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Photo: Dark discolouration on the side of the nose.After excision report shows it as a.1
(Nodular malignant malanoma.WOF is next Mx- (Antho-397 picture on the Sole
a.Observe
b.Do nothing
c. Wider local excision
d. Radiotherapy
e. Excision
Photo:A child with rash on the buttocks and legs .Both ankles swollen and tender, also.2
abdominal pain,but no fever. No neck stiffness.WOF is most common major complication-
((Dx:HS purpura ;AMC-286
a.Nephritis
Photo:Lipoma on the neck of a man.H/O soft swelling present for last 3 yrs, never had.4
-any trouble for that swelling.But now he came to you for your opinion.WOF you will do
(a.Reassure, nothing need to do ( Anthology-399
b.Refer for specialist opinion
c.FNAC
Photo:X-ray chest of a 8 months old infant with opacity in Rt lower zone and.5
(pneumatoceles(Staph. Pneumonia).Rx- (AMC: Fig-119
I/V Flucloxacillin
Photo:Eye and dilated pupil.Man came to you with h/o pain in the eye, also has headache.7
-and vomiting.Mx
a.Tropical Acetazolamide
b.Patch the eye to look for FB
cAtropine eye drops
d. Topical Pilocarpine
Photo: A man came with a soft swelling in groin for last 2 years.It is soft, slowly growing.9
-over inguinal ligament & lateral to pubic tubercle.WOF is your Dx
a. Lipoma
(b. Inguinal Hernia (May-2005
c. Femoral Hernia
Photo: X-ray chest of a 9 months old infant as shown in AMC book(page-119). What is.10
the Dx? Staph. Pneumonia( But most common in this age group is Streptococcus
(pneumonia
Photo: CT Scan. A lady complains that she feels her left side of body she feels heavy..11
-She also has paralysis & weakness of left side. WOF is your Dx
a. Cerebral Tumour
b. Cerebral Haemorrhage
c. Cerebral Infarction
d. SAH
-ECG: Wide QRS complex and tall T wave.12
a.Hyperkalaemia
b.Hypokalaemia
c.Hyponatremia
ECG:Vetricular Ectopic.15
A pt. present with ptosis of left eye, left side sensory loss of face. Left side gag reflex.17
was absent, Rt. Sided hemiparesis and incoordination of Rt. Upper and lower limb.Where is
?the lesion
a.Middle Cerebral Artery
b.Internal Carotid Artery
c. Vertebral Artery
d. Multiple Sclerosis
e.Post. Cerebral Artery
A baby has jaundice just after delivery. Mother is Rh –ve, baby also Rh –ve. Coomb’s.18
?Test is –ve.What may be the Dx
a.Autoimmune condition
b.ABO incompatibility
c.Rh incompatibility
A patient who was previously well comes to you with complains of weakness for last 2.27
weeks, his reflexes in lower limbs are absent though in upper limbs are normal.What will
-be the CSF findings
a.Elevated protein, elevated glucose, elevated leucocytes
b.Elevated protein, normal glucose,leucocytes< 5ml
c.Normal protein,normal glucose, leucocytes>5ml
d.No ignificant abnormality
Child with her mother in a Supermarket picked a packet of Baloon.His mum snatched it.28
& kept in place.The child started crying and at one stage he became unconscious but
-regain consciousness within 45 seconds.WOF may be the cause
a.Petitmal epilepsy
b.Infantile spasm
c. Breath holding attack
d.Complex partial seizure
e.Grand mal seizure
A man came to a country hospital in East Timor because of sudden onset of vomiting.30
and headache after a Motor Vehicle Accident(MVA).He was conscious at the time of
admission.There was no visuable major injury,so he was sent home after observation.But
3 days later he became unconscious and O/E there was unilateral fixed dilated pupil,BP-
increased, Pulse-decreased.He was taken to a tertiary hospital in Dili.Which will be the
-immediate Mx
a.X-ray of the skull
(b.Immediate Bur hole of the Skull (Rx of Extra Dural Haematoma
[c.Anti oedema measures [Investigation: CT Scan
d.Carotid angiogram
A pt. complains of severe pain on pressing on nail of thumb.WOF is most likely the.32
-cause
a.Fibrosarcoma
b.Osteosarcoma
c.Glomus tumour
After screening with faecal blood test WOF is the correct percentage of detection of .39
Duke A1 colonic carcinoma: Scott-323
a.<3%
(b.15% ( Duke A-tumour confined to bowel wall-survival 90%
c.25%
d.50%
e.75%
?WOF is a feature of Thyrotoxicosis.40
a.Fine tremor
b. Distal myopathy
.c.Small muscle weakness
You are called to solve a problem between a nurse and a psychiatric patient. On your.41
arrival the pt. told you that he should be allowed to remove his I/V line as he has private
insurance & you being a doctor would understand this, because you would also have
private insurance,and as a doctor you would not like these nurses those who has no
private insurance.What is the appropriate Dx of this case? (Compare Q.17/Oct.,04 &
(Q.9/May’2000
a.Regression
b.Splitting
c.Projection
d.Denial
e.Suppression
A 56 yrs old man has h/o melanoma.He is suffering from depression and now he.42
behaves very percusly.He doesn’t believe he has any depression or needs any
?treatment.What is your Dx
a.Relapse of depression
b. Psychotic depression
.c.Effects of melanoma
A 3 yrs old child came with her mother.The child has been suffering an attack usually.43
once in a month.The attack lasts for 2-3 minutes and during the attack she is seen in
spinning.She does not loose conscious during that, but feels frightened & runs to her
:mother’s lap for comfort.WOF is your Dx
a.Minor form of epilepsy
b. Benign positional vertigo
c.partial complexe seizure
A 40 yrs old man comes with short history of malaise and cachaxia when he was on a .44
short trip to Bangkok.His wife thinks he is suffering from jaundice.Now he presents with
fever and chills.Blood tests shows: S. Bilirubin- increased, Alk Phos- Much increased, AST-
?Slightly increased, ALT- Slightly increased.What is the Dx
a.Viral Hepatitis
b.Cholengitis
c.Malaria
A lady comes to you with low BP(100/65), Pulse 120/minute.She complains of.45
:pigmentation specially around her breasts.WOF is your Dx
a. SIADH
b. Addison’s disease
c. Hyperaldosteronism
In Oct.’05 : Pt. presents with lathergy, mucous membrane pigmentation and K+ :)
(increased, Na+:123 mmol/L(decreased)’BP- low and low glucose
A 54 yr old man has CRF, his MCV is 80-90.It falls even more after treatment with.46
Erythropoietin;when the therapy was stopped he becomes anaemic within two months.His
-condition is due to
a.Fe def. Anaemia
.b. Vit B12 def
.c.Folic acid def
d.Bone marrow fibrosis
e.Red Cell atypia
An old man suffering from cancer.Surgeon says that the man has no chance to survive .47
whether gone for a operation or not.Surgeon’s opinion is to send him home for rest of his
life to live with his family.But you feel that the pt. deserves every chance to be
operated.Your duty to explain the situation to the daughter of the patient.What will you
?do
a.You should say that though the surgeon does n’t want to go for a operation ,but you feel
.operation should be done
.b. Family should make an independent decision
.c.Request them to get him operated
d.Put on your view aside and tell her the Surgeon’s opinion
A 22 yr old football player during a game fell down in awkward position, and developed.67
pain and rapidly increasing swelling of the knee. Anterior, posterior and lateral X-rays are
-normal.WOF injuries you expect to find
a.Tear of Medial Meniscus
b.Rupture of Anterior Cruciate Ligament
Feature of Temporal Arteritis: Patient with loss of vision which lasted for few .78
?minutes.WOF is correct
a.Temporal arteritis
b.Lacuner infarct
c. Carotid artery stenosis
A 38 yr old lady with dull contineous headache, could not do her daily work.Most.79
-appropriate Ix
a.ESR
b.USG
c.CT Scan
A 35 yr old lady came to ED with twitching of fingers.Investigations done;CT .80
normal.Reassuranca given.But after few days she came back again with twitching in hand
:again.Another CT & USG.Management
Give calcium because this is hypoglycaemia
A 29 yr old woman developed severe paroxysm of pain in check and lip lasting for about .83
-15-20 minutes.There is loss of sensation in trigeminal nerve area.Most likely Dx
a.Tic dorulex
b. Trigeminal neuralgia
c.Multiple sclerosis
d.Migraine without aura
A 18 yr old girl comes to you for your advice regarding Contraceptives as she is going to.84
:start her sexual relationship.WOF you will prescribe
a. OCP
b.IUCD
c.Condom
d. Low dose progesterone
?WOF doesn’t produce keratotic scale.85
a. Basal cell carcinoma
b.Squamous cell carcinoma
c.Pityriasis versicolor
d.Keratoacanthoma
e.Psoriasis
?Hutchison’s Melanotic Freckle,WOF is not correct.86
a.Mainly occurs in the covered parts of body
b.Irregular border
c.Malignant
d.Mostly occurs in the elderly
Q. on Submandibular Gland:Still to be recalled .87
A mother complains of her 10 months old baby who wakes up during night many.88
times.The baby is otherwise healthy and gaining weight properly.The mother is worried
-about this.what is the Mx
a.Urine culture
b.Give sedative to the baby
c.Tell the mother to cuddle the baby when he cries 89. A 45 year old man has fainted.His
BP is 90/50 and Pulse 110/min.Serum Na-115(low), urine Osmolality-655.Most likely
:diagnosis is
SIADH
A man presents with sudden onset of Horner’s syndrome, 9 & 10 nerves palsy and loss .90
of touch and temperarure sensation on the opposite side of the body.Where is the site of
?lesion
a.Vertebrobasilar artery
b.Basilar artery
c.middle cerebral artery
d.Vertebral artery
e.Carotid artery
A lady undergone surgery for gallstones.She developed fever and tachycardia after 6 .91
-hrs.Oral Cholangiogram was done; findindings were normal.Dx
a.Atelectesis
b.Wound infection
c.Allergy to dye
A 63 yr old man presents with 3 days vomiting and has lost 3 kilos.Five years ago he.92
was treated with cimetidine.Over the last two months he has epigastric pain and has been
:treated with aspirin.Vomitus is clear in colour with identifiable food paticles.The Dx is
a.Drug induced gastritis
b.Chronic duodenal ulcer
c.Cancer of duodenum
d.Pyloric stenosis
e.Cancer of cardia
A 45 yr old lady complains of irregular menstrual bleeding.She has been treated for .93
CIN-II previously and a Pap smear done 6 months ago was fond normal.WOF is the most
?appropriate investigation for her
a.Colposcopy Repeat: March’06
b.USG to detect endometrial thickness
(c.Cone biopsy (see the difference: Q-40/oct’04
d.Endometrial curettage
e.Repeat Papsmear
A labourer who is a heavy smoker find difficult to perform his duties and worried about .94
his physical conditions.On examination there is ankle oedema, raised JVP, huge hepato-
(splenomegaly and ascitisWOF is likely- (May’05
a.Cirrhosis
b.Costrictive pericarditis due to previous tuberculosis
c.SVC obstruction
d.Budd Chiari Syndrome
A foot ball player while playing got injury in his Rt.Knee.The knee is locked.Dx: [Outline .95
of fractures-224:Locking is common & important
[Tear of Medial Meniscus feature of torn medial meniscus.Knee suddenly gives way
Two sisters are living together in a house.Elder sister thinks that their neighbours are.96
trying to poison them with germs,so they have sealed their house.Younger sister believes
what her sister says.But she is normal when she is away from her elder sister.This is an
-example of
(a.de clerabault syndrome (Oct.-2004
b.Induced delusion
c.Capgras syndrome
d.Folieodoux syndrome
A 29 yr old lady comes to you with obesity, irregular cycles and hirsutism.What will help .97
-you to Dx her condition
a.Increased FSH : increased LH
(.b.Incrased LH: increased FSH (Dx-Polycystic Ovarian Synd
c.Increased Prolactine level
98A 32 yr old primi in her 33 weeks of gestation informs you that her baby’s movement
suddenly become decrease for the last 28 hrs.Before that her pregnancy was going normal
:without any problem.WOF would be your management to combat the concern
[a.USG [October’03
(b. Do Cardiotopography(CTG
c.Fetal Scalp pH
d.Immediate delivery of the baby
A 38 yr old primi of 39 weeks pregnancy admitted in Labour Unit with the onset of .99
regular uterine contraction,her cervix is 8 cm dilated, fully effaced,station +1, initially fetal
hear rate was 155 but after a while on the progress of labour fetal heart beats suddenly
falls from 155 to 80 per minute; otherwise normal in respect of mother’s general
:condition.What would be your next step of Mx
a.Fetal scalp pH
(b.Cardiotopography (Oct.2003
c.Vaginal examination to exclude any cord prolapse
d.Emergency delivery by C/S
e.Percutaneous umbilical sampling
A 57 yr old lady develops sudden onset of left sided weakness and right eye.100
-blindness.This is most likely due to
a.Vertebro-basilar insufficy
b.Pituitary tumour
c.Carotid artery stenosis
d.Cerebellar lesion
e.Retinal detachment
A girl lost her father 6 months ago.She can not get over it.She lost weight 10 kg.Most.101
:important thing you need to enquire about her
(a.Eating pattern (May’05
b.Suicidal ideas
c.Menstrual regularity
Pleural Effusion: Typical presention.Stony dull on percussions,bronchial breath sound .102
.above the area, restricted movements on the affected side
A patient presents with impaired sensation on medial aspect of the hand, 4th and 5th.103
?fingers of the hand are flexed.Where is the lesion
Ulner nerve at elbow
A pt. was on warfarin, he developed haematemesis and melena.His INR is 10 times.104
(normal.WOF should be the management? (Sept.’05
a.Fresh plasma infusion
b.I/V Fluids
c. Oral Vit-K
d.Transfuse blood
e.Intra muscular Vit-K
? What is the best medication to give as Postcoital Contraception.105
a.OCP
.b.Levonogestrol within 72 hrs,and second dose 12 hrs after the first one
A man presents with pain over the L4 region.His X-ray shows multiple metastatic.114
:lesions in the spine.WOF investigations is most appropriate
a. Prostate specific antigen
b. CT Scan
c. MRI
A young man comes to you with epigastric pain.His wife is pregnant and he is “on.115
-edge”.AOF would support you inference that he is an alcoholic,EXCEPT
a.Attempt to Cut down in the past
b.Anger on enquiry CAGE- 1.cut down 2.anger 3.guilty 4.eye opener
c.Guilty about drinking
(d.Eye opener (drink first thing in the morning
d. Two bottle of light beer/day
A 12 yr old boy presented with painless lump in the scrotum for the last 6 months.He .116
?is otherwise healthy grown up.What is the most likely Dx
a.Hernia
b.Seminoma
c.Encysted hydrocelc of the cord
d.Saphena varix
e.Haematocele
A mother of a 4 yr old child noticed that there is a solid mass in the Rt. Loin area of her.117
child which she noticed for the first time with occasional blood in urine.WOF is your initial
Dx: OHCS-220
a.Neuroblastoma Wilm’s tumour:Commonest intraabdominal tumour of
b.Wilms tumour childhood.Haematuria not common,but fever,flank pain c
c.Hydronephrosis abdominal mass found. US-pelvicdisortion,hydronephrosis
. d.Plycystic kidney disease
Two months old child’s mother noticed a firm lump in her baby in the left side of upper.118
abdomen while bathing.Child has bilateral periorbital ecchymosis.what is the most likely
?cause
a.Neuroblastoma May-2000
b.Wilm’s tumour
Mother of a 3 year old child noticed a mass in the abdomen on the left side.AOF could.119
-be the cause,except
a.Hydronephrosis October’96
b.Neuroblastoma
(c.Nephroblastoma(Wilm’s tumour
( d.Poly cystic kidneys—(Die before 1 year of age
e.Chr. constipation
:In minimental examination WOF indicate severe outcome for the patient.120
a.Unable to recognize you
b.Unable to recall own identity
A 73 yr old woman presented with polymyalgia rheumatica.Most likely characteristic of .121
-this disorder
There are fatigue,fever and depression
A baby with Down’s syndrome is born to a couple who definitely refuse to take the child.122
:home after failure to convince them.The most appropriate course of action
Arrange temporary foster care
An 8 yr old girl presents with abdominal protusion,anaemia and tenderness.O/E there is.123
-a big irregular and mobile mass crossing the midline.Dx
Neuroblastoma
Derived from sympathetic neuroblasts,most common solid tumour in children<5yr.Likely to
present with abdominal swelling and urinary catecholamines (vanillylmandelic&
.homovanillic acids) raised in 92% cases
.Hypospadias: incidence of 1:350 male birth.124
-All are autosomal recessive , Except.125
a.Neurofibroblastoma
b.Phenylketonuria
c.Galactossemia
d.Cystic fibrosis
e.Sickle cell anaemia
After his baby sister was born, a 6 yr old boy began suck his thumb and wetting his.126
-bed, behaviour he had grown out of long before.This is an instance of
a. Regression
A child has swollen joints and cries whenever the napkin is changed, irritable,.127
? ecchymoses and hyperplastic gums. WOF is Dx
a.Rickets
b.Scurvy
A multigravida presents at 37 weeks gestation, not in labour, with a breech.128
?presentation and ruptured membranes.What should you do initially
a.Immediately C/S
b.Vaginal examination
A 23 yr old man limped into ED and stated that he was kicked in the post. Aspect of the.129
leg during a game of foot ball.He experienced immediate sharp pain which subsided.O/E
-there is decreased planter flexion.What is the Dx
Rupture of achillis tendon
.Peritonsilar abscess(Quinsy): Caused by Streptococcus& Trismus seen.130
-Zygomatic bone (maxillo facial) fractures characterized by.131
a. Involvement of infraorbital nerve
b. Subconjuctival hge. with no definitive posterior limit
c. Loss of senstion over canine & first premolars
d. Partial trismus
e. All of the above
: (In senile dementia WOF would be least likely to be lost(last to lose.132
a.Memory for faces
b.Memory fpr neighbourhood
c.Arithmetic memory
(d.Language memory(vocabulary
e.Short term memory
:WOF is most likely to be damaged during carotid endarterectomy.133
a .Vagus nerve
b.Hypoglossal nerve NMS-132
(c.Facial nerve ( 1.vagus 2.hypoglossal 3.Recurrent laryngeal 4.Marginal mandibular
d.Laryngeal nerve