Dr Zuhaib Khan, Peshawar, Pakistan.

This is one of the previous papers of MOH exam. I have solved to the best of my Knowledge.
Q1.Antipsychatric drug not administrated parentally in emergency in psychiatric presentation is:
A. ziprasidone
B. haloperidole
C. lorazepam

Answer : haloperidole
Q2. Pt presented with enlarged painful bilateral knee joints, there is normal ESR and CRP and
there is no signs of effusion so your diagnosis ?
1. gout
2. rheumatoid arthritis
3. Osteoarthritis

Answer: Osteoarthritis
Explanation: Normal inflammatory markers point out toward the diagnosis.

Q3. 20 yrs old lady presented in the first stage of labor, of the following which type of anesthesia
is most appropriated for her
1.morphpine
2.general anesthesia
3.local anesthesia

Answer: local anesthesia

Q4. Best drug used for chronic pain is:
1.ibuprofen
2.asprin
3. Acetaminophen

4. nepraxen

Answer: Acetaminophen
Explanation: Very safe drug having less side effects as compared to NSAIDs especially for
chronic use. Trade name Panadol
Q5. 40 yrs old lady diagnosed with TB presented with red painful eyes with photophobia
diagnosis is:
1. uveitis
2. bacterial conjunctivitis
3. viral conjuntivitis
4. glucoma

Answer: uveitis
Explanation:

It is basically keratoconjunctivitis Sicca (Dry eye) common in Sarcoidosis

and TB) Reference Sanjay Sharma MRCP 2

Q6. Case of ENT Patient working in noisy area,raise up the radio volume to listen properly
because he cannot listen while in noise.
What is the diagnosis?
Options not available but answer should be Noise induced deafness or noisy deafness .
Q7. Pt on OCP for the last 2 wks presented with thromboses veins.
what is the mechanism:
1. V Leiden
2. DIC
3. vonwillbrand disease
4. haemophilia B

Answer: 5 Leiden deficiency

Q8. what is the mechanism of noisy deafness

1. sensory neural
2. conductive

Answer: sensory neural

Q9. child presented with migratory arthritis, sore throat and fever.
what is the diagnosis
1. Rheumatic fever
2. rheumatoid arthritis
3. juvenile l RA
Answer: Rheumatic fever

Q10. Case of atrial fibrillation , causes include all except

1.
2.
3.
4.
5.

smoking
IHD
Hyperthyroidism
DM
Chest trauma

Answer: Chest trauma

Explanation: chest trauma is a recognized cause of cardiac temponade

Q11. known case of HTN,on beta blocker and hydrochrothaziades presanted with syncopal
attacks.He has been brought to ER.
O/E: PR:64,BP:120/80, ECG normal.
pt discharged to home but again he presented with the same syncopal attacks with stable vital
signs and normal ECG.
This is time what would you do:

1. stop hydrochrothiazides
2. Holter monitor
3. stress ECG

Answer: Holter monitor

Explanation: This gentleman probably is having paroxysmal arrhythmia and it will be
caught up in Holter monitor as ECGs usually miss that.
Q12. old pt with past history of stroke presented with abdominal pain,
Diagnosis
1.diverticolitis
2. mesentric ishaemia

Answer: Mesenteric Ischemia

Explanation: H/O stroke or IHD or Hyperlipidemia is a clue to the diagnosis. It usually
occurs after food intake as blood flow to the GIT is greatly increased.
Q13.Clear case of dehydration in infant with depressed anterior fontanelle, decreased tears
what is your management:
1.ORS
2. IV rehydration

Answer: IV rehydration
Explanation: It is moderate to severe dehydration so ORS wont work here.

Q14. Very obese patient with BMI42 ,he has HTN,and with painful ruptured thrombosed
veins.He was started on conservative management but still BP150/100,and painful thrombosed
ruptured veins what is your management ?
1. add antihypertensive
2. surgical referral
Answer: surgical referral

Explanation: Very vague Question not provided clearly. He has ruptured veins so probably he
needs surgery

Q15. Case of DKA

what is the most likely cause:
1. insulin mismanagement
2. diet mismanagement
Answer: insulin mismanagement

Q16. Obese diabetic pt ,failure of conservative management

so you will add :
1.insulin
2.Biguanides
3.glucagon
4. thiazolidinediones
Answer: Biguanides

Tip: Biguanides are Metformins and remember B for Biguanides and B for Big (Obese). While
Suphonylureas are Daonil and remember S for Sulphonylureas and S for Small(Thin).

Q17. picture of wart on foot, pt is basket ball player.

Treatment:
1. electrocautry
2.curretage
3. cyrotherapy
Answer: cyrotherapy

Q18. UTI in lady,

Treatment:
1. ciprofloxacin and check within 2 days
2. ampicilin and check within 2days
3. piperacillin/tazobactam
Answer: ciprofloxacin and check within 2 days
Explanation: This is also a vague Question.

Q19. pt underwent C/S ,Now got fever and vaginal discharge.

Treatment
1. clindamycin and gentamycin
2. metronidazole
Answer: clindamycin and gentamycin

Q20.Case of addision disease,presented with weakness ,clammy skin, shock with BP 80/40.
Treatment :
1. 0.9N/S over 1hour+hydrocotesion IV
2. 0.9 N/S over 8hours+hydrocortesion IV
3. 0.9 N/Sover 1 hr+fludrocortison orally
4. 0.9N/S over 8hrs +fludrocortison orally
Answer : 0.9N/S over 1hour+hydrocotesion IV
Explanation : This is Addisonian crisis so must be treated aggressively and Normal Saline
would be given immediately to restore the blood volume . 100 mg Hydrocortisone is given IV.
Fludrocortisone will be added when the patient is discharged home as it will restore mineral
corticoid deficiency associated with Addison.

Q21. HIV pt presented with purplish skin lesion with involvement of mouth .
Treatment ?
1.topical antibiotic
2. oral Antiboitic
3. oral cortisone
4. radiotherapy and chemotherapy
Answer : radiotherapy and chemotherapy
Explanation : It is a case of Kaposi Sarcoma
Q22. Chlid presented with vesicles over the roof of mouth but spares the gingival.
Diagnosis ?
1. aphsus ulcer
2. congenital ulcer
3. Herpangina
Answer : Herpangina
Q23. pt ate outside, presented with hepatosplenomegally ,fever and rash over abdomen after 10
days after that trip.
Diagnosis?
1. malaria
2.hepatitis
3.kalazar
4. typhoid fever
Answer: typhoid fever

Q24. pt of oligoovulation[as mentioned]due to polycystic ovary syndrome,she is G2P2 was on

progesterone but now she stopped it before 5 yrs
This will make her more prone to

1.cervical hyperplasia
2.breast ca
3. Endometriosis
4. hip fracture
Answer: Endometriosis

Q25. A 14 yrs old female ,menarche started before 6 months,presented with menstrual cycle
every 3 weeks. your action if pregnancy test is negative.
Answer would be that it is normal in initial few cycles

Q26. Diabetic pt presented with drooping right eye with normal gaze, the eye is out and
downward with limited up and down movement and he cannot adduct the eye.
so the diagnosis is
1. right fasical palsy
2. right oculomotor palsy
3. right trochlear palsy
4. right abducen palsy
Answer: right oculomotor palsy

Q27. Pt fear of parks and zoo and she cannot go out of home.
Diagnosis?
1. generaized anexity disorder
2. special phobia
3.post traumatic stress disorder
Answer: special phobia
Explanation: Can not go out of home is a clue to the diagnosis

Q28. pt diagnosed with bronchial carcinoma come for follow up.

The best modality of follow up is
1.MRI
2.CT
3. Xray
Answer: MRI

Q29. smoker diagnosed with bronchiectasis which of the following is more indicated?
1. continuous Antiboitics
2.postural drainage
3. bronchodilatros
4. CPAP
Answer: postural drainage

Q30. Child presented with limp. X ray showed avascular necrosis.

Treatment ?
1. physical
2. surgical
3.no wt bearing
Answer: no wt bearing

Wish you best of luck