jan 2008 questions in one page

Discussion in 'MRCP Forum' started by amjo10 ----, Feb 3, 2008.

  1. amjo10   ----

    amjo10 ---- Guest

    1) Few questions on differential diagnoses of sore throat e.g. EBV vrs. Strep. pyogenes

    2) Parkinson like syndromes e.g. parkinson's vrs. supranuclear palsy

    3) stats: what type of test to use for a set of data, NNT calculations

    4) Plenty of psych! e.g. personality disorder, differentiating this from suicidal intent

    5) pharmacology; p450 enzyme inducers and inhibitors, lung fibrosis

    6) Alport's syndrome

    7) risk factors for crohn's disease e.g genetic, OCP

    diagnosis of haemachromatosis vrs. PBC vrs. autoimmune hepatitis

    9) hepatitis A vrs. HIV in young man

    10) type on collagen affected in Marfans
    Organ directly in contact with left kidney - Pancreas

    - Dermatology .. red scaly circular lesions + very itchy...I thought the answer was Discoid eczema

    - Acid base imbalance in Cushings - Metabolic alkalosis

    - Central scotoma - Optic neuritis

    - T1 lesion mostly associated with ....Horners syndrome

    - Wasting of small muscles of hand - Ulnar nerve

    - African lady with Ring enhancing lesions in the brain on scan - what is the Treatment? - Pyrimethamine + Sulphadiazine
    Respiratory system

    A)occupational asthma ans pf messure 2 wks.

    b)central chest mass with muscle weakness ans small cell carcinoma.

    c)ca lung,contraindication of surgery ans superior vena caval obs.

    d)mesothalioma ans niddle sreak seddling.

    e)allergic alveolities ans upper lobe fibrosis.
    the question about the mechenism of cell death in chemotherapy ---i selected Apoptosis any one got the correct answer
    Question regarding wasting all muscles of the hand was T1 root lesion
    1)elderly men with visual symptoms and IG M monogammaglobinemia-waldenstrom
    2)RA-painless eye-episcleritis
    3)Vit d rich source-cod liver oil,dairy products?
    4)stastics-wat is power of study
    5)how to calculate-sensitivity,positive predictive value
    6)Wernickes dysphasia-meaning,location
    7)ciprofloaxacin-liver enzyme inhibitors
    8)causes of isolated increase in APTT
    9)a man who firmly believes that his ears were large and need plastics surgery-hypochondriasis?
    10)treatment of Af in structurally normal heart-flecainamide
    11)young male 12 days history of generalized lymphadenopathy,sore throat,oral ulcers,macular papular rash-acute hiv
    12)rx of infective endocarditis
    13)most diagnostic test for legionella pneumonia
    14)rx of necrotizing fascitis in MRSA
    15)erytematous papule-red elevated lesion
    16)treatment of tinea rubrum

    1. Genetic technique to test for DiGeorge --> FISH

    2. What method to use for size specific RNA molecules with DNA probe?

    3. Man with swollen and inflammed testis --> Clamydia trachomatis

    4. Woman whose husband died 3 months ago suddenly after RTA. Since then, down and depressed, visual and auditory hallucination of husband when out of house. --> Depressive psychosis

    5. Man who can look downwards --> Progressive Supranuclear Palsy

    6. Acute epiglotitis in 20 year old man caused by what organism --> H.Influenzae

    7. 5 year post renal transplant, sudden worsening of renal function --> late rejection/lymphoma?

    8. T1 nerve root lesion --> Horners

    9. Lady with joint pain, gritty eyes --> Sjogren syndrome

    10. Which receptors does apomorphine works on? --> I've checked its dopamine
    a girl took a handfull of her mother medx presenting with neck spasm>>>metchlopromide

    physiological effects of thyroid >>>>>

    19 years with sore throat & atypcal lymphocutosis on blood film with low plt>>>>> EBV

    von lindle girl with angioblastoma with no renal tumors what else to expect >>>i choosed cardiac rabdomyomas & i dont know why

    hamophilia trasmission >>i screwed that one because of my low IQ>>>non of the sons

    52mother with mild diz ,daughter 21 with the diz, son with the sever form at 23 mods of inhertance >>>i choosed mitochondrial (gentic anticipation)

    warfarin stable dose started new drug high INR choosed carbamzbine >>>again another low IQ question ,its not carbazinine itrs cipro

    auto induction of carbamzibines

    confused elderly female>>>> startt IV normal saline

    50 male with 2 days of chest pain ,pain now resolved with sublingual GTN ,troponin leak, whats next >>>>>> heparinize for sure

    70 years old female with MY 4 years ago with severe hip pains in the pre-operative clinic,how to asses the myocardium>>>echo,ecg,tredmill stress test, doubtamine challenge ,i choosed doubtamine challenage as she needs a stress test but her painfull knee is a contra-indication so the challenge is to offer the best results

    bloody diarrhea follewed by renal failure what to expect in blood film >>>>tear drop,penicil cells,target cells,howell joly or red cell fragments ,i choosed red cell fragments as its HUS & heamolysis is seen

    hep b serology ques

    hep c >>>cryogluibinlame

    young male with negative diplococci in urethral discharge ,negative VDRL,positive trponemal particls aglutinins, negative anti treponimal IG>>>i choosed false postive syphilis.not sure why but can u get the particles with no anti bodies

    young lady started working in a factory ,asthma how to confirm ,i choosed serial PFR at home & work (i thaught it was one of the creiteria of diagnosis of athma)

    young lady with parrot at home ,coughing with sob>>>> pistachi serology i think

    2 questions about respiratory function tests
    i choosed one with asthma as she had low co factor & all the other answers makes the co raised ,the other one was an obese lady so i choosed obese

    there was small muscles of the hand wasting >>>cant recal my answer or the answers

    a young lady with DVT post operative 2 years ago going on a long flight soon,was give instructions ,regular movement, drink fluids, restrict alcohol, what else ,there was 2 options that i choosed >>no further action & given deltaparin before the flight ,i choosed the no further action option then in the last minute i changed it to deltaparin,why? well in all the hospitals i worked in when the admit some one with no history of dvt but expected to stay in for some days they give prophylactic sub cut heparin so what about a young lady with proven DVT a couple of years ago ,again its all personal choices so dont rely on me ,i have a very low IQ

    some one with generalized lymphadenopathy on CT abdo & chest & HB was 0.1( n- 12--15) with right iliac fossa mass >>>i choosed carcinomatosis >>>i dont know whats is that but i dont leave my answer sheet blank

    old lady with confusion ,was thirsty for a couple of weeks with signs of hepercalcime ,low hb ,xray lytic lesions ,what the next immediate action ,i choosed electrphoresis as i was convinced thats myloma but because of the work next immedicate i choosed ca levels as the preseting symptoms were confusion & thirst & u need to establish the diagnosis of hypercalciema treat it then look for the mylome later ,not sure if my theory was right or my LOW iq played again


    alports found on renal biopsy what to expect i chosed sensoneurl defnease

    cushings metabolic status >>i choosed hyocholremic acidosis & i am quite sure i am wrong

    qustion about hypercholremic hypokalemia i chosed RTA 1

    multiple ring enhancing in an IV drug user with low CD ci\oubt & positive HIV ,whats treatment i chosed sulphadizne + pyrimethrine ( toxoplasmosis i think)

    young lady with UC coming with itch & obstructibve pic on liver enzu\ymes but no hyperbilbrin ,i choosed AMA

    clear crest choosed anticentromere then changed it to antio RNP but al7amdollah i went back to the anticentromere

    young lady with breathlessnes >>>pulm HTN

    IV drug user with sob ,cxr shows plueral effusion ,failed aspiration what to do next,i stoped between 2 options CT chest & U/S then i choosed U/s as i think it was encysted & fluid stuff is better visualized by u/s agaim i am not sure it might be my low IQ

    shypyard worker with SOB with cxr showing some plaqhes,i choosed asbestosis

    lady with morning stiffnes pains in shoulder joints,hips ,hands ,back ,kness with elevated CRP,i choosed pmr

    v5,v6 t wave inversion which art affected>>>> lad i choosed

    cause of death in angio >>>cva or arrythemia

    antichoinergic toxicity

    how to know that a young girl took extasy >>>hyperthermia

    alzhimers what to give>>> donbezil

    renal transplant lady 5 years ago had some some vaginal discharge given a course of fluconazole ,urea elvated 2 weeks aft6er that i choosed ciclosporin toxixty & dont aske me why

    question about some one with night sweats ,red lesions on both chins on lower limsb ,i chosed CXR looked like TB to me

    scaly lesion in a tanned young man , i choosed scraping for mycology ,i think its veriscolor

    recureent chest infection ,whats deficent >>>complement

    some one with recurent hand & facial swelling >>levels of C1 esterase

    SLE how ro monitor >>>>ANA

    patint with 2 cavitries on CXR renal symptoms with +ve canca negative panca >>>wagners

    some one had treatment for peptic ulcer presenting with dumping syndrome for 3 years ,i choosed rou en y reconstruction

    pt with diabetic symptoms + glucone in urine had ogt with normal values in fasting & post parandial but persisting glucose in urine ,choosed renal glucisuria

    there was a palliative treatment of gasrtic cancer & i choosed danazol (dont ask me why) prob low IQ


    lady with lytic lesions in back bone whats the primary>>breast

    cancers with RET proto oncogen i chosed calcitonin

    men type1 how to mointor >>low IQ made me choosed catecholamines in urine ,i should be shot in public

    increased risk of smoking in a young smoking girls on ocp ,i chosed smoking

    whats the poor prognosis for a young girl with RA & erosions ,i choosed xray changes

    russian sailer with greyesh exudate on his tonsils & confused >>>i chosed diph

    previously well moderate alcoholic with 2 seizures with sugar 3.1>>i choosed alcohol related seizures ,i think alcohol induced hypoglycaemia

    pt diagnosed with influenza whats the fasts invest,i choosed PCR blood as the other options had viral cultures of both sputum & blood & those would take at least 4 hours & the patient had viremia as he had shivers & so(in my hospital it takes 4 hours to get pcr results dispite that we send to another hospital for processing)

    89 years old with unsteady gait which vit is diffecient i choosed thaimine ,the only other option that can be right is pyrdoxine but didnt look like it

    young man started living by himself had easy gum bleeding on tooth brushing ( as if he knew about me) with anemia >>>>classic me ,vit c def ( i remember the only time i took vit c for a month i stopped gum bleeding for over 4 months but i stopped i hate medicines & doctors aslan)


    granulomas 9in rectal biopsy >>crohns

    young girl referred from dentisit with tooth erosions ,low BMI with all low blood parameters,i choosed bulimea nervosa


    contra-indications for lung cancer operation >>>svc obsrt ,plerual effusion,i choosed svc

    azathioprine mode of action

    colpidegrol mode of action

    a couple of VWD questions

    pt on dialysis for 5 years with back pain>>b2 microglobinemia


    side effect more with acei than losartan>>>cough

    pt with scleroderma ,severe rynouds,sloughing of the finger tips despite nifidipine whats next to use>>>warfarin,bosantan,moxodine,i chosed bosantan & i was lucky choosing it
    http://en.wikipedia.org/wiki/Bosentan

    question on malignant mesothelioma

    root of sciatica (pt with typical sciatica pain which root is affected)

    pt with oro-genital ulcers ,with leg pain>>>>venous thrombosis

    HLA type of reactive arthritis

    question on adult onset stills diz

    drug used to control AF in an asthamtic patient i choosed Amiodarone ( i think it was MAT multifocal atrial tachycardia)

    i think there was a quest on rate control of af i choosed dig

    also pt warfarinized for af,succesful cardioversion,how long to be on warfarin for 6 months or 4 weeks

    pt wiz recurrent syncope with displaced apex of the heart>>>ventricular tachycardia for sure
    Obese lady with infertility and type II diabetes treatment options i answered metformin
    Question with absent corneal reflex i selected acoustic neuroma
    question of minimal change glomerulonephritis answer was prednisolon
    one answer was staphylococcal infection
    question of glomerulonephritis after 3 days of urti was IgA nephropathy
    Question of carbanmazepine decreased effect --answer was carbanmazepine itself self induction
    one answer was short sunacten test in pt having hyponatraemia and K 5.5
    one question for hepatitis interpretation was previous hepatitis infection
    I dont remember the choice of drug in Alzheimers disease
    fusion of genes in pro myelocytic leukaemia(PML--RAR gene)
    one answer was tertiary parathyroidism
    two Questions of X- linked condition no son will be affected
    Increased aPTT i selected Anti thrombin II(not sure)
    one answer was COPD
    One condition was latex allergy the reaction pt developed with dental procedures etc
    The interpretation of blood sugars and GTT normal person
    one answer was renal glycosuria not diabetes
    One question with retinal vein or artery thrombosis macroglobilunuria
    Atrial fibrillation rate control answer was Digoxin
    The question with IGT and glucosuria with HPT - ? Cushing Syndrome
    Big ears ,request surgery review--dysmorphophobia
    Newscaster telling world matter to a patient--idea of reference
    Pt with violent relations and parasuicidal--Borderline personality disorder
    Pt with RA becames worse after treatment--MG

    CLL with recurrebt RTI , the answer is deficent Ig G


    Dear friends, most of the answer to the questions in MRCP(UK) is in Oxford Handbook of medicine. For your info, according to MRCP examiner , the gold standard book for MRCP is Oxford Textbook of Medicine ( very thick) , so just read the handbook , all the required notes is there, plus with kalra-- sure pass
    Defidiency of Any factor needed in Intrinsic pathway causes prolongation of APTT.....so the answer was Xl...
    1.Large ears -dysmorphophobia

    2.AF 2 qs, one with heart failure- Rx digoxin (as basal crackles)
    other without failure..-best Rx beta blocker (as given in onexam)

    3.HUS-- cells seen are howell jolly bodies (Howell-Jolly bodies are histopathological findings of basophilic nuclear remnants (clusters of DNA) in young erythrocytes during the

    response to severe hemolytic anemia, megaloblastic anemia, splenectomy, or due to a damaged spleen. They can be present in conditions such as hyposplenism, hereditary

    spherocytosis, sickle cell anemia and myelodysplastic syndrome(MDS). -wikipedia) mnemonic for HUS-FANTM- FEVER ARF NEURO MANIFESTATION,

    MICROANGIOPATHIC HEMOLYTIC ANEMIA

    4.HEP B -man was previously infected and had immunity due to tht (as hbsag neg and anti hbc positive)

    5.SMALL MUSCLES OF HAND _ t1 lesion (onexam)

    6.RTA -1 coz hypokalemia, loin pain(calculus) and severe acidosis (mnemonic hypo-ren-cal-sev-dis= hypokalemia, renal calculi, severe acido.sis)

    7.V5,V6- lateral wall ischemia..signifies circumflex artery (emrcp)

    8.CICLOSPORIN -nephrotoxic drug (1st complication in easterbrooke)

    9.SLE MONITORING-think anti sm(most specific-kalra) am not sure

    10.DUMPING SYNDROME- MODIFY THE DIET OF THE PATIENT...coz hes having symptoms of hypoglycemia after 30 mins...means he has to take a small meal of

    carbohydrate and then after 30 mins tk more food.. (refer bailey)

    11.ERECTILE DYSFUNCTION -56 yo m pt with hypogonadism, lh fsh decrease, prolactin increase slight....choices were asking for cause of er dys..vascular, hypogonadism,

    hypopit, phychological, prolactin increase..ans: psychological...as erection is a parasympathetic process (ohcm) further discussion warranted

    12.NATURAL SOURCE VIT D- FISH OILS-not milk as milk and mmilk products are fortified with vitd ...

    13.Q ON SSRI WITHDRAWAL ABRUPT

    14.PT HAD SINGLE EPISODE AF- WARFARIN FOR---6 months...if repeated then life long- refer emrcp

    15.SELEGELINE -MAO I INHIBITOR

    16.T1 ROOT LESION-HORNERS

    17.PARKINSONS PLUS CAN LOOK DOWN--supranuclear palsy(refer ohcm -steele olszewski syndrome)

    18.HAEMOPHILUS INFLUENZAE-ACUTE epiglottitis

    19.MARFANS CONNECTIVE TISSUE COMPONENT-fibrillin-1

    20.70 years old female with MI 4 years ago with HIP OSTEOARTHRITIS FOR HIP REPLACEMENT in the pre-operative clinic,how to asses the myocardium dobutamine

    challenge .SHE needs a stress test but her painfull hip is a contra-indication ...

    21.HEP C -CRYOGLOBULINEMIA

    22.ORAL GENITAL ULCER - BEHCETS has dvt....

    23.GUY COMES FROM SOME COUNTRY AND HAS PAINFUL PENILE ULCERS-( Chancroid is a sexually transmitted infection characterized by painful sores on the genitalia.

    Chancroid is known to be spread from one to another individual through sexual contact.---WIKIPEDIA)

    24. VZV IG in unimmunized pregnant woman.

    25.FACTOR V LEIDEN-defect seen is activated protien c resistance

    26.HAS MILD SYSTOLIC DYSFUNCTION-RAMIPRIL-decreases afterload as dilates arterioles due to angiotensin 2 antagonism ( onexam)

    27.DEMYELINATION-decreased motor conduction velocity

    28.CONNS SYNDROME_ diag by hypokalemia, difficult to treat htn...test is ARR ratio

    29.CLOPIDOGREL -MECH IS ADP ANTAGONIST (EASTERBROOK- MNEMONIC CaT CLOPIDOGREL AND TICLOPIDINE HAVE ADP ACTION)

    30.VARICEAL PROPHYLAXIS AFTER 2-3 EPISODES BLEED -PROPRANOLOL (actually propranolol is used when theres no episodes of bleeding and u want to prevent , but

    this patient had already undergone banding and other options were spironolactone...which didnt suit)

    31.WHO GIVES ORDER TO STOP RESUSCITATION IN 18 YR OLD GUY -fiance, parents, consultant on call, cheif of emergency (or smth)--think consultant and parents both r

    correct

    32.ASKED WHICH DECREASES PULM VASC RESISTANCE- NATURALLY- ADENOSINE--PGSMAY ALSO BE RIGHT( DISCUSSION WARRANTED)

    33.BLOODY DIARRHOEA- shigella (emrcp) salmonella doesnt cause bloody diarrhoea

    34.ECSTASY -HYPERTHERMIA

    35.AFTER 3 DAYS REINFARCTION CHECK CKMB (ONEXAM)

    36.FAMILY WITH PC KD....check usg of all as all relatives were greater than 20 yrs of age (if less than 20 then genetic studies) -refer onexam

    37.GUY WITH HEARING LOSS RINNE POSITIVE AND SEVERE HEADACHE IMM INV- here do skull xray as pt is haveing pagets


    38.guy with motor aphasia- lesion --brocas area posterior frontal (anterior frontal was also given)

    39.SCOTOMA CENTRAL- optic neuritis

    40.ALPORTS PT- (Alport syndrome is a genetic disorder characterized by glomerulonephritis, endstage kidney disease, and hearing loss. Alport syndrome can also affect the

    eyes. The presence of blood in the urine (hematuria) is almost always found in this condition.- WIKIPEDIA)

    41.CARBAMAZEPINE AUTOINDUCTION

    42.SPECIFICITY Q

    43.NNT Q

    44.PURPOSE OF CALCULATING POWER OF A STUDY-(to know which test is the best to use- minimum 80 percent power required--easterbrook)

    45.LITHIUM -HYDROCHLOROTHIAZIDE INTERACTION

    46.TORTICOLLIS - METOCLOPROMIDE

    47.GUYS FLECAINADE IS GIVEN ONLY on hospital set up as its dangerous drug and never the first choice

    48.q on obsessive c d

    49.gas used for calculating transfer factor--carbon monoxide

    50.THYROXINE-increases insulin sensitivity

    51.INSULIN RECEPTOR LOCATION-(-In molecular biology, the insulin receptor is a transmembrane receptor that is activated by insulin. It belongs to the large class of

    tyrosine kinase receptors.Two alpha subunits and two beta subunits make up the insulin receptor. The beta subunits pass through the cellular membrane and are linked by

    disulfide bonds.-WIKIPEDIA)

    52.CONFUSED FEMALE-old lady with confusion ,was thirsty for a couple of weeks with signs of hepercalcemia low hb ,xray lytic lesions ,what the next immediate action

    immediate thing is iv saline as pt had hypercalcemia which is an emergency later look for ur dear multiple myeloma

    53.YOUNG LADY WAS CENTRALLY CYANOSED + BREATHLESS-40 yr old lady..presents ansr is asd with eisenmenger...pulm htn cant b as thers no cyanosis in pulm htn and

    cant b vsd either as it presents early( refer op ghai book of paediatrics)

    54.complication of angio-ansrs were arrhythmia, coronary artery dissection, mi.....think its arrhythmia....(discuss)

    55.thalidomide mech of action- acts on cd8 lymphocytes

    56.guy with symmetric rash on nose chin and cheeks with papules and pustules was rosacea(not simple acne)

    57.aberrant fusion of 2 genes in aml promyelocytic leukemia

    58.GUY ON IMMUNOSUPRESSION DEVELOPS PAINFUL SWALLOWING- candidiasis

    59.pcod PT ALREADY DID CLOMIPHENECITRATE. IS OBESE AND FASTING GLUCOSE IS INCREASED--DOC METFORMIN


    60.HAEMOPHILIA--PTS NONE OF SONS WILL HAVE AS daddy contribute only the y chromosome

    61.immunophenotyping in CLL


    62.GUY WITH TREMORS ONLY IN CERTAIN HAND POSTURES BILATERAL....BENIGN ESS TREMOR( DISCUSS)

    63CIPRO CAUSE DECREASED SEIZURE THRESHOLD (SEE PHILIPPA EASTERBRROKE)

    64.MAN THIS WAS COOL---2 SAME QS I GOT BOTH RIGHT.....STEROIDS DECREASE THE NUMBER OF EXACERBATION IN COPD AND DONT HAVE AFFECT ON

    MORTALITY

    65.Dexamethasone in pt. with liver mets suffering from anorexia & wt.loss (HERE Q WAS HOW DO U IMPROVE THE SYMPTOMS)

    66.IDIOPATHIC URTICARIA -first treatment would b to try oral antihistamines as CETRIZINE...(ONEXAM)-

    67.two drugs op1 and op2 ,op1 binds with 10 times more affinity to the same receptor then means tht op1 has more POTENCY

    68.THT GIRL WAS TAKING EXOGENOUS INSULIN

    69.GUY WITH ACUTE GOUT (ALCOHOLIC) TOOK ALLOPURINOL-acute exacerbation due to allopurinol therapy (not alcohol binge-refer onexam)

    70.mean is for taking average income

    71.guy with absent knee jerk and sensory loss on anterior thigh with absent knee jerk(action of quadriceps)-think was femoral nerve lesion discuss)

    72.C1 ESTERASE DEFICIENCY

    73FLUOXETINE DEPRESSION NOT CONTROLLED - 2 ANSRS DOUBTFUL CITALOPRAM AND LOFEPRAMINE-(DISCUSS)

    74.SPLENECTOMY PATIENT --HERE pt came 2 wks after getting splenectomy --guidelines acc to onexam suggest immediate vaccination for pneumococcus--there no need for

    penicillin as pt is havin no active infection

    75.ADH WORKS ON COLLECTING DUCT

    76.UNILATERAL MASTECTOMY FOR MALE PT...NOW PRESNTS WITH THE OTHER BREAST ENLARGED---LH , FSH NORMAL.....OR INCR...KLINEFELTERS (NOT

    KALLMANS AS NO ANOSMIA , and also kallmans is hypogonadotropic hypogonadism and lh fsh will be decreased along with testosterone)

    77.Boy with one kidney absent & nephrotic proteinuria give steroid trial( BP 126/66)

    78.hypomg due to thiazide diuretic (mnemonic remember this thoroughly- hyper GLUC fr thiazide (glucose, uric acid, calcium--rest all DECREASED) --U WILL B AMAZED HOW

    MANY QS U CAN ANSR IF U REMEMBER THIS

    79.HYPERINFLATED CHEST WITH REDUCED TLCO AND FEV1/FVC RATIO 55% IS EMPHYSEMA

    80.MS pt with 20 ml post void bladder vol. give anti-cholinergic( or intermittent catheterization) --HERE Q SAID HOW DO U CONTROL THE PAT. SYMPTOMS OF

    INCONTINENCE AND NOT HOW TO PREVENT INFECTION--FOR FORMER ITS OXYBUTININ i.e antichol..but for latter its intermittent cath..

    81.pretibial myxedema --graves

    82. ret protooncogene -med carcinoma--mnemonic( pipapa for men1 : para.pheo.med for men2a: muco.pheo.med for men2b)

    83. ecstasy hyperthermia ...omg rcp loves to repeat qs and i love rcp

    84.Lasix-enalapril in LVf ?? here pt didnt have edema (they said no edema in the q) and mild lvf ..options were digoxin, ramipril, and lasix---digoxin try to avoid in mild lvf..and

    as no edema why give a diuretic....ramipril decreases afterload therefore preferred (discuss)

    85. CI TO LUNG CA SURGERY (SVC OBSTRUCTION)

    86. TOXOPLASMOSIS - SULFADOXINE AND PYREMETHAMINE

    87. Pulsus paradoxus Physiology ( dec. Lt. atrial filling)

    88. Walder. Macroglobinemia --IGM PARAPROTIEN INCREASED AND ...THROMBOTIC COMPLICATIONS

    89. Check prolactin in asymptomatic MEN-1

    90. PT WITH VWF AND WAS ASKED WHT ABNORMALITY WILL U SEE...ITS THT THE PLATELETS CANT ADHERE TO EACH OTHER DUE TO SOME PROBLEM WITH

    GP 1

    91. VZV IG in unimmunized pregnant woman.

    92. PT WITH RECURRENT CHEST INFECTIONS HAD CLL WAS ON PREDNISOLONE AND ONE CYTOTOXIC I THINK CHLORAMBUCIL......HERE IMMUNOGLOBULIN

    DEFICIENCY.....(REFER ONEXAM)

    93.erytematous MACULE --FLAT RED LESION

    94.pt on dialysis for 5 years with back pain=b2 microglobinemia

    95.granulomas in rectal biopsy -------crohns

    96. hypopigmented..scaly lesion in a tanned young man---- scraping for mycology ,TAENIA versicolor

    97.Question with absent corneal reflex i selected acoustic neuroma

    98.DONEPEZIL-DRUG IN ALZHEIMERS

    99. LEGIONELLA TEST WAS URINARY ANTIGEN

    100. RA PAINLESS EYE -EPISCLERITIS......

    The blood film is HUS is more likely to show red cell fragmentation:-

    You only need to use warfarin for 4 weeks after DC Cardioversion :-
    1) What is the cause of raised PHOSPHATE in CRF?
    a)Dec 125 HO Vit D
    b)Dec Phosphate Clearence
    c) Hyper vitaminosis D

    2)RET oncogene is aaassociated with
    a) Anaplastic Thyroid CA
    B) Folliculer Thyroid CA
    c) Pappillary Thyroid CA

    3)ECG finding of Hypothermia
    a) Long QT Interval
    b) Short PR Interval
    c) II degree Heart Block

    4) Thyorxine Causes
    a) Enhance Insulin sensitivity
    b) Dec Myocardial Oxgen demand
    c) Dec elasticitiy

    5) Thrombosis & raised IgM ass with
    a)MGUS
    b) Antiphospholipid Syndrome
    c) M. Myeloma

    6)Girl who took overdose of Ectascy
    a)Hypernatremia
    b)Hyeprthermia
    c)Hyperthyroiddism

    7)A pt known case of Asthma, PEFR normal, no chest finding, Atrial rate 100 in Af.Rx
    a)Amiadarone
    b)Digoxin
    c)|Dilteiazem

    A pt known case of epilepsy diagnosed 1 month back, now 8th wk pregnant?
    a)Na Valproate
    b) Phenytoin
    c) No Rx

    9) Pt with splenectomy, already had Pneumococus vaccine, next to do
    a) Annual Pneumococcus Vaccine
    b) No Rx for now
    c) Regular Peniciilin

    10) Acute epiglottitis is caused by
    a) H.Influenza
    b) Strep Pneumonie
    c) EBV

    11) Pt with HBVc Antibody & HBVs Antibody +ve with all other -ve
    a)Carrier
    b)Prevoius Immunization
    c)Previously infected , now recovered

    12) Acoutic Neuroma may presents with
    a)Cerebeller Signs
    b)Facial Weakness
    c)Dysphonia

    13)Which of the following may hamper recovery of RECOVERY of stroke
    a)Dysphagia
    b)Dysphonia
    c)Hemiparesis

    14)Amaurosis Fugax is caused by
    a)Middle miningeal Artery
    b) Internal Carotid Artery
    c) External Carotid Artery

    15) Skin lesion in relation with ERYTHEMA AB IGNE may develop
    a) Sq Cell CA
    b) Basal Cell CA
    c) Malignant Melanoma

    16)Chemotherapy results in
    a) Necrosis
    b)Sensecence
    c)Mitosis

    17)Rx of pyogenic liver abcess in Penicllin Allergic
    a)Clindamycin + Metronidazole
    b)Clindamycin + Ciprofloxacin
    c) Vancomycin + Meropenem

    18)Young Women with Crohn Disease, what will be the contributing factor
    a) Age
    b) Smoking
    c) OCP

    19)Two opiods are tested in same patients with results arranged in what
    a) Paired T Test
    b) Two Sample T test
    c) Chi Square Test

    20)A young male presnted with Aystole, CPR started, who is going to decide to stop CPR
    a)Parents
    b) Fiance
    c) A & E Consultant

    21)Drug that affect on CD 20
    a)Infliximab
    b)Tratuzumab
    c)Rituximab
    1. VZV IG in unimmunized pregnant woman.
    2. Vit. C def( gum bleeding with multiple non-healing wounds on legs)
    3. Bulimia nervosa (BMI 23 with dental erosions) other option: purgative absue
    4. Alzheimer Rx donepzil
    5. Life long penicillin to splenectomy pt.
    6. Ret oncogene medullary Ca
    7. Demyelination dec. velocity
    8. Clopidogrel MOA
    9. Iberstran in systolic dysfunction
    10. Cons syndrome rennin:aldosterone
    11. Metochlopropamide (torticollis)
    12. Peritibial myxedema for graves dis.
    13. Rosiglitazone MOA
    14. Testicular feminization (female phenotype with normal ext. genitalia)
    15. Marfan syndrome fibrillin-1
    16. H.influenzae (epiglottitis)
    17. Smoking inc. risk of crohn’s dis.
    18. Pul resis. Dec. by epoprostenol
    19. Acute inflammation marker (ferritin)
    20. Propronol for vericeal prophylaxis
    21. Valproate in pregnancy (mom Dx with epilepsy option included no Rx, phenytoin, gabapentin)
    22. MS pt with 20 ml post void bladder vol. give anti-cholinergic( or intermittent catheterization)
    23. Ecoli Beta lactamase positive, give ciprox
    24. Shigella (man from Egypt with dysentery options include salmonella)
    25. RA episcleritis
    26. HLAB27 (Reiter’s)
    27. CKMB after 3 days to check 4 reinfarction
    28. Minimal change dis. Give prednisolone
    29. Boy with one kidney absent & nephrotic proteinuria give steroid trial( BP 126/66)so I didn’t go 4 ace inhibitors
    30. Rituximab
    31. Emphysema
    32. Lofepramine (after flouxetine in depression)
    33. Hepc type 2 cryoglobinemia
    34. N/saline for inc. Ca++
    35. L3/L4 lesion
    36. Psoriatic arthritis
    37. Hypomagnesemia due to diuretics
    38. RTA (normal anion gap acidosis) options include aspirin
    39. PBC check AMA( also features of thyroiditis, pernicious anemia & sjogren’s)
    40. MR cholangiogram for P S Cholangitis( pt has Ul. Colitis)
    41. Ecstacy 40deg temp.
    42. Inc. po4 reabsorption in CRF
    43. Mean 4 average income.
    44. Diphtheria
    45. C1 esterase def.
    46. Cetrizine 4 cholinergic urticaria
    47. Cholicalciferol def.(elderly woman unable to stand after squatting)
    48. Binge alcohol +allopurinol=gout exacerbation
    49. E.nodosum with oro-genital ulcers wats the cuase of legs swelling( recurrent thrombosis)
    50. Dexamethasone in pt. with liver mets suffering from anorexia & wt.loss
    51. Beclomethasone dec. exacerbations of COPD.
    52. Same Q. as above repeated in second paper(here inquiry was regarding long-acting inhales steroids)
    53. Anti-centromere in crest dis.
    54. IgA nephropathy
    55. Affinity=potency(comparison of OP1 with OP2)
    56. Benign essential tremors
    57. Fragmented RBC’s in HUS
    58. How to check factor 5 leiden(late respose to protein C)
    59. A-dominant pedigree (women with her brother & their mother suffering)
    60. Exogenous insulin
    61. EBV
    62. HIV with atypical lymphos
    63. Fansidar 4 toxoplasma
    64. Copd(FEV1/fVC=74% with Kco 55%)man on ship-yard. Heavy smoker
    65. ADH works on C duct
    66. Ciprox causes fits
    67. Immunophenotyping in AML
    68. Abberant fusion in APML
    69. Haemochromatosis
    70. Candida esophagitis in AIDS
    71. V5-V6 Lt. circumflex A.
    72. Metformin for fertility in PCOD
    73. Klinefelter synd.( man with Hx of Mastectomy)
    74. Hemophila father (no dis. In sons)
    75. Alport syndrome with deafness
    76. Contra-indication to surgery( Sup. Vena cava obst.)
    77. Lasix-enalapril in LVf
    78. Scotoma-optic neuritis
    79. Pulsus paradoxus physiology( dec. Lt. atrial filling)
    80. Anti smith Ab in lupus nephritis (or C3-4???????)
    81. Walder. Macroglobinemia
    82. Muti-system atrophy
    83. Check prolactin in asymptomatic MEN-1
    84. Thallium 4 OA pt. with Hx of MI (pre-op assessment)
    85. Insulin receptor location
    86. Carbamezapine auto-induction
    87. T1 lesion with horner
    88. Legionella check 4 urinary antigen
    89. Pt. with hypothermia (I wrote long QT)
    90. Erythema ab igne Sq. cell Ca
    91. Tertiary hyperparathyroid
    92. Renal glycosuria/impared GTT?????
    93. Morphine causes diplopia
    94. Brocas area in post. Frontal
    95. Family with PKCD how to check( I wrote linkage analysis)
    96. Still’s dis. Causes inc. ferittin
    97. Short synacthen test for pt. with Addison and hypothyroid features
    98. Ace inhibitor in memb. Nephropathy
    99. Acne-rosacea
    100. Abd. Digiti minimi in ulnar nerve palsy
    101. EBV with rash given amoxillin
    102. Thyroxine inc. insulin sensitivity
    103. Plasma electrophroesis in MM
    104. Amiodarone for A-fib rate control
    105. Lithium-thiazide interaction
    106. Flucloxacillin+gentamycin in I-endocarditis
    107. Staph aureus in IV abuser with TR murmur
    108. Wegner granulomatosis
    109. E. nodosum with knee arthritis( check CXR 4 sarcoid/TB)
    110. R.A
    111. Worst prognosis for RA =joint erosion
    112. Erythromycin inc. gut motility
    113. Mesothelioma with chance of seeding needle track
    114. FISH for micro-deletion
    115. Azathioprine MOA
    116. Pt. with refracrory unstable angina (trop-t raised) give necorandil (or monis)
    117. Wat is erythrematous macule? {LOL} red –flat
    118. Aloprost for raynaud’s
    119. NNT(100/18-
    120. Specificity(890/900)
    121. OCD(pt thinks there is someone in his basement and checks repetitively but to no avail!!!!) (I hate psychiatry)
    122. Behcet disease( genitor-oral ulcers with neurological signs)
    123. Pt. with pleural effusion on CXR; can’t B tapped so wats next( I opted for bronchoscopy)
    124. Pagets disease; wats next management step ( skull X-ray)
    125. Parietal lobe lesion 4 astereognosis
    126. Resperidone causes galacrorrhea
    127. How to check diffusion capacity( CO gas)
    128. Selegiline is MAO-B INHIBITOR
    129. Dumping syndrome give dietry advice
    130. Dietry source of vit.D(milk/fish)


    1) Pt. with CVa wats the deficit which is gonna hinder his rehabilitation.(hemiparesis/neglect???)
    2) Pt. of COPD with type -2 failure . wat to do( Doxapram/non-invasive vent/ invasive vent???)
    3) PKCD pt. with acute loin pain, wats the cause (cyst haemmorhage/calculi)??
    4) Young man with painful genital ulcers (HSV/chancroid?????)
    5) Amaurosis fugax; wats source of embolism( ICA???????????)
    6) Pt. with S/S of CJD(??????) I opted for MR scan
    7) Lady with BMI 13.5 severe pain on eating (phobia/body dysmorphea)
    How does ace inhibitor dec. heart remodeling in CHF(inc. wall tension/dec. TPR)
    9) Girl with 1 episode of DVT now planning for air travel wat to advise( I opted for LMW heparin)?????
    10) 2(two) Q. of transplant rejection(????????)[one with CMV & other getting fluconazole]
    11) Q. of transplant rejection(????????)[one with CMV & other getting fluconazole]
    12) 52 yrs smoker with impotence dec LH, dec testosterone, dec SHBG, prolactin 470(N<360)panhypopituitarism?????
    13) Pt. having difficulty in lifting objects with no pulse when arm raised above head no neurologic sign(takayasu’s dis.???????)
    14) Pt. thinks his ears ‘ve gone bigger now keeps on visiting doc.(hypochondriasis/somatization????)(aaaah WTF!!!!)
    15) Women with GERD and recurrent RTIs’ not improved with PPI wat to do( I opted 4 surgery??)
    16) Watery diarrhea with mucus & dec. K+ (villous adenoma or Z-E syndrome)
    17) Pt. with slowly growing scaly lesions pruritic wat to do( skin scrap for mycology).
    1 Coronary arteriography complication(coronary dissection/CVA/arrhythmia)
    19) V-Wf disease??(absent/defective 1b receptor)??????
    20) Asthmatic lady eith A-fib(paper-1)[amiodarone/flecainide/digoxin]


    I. How to check RNA?(northern blot/in-situ hybridization)??
    II. Wats most contagious organism(VZV/H.influenzae/others)??
    III. Pt with crohn’s dis.(on rectal biopsy)
    IV. Warfarin post-defib! Wats minimum duration(4 weeks/6months)??
    V. Pancreas in direct contact with Lt. kidney
    VI. Tachy/dilatation with atropine poisoning
    VII. HbsAb+,HbcAb+(succeful Rx)not immunization!!
    VIII. Myesthenia gravis(25 yrs pt. with diplopia & prox. Muscles weakness)
    IX. Old lady taking Beta blockes, warfarin, diabetic medications & aspirin getting confused 4 last 5 weeks. Wats the cause(Beta blocker, ) I went 4 warfarin coz I thought she might B haning SD hematoma.(no wonder they say : an empty brain is the Devil’s workshop)
    X. Pt taking medics 4 HTN & others getting pedal edema wats the cause( only CCB mentioned was diltiazem so I went 4 it)????
    XI. Cushing’s dis. Causes Met. Alkalosis
    XII. A Q of factor 11 def. (I wrote factor 10)
    XIII. A case of NASH
    XIV. A case of Ca pancreas ( I wrote haemochromatosis)
    XV. PEFR both at work and home 4 occupational asthma.
    XVI. Extrinsic allergic alveolitis(upper lobe infiltrates/antibodies)?????
    XVII. Who’z gonna order for DNR ???????
    XVIII. Pt. with 0.1 Hb on methotrexate (I went for carcinomatosis).But I think its due to methotrexate.???????
    XIX. MRSA (I chose flucloxxacillin) but my friend says pt. was penicillin allergic in that case its linezolid [ need ya’ help 2 sort this one]
    XX. 2 Q. of rejection(????????)[one with CMV & other getting fluconazole]
    XXI. A pt. with diamorphic picture on CBC (I didn’t write celiac dis. )???
    XXII. Wats the quickest way 2 detect influenza( I went 4 Immno-assay).some say its PCR of Blood/or/nasal secretions.
    XXIII. Wats pathognomic of heart dis. In last trimester pregnancy(S3/inc.JVP/irregular HR)??
    XXIV. Loss of corneal reflex in CPA lesion
    XXV. Check serum Ca++ in 92 yrs old man with prostate Ca( I chose PSA, which is bull-shit)
    XXVI. Pt. with repetitive dreams of her deceased husband who died in accident.(I chose adjustment disorder) but correct answer may B PTSD.?????
    XXVII. Pt. with inc. INR( answer was ciprox) I wrote HRT
    XXVIII. Wats the mmost pathognomic of depression( I chose the option ending with “SEQUENCINGâ€) [need ya’ help 2 sort this one]
    XXIX. A scientist wants to check for new viruses wats the pre-requisite?( I chose the 1st option saying need 4 genome)???????
    XXX. Effect of sotalol on cardiac –cycle??????
    XXXI. Omeprazole Vs ranitidine wats the edge of former( I went 4 dec. post-prandial acid production)??????????
    XXXII. Side-effects of temoxifen(hair-loss) I chose cataract., aaah I think I was having blue balls at that time!!!!!!
    XXXIII. Q. of power of test(in 2nd paper)
    XXXIV. Q. of power of test(in 1st paper)
    XXXV. Post-marketing trial( answer was adverde effects) I screwed this one!
    XXXVI. Y the hell testicular tumor responds so well to chemotherapy(I opted for differentiation)?? [need ya’ help 2 sort this one]
    XXXVII. Pt. on CLL Rx gets recurrent URtis’ wats the cause ??
    XXXVIII. Woman with central cyanosis and pedal edema( I went for PPH, which is wrong) may B ans is ASD with shunt reversal?
    XXXIX. Pt. with ant. ST elevatation and Q waves without reciprocal changes (answer was VT)
    ciprofloxacin causes tendon rupture - according to onexamination
    Fluroquinolone causes Achilles tendon rupture
    Hypomagnesemia may inhibit parathyroid hormone secretion, causing hypocalcemia and hyperphosphatemia
    I. How to check RNA?(northern blot/in-situ hybridization)??
    II. Wats most contagious organism(VZV/H.influenzae/others)??
    III. Pt with crohn’s dis.(on rectal biopsy)
    IV. Warfarin post-defib! Wats minimum duration(4 weeks/6months)??
    V. Pancreas in direct contact with Lt. kidney
    VI. Tachy/dilatation with atropine poisoning
    VII. HbsAb+,HbcAb+(succeful Rx)not immunization!!
    VIII. Myesthenia gravis(25 yrs pt. with diplopia & prox. Muscles weakness)
    IX. Old lady taking Beta blockes, warfarin, diabetic medications & aspirin getting confused 4 last 5 weeks. Wats the cause(Beta blocker, ) I went 4 warfarin coz I thought she might B haning SD hematoma.(no wonder they say : an empty brain is the Devil’s workshop)
    X. Pt taking medics 4 HTN & others getting pedal edema wats the cause( only CCB mentioned was diltiazem so I went 4 it)????
    XI. Cushing’s dis. Causes Met. Alkalosis
    XII. A Q of factor 11 def. (I wrote factor 10)
    XIII. A case of NASH
    XIV. A case of Ca pancreas ( I wrote haemochromatosis)
    XV. PEFR both at work and home 4 occupational asthma.
    XVI. Extrinsic allergic alveolitis(upper lobe infiltrates/antibodies)?????
    XVII. Who’z gonna order for DNR ???????
    XVIII. Pt. with 0.1 Hb on methotrexate (I went for carcinomatosis).But I think its due to methotrexate.???????
    XIX. MRSA (I chose flucloxxacillin) but my friend says pt. was penicillin allergic in that case its linezolid [ need ya’ help 2 sort this one]
    XX. 2 Q. of rejection(????????)[one with CMV & other getting fluconazole]
    XXI. A pt. with diamorphic picture on CBC (I didn’t write celiac dis. )???
    XXII. Wats the quickest way 2 detect influenza( I went 4 Immno-assay).some say its PCR of Blood/or/nasal secretions.
    XXIII. Wats pathognomic of heart dis. In last trimester pregnancy(S3/inc.JVP/irregular HR)??
    XXIV. Loss of corneal reflex in CPA lesion
    XXV. Check serum Ca++ in 92 yrs old man with prostate Ca( I chose PSA, which is [bleep]-shit)
    XXVI. Pt. with repetitive dreams of her deceased husband who died in accident.(I chose adjustment disorder) but correct answer may B PTSD.?????
    XXVII. Pt. with inc. INR( answer was ciprox) I wrote HRT
    XXVIII. Wats the mmost pathognomic of depression( I chose the option ending with “SEQUENCINGâ€) [need ya’ help 2 sort this one]
    XXIX. A scientist wants to check for new viruses wats the pre-requisite?( I chose the 1st option saying need 4 genome)???????
    XXX. Effect of sotalol on cardiac –cycle??????
    XXXI. Omeprazole Vs ranitidine wats the edge of former( I went 4 dec. post-prandial acid production)??????????
    XXXII. Side-effects of temoxifen(hair-loss) I chose cataract., aaah I think I was having blue balls at that time!!!!!!
    XXXIII. Q. of power of test(in 2nd paper)
    XXXIV. Q. of power of test(in 1st paper)
    XXXV. Post-marketing trial( answer was adverde effects) I screwed this one!
    XXXVI. Y the hell testicular tumor responds so well to chemotherapy(I opted for differentiation)?? [need ya’ help 2 sort this one]
    XXXVII. Pt. on CLL Rx gets recurrent URtis’ wats the cause ??
    XXXVIII. Woman with central cyanosis and pedal edema( I went for PPH, which is wrong) may B ans is ASD with shunt reversal?
    XXXIX. Pt. with ant. ST elevatation and Q waves without reciprocal changes (answer was VT) .
    in reynauds use inoprost=prostacyclin

    1.Azathioprine MOA ,TPMT
    2.Torticollis -metoclopramide
    3.hemolytic anemia?howell jolly bodies
    4.granulomas- crohns disease
    5.decreased TLCO;empysema
    6.legionella diagnosis urine antigen
    7.acoustic neuroma-absent corneal reflex
    8.hemophilia in father. none of sons will be affected
    9.CML.Cytogenic karyotyping
    10.nurse with flexural rash-latex allergy
    11.treatment of toxoplasmosis,fansidar i wrote co trimoxazole,dont know why?
    12.V5 V6 on ecg.no territory involved.circumflex involves I,aVL plus,minus V5 V6
    13.large ears insisting on surgery, dysmorphia
    14.alports- sensorineural deafness
    15.post marketing surveillance,for adverse effects profile.
    16.ant relation of kidney. pancreas
    17.marfans- fibrillin protein
    18.transplant rejection. cytomegalovirus
    19.influenza fastest test.blood for PCR
    20.female anorexic afraid to eat.phobic anxiety
    21.acute epiglotittis H. influenza
    22.occupational asthma.?skin prick
    23.patient with parrots. ch. psittaci
    24.ulnar nerve supplies flexor digiti minimi
    25.something with absent knee jerk L3 L4
    26.female not adjusted to death? adjustment disorder
    girl took a handfull of her mother medx presenting with neck spasm>>>metchlopromide

    physiological effects of thyroid >>>>>

    19 years with sore throat & atypcal lymphocutosis on blood film with low plt>>>>> EBV

    von lindle girl with angioblastoma with no renal tumors what else to expect >>>i choosed cardiac rabdomyomas & i dont know why

    hamophilia trasmission >>i screwed that one because of my low IQ>>>non of the sons

    52mother with mild diz ,daughter 21 with the diz, son with the sever form at 23 mods of inhertance >>>i choosed mitochondrial (gentic anticipation)

    warfarin stable dose started new drug high INR choosed carbamzbine >>>again another low IQ question ,its not carbazinine itrs cipro

    auto induction of carbamzibines

    confused elderly female>>>> startt IV normal saline

    50 male with 2 days of chest pain ,pain now resolved with sublingual GTN ,troponin leak, whats next >>>>>> heparinize for sure

    70 years old female with MY 4 years ago with severe hip pains in the pre-operative clinic,how to asses the myocardium>>>echo,ecg,tredmill stress test, doubtamine challenge ,i choosed doubtamine challenage as she needs a stress test but her painfull knee is a contra-indication so the challenge is to offer the best results

    bloody diarrhea follewed by renal failure what to expect in blood film >>>>tear drop,penicil cells,target cells,howell joly or red cell fragments ,i choosed red cell fragments as its HUS & heamolysis is seen

    hep b serology ques

    hep c >>>cryogluibinlame

    young male with negative diplococci in urethral discharge ,negative VDRL,positive trponemal particls aglutinins, negative anti treponimal IG>>>i choosed false postive syphilis.not sure why but can u get the particles with no anti bodies

    young lady started working in a factory ,asthma how to confirm ,i choosed serial PFR at home & work (i thaught it was one of the creiteria of diagnosis of athma)

    young lady with parrot at home ,coughing with sob>>>> pistachi serology i think

    2 questions about respiratory function tests
    i choosed one with asthma as she had low co factor & all the other answers makes the co raised ,the other one was an obese lady so i choosed obese

    there was small muscles of the hand wasting >>>cant recal my answer or the answers

    a young lady with DVT post operative 2 years ago going on a long flight soon,was give instructions ,regular movement, drink fluids, restrict alcohol, what else ,there was 2 options that i choosed >>no further action & given deltaparin before the flight ,i choosed the no further action option then in the last minute i changed it to deltaparin,why? well in all the hospitals i worked in when the admit some one with no history of dvt but expected to stay in for some days they give prophylactic sub cut heparin so what about a young lady with proven DVT a couple of years ago ,again its all personal choices so dont rely on me ,i have a very low IQ

    some one with generalized lymphadenopathy on CT abdo & chest & HB was 0.1( n- 12--15) with right iliac fossa mass >>>i choosed carcinomatosis >>>i dont know whats is that but i dont leave my answer sheet blank

    old lady with confusion ,was thirsty for a couple of weeks with signs of hepercalcime ,low hb ,xray lytic lesions ,what the next immediate action ,i choosed electrphoresis as i was convinced thats myloma but because of the work next immedicate i choosed ca levels as the preseting symptoms were confusion & thirst & u need to establish the diagnosis of hypercalciema treat it then look for the mylome later ,not sure if my theory was right or my LOW iq played again


    alports found on renal biopsy what to expect i chosed sensoneurl defnease

    cushings metabolic status >>i choosed hyocholremic acidosis & i am quite sure i am wrong

    qustion about hypercholremic hypokalemia i chosed RTA 1

    multiple ring enhancing in an IV drug user with low CD ci\oubt & positive HIV ,whats treatment i chosed sulphadizne + pyrimethrine ( toxoplasmosis i think)

    young lady with UC coming with itch & obstructibve pic on liver enzu\ymes but no hyperbilbrin ,i choosed AMA

    clear crest choosed anticentromere then changed it to antio RNP but al7amdollah i went back to the anticentromere

    young lady with breathlessnes >>>pulm HTN

    IV drug user with sob ,cxr shows plueral effusion ,failed aspiration what to do next,i stoped between 2 options CT chest & U/S then i choosed U/s as i think it was encysted & fluid stuff is better visualized by u/s agaim i am not sure it might be my low IQ

    shypyard worker with SOB with cxr showing some plaqhes,i choosed asbestosis

    lady with morning stiffnes pains in shoulder joints,hips ,hands ,back ,kness with elevated CRP,i choosed pmr

    v5,v6 t wave inversion which art affected>>>> lad i choosed

    cause of death in angio >>>cva or arrythemia

    antichoinergic toxicity

    how to know that a young girl took extasy >>>hyperthermia

    alzhimers what to give>>> donbezil

    renal transplant lady 5 years ago had some some vaginal discharge given a course of fluconazole ,urea elvated 2 weeks aft6er that i choosed ciclosporin toxixty & dont aske me why

    question about some one with night sweats ,red lesions on both chins on lower limsb ,i chosed CXR looked like TB to me

    scaly lesion in a tanned young man , i choosed scraping for mycology ,i think its veriscolor

    recureent chest infection ,whats deficent >>>complement

    some one with recurent hand & facial swelling >>levels of C1 esterase

    SLE how ro monitor >>>>ANA

    patint with 2 cavitries on CXR renal symptoms with +ve canca negative panca >>>wagners

    some one had treatment for peptic ulcer presenting with dumping syndrome for 3 years ,i choosed rou en y reconstruction

    pt with diabetic symptoms + glucone in urine had ogt with normal values in fasting & post parandial but persisting glucose in urine ,choosed renal glucisuria

    there was a palliative treatment of gasrtic cancer & i choosed danazol (dont ask me why) prob low IQ


    lady with lytic lesions in back bone whats the primary>>breast

    cancers with RET proto oncogen i chosed calcitonin

    men type1 how to mointor >>low IQ made me choosed catecholamines in urine ,i should be shot in public

    increased risk of smoking in a young smoking girls on ocp ,i chosed smoking

    whats the poor prognosis for a young girl with RA & erosions ,i choosed xray changes

    russian sailer with greyesh exudate on his tonsils & confused >>>i chosed diph

    previously well moderate alcoholic with 2 seizures with sugar 3.1>>i choosed alcohol related seizures ,i think alcohol induced hypoglycaemia

    pt diagnosed with influenza whats the fasts invest,i choosed PCR blood as the other options had viral cultures of both sputum & blood & those would take at least 4 hours & the patient had viremia as he had shivers & so(in my hospital it takes 4 hours to get pcr results dispite that we send to another hospital for processing)

    89 years old with unsteady gait which vit is diffecient i choosed thaimine ,the only other option that can be right is pyrdoxine but didnt look like it

    young man started living by himself had easy gum bleeding on tooth brushing ( as if he knew about me) with anemia >>>>classic me ,vit c def ( i remember the only time i took vit c for a month i stopped gum bleeding for over 4 months but i stopped i hate medicines & doctors aslan)


    granulomas 9in rectal biopsy >>crohns

    young girl referred from dentisit with tooth erosions ,low BMI with all low blood parameters,i choosed bulimea nervosa


    contra-indications for lung cancer operation >>>svc obsrt ,plerual effusion,i choosed svc

    azathioprine mode of action

    colpidegrol mode of action

    a couple of VWD questions

    pt on dialysis for 5 years with back pain>>b2 microglobinemia
    side effect more with acei than losartan>>>cough

    pt with scleroderma ,severe rynouds,sloughing of the finger tips despite nifidipine whats next to use>>>warfarin,bosantan,moxodine,i chosed bosantan & i was lucky choosing it
    http://en.wikipedia.org/wiki/Bosentan

    question on malignant mesothelioma

    root of sciatica (pt with typical sciatica pain which root is affected)

    pt with oro-genital ulcers ,with leg pain>>>>venous thrombosis

    HLA type of reactive arthritis

    question on adult onset stills diz

    drug used to control AF in an asthamtic patient i choosed Amiodarone ( i think it was MAT multifocal atrial tachycardia)

    i think there was a quest on rate control of af i choosed dig

    also pt warfarinized for af,succesful cardioversion,how long to be on warfarin for 6 months or 4 weeks

    pt wiz recurrent syncope with displaced apex of the heart>>>ventricular tachycardia for sure

    btw found this on gpnotebook

    Quote:
    thromboembolic disease
    acute thromboembolic disease e.g. DVT is an absolute contraindication to flying - also see notes below
    patients with a history of pulmonary embolism or DVT should be considered for full oral anticoagulation
    In a patient with a history of a DVT undertaking a long-haul flight, and not already on long-term oral anticoagulant therapy, then another possible management strategy might be (2):

    a patient with a history of a previous DVT should wear blow-knee compression stockings (if no contraindications)
    if the patient has only had one episode of DVT and there are no other risk factors then no other measures are indicated
    if the patient has other conditions that increase the risk of DVT e.g. inherited or acquired thrombophilia state, gross obesity, a plaster of Paris of the lower limb, or has very long legs in a small seat space, then some would recommend a prophylactic injection of low molecular weight heparin before leaving the airport. This is in addition to use of compression stockings.
    http://www.gpnotebook[snip]/simplepage.cfm?ID=x20020722234917423730


    the word in that question were exactly whats written in here so i changed the right answer by my hand ,my IQ is my problem,

    i think i already failed ,i changed half of my correct answers to the worng answers at the last minute anyway i didnt deserve to pass from the start i studied for one months about 10 weeks ago & thats it

    q on monitoring of SLE was c3 &c4
    -reinfarction=kinases
    -insulin receptors= in the cell mem
    -ret-gene=medullary
    -glycosuria=cushing
    -I AM VERY SAD A LOT OF EASY QS I KNOW THE ANSWERS BUT I CHOOSE THE WRONG ONE!!!! WHAT SHALL I DO??
  2. Guest

    Guest Guest

    :) :? Hi ,
    I am in NZ & hope to sit for the AMC MCQ in May 2008 . Would like to have a partner for question /answer discussions
    Ayan,
  3. jb

    jb Guest

    hi

    how is nz....are there any training options on medicine.i am in uk i will have 3 years experience at house officer and sho level in another 6 omths and i will be eligible for nz registration.
  4. Guest

    Guest Guest

  5. Guest

    Guest Guest

    thanks a lot for ur effort

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