregnant
woman
presents
with
tingling
and
numbness
in
the
index
and
middle
finger.
What
is
the
lost
likely
diagnosis?
a. Carpal
tunnel
syndrome
b. Diabetes
in
pregnancy
c. Hypertension
in
pregnancy
d. Cushing
syndrome
e. Acromegaly
78.
A
40
year
old
man
presents
with
2
months
history
of
chronic
short
breath
and
an
erythema
on
his
shin.
What
is
the
most
likely
cause
of
the
lesion?
a. Erythema
nodosum
b. Erythema
multiforme
c. Urticaria
d. Purpura
e. Maculopapular
rash
79.
A
60
year
old
woman
presents
with
bleeding
per
vaginum.
Her
last
cervical
smear
was
3
years
ago.
What
is
the
most
likely
diagnosis?
a. Cervical
cancer
b. Endometrial
carcinoma
c. Cervical
poly
d. Vaginal
cancer
e. Pelvic
inflammatory
disease
80.
A
50
year
old
woman
presents
with
bleeding
from
one
of
her
mammary
duct.
What
is
the
most
appropriate
investigation?
a. Mammography
b. Open
biopsy
c. FNAC
d. Ductography
e. Core
biopsy
81.
A
70
year
old
lady
with
severe
heart
failure
presents
with
stress
urinary
incontinence.
She
has
got
a
feeling
of
dragging
sensation
in
her
perineum.
What
is
the
most
appropriate
management?
a. Pelvic
floor
exercise
b. Ring
pessary
c. Oxybutinin
d. Bladder
neck
surgery
e. Local
estrogen
82.
A
1
year
old
child
presents
with
dehydration.
Which
of
the
following
is
an
indication
for
intravenous
fluids?
86.
A
30
year
old
lady
who
is
27
weeks
pregnant
is
found
to
have
anemia
of
10.
She
has
normal
MCHC
and
MCV.
What
is
the
most
appropriate
action?
a. No
treatment
required
b. Endoscopy
c. Blood
transfusion
d. Vitamin
B12
replacement
e. Iron
and
folate
87.
A
30
year
old
lady
in
her
30
weeks
of
pregnancy
presents
with
sudden
onset
of
uterine
bleeding
and
a
tender
uterus.
She
has
no
previous
history
of
caesarian
section.
Fetal
heart
sounds
are
increased.
What
is
the
most
likely
diagnosis?
a. Placenta
praevia
b. Uterus
rupture
c. Cervical
ectropion
d. Trauma
e. Placental
abruption
88.
A
23
year
old
lady
in
her
34
weeks
of
pregnancy
presents
with
seizures.
Her
BP
is
170/110mmHg.
What
is
the
most
appropriate
management?
a. Intravenous
hydralazine
b. Intravenous
methyldopa
c. Intravenous
magnesium
sulphate
d. Caesarian
section
e. Induce
labor
89.
A
35
year
old
lady
with
previous
history
of
pelvic
inflammatory
disease
has
6
weeks
history
of
amenorrhea.
She
presents
with
right
sided
lower
abdominal
pain.
What
is
the
most
likely
diagnosis?
a. Miscarriage
b. Exacerbation
of
pelvic
inflammatory
disease
c. Ectopic
pregnancy
d. Molar
pregnancy
e. Acute
pancreatitis
90.
A
70
year
old
woman
with
breast
cancer
has
had
it
spread
to
her
lung,
liver
and
bones.
There
is
also
increasing
constipation,
weakness,
thirst
and
anorexia
for
3
days.
She
is
taking
only
haloperidol
for
hiccups.
She
is
more
disorientated
today.
What
is
the
most
likely
diagnosis?
a. Cerebral
metastases
b. Hypercalcemia
c. Spinal
cord
compression
d. UTI
e. Chest
infection
91.
A
30
year
old
man
after
an
appendicectomy
develops
abdominal
pain
radiating
to
the
shoulder.
What
is
the
most
likely
nerve
to
be
involved?
a. Phrenic
nerve
b. T10
c. Aortic
nerve
d. T12
e. Celiac
nerve
92.
A
40
year
old
lady
has
had
appendicectomy.
She
presents
with
numbness
on
her
umbilical
area.
Which
nerve
is
damaged?
a. Phrenic
nerve
b. Celiac
nerve
c. T12
d. T10
e. T5
93.
A
40
year
old
man
is
stabbed
in
the
chest
BP
is
60/0,
HR
140.
On
examination
he
has
engonged
neck
veins
and
trachea
is
on
the
midline.
What
is
the
single
most
likely
diagnosis?
A. simple
pneumothorax
B. Tension
pneumothorax
C. Haemothorax
D. Cardiac
temponade
Aortic
laceration
94.
An
89
year
old
lady
is
terminally
ill
with
advanced
cancer
and
is
in
severe
pain.
The
pain
is
not
controlled
by
morphine.
She
also
has
nerve
root
pain.
What
is
the
most
appropriate
management?
a. Oral
morphine
b. Paracetamol
c. Gabapentin
d. Increase
analgesia
e. No
further
action
95.
A
6
month
old
child
develops
fever
and
difficulty
in
breathing
and
feeding.
What
is
the
most
likely
diagnosis?
a. Pneumonia
b. URTI
c. Broncholitis
d. Croup
e. Epiglottitis
96.
A
6
week
old
child
has
repeated
vomiting
after
feeding.
What
is
the
most
appropriate
investigation?
a. CT
abdomen
b. USS
abdomen
c. Endoscopy
d. Barium
enema
e. No
investigations
required
97.
A
40
year
old
woman
with
family
history
of
cancer
on
routine
screening
was
found
to
have
an
APC
gene.
Which
cancer
is
most
likely
at
risk?
a. Colonic
adenocarcinoma
b. Ovarian
carconima
c. Endometrial
carcinoma
d. Cervical
carcinoma
e. Breast
cancer
98.
A
30
year
old
lady
presents
with
fresh
blood
per
rectum
after
defecation.
She
has
been
constipated
for
the
past
2
months.
She
has
no
pain.
What
is
the
diagnosis?
a. Anal
fissure
b. Haemorrhoids
c. Inflammatory
bowel
disease
d. Colonic
cancer
e. Rectal
cancer
99.
A
25
year
old
lady
presents
with
intermittent
abdominal
pain
and
bloody
diarrhea.
What
is
the
most
likely
diagnosis?
a. Crohn’s
disease
b. Ulcerative
colitis
c. Irritable
bowel
syndrome
d. Colonic
cancer
e. Abdominal
migraine
100.
A
76
year
old
man
suddenly
collapses
and
dies.
The
post
mortem
examination
d.
Antibiotics
e.
Refer
to
burns
team
104.
A
28
year
old
man
presents
with
abdominal
distension
and
pain.
His
stools
have
been
mucoid
and
sometimes
blood
stained.
What
is
the
most
appropriate
investigation?
a.
Barium
meal
b.
Gastroscopy
c.
IgA
tissue
transaminase
d.
Jejunal
biopsy
e.
Stoll
culture
and
sensitivity
105.
A
67
year
old
lady
presents
with
nausea
,
vomiting
and
diarrhea
for
3
days.
She
has
atrial
fibrillation
and
on
digoxin.
What
is
the
single
most
likely
diagnosis?
A. Clostridium
difficile
B. Digoxin
C. Gastroenteritis
D. Inflammatory
bowel
disease
E. Colonic
cancer
106.
A
73
year
old
patient
has
last
stage
colon
cancer
and
is
suffering
from
severe
pain
although
he
has
reached
the
maximum
dose
of
opiates.
What
would
you
prescribe
to
improve
his
symptoms?
a.
Subcutaneous
morphine
b.
Fentanyl
patches
c.
Oxycodone
d.
Radiotherapy
107.
A
25
year
old
man
presented
with
history
of
breathlessness.
A
transthoracic
114.
A
20
year
old
mother
who
had
been
alcohol
dependence
for
over
20
years.
She
has
been
misusing
of
different
types
of
drugs.
She
is
now
well
and
alert..
She
would
like
to
be
helped?
A. Voluntary
admission
to
psychiatric
ward
B. Compulsary
admission
to
psychiatry
C. Refer
to
community
mental
healthy
team
D. Methadone
E. Refer
to
the
psychiatrist
115.
A
35
year
old
lady
presents
with
painless
bleeding
from
a
single
duct.
What
is
the
most
likely
diagnosis?
a.
Duct
ectasia
b.
Paget’s
disease
c.
Duct
papilloma
d.
Intraduct
pailloma
e.
Breast
carcinoma
116.
A
25
year
old
man
was
involved
in
a
road
traffic
accident
and
got
his
foot
trapped
under
the
car
for
4
hours.
Dorsalis
pedia
is
not
palpable
and
he
has
got
tenderness
between
the
big
toe
and
the
second
toe.
What
is
the
most
likely
diagnosis?
a.
Arterial
puncture
b.
Compartment
syndrome
c.
Arterial
embolus
d.
DVT
e.
Fracture
of
the
big
toe
117.
A
57
year
old
man
is
on
treatment
for
hypertension
with
bendroflumethiazide
and
amlodipine.
His
BP
is
140/80mmHg
and
pulse
is
38b/m.
What
is
the
most
appropriate
investigation?
a. ECG
b. Ambulatory
ECG
c. Ambulatory
BP
d. ECHO
e. BP
118.
A
64
year
old
man
presnstw
ith
dyspepsia
and
epigastric
pain.
He
has
no
pas
history
of
helicobacter
pylori.
What
is
the
single
most
appropriate
investigation?
A. Ultrasound
scan
abdomen
B. Upper
GI
endoscopy
C. H.
Pylori
serology
D. Urea
breath
tests
E. Barium
swallow
119.
A
7
year
old
boy
fell
down
from
a
bicycle.
He
now
presents
with
swelling
of
the
right
knee
and
is
unable
to
bear
weight.
What
is
the
most
appropriate
management?
a. X-‐ray
of
the
knee
b. Analgesia
c. Immobilise
in
a
cast
d. Refer
to
fracture
clinic
e. Reassure
120.
A
2
year
old
boy
fell
down
from
the
stairs.
He
cried
for
sometime
and
suddenly
became
quiet.
When
the
mother
turned
to
look
at
him,
he
was
unconscious
and
stopped
breathing.
After
1
hour,
the
child
was
completely
fine
and
playing
actively.
The
mother
said
that
this
has
happened
in
the
past.
What
is
the
most
likely
diagnosis?
a. Epilepsy
b. Anoxic
episodes
c. Febrile
convulsions
d. Brain
tumour
121.
A
2
year
old
boy
has
had
urinary
infection.
Investigation
shows
vesico-‐ureteric
reflux.
What
will
you
tell
the
parents?
a.
Requires
antibiotic
prophylaxis
b.
Requires
surgery
c.
In
most
kidneys
will
be
scarred
by
the
age
of
5
d.
No
further
action
required
e.
It
will
resolve
on
its
own
122.
A
70
year
old
man
presents
with
back-‐pain,
anemia
and
raised
ESR.
Corrected
serum
blood
calcium
is
3.70.
He
is
already
on
intravenous
fluid.
What
is
the
most
appropriate
management?
a.
Pamidronate
b.
Rehydration
c.
Calcitonin
d.
Allopurinol
e.
Parathormone
123.
A
45
year
old
man
while
in
the
gym
had
sudden
onset
of
back
pan.
He
presents
wot
accident
and
emergency
department
with
lower
back
pain.
He
has
been
given
analgesia
and
now
feels
better.
All
examination
is
normal
.
What
is
most
appropriate
advice
to
him?
A. Continue
moving
B. Bed
rest
C. Needs
MRI
scan
of
the
spine
D. Needs
CT
scan
spine
E. Bed
rest
and
analgesia
124.
A
76
year
old
man
fell
down
and
hit
his
head.
Five
days
later
he
comes
back
with
confusion.
Which
of
the
following
is
the
most
likely
sight
of
bleeding?
A. Middle
meningeal
artery
B. Internal
cerebral
artery
C. Cerebral
vein
plexes
D.
Bery
aneuryms
E. Inernal
carotid
vein
125.
A
70
year
old
man
presents
with
back
pain,
anemia
and
raised
calcium.
What
finding
will
be
on
bone
marrow
aspirate?
a.
Increased
plasma
cell
b.
Increased
leucocytes
c.
Increased
T-‐cells
d.
Reduced
plasma
cells
e.
Increased
neutrophils
126.
A
70
year
old
man
presents
with
progressive
headaches,
nystagmus,
dizziness,
slurred
speech
and
unsteadiness
for
the
past
4
months.
What
investigation
is
the
best
to
localize
the
affected
area?
a.
CT
head
b.
MRI
brain
c.
CT
angiogram
d.
USS
head
e.
Skull
X-‐ray
127.
A
2year
old
boy
presents
with
redish
blistering
rash
on
the
face
especially
around
the
mouth
and
nose.
What
is
the
single
most
likely
diagnosis?
A. Impetigo
B. Shingles
C. Chicken
pox
D. Measles
E. Herpes
simplex
128.
An
elderly
woman
cannot
carry
on
her
household
chores
and
has
to
sit
down
every
few
minutes.
A
chest
X-‐ray
shows
diffuse
reticular
nodular
shadows
especially
in
the
lower
lobes.
What
is
the
next
step
in
management?
a.
Oxygen
b.
Thymectomy
c.
Chemotherapy
d.
Change
occupation
e.
Radiotherapy
129.
A
4
year
old
boy
presents
with
frontal
headaches.
Physical
examination
reveals
that
the
child
is
below
the
normal
percentile
for
height
and
weight
for
his
age.
A
computerized
tomography
study
of
his
skull
reveals
a
cystic,
suprasellar
mass
with
focal
areas
of
calcification.
There
is
an
enlargement
of
the
sella
turcica.
The
lesion
is
most
likely
derived
from?
a.
Rathke
pouch
remnants
b.
Histiocytes
c.
Chromophobe
cells
d.
Cells
in
the
posterior
pituitary
e.
Astrocytes
130.
A
45
year
old
man
presents
with
knee
pain
to
accident
and
emergency
department.
He
was
later
found
to
have
gout.
What
is
the
single
most
appropriate
management?
A. Allopurinol
B. Non
steroid
anti-‐inflammatory
drugs
C. Colchicine
D. Paracetamol
E. Oral
morphine.
131.
A
36
year
old
lady
with
long
standing
history
of
migraine
presents
with
severe
headache.
She
says
it
is
the
worst
headache
of
her
life.
What
is
the
most
appropriate
management?
a.
Give
analgesia
b.
CT
scan
of
the
head
c.
Reassure
d.
Observe
in
emergency
department
e.
Admit
for
24
hours
132.
A
boy
is
brought
to
the
A&E
with
feeling
of
being
unwell
for
a
few
days
and
vomiting.
His
pulse
is
100b/m
and
capillary
refill
is
3
seconds.
He
is
confused
and
his
arterial
blood
gas
results
are
shown
as
follows;
Ph:
7.25
PaCO2:
3.2kPa
PaO2:
20kPa
Base
excess:
-‐15
What
is
the
single
correct
interpretation
of
the
blood
gas
result?
a.
Metabolic
acidosis
b.
Metabolic
alkalosis
c.
Normal
d.
Respiratory
disorder
e.
Respiratory
alkalosis
133.
A
3
day
old
child
has
a
harsh
systolic
murmur
without
any
radiation.
What
is
the
likely
diagnosis?
a.
VSD
b.
Tetralogy
of
Fallot
c.
ASD
d.
Pulmonary
Stenosis
134.
A
5
year
old
boy
complains
about
an
offensive
unilateral
discharge
from
the
nose
for
6
months.
What
is
the
most
likely
cause?
a.
Foreign
body
b.
Allergic
rhinitis
c.
Polyp
d.
Sinusitis
e.
ITP
135.
A
25
year
old
man
was
brought
to
the
A&E
department
after
partying
in
the
night
club.
He
is
hallucinated,
has
high
temperature
and
his
pupils
are
dilated.
His
friends
would
not
admit
which
substance
he
took.
The
patient
said
that
the
‘‘orange
colored’’
doctor
is
talking
to
him.
What
drug
is
most
likely
implicated?
a.
LSD
b.
Ecstasy
c.
Cocaine
d.
Alcohol
e.
Heroin
136.
An
old
woman
develops
pain
in
the
lower
part
of
the
knee
joint
anteriorly
on
sitting.
Which
bursa
is
affected?
a.
Suprapatellar
b.
Infrapatellar
c.
Prepatellar
137.
An
old
woman
develops
sudden
pain
in
the
upper
part
of
her
arm
after
carrying
heavy
loads.
Which
part
of
the
arm
is
affected?
a.
Ruptured
supraspinatus
tendon
b.
Posterior
capsulitis
c.
Biceps
tear
d.
Bursitis
138.
A
lady
said
that
she
is
being
controlled
by
some
outside
force
who
tells
her
to
do
everything.
What
is
this
condition
that
she
is
having?
a.
Delusion
b.
Thought
insertion
c.
Thought
broadcasting
d.
Acute
anxiety
e.
Passivity
phenomenon
139.
A
40
year
old
patient
presents
with
dry
cough
and
confusion.
Blood
tests
reveal
lymphopenia
and
hyponatremia.
Chest
X-‐ray
shows
right
lobar
shadowing.
What
is
the
single
most
appropriate
treatment?
a.
Erythromycin
b.
Cyclophosphamide
c.
Tobramycine
and
carbenicillin
d.
Plasmaphoresis
e.
Ciprofloxacin
140.
A
2
week
s
old
babay
has
been
diagnosed
with
breast
milk
jaundice.
What
would
the
blood
test
investigation
show?
A. Bilirubin
40,
conjugated
less
5.
B. Bilirubin
40
conjugated
<10
C. Bilirubin
40,
unconjugated………
D. Bilirubin
40,
…..
E.
Bilirubin……
141.
A
40
year
old
man
presents
with
vertigo,
nystagmus
and
weakness.
He
also
has
tingling
sensation
in
his
right
arm
and
diplopia.
On
examination,
there
is
loss
of
central
vision,
nystagmus
and
ataxia.
What
is
the
most
likely
diagnosis?
a.
Vertebra-‐basilar
ischemia
b.
Multiple
sclerosis
c.
Acoustic
neuroma
d.
Lateral
medullary
syndrome
142.
A
40
year
old
Afro-‐Caribbean
woman’s
lung
function
tests
are
as
follows:
PET/FEV1
2.51,
FEV1/FVC
86%,
Serum
ACE
levels
-‐High.
What
is
the
single
most
likely
diagnosis?
a.
Pneumonectomy
b.
Pulmonary
fibrosis
c.
Pulmonary
embolism
d.
Panic
attack
e.
Sarcoidosis
143.
A
34
year
old
man
presents
with
right
upper
quadrant
pain
and
was
later
found
to
have
acute
hepatitis.
What
would
be
the
values
of
liver
function
tests?
A. AST…..
B. ALT…….
C. Bilirubin…..400
D. Alkaline
phosphatase
E. AST
144.
A
62
year
old
man
has
a
5
years
history
of
diabetes.
On
examination,
his
blood
pressure
is
120/80mmHg.
Laboratory
tests
for
a
24
hour
urine
collection
show
a
protein
level
of
200mg/l.
What
medication
should
be
added
to
this
patient?
a.
B-‐blockers
b.
Calcium
channel
blockers
c.
ACE
inhibitors
d.
Diuretics
145.
A
woman
has
a
35
days
period.
On
what
day
should
her
progesterone
level
be
measured
to
determine
ovulation?
a.
Day
14th
b.
Day
16th
c.
Day
21st
d.
Day
25th
e.
Day
28th
146.
A
patient
after
trauma
has
a
claw
hand.
What
clinical
test
should
you
perform
to
prove
the
diagnosis?
a.
Abduction
of
the
fingers
b.
Extension
of
the
wrist
c.
Flexion
of
the
wrist
d.
Abduction
of
the
thumb
e.
Opposition
of
the
thumb
147.
A
middle
aged
woman
presents
with
chronic
cough
and
purulent
sputum.
Recently
she
has
become
very
wheezy
and
dyspnoeic.
ECG
gives
a
low
voltage
reading
and
chest
X-‐ray
shows
a
large
heart
shadow.
What
is
the
most
appropriate
management?
a. Antibiotics
b. Sputum
culture
c. Pericardial
aspiration
d. Streptokinase
e. Furosemide
148.
A
60
year
old
farmer
presents
with
fever,
cough
and
shortness
of
breath.
He
was
forking
hay
that
morning.
Chest
X-‐ray
shows
fatty
nodular
shadows
in
the
upper
zone.
What
is
the
single
most
appropriate
treatment?
a. Prednisolone
b. Erythromycin
c. Cyclophosphamide
d. Tobramycin
and
carbenicillin
149.
A
woman
after
road
traffic
accident
is
in
the
A&E
department.
Her
blood
pressure
is
low
and
she
has
pain
in
the
left
part
of
her
abdomen.
What
will
you
do
first?
a.
Abdominal
Ultrasound
b.
IV
fluid
c.
Laparatomy
d.
CT
abdomen
e.
Blood
transfusion
150.
A
child
has
a
dry
skin
on
the
arm.
Parents
tried
emollients
which
did
not
help.
What
is
the
next
step
of
management?
a.
1%
prednisolone
b.
2%
hydrocortisone
c.
0.1%
betamethasone
d.
Antibiotics
e.
Clobetasol
151.
A
22
year
old
collapses
at
a
football
match
and
is
brought
in
by
the
ambulance.
He
is
pale,
sweaty
and
has
a
Glasgow
coma
scale
of
10.
His
eyes
are
open
to
pain,
he
also
localizes
to
painful
stimuli
and
is
speaking
inappropriate
words.
His
blood
pressure
is
120/30mmHg,
pulse
rate
is
100b/m
and
the
capillary
refill
time
is
less
than
2
seconds.
His
airways
are
also
patent.
What
is
the
single
most
appropriate
initial
investigation?
a.
Blood
ethanol
(alcohol)
level
b.
Capillary
blood
glucose
c.
Computed
tomography
scan
of
the
brain
d.
Drug
screen
e. Serum
urea
and
electrolytes
concentration
152.
A
23
year
old
lady
who
10
weeks
pregnant
presents
to
antenatal
clinic
and
she
is
worried
that
her
child
could
have
cystic
fibrosis.
What
would
be
the
most
appropriate
investigation?
A. amniocentesis
B. Chorionic
villus
sampling
C. Tripple
tests
D. Anomaly
ultrasound
scan
E. Prenatal
diagnosis.
153.
An
elderly
woman
who
lives
alone
presents
with
pain
for
a
few
days
in
the
6th
and
7th
intercostals
space.
What
is
the
most
likely
diagnosis?
a.
Herpes
zoster
b.
Broken
rib
c.
Myalgia
d.
Herpes
simplex
e.
Staphylococcus
infection
154.
A
child
after
viral
infection
has
otitis
media.
What
antibiotic
will
you
prescribe?
a.
Amoxicillin
b.
Flucloxacillin
c.
Gentamycin
drops
d.
Gentamycin
tablets
e.
Benzylpenicillin
155.
A
patient
with
long
history
of
GERD
underwent
oesophago-‐
duodenoscopy
and
Barret’s
oesophagus
was
diagnosed.
What
is
the
single
most
important
term
to
define
this
condition?
a.
Squamous
metaplasia
b.
Columnar
metaplasia
c.
Dysplasia
d. basal
cell
carcinoma
e. Squamous
cell
carcinoma
156.
A
76
year
old
man
presents
with
a
right
hemi-‐paresis.
CT
scan
shows
an
ischemic
stroke
and
Aspirin
300mg
is
commenced.
In
terms
of
further
management
in
the
acute
phase,
which
one
of
the
following
values
should
not
be
corrected?
a.
Blood
pressure
210/110mmHg
b.
Blood
glucose
9.4mmol/l
c.
Oxygen
saturation
94%
d.
Blood
glucose
2.5mmol/l
e.
Temperature
38.5
C
157.
A
35
year
old
woman
presents
with
thyrotoxicosis.
Which
one
of
the
following
physical
signs
support
a
diagnosis
of
Grave’s
disease?
a.
Opthalmoplegia
b.
Lid
retraction
c.
Tremor
d.
Atrial
fibrillation
e.
Symmetrical
goiter
158.
A
woman
presents
with
a
lump
in
her
breast
with
lymphadenopathy
and
possible
malignancy
suspected
after
a
fine
needle
biopsy.
What
sit
the
next
step
of
investigation?
a.
Core
biopsy
b.
Mammography
c.
Ultrasound
d.
Open
biopsy
e.
FNAC
159.
A
4
year
old
girl
presents
with
dyusria,
frequency
and
fever.
Culture
of
urine
shows
E.coli.
Which
antibiotic
will
you
give?
a.
Rifampicin
b.
Cefuroxime
c.
Ciprofloxacin
d.
Trimethoprim
e.
Gentamicin
160.
A
35
year
old
man
presents
with
acute
onset
of
red
eye,
pain
and
blurry
vision.
He
has
peri-‐orbital
edema
and
redness.
What
is
the
best
initial
management?
a.
Put
patient
in
a
dark
room
with
reduced
light
b.
IV
morphine
and
routine
ophthalmological
referral
c.
IV
morphine
and
emergency
ophthalmological
referral
d.
IV
morphine
and
antibiotics
161.
A
5
year
old
child
was
admitted
to
hospital
with
chest
infection.
5
day
after
admission
he
was
found
to
be
MRSA
positive.
What
is
the
most
appropriate
next
action?
d.
ECG
e.
ECHO
169.
A
12
year
old
boy
presents
with
vomiting.
On
examination,
he
is
dehydrated,
has
cold
peripheries
and
deep
breathing.
His
blood
glucose
is
28mmol/l.
What
is
the
first
step
in
management?
a.
Give
IV
insulin
b.
Give
normal
saline
0.9%
c.
Reassure
the
patient
d.
Give
normal
saline
9%
e.
Give
insulin
SC
170.
An
18months
old
child
choked
on
food.
What
will
be
your
next
step?
a.
Helmich
manoeuvre
b.
Back
blows
with
chest
compression
with
child
on
parents
lap
c.
Chest
compression
with
child
on
parents
lap
d.
Induced
vomiting
171.
An
elderly
man
had
pneumonia
and
then
suffered
myocardial
infarction
for
which
he
was
thrombosed.
Then
he
was
found
to
have
multiple
mucosal
hemorrhages
and
ulcer
15cm
in
diameter
at
the
splenic
flexure
of
the
colon.
What
is
the
cause?
a.
Thrombosis
b.
Antibiotics
c.
Ischemia
d.
Malignancy
172.
A
5
year
old
child
ws
involved
in
a
road
traffic
accident
with
her
parents.
On
examination
she
has
noise
breathing?
What
is
the
single
most
appropriate
management?
A. Intravenous
fluid
B. Secure
airway
C. CT
scan
head
D. MRI
chest
E. MRI
brain
173.
A
40
year
old
patient
who
has
been
complaining
of
pain
was
given
paracetamol
and
ibuprofen
but
is
still
complaining
of
pain.
What
drug
should
be
given
to
this
patient
to
ease
his
symptoms?
a.
Codydramol
b.
Codeine
phosphate
c.
Morphine
orally
d.
Tramadol
e.
IV
morphine
174.
A
4
year
old
child
develops
chicken
pox.
The
parents
brings
her
to
hospital
.
she
is
adviced
that
no
treatment
is
required.
The
mother
says
when
can
the
child
go
back
to
school?
A. When
rush
crusted
over
B. After
2
days
C.
All
the
times
D.
Never
E.
Intermittently
175.
A
45
year
old
man
who
is
on
multiple
medication
presents
with
tremors
of
the
hands
and
difficulty
to
initiate
movement.
Which
of
the
following
medication
is
the
most
likely
cause?
A. Anti-‐depressant
B. Anti-‐epileptic
medication
C. Anti-‐psychotic
D. Aspirin
E. Simvastatin
176.
A
45
year
old
man
travelled
to
Thailand
for
a
holiday
and
returned
a
few
days
ago.
He
now
presents
with
fever
and
cough.
On
examination
he
has
cervical
lymphadenopathy.
What
is
the
most
likely
diagnosis?
a.
Estein
Barr
Virus
b.
Tuberculosis
c.
Herpes
simplex
d.
Human
immunodeficiency
syndrome
177.
A
70
year
old
lady
who
has
been
on
treatment
who
has
been
treated
with
carbamezepine
for
aplastic
anemia.
She
now
presents
with
shortness
of
breath
and
light
headedness.
Blood
results
show
MCV
70,
Hb
8.5,
WBC
2.0,
Neutrophils
1,
Platelets
50.
a.
Hemorrhage
anaemia
b.
Aplastic
anemia
c.
Hereditary
spherocytosis
d.
Pernicious
anaemia
e.
Folate
deficiency
anemia
178.
A
60
year
lady
fell
down
and
sustained
neck
of
femur
fracture.
Which
artery
is
she
likely
to
bleed
from?
a.
Femoral
artery
b.
Circumferential
artery
c.
Popliteal
d.
Common
iliac
artery
e.
External
iliac
artery
179.
A
45
year
old
man
had
developed
lower
back
pain
radiating
down
the
posterior
aspect
of
his
legs
down
to
his
knees.
What
is
the
most
likely
diagnosis?
a.
Spinal
cord
compression
b.
Disc
proplapse
c.
Spine
malignancy
d.
Tuberculosis
e.
Musculoskeletal
pain.
c.
Cast
d.
Sling
e.
Open
reduction
and
internal
fixation
184.
A
26
year
old
woman
has
been
promoted
at
work
to
a
job
that
requires
a
lot
of
public
speaking.
She
is
worried
and
anxious
about
it
and
feels
that
she
would
faint.
What
is
the
single
most
useful
intervention?
a.
Cognitive
behavioural
therapy
b.
Diazepam
c.
Fluoxetine
d.
Psychodynamic
psychotherapy
e.
Relaxation
therapy
185.
A
lady
has
developed
breast
abscess
after
delivery.
What
is
the
most
likely
causative
organism?
a.
Staphylococcus
aureus
b.
Staphylococcus
albus
c.
Streptococcus
pyogenes
d.
Streptococcus
faecalis
e.
E.coli
186.
An
old
man
suffers
from
end
stage
prostatic
cancer.
He
has
pain,
anuria
and
bilateral
hydronephrosis.
His
daughter’s
wedding
is
in
3
weeks
time
and
he
is
looking
forward
to
enjoying
the
ceremony.
What
is
the
most
appropriate
palliative
treatment
for
him?
a.
Bilateral
nephrostomy
b.
Palliative
chemotherapy
c.
Catheterization
d.
Palliative
radiotherapy
187.
A
10
year
old
child
has
got
progressive
bilateral
hearing
loss.
He
has
started
to
increase
the
television
volume.
All
other
examinations
are
normal.
What
is
the
most
likely
diagnosis?
a.
Bilateral
otitis
media
with
effusion
b.
Nasopharyngeal
carcinoma
c.
Presbyacusis
d.
Noise
induced
hearing
loss
188.
A
34
year
old
man
present
with
mass
in
the
testis
which
has
been
found
to
malignant.
To
which
of
the
following
lymph
nodes
will
it
metastasis
first?
A. Para-‐aortic
B. Internal
iliac
C. Common
Iliac
D. Superficial
inguinal
E. Deep
inguinal.
189.
Which
of
the
flowing
results
establish
a
diagnosis
of
diabetes
mellitus?
a.
Asymptomatic
patient
with
fasting
glucose
7.9mmol/l
on
one
occasion.
b.
Symptomatic
patient
with
fasting
glucose
6.8mmol/l
on
2
occasions.
c.
Asymptomatic
patient
with
random
glucose
22.0mmol/l
on
1
occasion.
d.
Symptomatic
patient
with
random
glucose
12.0mmol/l
on
1
occasion.
190.
A
45
year
old
man
presents
with
bi-‐temporal
hemianopia
and
spade
like
hands.
What
is
the
definitive
test
to
confirm
the
diagnosis?
a.
Early
morning
growth
hormone
b.
Insulin
tolerance
test
c.
OGTT
with
growth
hormone
measurements
d.
Random
insulin
growth
hormone
measurements
e.
Short
ACTH
test
191.
A
26
year
old
man
with
history
of
hereditary
hemorrhagic
telangiectasia
is
planning
to
start
a
family.
What
will
the
mode
of
inheritance?
a.
Autosomal
dominant
with
incomplete
penetrance
b.
Autosomal
co-‐dominant
c.
Autosomal
recessive
with
incomplete
penetrance
d.
Autosomal
dominant
e.
Autosomal
recessive
192.
A
67
year
old
man
was
diagnosed
with
cancer
of
the
oesophagus
with
metastasis
to
the
liver
.
What
is
the
single
most
appropriate
management?
A. Chemotherapy
B. Radiotherapy
C. Resection
D. Stenting
E. Chemotherapy
and
radiotherapy.
193.
A
34
year
old
man
with
multiple
sclerosis
has
taken
an
overdose
of
100
paracetamol
tablets
with
intent
to
end
his
life.
He
has
been
brought
to
the
A&E
for
treatment
but
is
still
refusing
interventions.
What
is
the
most
appropriate
management?
a.
Assessment
of
suicide