Recall of Dec/2014 mrcp 2

Discussion in 'MRCP Forum' started by samuel, Dec 15, 2014.

  1. samuel

    samuel New Member

    -pituitary prolactinoma with eye symptom first treament ?cabergoline
    -Q pituitary adenoma extended to the sella .non functing piutuitary adenoma ?
    -remal failure with amylodosis =B microglobulin ?
    -one Q TTP
    -Another one ITP
    pregnant women with low platelet ,high ALT?
    _ECG of complete heart block
    -ECG of posterior MI
    -ECG LBBB
    -ECG HOCM
    -ECG PE OR hyperkalemia ?
    -Case o crutz jacod disesaes
    -Frontotempral Dementia
    -Q foot drop =polyartitis Nodosa
    -cystic fibrosis with bronchiactsis and high KOCL =Bronchiactesis excacerbation
    -Empysema with saturation of 92 % become breathless =Treatment Respiratory Rehablitation ?
    -chest x ray of pleural effusion =Diagnosis plerural aspiration .
    -chest x ray shows percardial calcification Q what is most common cause in UK ?hyperparathyrodism ?
    -Echo shows either pericardial effusion or Mitral stenosis ,Q raised JVP with murmer ?
    -systolic murmer in the left stertnal angle with history of Rhumatic fever =mixed mitral lesion .
    contnious systolic murmer in the lower sternal edge =ASD ?
    -exercise test ,postive test =decrease in blood pressure ?
    -Bone scan shows osteoprosis ,metastaic ca ?
    -picture shows homonomous heminopia ,where is the lesion ,=occipital ?
    -patient with papledima and normal CT scan ,very slighlty increse in protien ,normal csf =PIH ?
    -obese patient with creatinine clearnce <50 ,s.cr 113 uncontrolled DM inspite of Diet control ,what to start ?Gliclizide ,Metformin ?
    -patient with swelling of interphalangeal joint and small ulcer in the left index ?Gout ?psoraisis ?
    -Patient with swelling in both hand ,aggrevated by cold with history of GERD ,Smoking of 10 cigarete /day =Berger`s OR systemic sclerosis ?
    -Patient with iron Defeincy Anaemia ,colonoscopy shows Diverticulr Disease What to DO ?
    -Patient with chronic renal failure ,anaemia ,low ferrtin and high Blood pressure =give Ferrous sulphat
    -patient Given Heparin and developed low platelet ,what to do?=Give Argetoban
    -patient with Feature of aneamia of chronic disease
    -patient with factor v111 defiency ,slightly correctd with mixing with normal plasma =inhibitor of factor v111
    -Patient with ptosis upper limb weakness ,and normal reflex =Mythenia Graves
    -patient with weakness in the upper limb ,Autonomic Dysfunction ,Labert eton syndrome ,?
    -patient with fever 40 ,normal reflexes ,high ck ,Hx of antisychotic medication ,underwent anahesia ,developed vomiting ,given metchlopromide =Neuroleptic malignant ?
    patient fro Asia with COPD ,developed vomiting ,Diarrhoea and abdominal pain ,chest wheez ,high esinophill =strongoliods serology ,Fungus preciptanat?
    -patient with Diarhoea and vomiting ,leave in elderly accomdation ,previous Hx of same condition 2 week ago with another 2 patient =viral GE ?
    patient with vomiting and abdominal pain with locked jaw ,i.v drug abuser and groin abcess =Tetanus ?
    -patient with pytairasis Rosea .
    -Tuberculos Meningitis ,typical CSF
    -Patient with transient dizzness , loss of conousness awake afert 2 hours =posterior circulation TIA
    -patient with Hx of DVT now came with PE ,warfarin for life vs warfarin for 6 month ?
    -x ray of sacroilliac joint with feature of Ankylosing spondylolitis but negative B27 =still Ankylosisng
    -MIBG of reversible inferior lesion vs anterior apical region ?
    -picture of patient with eczema ?
    -patient with analegesic headache taking paracetamol an co codamol ,what to do ?
    -pateint with obesity ,postive low dexmaesthasone suppression test ,high ACTH ,low LH ,FSH =cushing disease ?
    -patient with polyuria and polydypsia ,Fasting blood sugar 6,6 , condition aggrevated after introduction of lithium ,Normal kindney concentration ability after dehydartion =primay poly dypsia
    -patient with diarrhoea stoped by fasting ,low BMI ,microcytic Aneamia ,what to do next =Antiendomyseal antibodies vs laxative screen ?
    -patient with primary Amenorrhoea ,high blood pressure and pigmentation what to Do ?
    -patient who wake up with nubness in the lateral hand ,absent triceps reflex ,weak extention of the wrist and elbow =Radial nerve palsy ?
    -patient with SVO ,given dexamesathone ,bronchoscopy shows small cell carcinoma ,what to Do next =Radiotherapy
    -patient with CA colon with lymph node metastasis what to do next ,chemotherapy +Radiotherapy
    -patient with barret oesophagus after endoscopy what to Do next ?PPI?
    -patient with cough aggrevated by laughing ,eating ,all senstivity test normal ,peak flow meter normal what to do next ?
    -pateint with acute exacerbation of ulcerative colitis bestvtreatment =rectal steroid +oral mesalazine ?
    -patient with familial cacolon ,screening test =colonoscopy
    -62 year old patient with hematuria ,what to do =cystoscopy ?
    -patient with clostridium difficle became asymptomatic after metronidazole ?what to do ,toxin postive
    -patient with bright liver in U/s ,raised liver enzyme =Autoimmune hepatitis
    -patient with tender hepatomegaly with obstructive liver function and high grade fever =liver abcess ?
    -patient came from holiday in Oman ,tender hepatomegaly ,sterile abcesess =Ecconococus ?
    -patient with obsrtuctive jundice and febrile with dilated common bile duct what to do ERCP VS MRCP ?
    -patient with gastrostomy tube dislodgement ,take bu NG tube since 2 moth ,on traetment for laryngeal carcinoma ,what to do ?Dressing or emergency endoscopy ?
    -young girl with ingestion of 4 tab of Atenolol 25 mg ,what to do ?
    -patient with tender hepatomegaly and Protienuria ,what is the underlying cause ?=Nephrotic syndrome
    -patient with recurent infection ,what is the cause .Also Nephrotic syndrome
    -feature of GN can be seen in =Urnianalysis ?
    -patient with polycystic kidney disesaes ,shown by CT scan
    -patient with resistant hypertension ,what to do ,MR angiography
    -patient with with hypertension ,high aldosterne and Renin Test ,what to do ?=stop antiHTN medication for 2 week and repeat the test
    -patient with pain in the lower limb even at night with absent ankle reflex =Peripheral Neuropathy
    -patient taking thyroxine ,with anticonvulsant Carbamazepine ,changed to lamotrigine and devolped nausea and symptoms =due to chnging anticonvulsant
    -patient taking Amiodarone with TFT of hyperthyroidism and tremor =Give Carbimazole
    -patient with hypopituitrim what drug to give first =hydrocortisone
    -patient with pale optic disc and absent pupillary reflex +central loss of vission =optic Neuritis
    -sudden eye pain over 2 days with consrticted eye Acute Angle glucoma vs uveitis ?
    -prospective risk assement for patinet withTIA ?
    -pepti ulcer after endoscopy and eradication what to do ? Nothing vs Fasting gastrin ?
  2. samuel

    samuel New Member

    Patient with malignant neuroleptic syndrome-Bromicriptine Rx
    Put whose PEG fell out-Foley's catheter option
    Hand photo-Systemic sclerosis
    Patient with polyuria recently started on Lithium-Nephrogenjc diabetes Instipidus
    Sickle cell patient needing pain relief-wrote IV diamorphine
    Sickle cell patient with Liver sequestration
    Patient with ascending cholangitis
    Patient with mildly raised prolactin,bi-temporal hemianopia-nonfunctioning pituitary adenoma
    Patient with pneumonia and renal impairment -legionella
    Lady who's moved home and husband changed water system- legionella
    Patient with erythema chronicum migrans -Lyme disease
    Echo-mitral prolapse
    Patient with painful toes worse in cold-Thromboateritis obliterans
    Increased probability of stroke form TIA-wrote frequency of symptoms
    patient needing liver transplant who cares for elderly family and not had ETOH for 3mnths-what would prevent him from having transplant
    Rx for Patient with tremor especially with arms outstretched-?propranolol
    Schizophrenic patient with fever etc-Malignant neuroleptic Syndrome
    Patient with ulcerative colitis and erythema nodosum needing biopsy-rectal biopsy
    Man with 1st degree relatives with colic cancer and other relative with breast cancer-Colonoscopy
    Ct scan of APKD
    Patient with type1 DM starting ramipril with potassium 5.2, mild decrease in BP and mildly elevated Cr with improvement in GFR-with option to either decrease dose of Ramipril or No change in Rx.
  3. samuel

    samuel New Member

    -Patient taking warfarin with an INR 10 .warfarin stoped what is next?oral vit k .
    -patient with visual disturbance and photophobia followed by headache =migraine .
    -patient with Hx of treated Hodegking lymphoma presented with pancytopenia =Recurrance of hodeking ?
    -patient with gum high LDH .low haptoglobin .low plt =autoimmune heamolytic anaemia .
    -patient with raised liver enzyme ALT obese smooth liver Non Alcoholic steatohepatitis .
    -patient with sever astma .sielnt chest after one hour of trateatment saturation 92 % what is next step ?intubation vs i.v mg sulphate ?.
    -pregnant lady with Acute fatty liver of pregnancy
    -patient with Hx of cancer presented with sevet back pain next step to do MRI of the back
    -patient with swellung if the lips and tongue what is the next step ?stop Ramipril ?.
    -patient with obstructive sleep apnoea management with CPAP device .
    -patient with renal faliure and protienuria with hydronephrosis and DM what is the cause ?Diabetic nephropathy vs reflux nephropathy?.
    -patient with crusted lesion in the mouth and nasal mucosa and skin with recent Hx of Amoxicilline =steven johnson syndrome .
    -MRI scan of african patient with herpes encephalitis vs creptococcal vs progressive multivocal ?.
    -patient wuth tuberos sclerosis appeared in grandmother and grandson .justification incomplete penetrance ?
    -patient with heart failure .ejection fracture of 25%with all heartfailure treatment and progressive sever breathlessness next step to do resyncronization of the heart .
    -chest x ray with big heart and african patient ?chagas?mitral stenosis ?
    -patient with cosolidation in the lower zone =strep pneumonae
    -patient with honeycomb CT scan IPF vs Externsic Allergic allveollitis ?
    -patient with psoriasis developed erythroderma first treatment prednisolone
    -patient wirh Hx of cancer developed shortness if breath and type respiratory failure next step CTPA.
    -patient with Ascities and Ratio of serum albuumin to acietic fliud protuen Ratio of less than 1.1 causes=myxedema .
    -pateint with hepatitis c and Nephropathy causes= membranoproliferative GN.
    -patient with HIV started HARRT with improvement of CD 4 count but devolped fever with lymphadenoathy =Mycobacterum Avium .(immune reconsellation synfrome )
    -patient with mixed metabolic acidosis and alkalosis .
    -patient with upper lobe round lesion in patient with halo around it =Aspergilloma
    -patient undetwent thyroidectomy for carvinoma given lung function test and kocl ?upper airway obstruction ???.
    -typical patient with arthalgia skin rash and nephrooathy =SLE.
    -patient with anticardiolipin antibodies .
    -patient with SIADH what is the drug ?Na valporate .
    -patient with lip ulcer and genital ulcer = Behcet.
  4. samuel

    samuel New Member

    Residual volume in Flow volume curve, number 2 right at the end
    First question with picture, probably malignant melanoma
    Pregnant lady with HTN- label also
    Pregnant woman with deranged lfts- cholestasis of pregnancy
    Increased INR with bruises, give PO vitamin K and repeat INR
    Scenario with atypical Parkinson unsure about answer

    34 female, smoker, polyuria, bilateral UZ & MZ lesion- langerhans cell histiocytosis

    Female with IX,X,XI lesion- carotid body tumor

    56 male progrssive SOB, RF and ANA +Ve, CT- bi basal involvement- IPF

    there was question on BIH in day 1

    a boy on dentists chair having seizure..........
  5. samuel

    samuel New Member

    Carotid sinus

    Man post chemo for Hodgkins came with Sob, pneumocystis
    Man post surgery presented with confusion- delirium
    Woman with ptosis- probably myasthenia gravis
    Woman with ibd unable to take oral iron- IV iron
    Woman with ckd and anaemia-?blood transfusion?epo
    Woman given po abx for infection now has lethargy and increased creatinine interstitial Nephritis
    Case of minimal change disease
    Saggital sinus thrombosis?warfarin?alteplase
  6. samuel

    samuel New Member

    Case of HIT-????
    Free flowing thrombus- venacaval shunt
    Case of SBP- coamoxiclav as no cephalosporin given
    Abx with narrow spectrum?? trimethoprim
    Man with alcoholic hepatitis became drowsy in Ward probably hepatic encephalopathy
    Hydrocortisone for pituitary failure
    Case of adrenal insufficiency
    Man obese gfr <30 for treatment of DM, gliclazide
    Ecg given man post angioplasty came with chest pain,?pericarditis
  7. samuel

    samuel New Member

    1)Pregnant lady 20wk with DVT,started LMWH,what's next?
    2)lady First DVT anti coagulated 3 months after hysterectomy, then second DVT with no cause found...how long to anticoagulate?
    3)ventilator setting for fluid overload/ARDs pt
    4)clostridium difficult,after given a course of metronidazole, end of treatment some clostridium test positive, what to do?(oral metronidazole?vancomycin)
    5)systemic sclerosis renal crisis-treatment: captopril
    6)post traumatic brain injury, developed gtc...not responsive...later wean off ventilator,nurses said pt awake daytime and sleeping nighttime,sometimes smile,cough,but not respond to pain-?lock in syndrome/non tonic status epileptics / vegetative/brain stem death
    7)TRALI
    8)treatment for depression psychosis
    9)treatment for bipolar?with grandiosity?
    10)pt treated with IV flucloxacillin 3 days for erythema around cannulation side,blood c+s later mssa,what's next(given crp reduced,wound improved,ECHo no vegetation s)...cont Iv flucloxacillin another 11 days?
    11)some guy with malaria, treated with quinine and fluids. then drowsy..parasitemia reduce 2%->0.5%,glucose 1.9what's the cause?side effect of quinine?
  8. samuel

    samuel New Member

    -Pregnant lady with thrmbocytosis after delivery with iron defiency anaemia and vaginal discharge =cause iron defiency anaemia.
    -spontanous bacterial peritonitis =give co amoxiclav.
    -patient with cancer while on treatment developed cmv pneumonia=give foscarnet .
    -pic of malignant melanoma .
    -patient with skin lesion and pruritis =keratoacanthoma.
    -patient brought a bug with sever scratching exoriation =OCD .-patient with tender thyroid gland and low scan up take what to give =carbimazole ?.
  9. samuel

    samuel New Member

    -Patient with AF and asthmatic =verapamil .
    -pt with CABG 15 years ago with 3 coronory artery due to anterior MI ,presented now with larteral MI =native cirumflex
    -ECG with dextrocardia .???
    -cisplatin cradiomyopathy with heart faliure .
    -pregnant lady with DVT ;given LMWH =continue till 12 weeks (32 weeks) .
    -pt with grandiosity =clonzepine
    -patient with ascities ,high calculated serum albumin ascitic protien ratio =Nephrotic .
    -patient with hiatus hernia and high glucose PE =esophageal rupture .
    -pain in buttock and thigh with movement =OA.
    -knee pain with fever and restriction of movement =septic arthritis .
    -sore throat and rash =guttate psoriasis .
    -frontal headache ,diplopia and proptosis =cavernous sinus thrmbisis .
    -back pain with wt loss= tuberculosis .
    -pt with kalman chance of brother to get it ??????.
    -upper limb weakness and Hodgkin lymphoma with radiation=next step chest x ray .
    -Rt side weakness with only grade 4/5 power =functional weakness (using stiks ).
    -pt taking mrphine for sever eosphageal ca with stenting and liver metastasis =add dexamesathone .
    -pt taking morphine next step =gabapentin .
    -hydronephrosis with ureteric calcufication and fever =nephrostomy tube .
    -diabetic on galargine and aspartate high pre dinner =increase pre launch .
    -heavy vechile driver ,uncnotrolled DM=sitagliptin .
    -acute pancertitis with lipeamia =omega3?????.
    -fever hepatomegaly pericarditis PE respond to prednisolone after 48 h =PAN .
    -chest x ray of TB .
    -pic of melanoma .
  10. samuel

    samuel New Member

    Malnourished eldery gentleman was it wrenicke's.
    Post operative gentleman ct cerebral atrophy was it wrencke as well.
    Klienfilter chnace of brother getting disease.

    Cmv pneumonia medscape says first line is ganciclovir
    Fever pericarditis, responsive to steroids should be adult onset stills

    cytomegalovirus (CMV) retinitis. Either IV Ganciclovir or Foscarnet would be appropriate, but trial evidence suggests that viral clearance occurs marginally more quickly in patients treated with Foscarnet, and less resistance is seen versus Ganciclovir
    this from passtwst

    The drug of choice for prevention of cytomegalovirus (CMV) disease in solid-organ transplant patients is now valganciclovir.[4] Other than CMV retinitis, however, ganciclovir remains the mainstay of treatment, at least initially.

    To the person asking for advice on how to prepare, not trying to be rude but look at the title and you should really start a new thread.
    Dr Rahmat likes this.
  11. samuel

    samuel New Member

    1-pituitary prolactinoma with eye symptom first treament ?cabergoline
    2-Q pituitary adenoma extended to the sella .non functing piutuitary adenoma ?
    3-remal failure with amylodosis =B microglobulin ?
    4-one Q TTP
    5-Another one ITP
    6-pregnant women with low platelet ,high ALT?
    7_ECG of complete heart block
    8-ECG of posterior MI
    9-ECG LBBB
    10-ECG HOCM
    11-ECG PE OR hyperkalemia ?
    12-Case o crutz jacod disesaes
    13-Frontotempral Dementia
    13-Q foot drop =polyartitis Nodosa
    14-cystic fibrosis with bronchiactsis and high KOCL =Bronchiactesis excacerbation
    15-Empysema with saturation of 92 % become breathless =Treatment Respiratory Rehablitation ?
    16-chest x ray of pleural effusion =Diagnosis plerural aspiration .
    17-chest x ray shows percardial calcification Q what is most common cause in UK ?hyperparathyrodism ?
    18-Echo shows either pericardial effusion or Mitral stenosis ,Q raised JVP with murmer ?
    19-systolic murmer in the left stertnal angle with history of Rhumatic fever =mixed mitral lesion .
    20-contnious systolic murmer in the lower sternal edge =ASD ?
    21-exercise test ,postive test =decrease in blood pressure ?
    22-Bone scan shows osteoprosis ,metastaic ca ?
    23-picture shows homonomous heminopia ,where is the lesion ,=occipital ?
    24-patient with papledima and normal CT scan ,very slighlty increse in protien ,normal csf =PIH ?
    25-obese patient with creatinine clearnce <50 ,s.cr 113 uncontrolled DM inspite of Diet control ,what to start ?Gliclizide ,Metformin ?
    26-patient with swelling of interphalangeal joint and small ulcer in the left index ?Gout ?psoraisis ?
    27-Patient with swelling in both hand ,aggrevated by cold with history of GERD ,Smoking of 10 cigarete /day =Berger`s OR systemic sclerosis ?
    28-Patient with iron Defeincy Anaemia ,colonoscopy shows Diverticulr Disease What to DO ?
    29-Patient with chronic renal failure ,anaemia ,low ferrtin and high Blood pressure =give Ferrous sulphat
    30-patient Given Heparin and developed low platelet ,what to do?=Give Argetoban
    31-patient with Feature of aneamia of chronic disease
    32-patient with factor v111 defiency ,slightly correctd with mixing with normal plasma =inhibitor of factor v111
    33-Patient with ptosis upper limb weakness ,and normal reflex =Mythenia Graves
    34-patient with weakness in the upper limb ,Autonomic Dysfunction ,Labert eton syndrome ,?
    35-patient with fever 40 ,normal reflexes ,high ck ,Hx of antisychotic medication ,underwent anahesia ,developed vomiting ,given metchlopromide =Neuroleptic malignant ?
    36-patient fro Asia with COPD ,developed vomiting ,Diarrhoea and abdominal pain ,chest wheez ,high esinophill =strongoliods serology ,Fungus preciptanat?
    37-patient with Diarhoea and vomiting ,leave in elderly accomdation ,previous Hx of same condition 2 week ago with another 2 patient =viral GE ?
    38-patient with vomiting and abdominal pain with locked jaw ,i.v drug abuser and groin abcess =Tetanus ?
    39--patient with pytairasis Rosea .
    40-Tuberculos Meningitis ,typical CSF
    41-Patient with transient dizzness , loss of conousness awake afert 2 hours =posterior circulation TIA
    42-patient with Hx of DVT now came with PE ,warfarin for life vs warfarin for 6 month ?
    43-x ray of sacroilliac joint with feature of Ankylosing spondylolitis but negative B27 =still Ankylosisng
    44-MIBG of reversible inferior lesion vs anterior apical region ?
    45-picture of patient with eczema ?
    46-patient with analegesic headache taking paracetamol an co codamol ,what to do ?
    47-pateint with obesity ,postive low dexmaesthasone suppression test ,high ACTH ,low LH ,FSH =cushing disease ?
    48-patient with polyuria and polydypsia ,Fasting blood sugar 6,6 , condition aggrevated after introduction of lithium ,Normal kindney concentration ability after dehydartion =primay poly dypsia
    49-patient with diarrhoea stoped by fasting ,low BMI ,microcytic Aneamia ,what to do next =Antiendomyseal antibodies vs laxative screen ?
    50-patient with primary Amenorrhoea ,high blood pressure and pigmentation what to Do ?
    60-patient who wake up with nubness in the lateral hand ,absent triceps reflex ,weak extention of the wrist and elbow =Radial nerve palsy ?
    61-patient with SVO ,given dexamesathone ,bronchoscopy shows small cell carcinoma ,what to Do next =Radiotherapy
    62-patient with CA colon with lymph node metastasis what to do next ,chemotherapy +Radiotherapy
    63-patient with barret oesophagus after endoscopy what to Do next ?PPI?
    64-patient with cough aggrevated by laughing ,eating ,all senstivity test normal ,peak flow meter normal what to do next ?
    65-pateint with acute exacerbation of ulcerative colitis bestvtreatment =rectal steroid +oral mesalazine ?
    66-patient with familial cacolon ,screening test =colonoscopy
    67-62 year old patient with hematuria ,what to do =cystoscopy ?
    68-patient with clostridium difficle became asymptomatic after metronidazole ?what to do ,toxin postive
    69-patient with bright liver in U/s ,raised liver enzyme =Autoimmune hepatitis
    70-patient with tender hepatomegaly with obstructive liver function and high grade fever =liver abcess ?
    71-patient came from holiday in Oman ,tender hepatomegaly ,sterile abcesess =Ecconococus ?
    72-patient with obsrtuctive jundice and febrile with dilated common bile duct what to do ERCP VS MRCP ?
    73-patient with gastrostomy tube dislodgement ,take bu NG tube since 2 moth ,on traetment for laryngeal carcinoma ,what to do ?Dressing or emergency endoscopy ?
    74-young girl with ingestion of 4 tab of Atenolol 25 mg ,what to do ?
    75-patient with tender hepatomegaly and Protienuria ,what is the underlying cause ?=Nephrotic syndrome
    76-patient with recurent infection ,what is the cause .Also Nephrotic syndrome
    77-feature of GN can be seen in =Urnianalysis ?
    78-patient with polycystic kidney disesaes ,shown by CT scan
    79-patient with resistant hypertension ,what to do ,MR angiography
    80-patient with with hypertension ,high aldosterne and Renin Test ,what to do ?=stop antiHTN medication for 2 week and repeat the test
    81-patient with pain in the lower limb even at night with absent ankle reflex =Peripheral Neuropathy
    82-patient taking thyroxine ,with anticonvulsant Carbamazepine ,changed to lamotrigine and devolped nausea and symptoms =due to chnging anticonvulsant
    83-patient taking Amiodarone with TFT of hyperthyroidism and tremor =Give Carbimazole
    84-patient with hypopituitrim what drug to give first =hydrocortisone
    85-patient with pale optic disc and absent pupillary reflex +central loss of vission =optic Neuritis
    86-sudden eye pain over 2 days with consrticted eye Acute Angle glucoma vs uveitis ?
    87-prospective risk assement for patinet withTIA ?
    88-pepti ulcer after endoscopy and eradication what to do ? Nothing vs Fasting gastrin ? -Patient taking warfarin with an INR 10 .warfarin stoped what is next?oral vit k .
    89-patient with visual disturbance and photophobia followed by headache =migraine .
    90-patient with Hx of treated Hodegking lymphoma presented with pancytopenia =Recurrance of hodeking ?
  12. samuel

    samuel New Member

    91-patient with gum high LDH .low haptoglobin .low plt =autoimmune heamolytic anaemia .
    92-patient with raised liver enzyme ALT obese smooth liver Non Alcoholic steatohepatitis .
    93-patient with sever astma .sielnt chest after one hour of trateatment saturation 92 % what is next step ?intubation vs i.v mg sulphate ?.
    94-pregnant lady with Acute fatty liver of pregnancy
    95-patient with Hx of cancer presented with sevet back pain next step to do MRI of the back
    96-patient with swellung if the lips and tongue what is the next step ?stop Ramipril ?.
    97-patient with obstructive sleep apnoea management with CPAP device .
    98-patient with renal faliure and protienuria with hydronephrosis and DM what is the cause ?Diabetic nephropathy vs reflux nephropathy?.
    99-patient with crusted lesion in the mouth and nasal mucosa and skin with recent Hx of Amoxicilline =steven johnson syndrome .
    100-MRI scan of african patient with herpes encephalitis vs creptococcal vs progressive multivocal ?.
    101-patient wuth tuberos sclerosis appeared in grandmother and grandson .justification incomplete penetrance ?
    102-patient with heart failure .ejection fracture of 25%with all heartfailure treatment and progressive sever breathlessness next step to do resyncronization of the heart .
    103-chest x ray with big heart and african patient ?chagas?mitral stenosis ?
    104-patient with cosolidation in the lower zone =strep pneumonae
    105-patient with honeycomb CT scan IPF vs Externsic Allergic allveollitis ?
    106-patient with psoriasis developed erythroderma first treatment prednisolone
    107-patient wirh Hx of cancer developed shortness if breath and type respiratory failure next step CTPA.
    108-patient with Ascities and Ratio of serum albuumin to acietic fliud protuen Ratio of less than 1.1 causes=myxedema .
    109-pateint with hepatitis c and Nephropathy causes= membranoproliferative GN.
    110-patient with HIV started HARRT with improvement of CD 4 count but devolped fever with lymphadenoathy =Mycobacterum Avium .(immune reconsellation synfrome )
    111-patient with mixed metabolic acidosis and alkalosis .
    112-patient with upper lobe round lesion in patient with halo around it =Aspergilloma
    113-patient undetwent thyroidectomy for carvinoma given lung function test and kocl ?upper airway obstruction ???.
    114-typical patient with arthalgia skin rash and nephrooathy =SLE.
    115-patient with anticardiolipin antibodies .
    116-patient with SIADH what is the drug ?Na valporate .
    117-patient with lip ulcer and genital ulcer = Behcet
    118-Pregnant lady with thrmbocytosis after delivery with iron defiency anaemia and vaginal discharge =cause iron defiency anaemia.
    119-spontanous bacterial peritonitis =give co amoxiclav.
    120-patient with cancer while on treatment developed cmv pneumonia=give foscarnet
    121-pic of malignant melanoma .
    122-patient with skin lesion and pruritis =keratoacanthoma.
    123-patient brought a bug with sever scratching exoriation =OCD .
    124-patient with tender thyroid gland and low scan up take what to give =carbimazole ???
    125 -Patient with AF and asthmatic =verapamil .
    126-pt with CABG 15 years ago with 3 coronory artery due to anterior MI ,presented now with larteral MI =native cirumflex
    127-ECG with dextrocardia .???
    128-cisplatin cradiomyopathy with heart faliure .
    129-pregnant lady with DVT ;given LMWH =continue till 12 weeks (32 weeks) .
    130-pt with grandiosity =clonzepine
    131-patient with ascities ,high calculated serum albumin ascitic protien ratio =Nephrotic .
    132-patient with hiatus hernia and high glucose PE =esophageal rupture .
    133-pain in buttock and thigh with movement =OA.
    134-knee pain with fever and restriction of movement =septic arthritis .
    135-sore throat and rash =guttate psoriasis .
    136-frontal headache ,diplopia and proptosis =cavernous sinus thrmbisis .
    137-back pain with wt loss= tuberculosis .
    138-pt with kalman chance of brother to get it ??????.
    139-upper limb weakness and Hodgkin lymphoma with radiation=next step chest x ray .
    140-Rt side weakness with only grade 4/5 power =functional weakness (using stiks ).
    141-pt taking mrphine for sever eosphageal ca with stenting and liver metastasis =add dexamesathone .
    142-pt taking morphine next step =gabapentin .
    143-hydronephrosis with ureteric calcufication and fever =nephrostomy tube .
    144-diabetic on galargine and aspartate high pre dinner =increase pre launch .
    145-heavy vechile driver ,uncnotrolled DM=sitagliptin .
    146-acute pancertitis with lipeamia =omega3?????.
    147-fever hepatomegaly pericarditis PE respond to prednisolone after 48 h =PAN .
    148-chest x ray of TB .
  13. samuel

    samuel New Member

    xray with charcot joint
    cxr with bronchioalveolar cancer
    xray with acute gout -as pt was on diuretics
    oesophageal ca with new stenting-needs PPI
    Repeat PE/DVT- life long anticoagulation
    ECG-2 nd degree heart block-QRS Complexes were normal looking so did not went for pericarditis
    pt on morphine-developed side effects as dose was increased very quickly from 10 mg bd to 60 mg bd,so answer reduce dose to 30 mg as pain was under control
    Xray hand with rash-CREST syndrome -with high BP-Give ACE I
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  14. samuel

    samuel New Member

    Biliomycin lung fibrosis
    Klienfilter chnace of brother getting disease is < than 1%
    Diabetic with leg ulcer Lt foot Xray Osteomylitis
    Post transfusional crepitations, resp distress ... post transfusional lung injury
    one case of fever 2 min after starting Platelets transfusion endotoxinaemia ?
    skin rash & lip crusts after he recieved Penicillin ... Epidermal necrolysis syn
    a woman with Rt eye diplopia, ptosis.. Oculomotor nerve palsy
    asthmatic recieved salbutamol & oral prednisolone 40mg ,not improved what next ? ( Aminophilline, Atrovent , Hydrocortisone )
    Pt with mild deterioration in renal function after stating ACE Inhibitor , no change in treatment
    bronchial asthma with silent chest , fast RR , low Bp, what next ... Entubation , Mg or Aminophiline
    HIV patient with contrast enhanced lesions , Toxoplasmosis
    another HIV pt with skin lesions what organism ...Cryptococcus
    one lady with solitary thigh visicle about 5 mm , what is the diagnosis?
    Risk of stroke ... more score is for hemiparesis ( 2 versus 1 for other options )
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  15. samuel

    samuel New Member

    A young female with loose stools and wieght loss prior history of extensive bowel resection tsh<0.1 t4 slightly raised = hyperthyroidism?

    Drug interaction patient takes benzodiazepine + methadone now started Att signs sweatings + abdominal cramps..rifampicin with methadone as it looks like symptoms of opiate withdrawal inducedby rifampicin

    Lorry driver with diabetes
    The guy was 63 years old with uncontrolled diabetes and egfr 20%
    (Ckd4) I went for Insulin

    Young patient took overdose of digoxin heart rate was 52 potasium was 5.2 ecg shows heart block dig level 8.1 = i did strict monitoring as there was no indication of atropine or digibind
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  16. samuel

    samuel New Member

    149-infective endocarditis in i.v drug abuser =Flucloxacilline +Gentamycin .
    150-skin rash with green colour under UV =Pytirosis versicolor .
    151-patient after platelet transfusion developed fever vomiting =Endotoxemia .
    152.patient after antibiotic developed sloughed skin in the back =TEN
    153-HIV with CT enhanced lesion =Toxoplasmosis
    154-patient with post trumatic brain injury ,only moving his eye and lip ,locked in syndrome .
    155-Sickle cell patient needing pain relief= IV diamorphine .
    156-Sickle cell patient with Liver sequestration =venoocclussive crisis.
    157-Rx for Patient with tremor especially with arms outstretched-?propranolol .
    158-picture of respiratory flow curve asked about vital capacity in the curve = answer 2.
    159 patient post surgery developed confusion ?what is the cause .
    160.Homosexual man with painfull groin mass =LGV.
    161. A man with big hiatus hernia+anaemia- how to correct anaemia-=, fe suppliment?
    162. bronchial asthma with silent chest , fast RR , low Bp, what next ... Intubation .163-patient came from trip ,bitten by dog ,developed muscle spasm .??
    164.patient with dyspeptic symptoms Age 44 year what is next ?trial of PPI
    165-Ventilator setting for patient with ARDS .
    166-malaria, treated with quinine and fluids. then drowsy..parasitemia reduce 2%->0.5%,glucose 1.9 what's the cause? side effect of quinine?
    167-lady First DVT anti coagulated 3 months after hysterectomy, then second DVT with no cause found...how long to anticoagulate? 6 month .
    168-systemic sclerosis renal crisis-treatment=captopril .
    169-patient with Hx of stroke ,takes baclofen for for post stroke spasm ,presented with spasm of the left lower limb impairing his movement and function =botilinum toxin .
    170-Pregnant Lady with elevated liver enzyme and low platelet =Preeclampsia .
    171-Pregnant Lady with elevated ALP and ALT =cholestasis of pregnancy
    172-patient with mildy elevated ferritin and only elevated ALT with abnormal behavior =Wilson`s
    173-CSF of patient with Normal glucose and high lymphocyte =viral meningitis
    174-patient with scaly rash in the scalp ,neck =Discoid Lupus
    175-patient with fever ,cough ,patchy consolidation in x ray =H.influenze vs streptococcus pneumonia ????
    176-patient with HTN ,no other co morbidities Age 66 ,ambulatory Bp monitoring confirm HTN =start with Amlodipine
    177-patient with lower edema, normal cardiovascular examination, takes Amlodipine =change Amlodipine to ACE .
    178-picture of Hands with swelling and ulcer in the left hand = Gout .
    179-Another x ray with Decreased joint space =Rheumatoid arthritis .
    180-Typical patient with GB but they mentioned it as Acute progressive polyneuropathy .
    181-one patient with multiple bizarre Nerve involvement ,Dx MS ,= treatment i.v methylprednisolone ??? I am not sure .
    182-one patient with bed sore ,what is the management =special mattress with air I think or something near that meaning .
    183-one patient collapsed at the Dentist chair ,vasovagal syncope =Management ,Reassurance .
    184-one patient with DIC ,chest infection and very high wcb (25 x 10) = Acute promylocytic Leukemia .
    184-one patient with hepatitis c and Renal impairment =cryoglobulineamia .
    185-old patient with UTI and required Narrow spectrum antibiotic =Trimethoprim .
    186-young patient with anemia ,next investigation =Anit endomysial Ab .
    187-one patient with recent travel ,diagnosed as traveler diarrhea ,given ciprofloxacin with improvement but still have diarrhea what to give =Lopermide .
    188-obese lady with amenorrhea ,high LH/FSH ratio and slightly high testosterone =polycystic overy syndrome .
    189-one patient with TB with low blood pressure ,high s.k and low Na =Adrenal TB .
    190 –Another patient with same finding but no TB =Adrenal insuffiency .
  17. samuel

    samuel New Member

    Young female took unknown quantity of digoxin heart rate 52 digoxin level 8.1potasium 5.2 ecg showed heart block= i did strict monitoring as thre were no indication of atropine or digibind

    Was there a scenario with low calcium , normal pth , i chose vit d levels.
    Menopause for lady with high fsh and lh.
    Schizoaffective for lady with excoriations and hallucinatons.
    To mimimize bias randomise patients.
    I chode eaa for lady with preciptans .
    Pulmomary haemorrhage for gentleman his kco was raised.no change in cxr. Not sure i think it's wrong answer.
    I chose co troxazole for a question and pcp for another.
    Coarctation of aorta for cxr. Paradoxical embolus for another scenario.
    Dermatofibroma answer for lesion itchy increasing in size has been there for three years.
    Mestatic breast cancer for lady with aplastic picture.
    Apalastic anaemia another question.
    Myeloma for guy with hodgkins high globulin.
    Deoxycyclin for pregnant lady.
    Folic acid lady on carabamezapine.
    Chose ercp for psc.
    Cholangitis another question.
    Nash.
    What's the ab for sbp i chose metronedazole.
    Guilian barre for guy with pvc readings.
    Iv immunoglobulins in another.
    Wernicke's another scenario.
    Pan .
    Braca1.
    Hellp.
    Side effect of quinin.
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  18. samuel

    samuel New Member

    Cavernpuse sinus thrombosis as normal pupliary reflex.
    Non obstructive embolus warfarin.
    Sagittal sinus asprin.
    Aptt not correcting lupus anticoagulant , vs factor eight inhibitor as no history of bleeding had surgery and dental extractions.

    Two scenarios for anaphylaxis , one i chose adrenaline the other adrenlaine pen.
    Are you sure about the spahenous graft to LAD because i answered same .
    Can somebody recall the bruce protocol question , please.
    Ventilator settings i remember chosing low tidal volume don't remember first option.
    I chose retroperitoneal fibrosis for hydronephrosis as no other obstructive uropathy option.
  19. samuel

    samuel New Member

    For question 161 you may want to see this excerpt from Medscape, updated on 30th October, 2014.

    ...... Management

    When symptoms are due to GERD, treatment goals include the following:

    Prevention of reflux of gastric contents
    Improved esophageal clearance
    Reduction in acid production

    In the majority of patients, these goals are achieved by means of a combination of the following:

    Modifying lifestyle factors
    Neutralizing acid or inhibiting acid-producing mechanisms
    Enhancing esophageal and gastric motility

    If iron-deficiency anemia occurs, it usually responds well to proton-pump inhibitor (PPI) therapy.
  20. Dr Rahmat

    Dr Rahmat New Member

    Thank you Samuel..... you are doing great things for us . I am requesting all the examine to reall the exam question .
  21. Dr Rahmat

    Dr Rahmat New Member

    What will be the answer ..... Omeprazole or Domperidone ?
  22. Dr Rahmat

    Dr Rahmat New Member

    Bruce protocol answer may ..BP going down
  23. Dr Rahmat

    Dr Rahmat New Member

    one CXR ...may be vetricular aneurysm
    One of the ECG .. Long QT syndrome
  24. kadhaum

    kadhaum New Member

    1-patient with svc obstruction give steroid next given anticancer therapy because small cell ca in that case is the cause of svc obstruction.
    2-pregnant leady with lyme disease doxy cyclin contr in pregnancy either amoxyl or ceftrixone
    3-patient with ascites and increase jvp x ray picture calcification pericardium cause TB
    4-pregnant lady with HT treatment labetalol
    5-patient on warfarine high inr 8 mild echymosis treatment skip dose 3 days
    6-lady with subacutethyroditis low uptake radio active iodine treatment inderal
    7-lady with cataplexy
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  25. kadhaum

    kadhaum New Member

    8- lady with epilepsy on carbamazapine gets pregnant no change treatment given folic acid
    9-trnsient global amnezia
    10-temporal arteritis patient with jaw ciaudication
    11-f actor v ledian question
    12-most common cause hyponatremia hydrochlorthiazide
    13-stills syndrome
    15-embysema need embelectomy
    16-parkinson dementia treatment
    17-drug cause hypoglycemia gliclazide
    18-insuline regime increse morning glargine dose because blood sugar at dinner
    19-ECG bragada s
    20-pleral effusion indication to tube aspiration according to ph of effusion
    21-rt ventricular hyperatropy ECG picture-
    22- SCLERODERMA PICTURE
    23-SCLERODERM A RENAL CRYSIS TREATMENT CAPOTEN
    24-HT WITH EDEMA DUE TO CAICUM ANTAGONIST CHANGE TO CAPOTEN
    25-CEREBRAL CESTOCERCOSIS CAUSE TONIC CLONIC SEIZURE
    26-RENAL FAILURE WITH ANEMIA TREATMENT IV IRON
    27-AF WITH ASTHMA TREATMENT BY VERAPAMIL.
    28 PSEDOGOUT
    29-CA COLON TREATMENT RADIOTHERAPY WITH SURGERY
    30-HEPARINE INDUCE THROMPOCYTOPENIA
    31-TOXIC GOITER
    32-PLATELATE TRANSFUSION COMLICATION GROUB O NEGATIVE WITH GROUB A
    33-PITYROSIS ROSE DUE TO HERALD PATCH
    34-MULTIPLE SYSTEM ATROPHY
    35-CMV TRATMENT BY GANCYCLOVIRE
    36-herpes simplex encephlitis
    37-lady with cva after 19 hours ct not hemoragic only aspirine
    38-low ca + phoshate high alk osteomalacia
    39-sarcoidosis QUES
    40-tumor lysis picture
    41-giardiasia
    42-seminoma question
    43-charcot goint picture
    44-patient get absecc at site canula treatment fluoclxaciline when fever subside continue oral treatment.
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  26. samuel

    samuel New Member

    Indications for termination of exercise testing

    The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines also specify indications for termination of exercise testing. Absolute indications for termination of testing include the following:

    Drop in systolic blood pressure (SBP) of more than 10 mm Hg from baseline, despite an increase in workload, when accompanied by other evidence of ischemia
    Moderate-to-severe angina
    Increasing nervous system symptoms (eg, ataxia, dizziness, near-syncope)
    Signs of poor perfusion (cyanosis or pallor)
    Technical difficulties in monitoring electrocardiographic (ECG) tracings or SBP
    Subject’s desire to stop
    Sustained ventricular tachycardia
    ST elevation (> 1 mm) in leads without diagnostic Q waves (other than V1 or aVR)

    Relative indications for termination include the following:

    Drop in SBP of 10 mm Hg or more from baseline, despite an increase in workload, in the absence of other evidence of ischemia
    ST or QRS changes such as excessive ST depression (horizontal or downsloping ST-segment depression >2 mm) or marked axis shift
    Arrhythmias other than sustained ventricular tachycardia, including multifocal premature ventricular contractions (PVCs), triplets of PVCs, supraventricular tachycardia, heart block, or bradyarrhythmias
    Fatigue, shortness of breath, wheezing, leg cramps, or claudication
    Development of bundle branch block or intraventricular conduction delay that cannot be distinguished from ventricular tachycardia
    Increasing chest pain
    Hypertensive response (SBP of 250 mm Hg, diastolic blood pressure [DBP] higher than 115 mm Hg, or both)
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  27. samuel

    samuel New Member

    191-one patient with stroke and patent formen ovale diagnosis =paradoxical Embolus .
    192-one patient with breathlessness and desaturation with movement =PCP.
    193-patient with with same presnentation what the treatment =co trimoxazole .
    194-patient present with bone marrow Aplasia =Metastatic Breast cancer
    195- Apalastic anaemia another question cause =Parvo virus
    196- a scenario with low calcium , low phospate . normal PTH =osteomalcia .
    197-Another senario high ca ,high PTH i think the Q about the caues =primary hyperparathyrodism .
    198- lady with high FSH , LH fushing ,and headach =Menupose . .
    199-To mimimize confounding randomise each traetment group .
    200- a wife of Farmer with postive preciptant and cough with fever =Externsic Allergic Alveolitis .
    201-patient with fever dilated biliary system high ALP =Ascending cholangitis
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  28. Dr Rahmat

    Dr Rahmat New Member

    Well done

    The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines also specify indications for termination of exercise testing. Absolute indications for termination of testing include the following:

    Drop in systolic blood pressure (SBP) of more than 10 mm Hg from baseline, despite an increase in workload, when accompanied by other evidence of ischemia
    Moderate-to-severe angina
    Increasing nervous system symptoms (eg, ataxia, dizziness, near-syncope)
    Signs of poor perfusion (cyanosis or pallor)
    Technical difficulties in monitoring electrocardiographic (ECG) tracings or SBP
    Subject’s desire to stop
    Sustained ventricular tachycardia
    ST elevation (> 1 mm) in leads without diagnostic Q waves (other than V1 or aVR)

    Relative indications for termination include the following:

    Drop in SBP of 10 mm Hg or more from baseline, despite an increase in workload, in the absence of other evidence of ischemia
    ST or QRS changes such as excessive ST depression (horizontal or downsloping ST-segment depression >2 mm) or marked axis shift
    Arrhythmias other than sustained ventricular tachycardia, including multifocal premature ventricular contractions (PVCs), triplets of PVCs, supraventricular tachycardia, heart block, or bradyarrhythmias
    Fatigue, shortness of breath, wheezing, leg cramps, or claudication
    Development of bundle branch block or intraventricular conduction delay that cannot be distinguished from ventricular tachycardia
    Increasing chest pain
    Hypertensive response (SBP of 250 mm Hg, diastolic blood pressure [DBP] higher than 115 mm Hg, or both)[/quote]
  29. Dr Rahmat

    Dr Rahmat New Member

    Thank you ....

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