Amrit March 16, 2013

1 - Back stiffness cause? Osteoporosis/disc prolapsed/cervical spondylosis (ANS C)

Osteoarthritis of lumber that is lumber spondylosis is better answer.

2- Osteoporotic fracture

3- L5/s1? Absent ankle jerk/weakness dorsiflexor ( (ANS S1 ABSENT AJ & WEAK PLANTAR FLEXION))

S1
4- Estrogen/progesterone? Decreases breast cancer after 2 years use/ decreases cardiovascular disease/decreases thromboembolism

Bbbbbbbbbbbbbbbbb?????????????/ Decreases hot flushes

5- Pt. Taking hrt, what is the most likely problem in 2 years of time? Very tricky (( HRT DEC CVS RISK AFTR 5 YR USE, OSTEO RISK BY 10 YR, INC STROKE /THROMBOEMBOLISM,PROTECT AGAINST COLON CA & ALZHEIMER,IN 2 YR ONLY VASOMOTOR CAN DECREASE))

6- Case related with pulmonary atelectasis 7- Post of case sudden dysnea, most effective? Ctpa/dimer/vq [[ANS; A, CTPA ]] 8- Wegeners granuloma? (( a febrile illness and respiratory symptoms, but early diagnosis is essential. It usually gets confused with benign nasal conditions.

Clinical features Adolescence to elderly, mean age 40-45 years Constitutional symptoms (as for PN) Lower respiratory tract (LRT) symptoms (e.g. cough , dyspnoea) Oral ulcers Upper respiratory symptoms: rh inorrhoea, epistaxis, sinus pain Eye involvement-orbital mass Pol yarthritis Kidney involvement- usually not clinically apparent (about 75% get glomerulonephritis) Chest X-ray points to diagnosis-multiple nodes, cavitations Anti neutroph il anti bodies (c-ANCA) are a useful diagnostic marker (not specific) Diagnosis confirmed by biopsy, usually an open lung biopsy Better progn osis with early diagnosis and treatment with cyclophosphamide DxT: malaise+ URTs (e.g. rhinitis, sinusitis) + LRTs (e .g. wheeze, cough) =Wegener granulomatosis DxT: asthma + rhinitis + vasculitis+ hypereosinophilia = Churg-Strauss vasculitis))

9- Lactose intolerance baby case? [[ PERI ANAL EXCOIRATION]] [[ COW MILK ALLERGY HAS VARIOUS PRESENTATION ; Symptoms ; The principal symptoms are gastrointestinal, dermatological and

respiratory. These can translate to: skin rash, hives, vomiting, and gastric distress such as diarrhea, constipation, rhinitis, stomach pain or flatulence. The clinical spectrum extends to diverse disorders: anaphylactic reactions, atopic dermatitis, wheeze, infantile colic, gastroesophageal reflux (GER), oesophagitis, allergic colitis, headache/migraine, oral irritation, and constipation.]] 10- Ethics 3-4 questions 11- Very tricky question on Chlamydia infection 12- Read stds very carefully, i got about 3-4 qestion on those topics 13- Case of generalized lymphadenopathy, fever, painless maculopapular rash over penis 21 years old kid, most common cause? Primary hiv/ secondary syphilis [[ ANS; B SECONDARY SYPHILIS]] 14- Lump over neck for 6 months, lady. Two weeks on and off? What is the diagnosis? Lymphoma/cll/aml/all/glandular {{ ANS; LYMPHOMA }}

Follicular lymphoma..wax and wayne LAN

15- 8 yrs old child with mobile lump over her right breast brought by her mother? What inv would u do? Usg/reasurence/surgery/wait till it grows (( ans ;b REASSURE)) 16- Myocardial infarction case- 3-4 questions, 17- Case of copd? Domestic o2 therapy case 18- Child with eye flutter some seconds? Gradually increasing. Eeg 3 spikes. What treatment is needed? Carbamazepine/ct head/reassure (( ANS : ETHIOSUXIMDE FOR CHILDREN .))

Absence seizure.here reaasure

19- Case on alzhiemer 20- Tibia/fibula fracture with diagram what would you do next? Reduction/tt/analgesics/surgery ((ANS ; SURGERY)) 21- Transilluminable swelling on posterior compartment neck? Diagnosis: cystic hygroma/branchial cyst {{{ ANS : A}} 22- Venous ulcer with pic? Feb question- hemosiderin depositon/hemmorghage {{ANS ; A}} 23- Westnile fever encephalitis case, what would you do? Vaccination/avoid tse tse flies/mosquito repellants {{{ ANS :c}} [[[4/16/2013 3:37:59 PM] dorin hussain: Prevention

Low-cost, ceiling hung mosquito netting for a bed. Personal protective measures can be taken to greatly reduce the risk of being bitten by an infected mosquito: Using insect repellent on exposed skin to repel mosquitoes. EPA-registered repellents include products containing DEET (N,N-diethylmetatoluamide) and picaridin (KBR 3023). DEET concentrations of 30% to 50% are effective for several hours. Picaridin, available at 7% and 15% concentrations, needs more frequent application. DEET formulations as high as 50% are recommended for both adults and children over 2 months of age. Protect infants less than 2 months of age by using a carrier draped with mosquito netting with an elastic edge for a tight fit. When using sunscreen, apply sunscreen first and then repellent. Repellent should be washed off at the end of the day before going to bed. Wear long-sleeved shirts which should be tucked in, long pants, and hats to cover exposed skin. The application of permethrin-containing (e.g., Permanone) or other insect repellents to clothing, shoes, tents, mosquito nets, and other gear for greater protection. Permethrin is not labeled for use directly on skin. Most repellent is generally removed from clothing and gear by a single washing, but permethrin-treated clothing is effective for up to 5 washings. Be aware that most mosquitoes that transmit disease are most active during twilight periods (dawn and dusk or in the evening). A notable exception is the Asian Tiger mosquito which is a daytime feeder and is more apt to be found in, or on the periphery of, shaded areas with heavy vegetation. They are now widespread in the United States and in states such as Florida they have been found in all 67 counties.[51] Staying in air-conditioned or well-screened housing, and/or sleeping under an insecticide treated bed net. Bed nets should be tucked under mattresses and can be sprayed with a repellent if not already treated with an insecticide.]] 24- Case on preeclampsia 25- Diabetic foot 26- Case with pinpoint pupil? Caused by what? Benzo overdose/cocaione overdose/heroin ((ANS : HEROINE ;) LOL }} 27- Melanoma pic given? Many irrelevant options except punch biopsy 28- Question on pill endoscopy (thought it as a capsule endo)

29-Terminal painless hematuria 2 cases given? Investigation and management were asked((BLADDER CA )) 30-Svt ecg given. Adenosine/carotid massage 31- Heart block ecg given diagnosis 32- Hypertrophic cardiomegaly ecg asked 33- 16 wks pregnant lady comes with 37cms pelvic enlargement? Cause? Hydatidiform mole/diabetic/multiple pregnancy (ANS : A)) 34- Question on prevalence 35- Very tricky question on schizophrenia 36- Question on bone age 37- Xray and stem with empty rectum? Diagnosis 38- Small bowel obstruction xray, hx of appendicectomy previously. 39- Pt admires u and wanna go for a dinner, u get attracted too.. what would you do? Carry on dr/pt relation/refer to other doctor and explain why you cant continue the dr pt relationship(( LET HER GO )) 40- Xray on aortic dissection 41- Case of aortic aneurysm 42- Question related with barium enema 2 questions were asked 43- Case of papua guinea repeated question 44- All the hepatic enzymes values were raised? What might be the causes.. i opted for viral serology 45- Overian mass? What would you do? Laparatomy/laparoscopic ((ANS :B}} 46- Question on mammography of microcalcification? What would you do?[[ MICRO CA , MACRO BENIGN]] 47 Options were like sentinel node biopsy/core biopsy/chemoradio/excision ((ANS C }} 48- Gm positive cocci.. drugs? Ceftrixone/flucloxacillin/penicillin {{ANS :B}} 49- Case of intermittent claudication.. most appropriate? Venography/Doppler (( ANS :DOPPLER)) 50- Mode of inheritance percentage basis- b thallesemia and cystic fibrosis 51- A child immediately after birth presented with grunting and subcostal recession, pregnancy normal, no other complication noted? Meconium stained/pneumonia((MECONIUM))

52- Rt arm and leg weakness, lesion present? Frontal lobe/parietal/occipital/temporal/internal capsule {{ANS ;E}} 53- Question related with levodopa 54- Turp complication? Epididymitis/bladder neck stenosis {{ ANS ;B }} 55- Question related with rheumatic fever? Very tricky.. 56- Surgical case and various fluids were given? Haartman solution/2 lit saline/5% dextrose, very irrelevant and mindboggling one.. 57- Swelling infront of ear during eating? Submandibular/parotid/abscess {{PAROTID}} 58- Kid 3 mnths loose motion esr raised? 59- Past stem where undescented testes is commonly asso with?( hernia )) 60- Post partum psychosis? Appropriate treatment? Ect/cognitive/antipsychotics ((ANS A)) 61- Diagnosis of pregnancy of uncertain period question? How would you tell the date? Pelvic examination when its supra bulge or 24 weeks or 6 weeks or when bulge below umbilicus {{18 WEEKS BULGE BELOW UMBLICUS }} ans 6 weeks 62- One stem on stroke and paralysis? Very tricky one I dint get any milestone questions.. no fundoscopic pics.. no cts.. not a single stem from bluebook...

...Well guys, i find my stems were really very tough.. hardly got any recalls but that doesnt mean they dont get recalled... many others got them recalled ..so in terms of getting them back is entirely the lady luck.. as for me, all i had was my logic and clicking the very fresh vignettes infront .. Anyway, i have tried my best to recall my questions and this is all i could do.. i havent included the options, basically i couldnt recall them but to be honest.. its better to study this topic carefully and the answers are all in there.. so all the very best and keep working hard...