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A few recalls, and the 2 questions Dr. Swammy asked!

167) Old man, brought by daughter as he is doesnt want to live afer his wife death.Looks dirty, daughter cant take care of him- Admit to psy 168) Lady with heavy but regular periods was contraception-MIrena

1) Young female, normal pregancy no blood pressure problems, 6 hours post delivery has a seizure. Cause? Epilepsy 2) Scenario probably showed Cp angle tumor, with Caf au lait spots. Risk of next gen getting the disease? 1:2(NF) Best modality to test/confirm diagnosis? 3) put the baby at which end of the cot? On back at head of cot? 4) Mallet finger? Where he had to straighten his ring finger almost everyday? 5) hypercalcemia due to drugs? 6) What factor most likely enhances woman's chances to get ovarian cancer, answer was family history? 7) Long term contraception, normal uterus and period, foolproof with least failure rate and side effects ? I choose Mirena, Depot progesterone was an option too 8) Hoarseness of voice for 8 weeks, in a massively obese(BMI-32) male alcoholic, how will u evaluate? Send to dietician , other options ENT, psy, 9) Kid with two weeks history of poor feeding lethargy, facial sweeling and oliguria, protienuria, treatment? Prednisolone? 10) Female young mass in outer upper quadrant breast firm, tender mobile discrete family history positive for breast ca, aunty died at age of 40yrs. Answer ca beast? 11) the guy who was white, hypertensive and one a couple of drugs best one, to prevent nephropathy. ramipril 12) and one other scenario, diabetic pt where the pt has imparied renal function, but USG normal sized kidneys also ramipril?

13) Senario as in mock, pt with proteinuria++, prevent progression of disease; Ace inhibitor 14) Elderly female with lung ca Mets. Massive one sided Pleural effusion. Severe shortness of breath. End stage disease. Asked Best management will be...pleural aspiration or continuous pleural catheter(I choose it) or sedation or pleurodescis. 15) First Ekg AWMI, Pt was given Aspirin, morphine, GTN, pain subsided, asked Next best mgt? PCI 16) 2nd EKG, I chose IWMI(scenario described was a male has left side chest pain for 2 days radiation to back) ECG showed ST elevation in leads II,III, aVF, severe bardy(HR-40/min).. Other options were, Thoraxic aorta dissection, Pul Embolism, PWMI. 17) Picure: Child with fever, initially vesicles appeared on trunk now spread to limbs, few crused with necrotic centre:Chicken pox 18) A study comparing 2 groups on different drugs for, side effects in tx of Ca breast, in 2014? Comparative study(I think), other was cohort, case control) 19) A pop of 500,000, incidence of some diasease for 5 yrs 1250, 500 more added.Asked for incidence prer million per year? 700 20) Ulcer on labia majora - Superfical Ing LN 21) right Testicular tumor : LN drainage: para aortic 22) A lady who had inflammatory cells on cervical smear no dyskarkosis, Noraml smear 1 year ago. Cervix normal on app. Next step - Repeat in 6 months 23) One with hot flashes mood swings etc 40 yrs oldwhat would be the single most effective diagnostic test? fsh levels. 24) 40 plus year old female 15 weeks pregnant. Test to give diagnosis of any abnormality? Chorionic villous sampling or triple test(hcg/afp/etc?) Or amniocentesis 25) Alzheimer's diagnosed,what type od disease ..: Pregressive dementia 26) Bisphosphonates for osteoprotic female with second fracture? 27) One scenario with old male, inceared forgetfulness, blames wife of loosing things, forgets his way home: Alzheimers? 28)Male with recurrent pain in feet, ankle joints, on xray there were punched out lesions, with erosions thats pseudogout

29) Patient is pale, sweaty, hb was 67 (normal 140 plus) tachycardiac, not hypotensive, and low iron and microcytic picture. Severe sobsince 3days etc...next most appropriate management? Options included blood transfusion as well as iv fluids. I choose BT as HB was very low? 30) Amoxil in a child with fever sore throat etc causing severe rash is Erythema Multiforme 31) Antibiotic prophylaxis for rectal surgery in a 60 year old male vitally stable no comorbids healthy? Options were, local therapy perioperative, antibiotic 24hrs prior to surgery(ans), antibiobic at induction of anesthesia, none reqd? 32) Female on tamoxifen, worst side effect to look out for? Vaginal bleed 33) 30 year old female, severe pain in one breast radiating to axilla, happens on and off. Non cyclic mastalgia(no association with menstruation?) 34) Young child comes in with overdose of grandmothers unknown meds, brady with multiple ectopics?Digoxin, othr options Amitryl, 35) Dexa scan for similar scenario, from mocks as first line investigation 36) Another one with 18year old man brought by mother. Loner. Prefers to stay alone. Collects model cars etc. Apathetic outlook. Autistic 37) One was obsessive compulsive disorder. Checking locks and taps 38) young female, confused sweaty, vitals stable, ABG pic of met acidosis, next inv, I chose Cap. Bld sugar. 39) young female, primigravida 10 weeks, protienuria. History of recurrent uti in childhood.BP 120/70 Cause of proteins in urine? Chronic pyelonephritis? 40) Recurrent abdominal pains in middle aged male. Severe. Amylase 800. Precipitating factor?Acohol? 41) 30 yr old female with breat lump. next inv USG 42) ABGs - Projectile vomiting - metabolic alkalosis 43) other one had dirrhoea, so I chose option with M.acidosis 44) Young boy with one sided facial sweeling and swelling and pain around eye. Orbital cellulitis 45) lesion where mid shaft femoral fracture?( circumflex femoris, profunda femoris, femora,)l 46) Globular shaped heart post-MI ... Cardiac tamponade. 47) Peroneal nerve was damaged in motorbike accident 48) Bell's palsy with vesicular rash?

49) Young female recently back from a trip to Thailand, not taking any malaria prophylaxis, develops fever, headache, malaise, pharyngeal eryethema, macular rash, multiple small Cervial and inguinal LAP?Options Malaria, Lepto, Dengue, HIV,Sypillis? 50) Treatment for PID empirical?Ceftiaxone, Doxy, Metrogyl. 51) one female having a normal smear one year ago . presents with abnormal swelling in her vagina that bleeds to touch, abnormal on examination. Colposcopy? 52) Ring enhancing lesions in HIV positive aids patient with cd 4 count of 50. Treatment pyrimrtnamine and sulfasalazine. 53) scenario from mock, where pain controlled by oral morphine, but cannot take oral meds. I/V morphine 60 mg OD 54) Methadone for medical mgt of Heroin addict who wants to quit? 55) Sick child With drooling and fever? Epiglottitis 56) 35 year old man, severe painful episodes one side of face, with nasal congestion and drooping of eyelid on same side. Maxillary sinus Ca? 57) Trocar for laparoscopic chole on rt side bet mid line and mid axillary line goes through which one single structure? EO and IO aponeurosis?other options linea alba, rectus abdominis, 58) Three episodes of breast abscess in three years.now discharging sinus, what is the diagnosis? Duct fistula 59) Elderly Man, smoker, 3 months history of hoarseness. Hilar mass. Management? LN bx 60) Urinary retention in 60 plus year old male. Renal/ureteric structures normal on usg. catheterization reveals 650 ml urine. Management? Trial without catheter preceded by tamsulosin 61) Scenario with pt was given med for H.pylori eradication, to check it tx worked? Sr. Gastrin levels( other optins, were urea breath test, 62) 10 days post op case for rectal ca, has high grade fever and mass in pelvis? Pelvic Abcess 63) 34 weeks pregnant woman, sudden onset hard tender abdomen and vaginal bleeding. Placental abruption? 64) A mother brings her two month old baby to hospital for regular checkup. You notice a bluish discoloration on sacral region of baby. Mother says this has been present since birth. What is the next step in management?reassure

65) Young female with heartburn and abdominal discomfort, four weeks of omeprazole therapy syntpms are still there and she is h pylori antibody negative and stool is negative for antigens. What is next step?OGD scopy. 66) 14 year old diabetic child does not follow insulin regimen misses his doses and eats in between meals and is not happy in school, what is the next step in management? Refet to psychologist 67) Patient with hematemesis that was prolonged, sutured post gastic ulcer, required 15 units of blood to be trabdfused. Was found to have one unit of blood in drain by next day. What is the next step in management? Urgent USG 68) 20 year old male found collapsed, altered sensorium, pale sweaty, vitals stable, first step , check bld sugar.

69)Sudden blindness in one eye, Flame shaped hmg all over retina on fundoscopy. central retinal vein occlusion right? 69) Claudication in thigh and calf, problem in external iliac artry 70) Fat necrosis in breast, post injury to chest in rta, 71)Whichnerve was damaged in stab wound to root od neck causing chest movments unevenly Spinal accessory nerve 72) Scenario of scabies was given, what was the mechanism of the itching?allergic 73) Child with ezema.Apply emmolient ten mins before steroids?all other options had steroid first 74) Mechanism of recurrent infections in cystic fibrosis? Abnormal viscosity of mucus? 75) Ankle dislocated/fractured?, pulses not palpable, arrange urgent vascular evaluation/intervention. 76) scrotal swellings with Transillimination positive,testes not palpated seperately ...hydrocoele? 77) Patient on digoxin is vomitting, answer is check dig levels right? 78)Pt with tremors. Serum levels for Lithium? 79) Turner's syndrome, what will be present? Ovarian failure 80) Patient with progressively increasing sob worsening copd, two mcqs with similar stems, one mcq answer was oxygen therapy(type 1 RF ABG done), 80)Other scenario for anxiety to reduce sob, rebreathe into paper bag etc.

81) 18 year old male with testicular swelling markedly tender sexually active, reddened slightly swollen, optin had epididymitis 82) Ulcerated malignancy on labium majus, 1.5 cm depth, will go to which group of nodes? Sup ing 83) Elderly male immunocompromised...has whitish plaques in pharynx etc he has dementia, has stopped taking food due to the whitish plaques on tongue etc...how will u treat, fulconazole suspension 84) Treatment for c difficile? Only metrogyl( no vanco or meropenm In options_) 85) organ/structure damaged by rta left sided abdominal bruise abd rigidity, spleen. 86) patient who comes in with overdose and wants to go home intending to kill herself?refer to psy to access capacity to refuse 87) Treatment for trichomonas vaginalis? metro 88) Female treated for PID but wasnt getting better . Next step ..USG of abd and pelvis? 89) right sided weakness with left sided visual loss...where is the lesion?MCA a.internal carotid artery b.middle cerebral artery c.anterior cerebral artery 90) sudden loss of vision left eye, recovered completely in few hrs? PICA 91) young femaleFEV1/FVC got improved after salbutamol(2.0/3.5) later (3.0/3.7) ( but could not achieve target value(3.2/4.0)), h/o smoking, f/h/o asthma, hay fever,ezxema d x?asthma(due to reversibility) 92) Codine phosphate max dose pain relieved but now cant take orally, severe contipation, vomitting cachexia what should you give next? Fetanyl patch? 93)Ca pt, terminally ill Vomiting and Nauseated. Bp 200/70.Next IV drug?Onden 94)Pt with chest pain, fever SOB, 4 wks after MI, Dresslers. 95)old lady in nursing home, h/o fall, now confused-CT head 96) H/O rta, GCS dropped, Intubated vitals checked, next, CT head 97)