MRCP 2 dec 2013 recall

Discussion in 'MRCP Forum' started by samuel, Dec 13, 2013.

  1. samuel

    samuel New Member

    1-pt prolonged with derranged lft ?
    2-alt ast ldh very high
    3-one question alcoholic abuse - lft markedly derranged.
    4- kidney transplanted in father
    5- xlinked recessive or autosomal recessive.
    6- ecg of wpw with vt
    6- ecg- posterior mi or pulmonary embolism
    8-fredrich ataxia or hsmn
    9-central retinal vien occlusion
    10-normal anion gap with metabolic acidosis with hypokalemia
    11- conn syndrome
    12- di
    13-ms with urinary incontinence
    14-gilbert syndrome?
    15-serum ferritn 750 with liver disease
    16 - intermittent diarrhea, CHOLESTATIC PICTURE diagnosis
    17-autoimmune hepatitis.
    18-dystrophic myotonica
    19- lymes - doxycycline
    20- neisseria gonococcal infection.
    21- pregnancy
    22-leision of pons
    23-cluster headache / migrane
    24-fits not related to epilepsy - cheek bite / duration more than two moin
    25- after dc shock next step
    26-extradural/ subdural/ contusion
    27-frontotemporal dementia
    28- idiopathic parkinsonism
    29- sds
    30-treatement of gout
    31- treatment of diabetic neuropathy
    32-necrobiosis lipodica
    33-pyoderma gangriosum
    34-sick sinus syndrome
  2. samuel

    samuel New Member

    hypercalcemia bone scan
    as
    mi with severe as
    alcholic , pnumonia
    teporoparietal lesions
    toxoplasmosis
    nippv
    aspergolosis
    wegener/cs
    sleep apnea
  3. samuel

    samuel New Member

    1. Non epileptic fit - resist eye opening
    2. Chronic kidney disease with raised Uric acid - Febuxostat
    3. Lymes Disease (pt with arthralgia after a tour) - Doxycycline
    4. Photograph - skin lesion bleeding on minor trauma - Pyogenic Granuloma (?)
    5. CT scan - Extradural Haematoma (Biconvex lesion.....SDH is crescent shaped)
    6. Smoker with weakness and dry mouth - LEMS
    7. Perianal Ulcer/ ulcer at any other site - Nicorandil
  4. samuel

    samuel New Member

    Dermatomyositis in pt e ovatian ca
    Strogloid inf
    New epileptic attack in woman 2 times conv
    Mri spine brucellosis
    Mri head cerebellar degeneration
    Ct heah glioma or arachnoid cyst
    Ct head extradural hema
    Ecg af
    Ecg 3rd degree hb
    Ecg atria reentrant tachy
    Ecg long qt syndrome
    Xray chest milliary tb
    Xray chest aspergellosis
  5. samuel

    samuel New Member

    Diabetic neoropathy
    Diabetic ketoacidosis
    Insilin ttt
    Insulin hypoglycemia and high c peptide
    Duloxetin in dm neorop
    Methanol poisoning
    Aspirin or metformin posonin in lactic acidosis
    Meningococcal septicemia
    Cortisole checkin addison
    Renin aldosterone ratio
    Cranio pharyngioma or pit tumour
  6. samuel

    samuel New Member

    Hyper calcemic hypercalcuria
    Pamidrinate in resistant hypercalcemia
    Pamidronate in ttt of pagets
    Tazocin and piperacillin in ttt of neutropenic pt
    Mrcp
    Ercp
    Capsule endoscope
  7. samuel

    samuel New Member

    Klebsiella pneumonia
    Niv
    Avascular necrosis
    Crt
    Ddd
    Cryoglobulinemia
    Retroperitonial fibrosis?
    Fibromuscular dysplasia in pt e severe htn?
  8. samuel

    samuel New Member

    Mulluscum contagiosum?
    Melanonma or seborroic keratosis pic?
    Tilt table test
    Ct abdomen
    Anti jo in poliomyositis
    Propilthiouracil in hyperthyroid pt wants to conceive
    Give carbimazole in ait
  9. samuel

    samuel New Member

    CT SCAN IS MENINGIOMA NOT EDH
    PITYRIASIS VERSICOLOR
    RENIN ALDOSTERONE RATIO PT WITH BP AND HYPOKALEMIA
    LOW K,NA, INCREASE CA TRT NA +K
    KLINFELTERS
    PITUITARY TUMOR
    RAYNAUD,LUNG,MYOPATHY ANTI JO
    RTA B/L NEHROCALCINOSIS
  10. samuel

    samuel New Member

    The 5 ecgs r
    Atrial flutter ?
    Long qt?
    Avrt?
    Complete heart block?
    Pericarditis?
    Wpw?
    Dermatology photos?
    Bowens disease?
    Ct brain ? Glioma?
    Pt. on niv increase both EPA IPA ?
    Sulphonyurea misuse
    Echo left atria myxoma
    X ray non small cell hpoa
    X ray hand R.A?
    Limbic encephalitis ?
    Ovarian ca ? Hypothyroidism ?
    Anti thyroid pt want conceive carbimazole?
    Pt lupus anticoagulant ? Continue warfarin 6 mth
    Pt pulmonary edema increase mean airway time
    Splenomeagaly night sweat ? HIV
    Maculopapular rash groin. . Trichuris ?
    Cyanosis medicine Dapsone?
    Pt oral plaques normal x ray Med cotrimoxale?
    X-ray hip fracture right ramus?
    Boy gcs 10 ttp?
    Hepatomegaly ? Investigation Usg?
    Bile duct stone ? Ercp
  11. samuel

    samuel New Member

    Diloxanide furoate cysts entamoeba
    Hemochromatosis genotype
    Ring enchancing lesios indian male Toxoplasmosis
    Swallowing difficulties mnd
    Amoxicillin no interaction ocp
    decreasing rbc count in csf bottles- traumatic tap
    most significant in empyema-ph<7.2
    reducing investigator bias-double blinding

    TTP
    Microscopic polangitis or churg straus?
    Wegner gran
    Reflux neph
    Polychondritis
    Constrictive or amyloidosis?
    Pancytopenia in pt aplastic anaemia?
    Valve hemolysis
    X ray hip inv
    Vipoma pancratic insuffeciency?
    Holms addie or argyl robertson puppil?
    Periodic paralysis
    Duchene cardiomyopathy or arythmogenic cardiomyopathy?
    Lymphoma or toxoplasmosis in hiv sigle brain lesion?
    Toxoplasmosis or cysticercosis in indian multiple brain lesion
    Seritonin syndrome
    Psorisis or lichen sclerosis in female e vulval ulcers?
    Psoriasis in another quis
    Repeat tft in asymptomatic multinodular goitre
    Blood film in Ttp pt
    Coagulation profile in acute leukaemia
  12. samuel

    samuel New Member

    MRCP PART 2 RECALL
    1.ECG OF WPW SYND…...ABLATION
    2.ECG OF ATRIAL FLUTTER
    3. ECG OF AVNRT
    4.ECG OF CHB
    5.ECG OF ? BRUGADA/? ARRYTHMOGENIC RT VENT
    6. ECG OF PERICARDITIS.
    7.PIC OF ECHO…….ATRIAL MXOMA
    8. FUNDOSCOPY……. CRVO.
    9.FUNDOSCOPY…….. NIGHT BLINDNESS.
    10. CT CHEST WITH MITH METS…….PALLIATIVE
    11. MRI SPINE……. TB
    12. MRI HEAD…….. GLIOMA
    13. CXR WITH LT UPPER LOBE LESION……. NSCL
    14. CXR WITH RT UPPER LOBE LESION…… ASPERGILOMA
    15.CXR WITH HEPATORENAL SYNDROME
    16. CXR WITH RH NODULES.
    17.CXR WITH NEUTROPENIC PT……. TAZOCIN
    18. PELVIC XRAY….. AVN OF FEMORAL HEAD
    19. WRIST XRAY….. PULMONAY OSTEODYSTROPHY
    20. HAND XRAY…….. RA.
    21. CXR WITH ASBESTOSIS/SILICOSIS.
    22. MRI WITH ARNOLD CHAARI MALFORMATION.
    23. OLD LADY STACKING NEWS PAPERS……..SENILIE SQUALOR SYND
    24. PT WITH RENOYDS, HIGH CK…… ANTI JO ANTIBODIES
    25. YOUNG PT WITH 5% PNEUMOTHORAX….. ASPIRATION.
    26. LADY WITH POST PARTUM CARDIOMYOPATHY
    27. NEPHROTIC SYND WITH B/L FLANK PAIN…..RENAL VEIN THROMBOSIS.
    28. PT WITH BUDD CHARII SYNDROME.
    29. PT WITH METHANOL POISONING.
    30. PT WITH VIPOMA
    31. OLD LADY WITH ANEMIA. TREATED AGAIN ANEMIC….INVESTIGATION.
    32. LEWI BODY DEMENTIA.
    33. MYOTONIA DYSTROPHIA PT
    32. HSV PT
    33. NEUROCYSTICERCOSIS PT
    34. LISTERIA MONOCYTOGENS PT
    35. ELDERLY PT WITH WEAKNESS, NYSTAGMUS,……SCDC/WERNICKS
    36.ELDERLY PT WITH WEAKNESS……. INCLUSION BODY MYOCYTIS/POLYMYOSITIS
    37.BOUTILISM TOXIN PT
    38. LADY WITH PERIANAL RASH…..? NICORANDIL
    39. PT WITH OBS JAUNDICE…… AUGMENTIN.
    40. CT HEAD WITH CEREBRAL CONTUSION.
    41. PICTURE OF PATRIASIS VERSICOLOR
    42. PIC OF PYOGENIC GRANULOMA
    43. PIC OF BOWENS DISEASE.
    44. PIC OF HAMANGIOMA
    45. PT WITH IBD WITH PYODERMA GANGRINOSUM
    44. PT WITH LEG ITCHING…..VERICOSE ULCER DERMATITIS
    45. LADY WITH OVARY TUMOR, SKIN RASH, WEKNESS….. DERMATOMYOSITIS
    46. YOUNG PT WITH ALL LIMB WEAKNESSS…..HPPP
    47. RENAL ANGIO PIC…….RAS
    48. PIC OF DUDENAL BIOPSY…..CELIAC
    49. PT WITH KLENFELTIR SYND
    50. PT WITH MENOPAUSE.
    51. AUTONOMIC NEUROPATHY WITH TREMOR……MULTI SYS ATROPHY
    52. PT QUADRAPLEGIC, CATHETER CHANGER, SWEATY, HTN………
    53. PROLONGED PR INTERVAL…… RHEUMATIC FEVER.
    54. MS PT WITH URINARAY PROBLEM….. INTERMITTENT CATHETERIZATION.
    55. ESBL GROWTH IN URINE….. MEROPANUM/ CHANGE CATHETER.
    56. LADY WITH FAMILIAL HYPOCALCIURIC HYPERCALCEMIA
    57. YOUNG PT, ABDO PAIN, RESOLVED, INCREASED ALP……VIT D LEVEL.
    58. LOW HB POST VALVE REPLACEMENT….. VALVE INDUCED HEMOLYSIS
    59. LOCKED IN SYNDROME…… LESION IN PONS.
    60. OLD LADY WITH ULCERS IN URETHRAL AREA….. ACYCLOVIR
    61. NEPHROTIC SYND….. SOB AFTER BIOPSY….. PE
    62. LADY WITH OCP, STARTED ON AMOXICILLIN…. NOTHING REQUIRED.
    63.CHOLESTATIS OF PREGNANCY.
    64. NORMAL PREGNANCY
    65. DERANGED LFTS, HIGH CPK, MUSCLE PAIN,,,,,,, LEPTOSPIROSIS.
    66. LADY WITH SCAR KIDNEY…….REFLUX NEPHROPATHY
    67. PT WITH ABDO PAIN, HYPOGLYCEMIA, SURGICAL SCAR,,,,,,,DUMPING SYND, INSULINOMA
    68. PT WITH HYPOGLYCEMIA AND INCREASED C-PEPTIDE…….. INSULIN.
    69. YOUNG MALE WITH DEC LATERAL SPINE MOVEMENT…….. ? ANKYLO SPONDIL
    70. URGENT INVEST IN AML….. COAGULATION PROFILE
    71. DM PT WITH NECROBIOSIS LIPODICUM
    72. PIC OF X-LINKED RECESSIVE
    73. TREATMENT OF DIAB NEUROPATHY…….DOLEXITINE.
    75. PT WITH CONS SYNDROME
    76. PT WITH CRANIOPHYRANGIOMA
    77. TREATMENT OF LYME DISEASE……DOXYCYLINE.
    78. CLUSTER HEADACHE,,,,,, VERAPAMIL
    79. FITS NOT RELATED TO EPILEPSY…… TIGHT EYE CLOSING.
    80. SICK SINUS SYND…….
    81. OBS SLEEP APNEA…..
    82. COPD EX ON NIV
    83. COPD EX…… NEXT TREATMENT……
    84. AORTIC STENOSIS WITH LAD LESION…… CABG WITH VALVE CHANGE
    85. DM PT WITH PNEUMONIA….. KLEBSIALLA.
    86. POST VALVE CHANGE ENDOCARDITIS…. STAPH EPI
    87. IV DRUG USER WITH ABSCES……
    88. TOXOPLASMOSIS PT
    89. HIV PT WITH HEADACHE…….MULTIFOCAL PROGRESSIVE
    90. HYPERTHYROIDISM LADY PLANNING TO CONCEIVE….. PROPYLTHYOURACIL
    91. PREGNANAT LADY WITH PE….INVESTIGATION…. VQ SCAN
    92. AMIODORONE INDUCED HYPERTHYROIDISM…… TREATMENT
    93. AMIODORONE INDUCE HYPERTHYRODISM,,,,,, INVESTIGATION
    94. PT WITH PLATELETS OF 900…….TREATMENT……HYDROXYUREA
    95. PT WITH SLEEP APNEA….. CPAP OR WT REDUCTION
    96. SEVERITY OF AS….. SYMPTOMS
    97. SMOKER WITH WEAKNESS AND DRY MOUTH….. LEMS
    98.PT WITH CHURG STRASS SYND.
    99. PT WITH POLYARTERITIS NODUSA
    100. SICK SINUS SYNDROME….. DDD/VVI
    101. TREATMENT OF PID
    102. TREATMENTOF GONNORHOEA… ALLERGIC TO PENICILLIN
    103, PT WITH INFECTIVE ENDOCARIDITIS, BLD CULTURE NEGATIVE, WHAT TO DO
    104, MALE WITH INC DROWSYNESS, ANEMIC, THROMBOCYTOPENIC,,,,,,, TTP
    105, MALE PT WITH RECURRENT INFECTIONS….. MIXED DEFECIENCY.
    106, PT WITH CHEST INFECTIONS, GREEN SPUTUM,,,,NEXT INVESTIGATION,,,, CF GENE
    107, LADY WITH ANTIPHOSPHOLIPID ANTIBODY, STILL +VE AFTER TREATMENT,,,, NEXT TREATMEN,,,,,,WARFARIN
    108. INDICATION OF THROMBOPHILIA SCREENING
    109, PT HIV POST, HCV POS, …….. HAVING RASH, CRYOGLOBINEMIA
    110. GBS PT WITH DOB,,,,, FVC
    111. OLD LADY WITH VULVAR LESIONS,,,,, LICHEN SCLEROSIS
    112. PT WITH SKIN LESIONS,,,, LICHEN PLANUS
    113, PT WITH PURPULY WHITE LESIONS,,,, MOLLUSCUM COTIGIOSUM
    114. CKD PT WITH SEVERE ITCHING ON FINGERS AND WRIST… SCABIES/HYPERPHOSPHATEMIA
    115. CYANOSIS MEDICINE,,,,, DAPSONE
    116. PT WITH ORAL PALQUES, NORMAL XRAY,,,,, COTRIMOXAZOLE.
    117. CCF PT WITH OPTIMAL TREATMENT,,,,, CARDIAC REHAB
    118. AMEOBIC CYSTS…TREATMENT….
    119. HF GENOTYPE
    120. TRAUMATIC CSF TAP
    121. DIAGNOSIS OF EMPYEMA….. PH
    122. NGT DISLOGED…. ASPIRATE AND PH ANALYSIS
    123. CARDIAC ARREST,,,, START CPR
    124, OLD LADY WITH COLLAPSE,,,, CARDIAC ARRYTHMIA,,,, VASOVAGAL SYNCOPE.
    125. WEGNARS
    126. POLYCHONDRITIS
    127. CONSTRICTIVE PERICARDITIS
    128, HOLLS EDIS PUPIL
    129. ACUTE AKATHESIA
    130. EXTRINSIC ALLERGIC ALVEOLITIS
    131. MENINGOCOCAL MENINGITIS
  13. samuel

    samuel New Member

    Polyarteritis nodosa
    Methhemoglibenimia give sodium thiosulfate
    Chf e af give digoxin
    Hypersensitive pneumonitis in builder long time
    Panhypopituitarism
    Miller fisher syndrome
    Guillian barre syndrome
    Terbenafine deranged lft
    Amoxiclav jaundice
    Pyoderma gangrenosum post dog bite in uc pt?
  14. samuel

    samuel New Member

    1.ECG OF WPW SYND…...ABLATION
    2.ECG OF ATRIAL FLUTTER
    3. ECG OF AVNRT
    4.ECG OF CHB
    5.ECG OF ? BRUGADA/? ARRYTHMOGENIC RT VENT
    6. ECG OF PERICARDITIS.
    7.PIC OF ECHO…….ATRIAL MXOMA
    8. FUNDOSCOPY……. CRVO.
    9.FUNDOSCOPY…….. NIGHT BLINDNESS.
    10. CT CHEST WITH MITH METS…….PALLIATIVE
    11. MRI SPINE……. TB
    12. MRI HEAD…….. GLIOMA
    13. CXR WITH LT UPPER LOBE LESION……. NSCL
    14. CXR WITH RT UPPER LOBE LESION…… ASPERGILOMA
    15.CXR WITH HEPATORENAL SYNDROME
    16. CXR WITH RH NODULES.
    17.CXR WITH NEUTROPENIC PT……. TAZOCIN
    18. PELVIC XRAY….. AVN OF FEMORAL HEAD
    19. WRIST XRAY….. PULMONAY OSTEODYSTROPHY
    20. HAND XRAY…….. RA.
    21. CXR WITH ASBESTOSIS/SILICOSIS.
    22. MRI WITH ARNOLD CHAARI MALFORMATION.
    23. OLD LADY STACKING NEWS PAPERS……..SENILIE SQUALOR SYND
    24. PT WITH RENOYDS, HIGH CK…… ANTI JO ANTIBODIES
    25. YOUNG PT WITH 5% PNEUMOTHORAX….. ASPIRATION.
    26. LADY WITH POST PARTUM CARDIOMYOPATHY
    27. NEPHROTIC SYND WITH B/L FLANK PAIN…..RENAL VEIN THROMBOSIS.
    28. PT WITH BUDD CHARII SYNDROME.
    29. PT WITH METHANOL POISONING.
    30. PT WITH VIPOMA
    31. OLD LADY WITH ANEMIA. TREATED AGAIN ANEMIC….INVESTIGATION.
    32. LEWI BODY DEMENTIA.
    33. MYOTONIA DYSTROPHIA PT
    32. HSV PT
    33. NEUROCYSTICERCOSIS PT
    34. LISTERIA MONOCYTOGENS PT
    35. ELDERLY PT WITH WEAKNESS, NYSTAGMUS,……SCDC/WERNICKS
    36.ELDERLY PT WITH WEAKNESS……. INCLUSION BODY MYOCYTIS/POLYMYOSITIS
    37.BOUTILISM TOXIN PT
    38. LADY WITH PERIANAL RASH…..? NICORANDIL
    39. PT WITH OBS JAUNDICE…… AUGMENTIN.
    40. CT HEAD WITH CEREBRAL CONTUSION.
    41. PICTURE OF PATRIASIS VERSICOLOR
    42. PIC OF PYOGENIC GRANULOMA
    43. PIC OF BOWENS DISEASE.
    44. PIC OF HAMANGIOMA
    45. PT WITH IBD WITH PYODERMA GANGRINOSUM
    44. PT WITH LEG ITCHING…..VERICOSE ULCER DERMATITIS
    45. LADY WITH OVARY TUMOR, SKIN RASH, WEKNESS….. DERMATOMYOSITIS
    46. YOUNG PT WITH ALL LIMB WEAKNESSS…..HPPP
    47. RENAL ANGIO PIC…….RAS
    48. PIC OF DUDENAL BIOPSY…..CELIAC
    49. PT WITH KLENFELTIR SYND
    50. PT WITH MENOPAUSE.
    51. AUTONOMIC NEUROPATHY WITH TREMOR……MULTI SYS ATROPHY
    52. PT QUADRAPLEGIC, CATHETER CHANGER, SWEATY, HTN………
    53. PROLONGED PR INTERVAL…… RHEUMATIC FEVER.
    54. MS PT WITH URINARAY PROBLEM….. INTERMITTENT CATHETERIZATION.
    55. ESBL GROWTH IN URINE….. MEROPANUM/ CHANGE CATHETER.
    56. LADY WITH FAMILIAL HYPOCALCIURIC HYPERCALCEMIA
    57. YOUNG PT, ABDO PAIN, RESOLVED, INCREASED ALP……VIT D LEVEL.
    58. LOW HB POST VALVE REPLACEMENT….. VALVE INDUCED HEMOLYSIS
    59. LOCKED IN SYNDROME…… LESION IN PONS.
    60. OLD LADY WITH ULCERS IN URETHRAL AREA….. ACYCLOVIR
    61. NEPHROTIC SYND….. SOB AFTER BIOPSY….. PE
    62. LADY WITH OCP, STARTED ON AMOXICILLIN…. NOTHING REQUIRED.
    63.CHOLESTATIS OF PREGNANCY.
    64. NORMAL PREGNANCY
    65. DERANGED LFTS, HIGH CPK, MUSCLE PAIN,,,,,,, LEPTOSPIROSIS.
    66. LADY WITH SCAR KIDNEY…….REFLUX NEPHROPATHY
    67. PT WITH ABDO PAIN, HYPOGLYCEMIA, SURGICAL SCAR,,,,,,,DUMPING SYND, INSULINOMA
    68. PT WITH HYPOGLYCEMIA AND INCREASED C-PEPTIDE…….. INSULIN.
    69. YOUNG MALE WITH DEC LATERAL SPINE MOVEMENT…….. ? ANKYLO SPONDIL
    70. URGENT INVEST IN AML….. COAGULATION PROFILE
    71. DM PT WITH NECROBIOSIS LIPODICUM
    72. PIC OF X-LINKED RECESSIVE
    73. TREATMENT OF DIAB NEUROPATHY…….DOLEXITINE.
    75. PT WITH CONS SYNDROME
    76. PT WITH CRANIOPHYRANGIOMA
    77. TREATMENT OF LYME DISEASE……DOXYCYLINE.
    78. CLUSTER HEADACHE,,,,,, VERAPAMIL
    79. FITS NOT RELATED TO EPILEPSY…… TIGHT EYE CLOSING.
    80. SICK SINUS SYND…….
    81. OBS SLEEP APNEA…..
    82. COPD EX ON NIV
    83. COPD EX…… NEXT TREATMENT……
    84. AORTIC STENOSIS WITH LAD LESION…… CABG WITH VALVE CHANGE
    85. DM PT WITH PNEUMONIA….. KLEBSIALLA.
    86. POST VALVE CHANGE ENDOCARDITIS…. STAPH EPI
    87. IV DRUG USER WITH ABSCES……
    88. TOXOPLASMOSIS PT
    89. HIV PT WITH HEADACHE…….MULTIFOCAL PROGRESSIVE
    90. HYPERTHYROIDISM LADY PLANNING TO CONCEIVE….. PROPYLTHYOURACIL
    91. PREGNANAT LADY WITH PE….INVESTIGATION…. VQ SCAN
    92. AMIODORONE INDUCED HYPERTHYROIDISM…… TREATMENT
    93. AMIODORONE INDUCE HYPERTHYRODISM,,,,,, INVESTIGATION
    94. PT WITH PLATELETS OF 900…….TREATMENT……HYDROXYUREA
    95. PT WITH SLEEP APNEA….. CPAP OR WT REDUCTION
    96. SEVERITY OF AS….. SYMPTOMS
    97. SMOKER WITH WEAKNESS AND DRY MOUTH….. LEMS
    98.PT WITH CHURG STRASS SYND.
    99. PT WITH POLYARTERITIS NODUSA
    100. SICK SINUS SYNDROME….. DDD/VVI
    101. TREATMENT OF PID
    102. TREATMENTOF GONNORHOEA… ALLERGIC TO PENICILLIN
    103, PT WITH INFECTIVE ENDOCARIDITIS, BLD CULTURE NEGATIVE, WHAT TO DO
    104, MALE WITH INC DROWSYNESS, ANEMIC, THROMBOCYTOPENIC,,,,,,, TTP
    105, MALE PT WITH RECURRENT INFECTIONS….. MIXED DEFECIENCY.
    106, PT WITH CHEST INFECTIONS, GREEN SPUTUM,,,,NEXT INVESTIGATION,,,, CF GENE
    107, LADY WITH ANTIPHOSPHOLIPID ANTIBODY, STILL +VE AFTER TREATMENT,,,, NEXT TREATMEN,,,,,,WARFARIN
    108. INDICATION OF THROMBOPHILIA SCREENING
    109, PT HIV POST, HCV POS, …….. HAVING RASH, CRYOGLOBINEMIA
    110. GBS PT WITH DOB,,,,, FVC
    111. OLD LADY WITH VULVAR LESIONS,,,,, LICHEN SCLEROSIS
    112. PT WITH SKIN LESIONS,,,, LICHEN PLANUS
    113, PT WITH PURPULY WHITE LESIONS,,,, MOLLUSCUM COTIGIOSUM
    114. CKD PT WITH SEVERE ITCHING ON FINGERS AND WRIST… SCABIES/HYPERPHOSPHATEMIA
    115. CYANOSIS MEDICINE,,,,, DAPSONE
    116. PT WITH ORAL PALQUES, NORMAL XRAY,,,,, COTRIMOXAZOLE.
    117. CCF PT WITH OPTIMAL TREATMENT,,,,, CARDIAC REHAB
    118. AMEOBIC CYSTS…TREATMENT….
    119. HF GENOTYPE
    120. TRAUMATIC CSF TAP
    121. DIAGNOSIS OF EMPYEMA….. PH
    122. NGT DISLOGED…. ASPIRATE AND PH ANALYSIS
    123. CARDIAC ARREST,,,, START CPR
    124, OLD LADY WITH COLLAPSE,,,, CARDIAC ARRYTHMIA,,,, VASOVAGAL SYNCOPE.
    125. WEGNARS
    126. POLYCHONDRITIS
    127. CONSTRICTIVE PERICARDITIS
    128, HOLLS EDIS PUPIL
    129. ACUTE AKATHESIA
    130. EXTRINSIC ALLERGIC ALVEOLITIS
    131. MENINGOCOCAL MENINGITIS
    132. LADY WITH HYPOTHYROIDISM, SKIN RASH, ERYTHME AB IGNE
  15. samuel

    samuel New Member

    Contact lens now painful
    Diabetes insipidus
    Familial hypercalcemic hypocalciuria
    Pagets disease Rx?
    Glioma
    Obstruction at the pelviuretric junction as their was a dilated calyceal sys
    Menopause
    Alfacalcidol
    APL syn now pregnant switch to LMwhep
    Pe enixaparin
    Polymuositis
    Dermatomyositis
    Psoriasis drug. Atenolol
    Lft terbenafidine
    New epilepsy
    Clavulanic acid
    Avascular necrosis
    Puogenic granuloma
    MI now bp 96/60 min pleural effussion aw chest pain-> gtn infusion
    Gliclazide hypo
    Insulin as gastroparaesis type sx
    Osa co2 was high so cpap
    Latent sleepstudy
    Schizophrenia
    Lewy body dementia
    Avrt
    Aflutter
    Arryyjmogrnic R ventricular carfiomyopathy
    Carbimazole
    Pt pregnant t3 n tsh low repeat in 3 months
    Mother stacking up pile of newspaper?
    ?radiotherapy as mass was enroaching the spine
    Spironolactone before CRT
    Intubate
    Niv
  16. samuel

    samuel New Member

    1.ECG OF WPW SYND…...ABLATION
    2.ECG OF ATRIAL FLUTTER
    3. ECG OF AVNRT
    4.ECG OF CHB
    5.ECG OF ? BRUGADA/? ARRYTHMOGENIC RT VENT
    6. ECG OF PERICARDITIS.
    7.PIC OF ECHO…….ATRIAL MXOMA
    8. FUNDOSCOPY……. CRVO.
    9.FUNDOSCOPY…….. NIGHT BLINDNESS.
    10. CT CHEST WITH MITH METS…….PALLIATIVE
    11. MRI SPINE……. TB
    12. MRI HEAD…….. GLIOMA
    13. CXR WITH LT UPPER LOBE LESION……. NSCL
    14. CXR WITH RT UPPER LOBE LESION…… ASPERGILOMA
    15.CXR WITH HEPATORENAL SYNDROME
    16. CXR WITH RH NODULES.
    17.CXR WITH NEUTROPENIC PT……. TAZOCIN
    18. PELVIC XRAY….. AVN OF FEMORAL HEAD
    19. WRIST XRAY….. PULMONAY OSTEODYSTROPHY
    20. HAND XRAY…….. RA.
    21. CXR WITH ASBESTOSIS/SILICOSIS.
    22. MRI WITH ARNOLD CHAARI MALFORMATION.
    23. OLD LADY STACKING NEWS PAPERS……..SENILIE SQUALOR SYND
    24. PT WITH RENOYDS, HIGH CK…… ANTI JO ANTIBODIES
    25. YOUNG PT WITH 5% PNEUMOTHORAX….. ASPIRATION.
    26. LADY WITH POST PARTUM CARDIOMYOPATHY
    27. NEPHROTIC SYND WITH B/L FLANK PAIN…..RENAL VEIN THROMBOSIS.
    28. PT WITH BUDD CHARII SYNDROME.
    29. PT WITH METHANOL POISONING.
    30. PT WITH VIPOMA
    31. OLD LADY WITH ANEMIA. TREATED AGAIN ANEMIC….INVESTIGATION.
    32. LEWI BODY DEMENTIA.
    33. MYOTONIA DYSTROPHIA PT
    32. HSV PT
    33. NEUROCYSTICERCOSIS PT
    34. LISTERIA MONOCYTOGENS PT
    35. ELDERLY PT WITH WEAKNESS, NYSTAGMUS,……SCDC/WERNICKS
    36.ELDERLY PT WITH WEAKNESS……. INCLUSION BODY MYOCYTIS/POLYMYOSITIS
    37.BOUTILISM TOXIN PT
    38. LADY WITH PERIANAL RASH…..? NICORANDIL
    39. PT WITH OBS JAUNDICE…… AUGMENTIN.
    40. CT HEAD WITH CEREBRAL CONTUSION.
    41. PICTURE OF PATRIASIS VERSICOLOR
    42. PIC OF PYOGENIC GRANULOMA
    43. PIC OF BOWENS DISEASE.
    44. PIC OF HAMANGIOMA
    45. PT WITH IBD WITH PYODERMA GANGRINOSUM
    44. PT WITH LEG ITCHING…..VERICOSE ULCER DERMATITIS
    45. LADY WITH OVARY TUMOR, SKIN RASH, WEKNESS….. DERMATOMYOSITIS
    46. YOUNG PT WITH ALL LIMB WEAKNESSS…..HPPP
    47. RENAL ANGIO PIC…….RAS
    48. PIC OF DUDENAL BIOPSY…..CELIAC
    49. PT WITH KLENFELTIR SYND
    50. PT WITH MENOPAUSE.
    51. AUTONOMIC NEUROPATHY WITH TREMOR……MULTI SYS ATROPHY
    52. PT QUADRAPLEGIC, CATHETER CHANGER, SWEATY, HTN………
    53. PROLONGED PR INTERVAL…… RHEUMATIC FEVER.
    54. MS PT WITH URINARAY PROBLEM….. INTERMITTENT CATHETERIZATION.
    55. ESBL GROWTH IN URINE….. MEROPANUM/ CHANGE CATHETER.
    56. LADY WITH FAMILIAL HYPOCALCIURIC HYPERCALCEMIA
    57. YOUNG PT, ABDO PAIN, RESOLVED, INCREASED ALP……VIT D LEVEL.
    58. LOW HB POST VALVE REPLACEMENT….. VALVE INDUCED HEMOLYSIS
    59. LOCKED IN SYNDROME…… LESION IN PONS.
    60. OLD LADY WITH ULCERS IN URETHRAL AREA….. ACYCLOVIR
    61. NEPHROTIC SYND….. SOB AFTER BIOPSY….. PE
    62. LADY WITH OCP, STARTED ON AMOXICILLIN…. NOTHING REQUIRED.
    63.CHOLESTATIS OF PREGNANCY.
    64. NORMAL PREGNANCY
    65. DERANGED LFTS, HIGH CPK, MUSCLE PAIN,,,,,,, LEPTOSPIROSIS.
    66. LADY WITH SCAR KIDNEY…….REFLUX NEPHROPATHY
    67. PT WITH ABDO PAIN, HYPOGLYCEMIA, SURGICAL SCAR,,,,,,,DUMPING SYND, INSULINOMA
    68. PT WITH HYPOGLYCEMIA AND INCREASED C-PEPTIDE…….. INSULIN.
    69. YOUNG MALE WITH DEC LATERAL SPINE MOVEMENT…….. ? ANKYLO SPONDIL
    70. URGENT INVEST IN AML….. COAGULATION PROFILE
    71. DM PT WITH NECROBIOSIS LIPODICUM
    72. PIC OF X-LINKED RECESSIVE
    73. TREATMENT OF DIAB NEUROPATHY…….DOLEXITINE.
    75. PT WITH CONS SYNDROME
    76. PT WITH CRANIOPHYRANGIOMA
    77. TREATMENT OF LYME DISEASE……DOXYCYLINE.
    78. CLUSTER HEADACHE,,,,,, VERAPAMIL
    79. FITS NOT RELATED TO EPILEPSY…… TIGHT EYE CLOSING.
    80. SICK SINUS SYND…….
    82. COPD EX ON NIV
    83. COPD EX…… NEXT TREATMENT……
    84. AORTIC STENOSIS WITH LAD LESION…… CABG WITH VALVE CHANGE
    85. DM PT WITH PNEUMONIA….. KLEBSIALLA.
    86. POST VALVE CHANGE ENDOCARDITIS…. STAPH EPI
    87. IV DRUG USER WITH ABSCES……
    88. TOXOPLASMOSIS PT
    89. HIV PT WITH HEADACHE…….MULTIFOCAL PROGRESSIVE
    90. HYPERTHYROIDISM LADY PLANNING TO CONCEIVE….. PROPYLTHYOURACIL
    91. PREGNANAT LADY WITH PE….INVESTIGATION…. VQ SCAN
    92. AMIODORONE INDUCED HYPERTHYROIDISM…… TREATMENT
    93. AMIODORONE INDUCE HYPERTHYRODISM,,,,,, INVESTIGATION
    94. PT WITH PLATELETS OF 900…….TREATMENT……HYDROXYUREA
    95. PT WITH SLEEP APNEA….. CPAP OR WT REDUCTION
    96. SEVERITY OF AS….. SYMPTOMS
    97. SMOKER WITH WEAKNESS AND DRY MOUTH….. LEMS
    98.PT WITH CHURG STRASS SYND.
    99. PT WITH POLYARTERITIS NODUSA
    100. SICK SINUS SYNDROME….. DDD/VVI
    101. TREATMENT OF PID
    102. TREATMENTOF GONNORHOEA… ALLERGIC TO PENICILLIN
    103, PT WITH INFECTIVE ENDOCARIDITIS, BLD CULTURE NEGATIVE, WHAT TO DO
    104, MALE WITH INC DROWSYNESS, ANEMIC, THROMBOCYTOPENIC,,,,,,, TTP
    105, MALE PT WITH RECURRENT INFECTIONS….. MIXED DEFECIENCY.
    106, PT WITH CHEST INFECTIONS, GREEN SPUTUM,,,,NEXT INVESTIGATION,,,, CF GENE
    107, LADY WITH ANTIPHOSPHOLIPID ANTIBODY, STILL +VE AFTER TREATMENT,,,, NEXT TREATMEN,,,,,,WARFARIN
    108. INDICATION OF THROMBOPHILIA SCREENING
    109, PT HIV POST, HCV POS, …….. HAVING RASH, CRYOGLOBINEMIA
    110. GBS PT WITH DOB,,,,, FVC
    111. OLD LADY WITH VULVAR LESIONS,,,,, LICHEN SCLEROSIS
    112. PT WITH SKIN LESIONS,,,, LICHEN PLANUS
    113, PT WITH PURPULY WHITE LESIONS,,,, MOLLUSCUM COTIGIOSUM
    114. CKD PT WITH SEVERE ITCHING ON FINGERS AND WRIST… SCABIES/HYPERPHOSPHATEMIA
    115. CYANOSIS MEDICINE,,,,, DAPSONE
    116. PT WITH ORAL PALQUES, NORMAL XRAY,,,,, COTRIMOXAZOLE.
    117. CCF PT WITH OPTIMAL TREATMENT,,,,, CARDIAC REHAB
    118. AMEOBIC CYSTS…TREATMENT….
    119. HF GENOTYPE
    120. TRAUMATIC CSF TAP
    121. DIAGNOSIS OF EMPYEMA….. PH
    122. NGT DISLOGED…. ASPIRATE AND PH ANALYSIS
    123. CARDIAC ARREST,,,, START CPR
    124, OLD LADY WITH COLLAPSE,,,, CARDIAC ARRYTHMIA,,,, VASOVAGAL SYNCOPE.
    125. WEGNARS
    126. POLYCHONDRITIS
    127. CONSTRICTIVE PERICARDITIS
    128, HOLLS EDIS PUPIL
    129. ACUTE AKATHESIA
    130. EXTRINSIC ALLERGIC ALVEOLITIS
    131. MENINGOCOCAL MENINGITIS
    132. GRADED THERAPY IN FATIGUE.
    133. METHEMOGLOBINEMIA,,,,,,SODIUM THIOSULPHATE.
    134. CCF WITH AF…..GIVE DIGOXIN
    135, DIGOXIN TOXICITY WITH HYPERKALEMIA…..GIVE FAB
    136. PT WITH GBS
    137. TREATMENT OF GOUT IN RENAL FAILURE……COLCHICIN.
    138. PT WITH PICA SYNDROME
    139. PT WITH GOUT NOT TOLERATING ALLOPURINOL……PROBENISID
    140. LADY WITH MALIG MELANOMA, RIB PAIN, PREGNANT, NEXT INVESTIGATION…… ISOTOPE SCAN
    141. PT WITH TTP, NEXT INVESTIGATION, BLOOD FILM
    142. mixed sensorimotor neuropathy absent ankle reflex cause?diabetic neuropathy amyloiodis thalidomide
    143. ISCHEMIC HEPATITIS
    144. PARACETAMOL TOXICITY
    145. PORPHYRIA SCREEN IN PT EXPOSED TO SUN WITH BLISTERS.
    146. LADY WITH GE, NORMAL ANION GAP, ACIDOSIS, HYPOKALEMIA,,,,, IVF
    147. LADY WITH PE,,,,,, ANOXAPRIN
    148, PT WITH ALKALOSIS IN ABG,,NORMAL PO2,,,,,,ANXIETY
    149. OLD LADY WITH RT HIP PIAN AFTER SLEEP, UNABLE TO WT BEAR, ON WARFARIN, WHICH INVETIGATGATION
    150. LADY WITH FOOT PAIN AND SWELLING, ABX GIVEN, STILL SWELLING WITH ULCER, NEXT INVESTIGATION
    151, PT WITH FOOT PAIN, TENDER MTP JOINTS, OTHER JOINTS NORMAL, DIAGNOSIS…..GOUT
    152. ULCERATIVE COLITIS PT WITH DIARRHOEA, GIVEN STEROIDS, NOT IMPROVED, NEXT TREATMENT….AZATHIOPRINE.
    153. PT WITH STRONGLOIDS INFECTION.
    154. PT WITH DKA
    155. PT WITH METFORMIN INDUCED LACTIC ACIDOSIS.
    156, LADY WITH RTA, HEAD INJURY, NECK PAIN, EYE PAIN,,,,,,,, CAROTID ARTERY DISSECTION.
    157. PT WITH ADDISON DISEASE,,,,,,CORTISOL LEVEL CHK.
    158. RESISTENT HYPERCALCEMIA;;;;;;PAMIDRONATE
    159. PT WITH LOW NA 113,,,,,,,N/S OR 3% SALINE
    160. BONY CTST WITH FRACTURE,,,,, HIGH PTH,,,,TERTIARY HYPERPARATHYROIDISM
    161. PT WITH RESTING ESSENTIAL TREMOR,,,,,,PROPARONOL
    162. PALLIATIVE PT WITH SOB…..MORPHINE
    163. PT WITH HYPOKALEMIA AND HTN,,,,,RENIN ALDOSTERONE RATIO
    164. PT WITH DANUE;;;;;CHIKINGUNYA
    165. PT WITH SHOULDER PAIN,,,,,CAPSULE INJURY
    166. YOUNG PT WITH GROIN PAIN,,,,,, ILIOSOS PROBLEM
    167. CONTACT LENS NOW PAINFUL, TREATMENT……
    168. PT WITH OBS AT PUJ….. DILATED PELVICALACIAL SYSTEM,,,,,
    169. APL SYNDROME, NOW PREGNANT,CHANGE TO LMWH
    170. DERANGED LFTS,,,,,TERBENAFIDINE
    171. INF MI, NOW HYPOTENSIVE….TREATMENT,,,,,IVF
  17. samuel

    samuel New Member

    Contact lens now painful
    Diabetes insipidus
    Familial hypercalcemic hypocalciuria
    Pagets disease Rx?
    Glioma
    Obstruction at the pelviuretric junction as their was a dilated calyceal sys
    Menopause
    Alfacalcidol
    APL syn now pregnant switch to LMwhep
    Pe enixaparin
    Polymuositis
    Dermatomyositis
    Psoriasis drug. Atenolol
    Lft terbenafidine
    New epilepsy
    Clavulanic acid
    Avascular necrosis
    Puogenic granuloma
    MI now bp 96/60 min pleural effussion aw chest pain-> gtn infusion
    Gliclazide hypo
    Insulin as gastroparaesis type sx
    Osa co2 was high so cpap
    Latent sleepstudy
    Schizophrenia
    Lewy body dementia
    Avrt
    Aflutter
    Arryyjmogrnic R ventricular carfiomyopathy
    Carbimazole
    Pt pregnant t3 n tsh low repeat in 3 months
    Mother stacking up pile of newspaper?
    ?radiotherapy as mass was enroaching the spine
    Spironolactone before CRT
    Intubate
    Niv
    Bladder ca as bilateral obs ? Retroperitoneal fib

    Limbic enceph-> hippocampus
    Locked in synd-> pons
    Peripartumcardiacmyopathy
    Toxoplasmodis
    India yerisina colitis
    Picture of histopath of bx ? Celiac?crohns
    Rx with chemo -> major depressive illness
    Pml not improved with sulph
    Another one pml Rx clotrimaxole
    2 pics of TB
    Aspergilloma post chemo
    Gout was HTn
    Another gout febuxat
    Renal tubular acidosis
    Photoeruptive rash as dpared the limbs
    Varicella zoster
    Preg hepatitis E came from a holiday
    Cholestasis of preg
    Piohlitazone haematuria
    Stop metformin 2 days after the contrast
    ? Low platelets norm clotting low fibronogent wat to give before LP
    Ccf digoxin
    Why do we do thrombophillia screen? Todetermine the future thrombosis risk
    Amylodosis
    Progressive massive fibrosis cannt be EAA as it involves lower lobes
    IDiopathic parkinsons disease
    Carotid dissection
    Holmes aldie
    Epap and bipap
    Dspsone
    Wernicke
    chrugg strauss
    Dengue
    HPA-> NSCL xray prriostitis
    ?menigioma/?SAH
    LP-> traumatic tap
    Ct abdo pelvis as InR high unable to move hip
    Perfusion scan pregnant female hypoxic
    ApL lifelong warfarin
    Capsulate gram positive-> colistridium perferinges
    Strept pyogenes 3 months post avr
    Cef and met
    Cdiff diarrhea -> ct abdo as apdo tend distended
    Dm cellulitis as erythematous rash
    Polychondritis
    Stop amiadarine
    Psittacosis
    Myobacterium docycycline as erythema multifirme
    Rash with ulcer recent 3 partners? Sypyllis serology
    Aml
    Asthma recurrent infections immunofeficiency
    ? Pheochromocytoma rx
  18. samuel

    samuel New Member

    Thrombophila screen not required for this patient as the mother developed thrombosis provoked by surgery and this lady developed after provoked travel.

    Unprovoked thrombosis, thrombosis in unusal sites require thrombophilia screen.

    //Case finding
    of asymptomatic relatives of patients with VTE and thrombophilia has not been
    shown to reduce the incidence of VTE and the annual risk of unprovoked
    thrombosis in affected family members is low. If a family history suggests a
    high degree of genetic penetrance then it might be reasonable to test a
    symptomatic patient and then their relatives, with a view to enhanced
    prophylaxis at times of high risk in affected members.
  19. samuel

    samuel New Member

    - Contraindication for Ribavirin and Interferon therapy - Depression
    - Young Pt with 5% Pneumothorax- Review with CXR (its a primary pneumo <5% in a young pt)
    - Bowing of shin bones with high Alkaline Phosphatase , and Ca 2.8 - - - Pamidronate (bowing is charachteristic of Pagets's ds with high ALP...Ca is mildly raised and Phosphate is normal...so Rx - Bisphosphonate)
    - A pt from ICU, blood sample sent for APTT >100s....in vitro protamine correction (since CVC are flushed with heparin...so APTT is often raised in these patients)
    - A pt with diarrhea and raised creatinine (symptoms similar to HUS) - have to go for blood film (to check for schistocytes - microangiopathic hemolytic anemia)
    - Atenolol causes drug induced Psoriasis
    - Raynaud's phenomenon, with muscle weakness....features similar to MCTD- so have to check Anti RNP
    - Hypercalcemia in a pt with K-3.1 - give 0.9% NaCl with 40mmol K....(though i feel 40 mmol k is too much...but Nacl is always the first option in hypercalcemia)
  20. samuel

    samuel New Member

    - Claveulenic acid - cholestasis
    - Terbinafine - deranged liver funtion test
    - A patient with symptoms suggestive of GB syndrome - monitor FVC
    - MRI scan brain with down beat nystagmus - Arnold Chiari Malformation
    - A female patient with a tender thyroid - De Quervain Thyroiditis
    - A question on diarrhea after taking prolonged Antibiotics and blood showing raised CRP - Antibiotic induced Diarrhea
    - A patient who is iv drug user, presents with hypoglymeia (detected recently with DM)....given glucose but still has hypoglycemia....mutliple injection tracks noted - Insulin overdose (a patient with insulinoma...will not be recently detected with DM)
  21. samuel

    samuel New Member

    In pericarditis usually there is global ST elevation?

    Yes....giving a quote...from a standard ECG website
    " Pericarditis is an inflammation of the pericardium. This can lead to ST elevation in all leads. Therefore, it is important to distinguish pericarditis from a myocardial infarction, which has more acute complaints and ST-elevations are limited to the infarct area.
    In pericarditis four stages can be distinguished on the ECG:
    stage I: ST elevation in all leads. PTa depression (depression between the end of the P-wave and the beginning of the QRS- complex)
    stage II: pseudonormalisation (transition)
    stage III: inverted T-waves
    stage IV: normalisation
    Keep into account that in stage I pericarditis, ST-elevation is present in all leads except in aVR, V1 and III."
    You can check any standard ECG text book....schamroth etc
  22. samuel

    samuel New Member

    - Pioglitazone should be withdrawn in haematuria (since it leads to bladder Ca)
    - A 74 yrs old pt with asymptomatic hyperthyroidism - check TFT after 3 months (?)
    - A patient with features of pseudomembranous colitis with diffusely tense and tender abdomen - next investigation - Abdominal X-ray (to rule out toxic megacolon and perforation)
  23. samuel

    samuel New Member

    A patient with enlarged liver and father having a history of late onset diabetes mellitus - HFE gene testing (may point towards haemochromatosis)
    Pyoderma gangrenosum with infection with Staph epidermidis and Pseudomonas aeruginosa - treatment with?? I went for steroids (the bugs may be contaminants)
  24. samuel

    samuel New Member

    Phentolamine is the preferred drug in pheochromocytoma. alpha blockade. Unopposed beta can cause vasodilatation, which will further bring down the BP. Blocking both is not advantageous in this situation.

    With labetalol there is a problem particularly in pheocromocytoma.

    //paradoxical hypertensive responses have been reported in a few patients with this tumor; therefore, use caution when administering Labetalol HCl to patients with pheochromocytoma.//
  25. samuel

    samuel New Member

    pneumothorax upto 2% donot need any treatment. more than 2% if primary requires aspiration. this pt was having 5% pneumothorax, i marked aspiration
  26. samuel

    samuel New Member

    The problem is 2cm is different from 2% - I also made the same mistake.

    <15 % needs only observation in BTS guidelines.
  27. samuel

    samuel New Member

    Hypoglycemic - patient had raised C peptide - hence has it's endogenous insulin production - probably a insulin secretagogue like gliclazide. If it is exogenously administered insulin then C peptide will not be raised.
  28. samuel

    samuel New Member

    1.ECG OF WPW SYND…...ABLATION
    2.ECG OF ATRIAL FLUTTER
    3. ECG OF AVNRT
    4.ECG OF CHB
    5.ECG OF ? BRUGADA/? ARRYTHMOGENIC RT VENT
    6. ECG OF PERICARDITIS.
    7.PIC OF ECHO…….ATRIAL MXOMA
    8. FUNDOSCOPY……. CRVO.
    9.FUNDOSCOPY…….. NIGHT BLINDNESS.
    10. CT CHEST WITH MITH METS…….PALLIATIVE
    11. MRI SPINE……. TB
    12. MRI HEAD…….. GLIOMA
    13. CXR WITH LT UPPER LOBE LESION……. NSCL
    14. CXR WITH RT UPPER LOBE LESION…… ASPERGILOMA
    15.CXR WITH HEPATOPULMONARY SYNDROME
    16. CXR WITH RH NODULES.
    17.CXR WITH NEUTROPENIC PT……. TAZOCIN
    18. PELVIC XRAY….. AVN OF FEMORAL HEAD
    19. WRIST XRAY….. PULMONAY OSTEODYSTROPHY
    20. HAND XRAY…….. RA.
    21. CXR WITH ASBESTOSIS/SILICOSIS.
    22. MRI WITH ARNOLD CHAARI MALFORMATION.
    23. OLD LADY STACKING NEWS PAPERS……..SENILIE SQUALOR SYND
    24. PT WITH RENOYDS, HIGH CK…… ANTI JO ANTIBODIES
    25. YOUNG PT WITH 5% PNEUMOTHORAX….. ASPIRATION.
    26. LADY WITH POST PARTUM CARDIOMYOPATHY
    27. NEPHROTIC SYND WITH B/L FLANK PAIN…..RENAL VEIN THROMBOSIS.
    28. PT WITH BUDD CHARII SYNDROME.
    29. PT WITH METHANOL POISONING.
    30. PT WITH VIPOMA
    31. OLD LADY WITH ANEMIA. TREATED AGAIN ANEMIC….INVESTIGATION.
    32. LEWI BODY DEMENTIA.
    33. MYOTONIA DYSTROPHIA PT
    32. HSV PT
    33. NEUROCYSTICERCOSIS PT
    34. LISTERIA MONOCYTOGENS PT
    35. ELDERLY PT WITH WEAKNESS, NYSTAGMUS,……SCDC/WERNICKS
    36.ELDERLY PT WITH WEAKNESS……. INCLUSION BODY MYOCYTIS/POLYMYOSITIS
    37.BOUTILISM TOXIN PT
    38. LADY WITH PERIANAL RASH…..? NICORANDIL
    39. PT WITH OBS JAUNDICE…… AUGMENTIN.
    40. CT HEAD WITH CEREBRAL CONTUSION.
    41. PICTURE OF PATRIASIS VERSICOLOR
    42. PIC OF PYOGENIC GRANULOMA
    43. PIC OF BOWENS DISEASE.
    44. PIC OF HAMANGIOMA
    45. PT WITH IBD WITH PYODERMA GANGRINOSUM
    44. PT WITH LEG ITCHING…..VERICOSE ULCER DERMATITIS
    45. LADY WITH OVARY TUMOR, SKIN RASH, WEKNESS….. DERMATOMYOSITIS
    46. YOUNG PT WITH ALL LIMB WEAKNESSS…..HPPP
    47. RENAL ANGIO PIC…….RAS
    48. PIC OF DUDENAL BIOPSY…..CELIAC
    49. PT WITH KLENFELTIR SYND
    50. PT WITH MENOPAUSE.
    51. AUTONOMIC NEUROPATHY WITH TREMOR……MULTI SYS ATROPHY
    52. PT QUADRAPLEGIC, CATHETER CHANGER, SWEATY, HTN………
    53. PROLONGED PR INTERVAL…… RHEUMATIC FEVER.
    54. MS PT WITH URINARAY PROBLEM….. INTERMITTENT CATHETERIZATION.
    55. ESBL GROWTH IN URINE….. MEROPANUM/ CHANGE CATHETER.
    56. LADY WITH FAMILIAL HYPOCALCIURIC HYPERCALCEMIA
    57. YOUNG PT, ABDO PAIN, RESOLVED, INCREASED ALP……VIT D LEVEL.
    58. LOW HB POST VALVE REPLACEMENT….. VALVE INDUCED HEMOLYSIS
    59. LOCKED IN SYNDROME…… LESION IN PONS.
    60. OLD LADY WITH ULCERS IN URETHRAL AREA….. ACYCLOVIR
    61. NEPHROTIC SYND….. SOB AFTER BIOPSY….. DVT
    62. LADY WITH OCP, STARTED ON AMOXICILLIN…. NOTHING REQUIRED.
    63.CHOLESTATIS OF PREGNANCY.
    64. NORMAL PREGNANCY
    65. DERANGED LFTS, HIGH CPK, MUSCLE PAIN,,,,,,, LEPTOSPIROSIS.
    66. LADY WITH SCAR KIDNEY…….REFLUX NEPHROPATHY
    67. PT WITH ABDO PAIN, HYPOGLYCEMIA, SURGICAL SCAR,,,,,,,DUMPING SYND, INSULINOMA
    68. PT WITH HYPOGLYCEMIA AND INCREASED C-PEPTIDE…….. INSULIN.
    69. YOUNG MALE WITH DEC LATERAL SPINE MOVEMENT…….. ? ANKYLO SPONDIL
    70. URGENT INVEST IN AML….. COAGULATION PROFILE
    71. DM PT WITH NECROBIOSIS LIPODICUM
    72. PIC OF X-LINKED RECESSIVE
    73. TREATMENT OF DIAB NEUROPATHY…….DOLEXITINE.
    75. PT WITH CONS SYNDROME
    76. PT WITH CRANIOPHYRANGIOMA
    77. TREATMENT OF LYME DISEASE……DOXYCYLINE.
    78. CLUSTER HEADACHE,,,,,, VERAPAMIL
    79. FITS NOT RELATED TO EPILEPSY…… TIGHT EYE CLOSING.
    82. COPD EX ON NIV
    83. COPD EX…… NEXT TREATMENT……
    84. AORTIC STENOSIS WITH LAD LESION…… CABG WITH VALVE CHANGE
    85. DM PT WITH PNEUMONIA….. KLEBSIALLA.
    86. POST VALVE CHANGE ENDOCARDITIS…. STAPH EPI
    87. IV DRUG USER WITH ABSCES……
    88. TOXOPLASMOSIS PT WITH RING ENHANCING LESIONS.
    89. HIV PT WITH HEADACHE…….MULTIFOCAL PROGRESSIVE
    90. HYPERTHYROIDISM LADY PLANNING TO CONCEIVE….. PROPYLTHYOURACIL
    91. PREGNANAT LADY WITH PE….INVESTIGATION…. VQ SCAN
    92. AMIODORONE INDUCED HYPERTHYROIDISM…… TREATMENT,,,, STOP AMIODORONE.
    93. AMIODORONE INDUCE HYPERTHYRODISM,,,,,, INVESTIGATION,,,, IODINE SCAN.
    94. PT WITH PLATELETS OF 900…….TREATMENT……HYDROXYUREA
    95. PT WITH SLEEP APNEA….. WT REDUCTION
    96. SEVERITY OF AS….. SYMPTOMS
    97. SMOKER WITH WEAKNESS AND DRY MOUTH….. LEMS
    98.PT WITH CHURG STRASS SYND.
    99. PT WITH POLYARTERITIS NODUSA
    100. SICK SINUS SYNDROME….. DDD/VVI
    101. TREATMENT OF PID
    102. TREATMENTOF GONNORHOEA… ALLERGIC TO PENICILLIN
    103, PT WITH INFECTIVE ENDOCARIDITIS, BLD CULTURE NEGATIVE, WHAT TO DO ,,,,, REPT BLOOD CULTRUES.
    104, MALE WITH INC DROWSYNESS, ANEMIC, THROMBOCYTOPENIC,,,,,,, TTP
    105, MALE PT WITH RECURRENT INFECTIONS….. MIXED DEFECIENCY.
    106, PT WITH CHEST INFECTIONS, GREEN SPUTUM,,,,NEXT INVESTIGATION,,,, CF GENE
    107, LADY WITH ANTIPHOSPHOLIPID ANTIBODY, STILL +VE AFTER TREATMENT,,,, NEXT TREATMEN,,,,,,WARFARIN
    108. INDICATION OF THROMBOPHILIA SCREENING
    109, PT HIV POST, HCV POS, …….. HAVING RASH, CRYOGLOBINEMIA
    110. GBS PT WITH DOB,,,,, FVC
    111. OLD LADY WITH VULVAR LESIONS,,,,, LICHEN SCLEROSIS
    112. PT WITH SKIN LESIONS,,,, LICHEN PLANUS
    113, PT WITH PURPULY WHITE LESIONS,,,, MOLLUSCUM COTIGIOSUM
    114. CKD PT WITH SEVERE ITCHING ON FINGERS AND WRIST… SCABIES/HYPERPHOSPHATEMIA
    115. CYANOSIS MEDICINE,,,,, DAPSONE
    116. PT WITH ORAL PALQUES, NORMAL XRAY,,,,, COTRIMOXAZOLE.
    117. CCF PT WITH OPTIMAL TREATMENT,,,,, CARDIAC REHAB
    118. AMEOBIC CYSTS…TREATMENT….
    119. HF GENOTYPE
    120. TRAUMATIC CSF TAP
    121. DIAGNOSIS OF EMPYEMA….. PH
    122. NGT DISLOGED…. ASPIRATE AND PH ANALYSIS
    123. CARDIAC ARREST,,,, START CPR
    124, OLD LADY WITH COLLAPSE,,,, CARDIAC ARRYTHMIA,,,, VASOVAGAL SYNCOPE.
    125. WEGNARS
    126. POLYCHONDRITIS
    127. CONSTRICTIVE PERICARDITIS
    128, HOLLS EDIS PUPIL
    129. ACUTE AKATHESIA
    130. EXTRINSIC ALLERGIC ALVEOLITIS
    131. MENINGOCOCAL MENINGITIS
    132. GRADED THERAPY IN FATIGUE.
    133. METHEMOGLOBINEMIA,,,,,,SODIUM THIOSULPHATE.
    134. CCF WITH AF…..GIVE DIGOXIN
    135, DIGOXIN TOXICITY WITH HYPERKALEMIA…..GIVE FAB
    136. PT WITH GBS
    137. TREATMENT OF GOUT IN RENAL FAILURE……COLCHICIN.
    138. PT WITH PICA SYNDROME
    139. PT WITH GOUT NOT TOLERATING ALLOPURINOL……PROBENISID
    140. LADY WITH MALIG MELANOMA, RIB PAIN, PREGNANT, NEXT INVESTIGATION…… ISOTOPE SCAN
    141. PT WITH TTP, NEXT INVESTIGATION, BLOOD FILM
    142. mixed sensorimotor neuropathy absent ankle reflex cause?diabetic neuropathy amyloiodis thalidomide
    143. ISCHEMIC HEPATITIS
    144. PARACETAMOL TOXICITY
    145. PORPHYRIA SCREEN IN PT EXPOSED TO SUN WITH BLISTERS.
    146. LADY WITH GE, NORMAL ANION GAP, ACIDOSIS, HYPOKALEMIA,,,,, IVF
    147. LADY WITH PE,,,,,, ANOXAPRIN
    148, PT WITH ALKALOSIS IN ABG,,NORMAL PO2,,,,,,ANXIETY
    149. OLD LADY WITH RT HIP PIAN AFTER SLEEP, UNABLE TO WT BEAR, ON WARFARIN, WHICH INVETIGATGATION
    150. LADY WITH FOOT PAIN AND SWELLING, ABX GIVEN, STILL SWELLING WITH ULCER, NEXT INVESTIGATION ,,,,,, MRI
    151, PT WITH FOOT PAIN, TENDER MTP JOINTS, OTHER JOINTS NORMAL, DIAGNOSIS…..GOUT
    152. ULCERATIVE COLITIS PT WITH DIARRHOEA, GIVEN STEROIDS, NOT IMPROVED, NEXT TREATMENT….AZATHIOPRINE.
    153. PT WITH STRONGLOIDS INFECTION.
    154. PT WITH DKA
    155. PT WITH METFORMIN INDUCED LACTIC ACIDOSIS.
    156, LADY WITH RTA, HEAD INJURY, NECK PAIN, EYE PAIN,,,,,,,, CAROTID ARTERY DISSECTION.
    157. PT WITH ADDISON DISEASE,,,,,,CORTISOL LEVEL CHK.
    158. RESISTENT HYPERCALCEMIA;;;;;;PAMIDRONATE
    159. PT WITH LOW NA 113,,,,,,,N/S OR 3% SALINE
    160. BONY CTST WITH FRACTURE,,,,, HIGH PTH,,,,TERTIARY HYPERPARATHYROIDISM
    161. PT WITH RESTING ESSENTIAL TREMOR,,,,,,PROPARONOL
    162. PALLIATIVE PT WITH SOB…..MORPHINE
    163. PT WITH HYPOKALEMIA AND HTN,,,,,RENIN ALDOSTERONE RATIO
    164. PT WITH DANUE;;;;;CHIKINGUNYA
    165. PT WITH SHOULDER PAIN,,,,,CAPSULE INJURY
    166. YOUNG PT WITH GROIN PAIN,,,,,, ILIOSOS PROBLEM
    167. CONTACT LENS NOW PAINFUL, TREATMENT…… LEVOFLOXACIN
    168. PT WITH OBS AT PUJ….. DILATED PELVICALACIAL SYSTEM,,,,,
    169. APL SYNDROME, NOW PREGNANT,CHANGE TO LMWH
    170. DERANGED LFTS,,,,,TERBENAFIDINE
    171. INF MI, NOW HYPOTENSIVE….TREATMENT,,,,,IVF
    172, CONTRANDICATIONS TO RIBAVARIN…….DEPRESSION
    173. BOWING OF SHIN BONES, HIGH ALP…… PAMIDRONATE
    174. PT FROM ICU, INCREASED APTT…… INVITRO PROTAMINE CORRECTION
    175. PT WITH DIARRHOEA AND INCRE CR…..HUS…….BLOOD FILM
    176. PT WITH HYPERCALCEMIA….HYPOKALEMIA….. IVF WITH 40KCL
    177. DIARRHOEA AFTER ABX…… ABX INDUCED DIARRHOEA.
    178, PT WITH ASYMT HYPERTHYROIDIS,,,,,,RECHK IN 3/12
    179. PT WITH PSEUDOMEMBRANOUS COLITIS,,,,, TENDER ABDO… XRAY ABDO
    180. FEMALE PT WITH DM/OBESE/ RAISED LFTS,,,,,,, NON ALCOHOLIS STEOHAPATITIS
    181. SNAKE BITE, RASH AFTE ONE WK…… SERUM SICKNESS.
    182. TREATMENT OF PIT TUMOR….. CABARGOLINE
    183. FEATURES AFTER FRONTAL STROKE….. ? WEAKNESS.
    185. DRUG CAUSING PSORIASIS…… ATENALOL.
  29. samuel

    samuel New Member

    Capsule endoscopy/CTA bg if IHD
    AD/X linked recessive
    Father had nash son with hapatomegaly -> us abdo
    Diabetic haematuria
  30. samuel

    samuel New Member

    two questions from statics
    cardiology
    6 ecgs
    atrial flutter- saw tooth appearance not get well by adenosine
    pulmonar embolism - chest pain + breathlessness for 40 min tropinin i was mildly raised .
    wpw syndrome with vt - definative treatment - ablation
    mass in left atrium - atrial thrombus/embolus .but for this correct answer is myxoma with history of syncope
    ecg with t wave inversion in v1 -v3 lbbb history of sudden cardiac death in family - arvc
    acute mi with sever as treament of chioce is pct+ review
    aortic stenosis more than 100 - aortic replacement
    aortic stenosis severity by symptoms - the most
    thrombolysis contraindications - recent stroke
    patient with out warning became unconscious and repeat of this happened after some time and fit and patient again recover - tia
    patient with rayaunds + vascilitis = ss
    raynauds treatment with symptoms of oral ulcerations - ca channel blocker
    acute attack of gout with peptic ulcer disease and renal impairement-
    patient present with hepatic derranged lft s alt ast raised but not alp - drug responsible
    patient with intermittent diarrhea + alp raissed + rhc pain - psc -mrcp
    symptomatic biliary disease with ultrasound detection of cbd dilatation and stone - ercp
    chronic liver disease with serum ferittin 700 - haemochromotosis
    sun exposeds area rash +itching pct
    visual hallucination +parkinsonism = lewy body dementia
    diarrhea with repeated stool samples elevated vipoma
    patient with pao2 6.7 with paco2 high not responding copd to medical treatment - nippv
    paco2 12 with oxygen delivered on 40 what is next step - reduce the oxygen to 28
    metabolic alkalosis- hco3 38 + hypokalemia +hypertension - conn syndromes - ratio
    carbon monooxide treatment trapped in fire - hyperbaric oxygen
    anticoagulation in pregnant lady with lmw heparin throught until term
    retinal image - in diabetic patient - central retinal vein occlusion
    night blindness - second image
    patient has urti infetion with productive cough of sputum most of days also wheeze - cystic fibrosis
    patient with metabolic acidosis with glucose 34- honk not ketone in blood or urine
    patient from nigeria has pancytopenia and fever - infection with parvo virus b 19
    hiv patient with cd count lower side and white matter leision without mass effect pml
    patients with hypercalcemi a+ bone scan lesions in spine - myeloma
  31. samuel

    samuel New Member

    two questions from statics
    cardiology
    6 ecgs
    atrial flutter- saw tooth appearance not get well by adenosine
    pulmonar embolism - chest pain + breathlessness for 40 min tropinin i was mildly raised .
    wpw syndrome with vt - definative treatment - ablation
    mass in left atrium - atrial thrombus/embolus .but for this correct answer is myxoma with history of syncope
    ecg with t wave inversion in v1 -v3 lbbb history of sudden cardiac death in family - arvc
    acute mi with sever as treament of chioce is pct+ review
    aortic stenosis more than 100 - aortic replacement
    aortic stenosis severity by symptoms - the most
    thrombolysis contraindications - recent stroke
    patient with out warning became unconscious and repeat of this happened after some time and fit and patient again recover - tia
    patient with rayaunds + vascilitis = ss
    raynauds treatment with symptoms of oral ulcerations - ca channel blocker
    acute attack of gout with peptic ulcer disease and renal impairement-
    patient present with hepatic derranged lft s alt ast raised but not alp - drug responsible
    patient with intermittent diarrhea + alp raissed + rhc pain - psc -mrcp
    symptomatic biliary disease with ultrasound detection of cbd dilatation and stone - ercp
    chronic liver disease with serum ferittin 700 - haemochromotosis
    sun exposeds area rash +itching pct
    visual hallucination +parkinsonism = lewy body dementia
    diarrhea with repeated stool samples elevated vipoma
    patient with pao2 6.7 with paco2 high not responding copd to medical treatment - nippv
    paco2 12 with oxygen delivered on 40 what is next step - reduce the oxygen to 28
    metabolic alkalosis- hco3 38 + hypokalemia +hypertension - conn syndromes - ratio
    carbon monooxide treatment trapped in fire - hyperbaric oxygen
    anticoagulation in pregnant lady with lmw heparin throught until term
    retinal image - in diabetic patient - central retinal vein occlusion
    night blindness - second image
    patient has urti infetion with productive cough of sputum most of days also wheeze - cystic fibrosis
    patient with metabolic acidosis with glucose 34- honk not ketone in blood or urine
    patient from nigeria has pancytopenia and fever - infection with parvo virus b 19
    hiv patient with cd count lower side and white matter leision without mass effect pml
    patients with hypercalcemi a+ bone scan lesions in spine - myeloma
  32. samuel

    samuel New Member

    hypergonadotrphic hypogonadism - klinfilter syndrome .
    woman works in farms with restrictive pattern in pulmonary function test and xray chest - hypersensitivty pneumonitis.
    alcholic patient admitted in hospital now has lower respiratory tract infection - treatment i went for third generation cefhlosporins + metronidazole.
    after three months prosthatic valve replacement in infective endocarditis infection - organism involved- staphylococci epidermis
  33. samuel

    samuel New Member

    Patient with gram +ve rods - Bacillus anthracis

    Patient with pneumonia and gram -ve bacilli - Klepsiella , not haemophilus because it is cocco-bacilli not bacilli.

    Patient with general weakness after excerise and heavy meals - hypokalemic periodic paralysis

    Cause of muscle weakness - I went with hypomagnesemia , I didn't go with hypokalemia because K replacement is not enough when there is low mg
  34. samuel

    samuel New Member

    Patient with digoxin toxicity - digoxin binding antibody

    Patient with cystic fibrosis and suspected pseudomonas - sputum culture

    Patient with hemochromatosis investigation of choice - liver biopsy

    Patient with prolactinoma - cabergoline

    Patient with abnormal liver function and metabolic acidosis - Paracetamol overdose

    Patient with abnormal liver function (AST more than ALT) and metabolic acidosis - Alcohol toxicity
  35. samuel

    samuel New Member

    There were some questions on alkaline phosphatase this time
    - A young male patient with raised ALP - reassure, normal phenomenon
    - Another scenario of a lady with raised ALP - normal pregnancy
  36. samuel

    samuel New Member

    A young Afro-Carribean woman with menorrhagia after a routine blood test show slightly low neutrophils (lymphocytes normal) - reassure and discharge (american-african population of women have lower neutrophil counts)
  37. samuel

    samuel New Member

    Lateral medullary syndrome - vertebral artery

    Patient with rotator cough tendonitis - joint capsule (plz correct me if i am wrong)

    Osteomalacia treatment - alfaclcidol

    Paget's treatment - Pamidronate

    CKD with amyloidosis - b2 microglobulin

    Patient with HIV and HCV - serum cryoglobulin

    Patinet with HIV, maculopapular rash and conductive hearing loss- 2ndary syphilis

    Patient with severe left ventricular failure (EF 25%) - cardiac resynchronization therapy

    Patient with otitis externa not responsive to treatment - Pseudomonal
  38. samuel

    samuel New Member

    The question of cardiac resyncronization therapy came from pastest as I remember.

    The scenario was of patient with CKD on haemodialysis who developed amyloidosis

    The scenario for osteomalacia was of typical low ca and phosphate levels with high ALP and back pains

    A young male patient with restricted lateral spinal movement since along time.....forward flexion, X-ray of SI joint- all normal - Is that Ank spond or Scheuermann's disease?
    Gentamicin - acute tubular nerosis (though I went fro tubulointerstitial nephritis...which is not the preferred option)

    What were the answers to the 2 statistics questions?
    - Purpose of double blinded trial- I went for Investigator bias
    - Number required for safety analysis - No idea abt thisWhat were the answers to the 2 statistics questions?
    - Purpose of double blinded trial- I went for Investigator bias
    - Number required for safety analysis - No idea abt this
  39. samuel

    samuel New Member

    1. Patient with raynaud's, muscle weakness - Anti RNP (history was suggestive of MCTD)
    2. A question on relapsing Polychondritis
    3. A question on a pt having painful, swollen joints....started on bendroflumethazide recently - Gout
    4. A patient with APLA, detected with positive anticardiolipin in the second sample- Warfarin for life
    5. X-ray of the hip joint - Avascular necrosis of the femur head
    6. A question with scenario suggestive of Wegener's granulomatosis
    7. A question with scenario suggestive of Churg Strauss syndrome
    8. DOC for hyperuricemia in renal compromise - Febuxostat (The GFR was quite high so Colchicine is C/I)
    9. A patient with a disease suggestive of Wegeners, on therapy with Cyclophosphamide, methylprednisolone, with SOB and alveolar infiltrates - Pulmonary Haemorrhage (DAH is a known complication of Wegener's)
    10.A pregnant lady with APLA - i opted for LMWH till term (ideally it should be LMWH in the first trimester followed by Warfarin till term....but this wasnt an option)
    11. A patient with restricted shoulder movement - Capsule pathology
    12. Pagets disease management - Pamidronate

    The questions which came from pastest ques bank (sure about answers):
    - Sputum culture for pseudomona
    - Liver biopsy for hemochromatosis
    - Myocarditis
    - Cardiac resyncronization therapy
    - Double blind study
    - Topical capiscain for diabetic neuropathy
    - Pituitary stalk compression
  40. samuel

    samuel New Member

    Pyoderma gangrenosum was a popular toic in this exam :

    There was a ques asking about a skin lesion with IBD - pyoderma gangrenosum

    - Patient with dog bite developed skin lesion - pyoderma gangrenosum

    - Patient with infected pyoderma gangrenosum asking for initial treatment- oral corticosteroid but not sure.


    Pregnancy ques:

    - Peripartum cardiomyopathy.
    - Elevated ALP- Normal pregnancy.
    - Itching and elevated ALP - Cholestasis of pregnancy.
    - Hyperthyroid trying to conceive- Propylthiouracil.
  41. samuel

    samuel New Member

    weak finger grip ---inclusion body myositis
    b/l pes cavus with ataxia--- fredrich's ataxia
    inf. wall MI---IV fluids
    ECHO-- lt atrial thrombus/myxoma...i wrote thrombus as his platelets were high
    1question on hemiplegic migraine
    carotid art. dessection
    amoxy + OCP---nothing to do
    derranged LFT--simvastatin/terbinafine----i put simvast.
    Renal cell carcinoma
    hepatopulm syndrome
    Hepato cellular carcinoma
    budd chiari synd.
    cluster headache-- prophylax--verapamil
    1 question on Alport syndrome (?)
    Diffuse proliferative GN
    Rhabdomyolysis..already recieved 2.5Lt of IVF but urine output= 5ml---i gave furosemide( other options--IVF/dopamine...)
    56 yr lady came with jaundice with h/o blood transfusion 10-12 yrs back--i put hepatitis C.
    Ischaemic hetitis
    PCM levels
    Man with rashes on sun exposed areas--porphyria screen
    cryglobulinemia--with hep-C
    pt recieved haloperidol--Acute dystonia.
    SLE pt developed delusions---i put organic psychotic behaviour
    MRI---renal art. stenosis
    HTN---atheromatous RAS
    B/l flank pain-- b/l Renal vein thrombosis
    pt. with petechia, fever, headache, low PLT---dengue
    TTP
    leptospirosis
    Diabetic pt. with problems in lower leg...xray normal----MRI
    Old lady on warfarin, unable to move Rt leg--CT scan of pelvis and hip to rule out hematoma.
    fever with massive spleen--- leishmaniasis
    sinus thrombosis.
    contrast CT--- stop metformin before and after 48 hrs
    Diabetic pt. with high urea/ creat----stop metformin
  42. samuel

    samuel New Member

    Cholestatic jaundice : clavulanic acid

    Patient with high BP (190/120) - I wrote labetalol but not sure.

    Patient with mood change following chemotherapy - major depression.
  43. samuel

    samuel New Member

    1- Cardiology

    1-ECG:complete heart block

    2-ECG:ATRIAL FLUTTER

    3-ECG:ATRIL NODAL RE ENTRANT TACHY CARDIA

    4-ECG :pATIENT WITH SUDDDEN ONSET COLLAPSE AND FAMILY HISTORY OF SUDDEN DEATH BURGADA SYNDROME OR LONG QT OR ARYTHMOGENIC RT VENTRICLE(debetable)

    5-ECG:YOUNG PATIENT WITH SUDDEN CHEST PAIN AN ELEVATED TROPONIN >>>>PERICARDITIS OR ACUTE MI?

    6-ECG :pATIENT WITH WPW WHAT TO DO>>>ABLATION

    7-ECG :SICK SINUS SYNDROME WHAT TO DO >>>DDD
    8- ECHO :LT ATRIAL MYOXOMA

    9- YOUNG PATIEN WITH FEVER ,MURMER AND CHOREA>>>RHEUMATIC FEVER

    10-USE DIGOXIN IN CHF AND AF

    11-USE DIGIBRID IN DIGITALIS TOXICITY

    12-PERIPARTUM CARDIOMYOPATHY FEMAL WITH 6 MONTHS OLD CHILD AND SIGN OF HF

    13- PATIENT WITH SON HAD DUCHENE AND HAS HF???DUCHENE CRDIOMYOPATHY OR ARYTHMOGENIC RT VENTRICLE?


    14-START CPR AGAIN AFTER GIVING DC SHOCK IN PATIENT CARDIAC ARREST WITH VF


    15-ONE PATIEN WITH SEVERE LAD LESION AND SEVERE AS
    >>>DO CABG AND AVR?

    16- SENARIO OF CARDIAC TAMPONADE

    17-SEVERITY OF AS DETERMINED BY SYMPTOMS(SYNCOPE)

    18-ONE SENARIO OF RSHF AND HEPATOMEGALY >>>>ONSTRICTIVE CARDIOMYOPATHY OR AMYLOIDOSIS?

    19-ONE PATIEN WITH ARYTHMIA .HF AND EF 26%>>>>CRT

    20-ONE PATIEN WITH VALVE REPLACEMENT AND HEMOLITIC ANAEMI>>>VALVE HEMOLYSIS

    21-PATIENT WITH 4 WEEKS VALVE REPLACEMENT NOW HAS IE>>>STAPH EPIDERMITIS

    22-ANOTHER PATIENT WITH IE>>>GIVE VANCOMYCIN AND GENRAMICIN

    23- ONE PATIENT POST INF MI AND HF>>>GIVE IVF


    24-ONE PATIENT WITH AND EXPLAINED DYSPNEA>>>DO ECHO

    25-PULMONARY EMBOLISM AND SEVERE HYPOTENTION>>>ATLEPTASE

    26-ANOTHER PE DIAGNOSIS

    27-PE IN PREGNANT WOMAN >>DO PEFUSION SAN

    28- PE IN PREGNANT PATIENT>>>ENOXAPARIN

    29 - PREGNANT PATIENT WITH H/F PE WT TO GIVE DURING PRENANCY>>>LMWH
  44. samuel

    samuel New Member

    Pt with pheochromocytoma Iv phentolamine not labetalol


    "Complete tumor removal is the ultimate therapeutic goal. Preoperative patient preparation is essential for safe surgery. -Adrenergic blockers (phenoxybenzamine) should be initiated at relatively low doses (e.g., 5–10 mg orally three times per day) and increased as tolerated every few days. Because patients are volume-constricted, liberal salt intake and hydration are necessary to avoid orthostasis. Adequate alpha blockade generally requires 7 days, with a typical final dose of 20–30 mg phenoxybenzamine three times per day. Oral prazosin or intravenous phentolamine can be used to manage paroxysms while awaiting adequate alpha blockade. Before surgery, blood pressure should be consistently below 160/90 mmHg, with moderate orthostasis. Beta blockers (e.g., 10 mg propranolol three to four times per day) can be added after starting alpha blockers and increased as needed if tachycardia persists. Other antihypertensives, such as calcium channel blockers or angiotensin-converting enzyme inhibitors, have been used when blood pressure is difficult to control with phenoxybenzamine alone.

    Surgery should be performed by teams of anesthesiologists and surgeons with experience in the management of pheochromocytomas. Blood pressure can be labile during surgery, particularly at the onset of intubation or when the tumor is manipulated. Nitroprusside infusion is useful for intraoperative hypertensive crises, and hypotension usually responds to volume infusion. Although laparotomy was the traditional surgical approach, endoscopic surgery, using either a transperitoneal or a retroperitoneal approach, is associated with fewer complications, a faster recovery, and optimal cosmetic results. Atraumatic endoscopic surgery has become the method of choice. It may be possible to preserve the normal adrenal cortex, particularly in hereditary disorders in which bilateral pheochromocytomas are more likely. Extra-adrenal abdominal as well as most thoracic pheochromocytomas also can be removed endoscopically. Postoperatively, catecholamine normalization should be documented. An adrenocorticotropic hormone test should be used to exclude cortisol deficiency when bilateral adrenal cortex–sparing surgery is performed."

    The only problem is that it has mentioned about the pre-op preparation and alpha blocker should be given as first choice followed by Beta blockade....but nothing has been mentioned when a patient is not planned for surgery (the question did not have this point).
  45. samuel

    samuel New Member

    "Anaphylactic Reaction

    This severe reaction presents after transfusion of only a few milliliters of the blood component. Symptoms and signs include difficulty breathing, coughing, nausea and vomiting, hypotension, bronchospasm, loss of consciousness, respiratory arrest, and shock. Treatment includes stopping the transfusion, maintaining vascular access, and administering epinephrine (0.5–1 mL of 1:1000 dilution subcutaneously). Glucocorticoids may be required in severe cases.

    Patients who are IgA-deficient, <1% of the population, may be sensitized to this Ig class and are at risk for anaphylactic reactions associated with plasma transfusion. Individuals with severe IgA deficiency should therefore receive only IgA-deficient plasma and washed cellular blood components. Patients who have anaphylactic or repeated allergic reactions to blood components should be tested for IgA deficiency."
    So it is indeed IgA deficiency
  46. samuel

    samuel New Member

    "Aldosterone Antagonists

    Although classified as potassium-sparing diuretics, drugs that block the effects of aldosterone (spironolactone or eplerenone) have beneficial effects that are independent of the effects of these agents on sodium balance. Although ACE inhibition may transiently decrease aldosterone secretion, with chronic therapy there is a rapid return of aldosterone to levels similar to those before ACE inhibition. Accordingly, the administration of an aldosterone antagonist is recommended for patients with NYHA class IV or class III (previously class IV) HF who have a depressed EF (<35%) and are receiving standard therapy, including diuretics, ACE inhibitors, and beta blockers. The dose of aldosterone antagonist should be increased until the doses used are similar to those which have been shown to be effective in clinical trials.


    Device Therapy

    Cardiac Resynchronization

    Approximately one-third of patients with a depressed EF and symptomatic HF (NYHA class III–IV) manifest a QRS duration >120 ms. This ECG finding of abnormal inter- or intraventricular conduction has been used to identify patients with dyssynchronous ventricular contraction. The mechanical consequences of ventricular dyssynchrony include suboptimal ventricular filling, a reduction in LV contractility, prolonged duration (and therefore greater severity) of mitral regurgitation, and paradoxical septal wall motion. Biventricular pacing, also termed cardiac resynchronization therapy (CRT), stimulates both ventricles nearly simultaneously, thereby improving the coordination of ventricular contraction and reducing the severity of mitral regurgitation. When CRT is added to optimal medical therapy in patients in sinus rhythm, there is a significant decrease in patient mortality rates and hospitalization and a reversal of LV remodeling, as well as improved quality of life and exercise capacity. Accordingly, CRT is recommended for patients in sinus rhythm with an EF <35% and a QRS >120 ms and those who remain symptomatic (NYHA III–IV) despite optimal medical therapy. The benefits of CRT in patients with atrial fibrillation have not been clearly established.

    Implantable Cardiac Defibrillators-

    The prophylactic implantation of ICDs in patients with mild to moderate HF (NYHA class II–III) has been shown to reduce the incidence of sudden cardiac death in patients with ischemic or nonischemic cardiomyopathy. Accordingly, implantation of an ICD should be considered for patients in NYHA class II–III HF with a depressed EF of <35% who are already on optimal background therapy, including an ACE inhibitor (or ARB), a beta blocker, and an aldosterone antagonist. An ICD may also be combined with a biventricular pacemaker in patients with NYHA class III–IV HF."
  47. samuel

    samuel New Member

    A quote from Harrison's internal medicine 18th edition
    "The thyroid shows a characteristic patchy inflammatory infiltrate with disruption of the thyroid follicles and multinucleated giant cells within some follicles. The follicular changes progress to granulomas accompanied by fibrosis. Finally, the thyroid returns to normal, usually several months after onset. During the initial phase of follicular destruction, there is release of Tg and thyroid hormones, leading to increased circulating T4 and T3 and suppression of TSH (Fig. 341-9). During this destructive phase, radioactive iodine uptake is low or undetectable. After several weeks, the thyroid is depleted of stored thyroid hormone and a phase of hypothyroidism typically occurs, with low unbound T4 (and sometimes T3) and moderately increased TSH levels. Radioactive iodine uptake returns to normal or is even increased as a result of the rise in TSH. Finally, thyroid hormone and TSH levels return to normal as the disease subsides."
  48. samuel

    samuel New Member

    endocrinology questions
    1- ammenorrhea+dm+htn in lady - i went for cushing syndrome with serum sodium of 137
    2- prolactinoma more than 1cm - i went for medication
    3- diabetic patient with high serum glucose 13 and hba1c 9 + gastropareasis - insulin
    4-patient on diabetes +investigation including contrast studies- stop metformin
    5-patient with low serum sodium + inappropriately high urine osmolality - siadh
    6-tender goiter- viral
    7-multinodular swelling neck- fine niddle aspiration
    8-patient with gastric surgery and hypoglycemia
    dm - dumping syndrome
    9- cpeptide is elevated - sulphonylurea
    10- hypokalemia +hypertension +hco3 36 -conn syndrome
    11-phaeocromocytoma - alpha blocker
  49. samuel

    samuel New Member

    1-CT HEAD>>>GLOIMA OR CEREBELLAR DEGENERATION

    2-CT HEAD >>>ARACHNOID CYST?

    3-FUNDUS PIC>>>CRVO OR CRAO?

    4-FUNDUS PIC>>RETINITIS PIGMENTOSA AND ASKS ABOUT MOST SYMPTOMS>>NIGHT BLINDNESS

    5-MRI SPINE>>>TB OR SPINAL MENENGIOMA OR BRUCELLOSIS?

    6-TRAUMATIC LUMBAR PUNCTURE IN PATIENT WITH SEVERE HEADACHE AND PHOTOFOBIA

    7- ONE HIV WITH CD 40 AND ONE LESION SURROUNDED BY EDEMA>>TOXOPLASMOSIS OR LYMPHOMA?

    8-ANOTHER INDIAN VEGETARIAN WITH NORMAL CD COUNT AND HAS MULTIPLE RING INHANCED LESION>>NEUROCYSTICYRCOSIS OR TOXOPLASMOSIS

    9-ONE LUMBAR PUNCTURE ANALYSIS HIV VERY LOW GLUCOSE AND HIGH PTN AND LYMPHOCYTES ?TB ASKS ABOUT INVESTIGATION>>>PCR FOR TB

    10- ANOTHER HIV PATIENT WITH LUMBAR PUNCTURE ANALYSIS LOW GLUCOSE AND HIGH PTN ,LYMPHOCYTES AND LEUCOCYTES>>>TB OR CRYPTOCOCCAL OR LESTERIOSIS?


    11-HIV WITH LOW CD COUNT>>>PROGRESSIVE MULTIFOCAL LEUCOENCEPHALOPATHU

    12-ONE PATIENT WITH CHANGES IN THE TEMPORO FRONTAL LOBES>> HERPES SIMPLEX ENCEPHALITIS

    13-ONE CT HEAD PATIENT POST CAR ACCIDENT AND LUCID INTERVAL>>EXTRADURAL HEMATOMA OR BRAIN CONTUSION?

    14-ONE ASE WITH DESCRIPTION OF DIABETI NEOROPATHY?

    15-ONE PREGNANT PATIENT WITH VAGUE NEOROGICAL SIGNS?>>>SINUS THROMBOSIS OR MIGRANE?

    16-ONE MS PATIENT WITH URINE INCONTINENCE>>SELF CATHETERIZATION?

    17-ONE PATIENT WITH VASOVAGAL ATTACK ASKS ABOUT INV>>TILT TABLE TEST

    18-ANOTHER PATIENT WITH SUDDENT SYNCOPE THEN CONVULSIONS>>>NEW ONSET EPILEPSY OR VASOVAGAL SYNCOPE

    19-ONE CASE>>>MYOTONICA DYSTROFIA

    20-ONE PATIENT POST TRAUMA AND PTOSIS AND SOME CEREBELLAR SIGNS>>>VERTEBRAL ARTERY OR CAROTID??

    21-PROPHYLACSIS IN CLUSTER HEADACHE>>>VERAPAMIL

    22-NON EPILEPSY SIGNS>>>>RESIST EYE OPENING

    23-ONE ASE INCLUSION BODY MYOSITIS

    24-ONE CASE LAMBERT EATON SYNDROME

    25-HARLES BONNET SYNDROME?

    26-ONE CASE GULLIAN BARE SYNDROME OR BOTULISM?

    27-ONE CASE MOTOR NEURON DISEASE

    28- ONE CASE MULTI INFARCT DEMENTIA OR LEWY BODY DEMENTIA

    29- ONE CASE BILATERAL UNEQUAL PUPPIL SIZE>>>HOLMS ADDIE OR ARGYL ROBERTSON?

    30-ONE PATIENT WITH SUDDEN PARALYSIS POST SEVERE DIARRHEA AND HYPOKALEMIA>>>PERIODIC PARALYSIS

    31-GRADED EXERCISES IN CHRONIC FATIGUE SYNDROME

    32-POST PNEUMONECTOMY STRANGE BEHAVIOR>>>MAJOR DEPRESSION OR ACUTE SCHIZOPHRENIA OR GENERALIZED ANXIETY DISORDER?

    33-ONE SCENARIO MOST PROBABLY SENILE SQUALOR SYNDROME

    34- LESION IN LOCKED IN SYNDROME>>>PONS?

    35-YOUND PATIENT WITH ATAXIA AND OTHER SIGNS>>>FRIDRICHS ATAXIA OF CHACHOT MARIE TOOTH

    36-CHECK SERUM PROLACTIN IN PATIENT WITH SIGNS OF PROLATINOMA

    37-YOUNG PATIEN WITH MACRO PROLACTINOMA PROLACTINE MORE THAN 9000 >>>TTT SURGERY OR CABERGOLINE?

    38-ONE PATIENT WITH BITEMPORAL HEMIANOPIA>>>PITUITARY TUMOUR OR CRANIOPHARYNGIOMA?

    39- ONE PATIENT WITH DESCRIPTION OF ESSENTIAL TREMORS (RELEIVED ON REST)

    40-TTT OF ESSENTIAL TREMORS>>PROPRANOLOL

    41-DOWN BEAT NYSTAGMUS>> ARNOLD CHIARI MALFORMATION

    42-ONE CASE OLD LADY WITH STRANGE BEHAVIOR>>>FRONTOTEMPORAL DEMENTIA?

    43-ONE CASE MULTISYSTEM ATROPHY?

    44-ONE CASE MENINGOCOCCAL SEPTICEMIA
  50. samuel

    samuel New Member

    There were straightforward scenarios :
    - Hypoparathyroidism.
    - Gout.
    - Polyarteritis nodosa.
    - Wegner's.
    - P.jirovicii.

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