146. A young man complains of fatigue and breathlessness.

On evaluation he has spherocytes in his

blood film and reticulocytes 6%. What is the next appropriate test?
A. Coomb’s Test
B. White blood Cell Count
C. Platelet Count
D. Genetic Analysis
E. G6PD assay

147. A 20 year old pregnant, 32/40 weeks by date, presents to the antenatal clinic with a history of
painless per vaginal bleeding after intercourse. On examination: P/A – soft and relaxed, uterus =
dates, CTG is reactive. Choose the SINGLE most likely diagnosis.
A. Abruption of placenta secondary to pre- eclampsia
B. Ante partum haemorrhage
C. Placenta previa
D. Preterm labour
E. Placenta percreta

148. A patient with Hodgkins Lymphoma, who is under treatment, developed high fever. His blood
results show WBC less than 2000 and has chest infection. Choose the most likely treatment?
A. Co- Amoxiclav
B. Piperacillin +Tazobactam
C. Erythromycin
D. Piperacillin +Co-Amoxiclav
E. Penicillin +Tazobactam

149. A 49 year old obese patient presents with right hypochondriac pain. Investigations show a big
gall stone. What is the most appropriate management?
A. Laparoscopic Cholecystectomy
B. Reassure
C. Low fat diet
D. Ursodeoxycholic acid
E. Emergency Laparotomy

150. A 16 year old girl presents with dehydration, dry mucus membranes, tachypnoea and abdominal
pain. She is drowsy. Blood glucose is 18mmol/L. What is the next step?
A. ABG
B. Check BP
C. Serum Alcohol Levels
D. Blood Sugar levels
E. CT Scan

151. A 16 year old girl is brought to the hospital by her parents as they are worried about her poor
appetite and her rigorous exercise regimen. And she does not think there is anything wrong with her
eating habits. She says she is overweight which is why she follows such a strict diet and exercise
regimen. What is your next line of management? The girl’s Height- 165cm. Weight- 33kg
A. Reassure parents
B. Detain under mental health Act
C. Eating disorder clinic
D. Psychodynamic Therapy

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152. An 8 year old child, who is tall for his age and has a refractory error for which he wears glasses,
has presented with severe crushing chest pain. What is the most likely diagnosis?
A. Fragile X Syndrome
B. PraderWilli Syndrome
C. Di George Syndrome
D. Marfan’s Syndrome

153. A lady developed breast abscess after delivery. What is the most likely organism?
A. Staph aureus
B. Staph albus
C. Group B streptococcus
D. Strep pyogenes
E. Strep faecalis

154. A 27 year old waitress has pelvic pain, dysmenorrhoea and increasingly heavy periods. She also
complains of dyspareunia. There is generalized pelvic tenderness without peritonium. Pelvic
ultrasound scan is reported as normal. What is the most likely diagnosis?
A. Endometriosis
B. Uterine Fibroid
C. Pelvic Congestion Syndrome
D. Pelvic Inflammatory Disease
E. Tubal Pregnancy

155. Patient immunized against hep B. What do you expect to find on investigation?
A. HbsAg negative, Anti HBc positive, Anti HBe negative
B. HbsAg negative, Anti HBc negative, Anti HBs positive /Anti HBe positive
C. HBsAg positive, Anti HBc negative, Anti HBe negative
D. HBsAg positive, AntiHBs, HBeAg, Anti HBe, Anti HBc.

156. A 14 year old girl who asks for oral contraception. Her boyfriend is a school teacher.
A. Tell her that you can’t prescribe because she is child
B. Call her parents and tell them
C. Report to police
D. Report to local safe guards

157. A 12 year old patient presents with copious diarrhoea. On examination his urine output is low,
mucous membranes are dry and skin turgor is low. What is the single most initial management?
A. Antibiotic
B. Antimotility
C. Anti-emetic
D. Fluid replacement
E. Reassure

158. A 24 year old woman presents with deep dyspareunia and severe pain in every cycle. What is the
initial investigation?
A. Laparoscopy
B. Pelvic ultrasound
C. Hystroscopy
D. Vaginal swab

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