I remember that theme and I wasnt sure about one question which has got red cell cast

and s. creatine and urea raised. typical case of diabetic ketoacidosis ,what investigattion. Arterial blood gases serum acide concentration unfortunately i chose 2nd despite i knew its wrong! Hello, i recall a theme on hematuria, it was on the page before the last. Breast abcess organism -> Staph. aureus -UTI theme -Hematuria theme -progesterone 21 test in a 32 cycle length -> 25 as we all agreed before! -Theme cranial nerves -Theme on Anatomy : in anaphylaxis intubate... in pneumothorax needle go thru..... something like that -Theme on same old Psychiatry questions, pressure of speech, thought broadcasting i think etc.. -Another theme on Psychiatry but more specifically on anxiety and panic attacks well, there has been repeatitive questions but only the ones which we couldnt find their answers before, like the UTI theme, Choose the right antibiotic in each of these cases: - child with nitrites in urine - child with protues - child with e.coli 5 different cases of burns ,, management asked 5 cases of how to correct dehydration in a child I can not remember any exact question there was a theme of fractures, theme of prescribing in renal desiases, alcohol and drug misuse - questions where i was strugling were: patient with amphetamines misuse and is not ready to stop it, want to have a safer option Is it metadone? a patient with alcohol problems is not ready for strong body reactions, wants to stop alcohol What is it? the questions about cranial nerves were: a patient with fixed and dilated pupil a rash on the frontal part of the face and painful cornea a patient with deviation of the tong theme of Antibiotics for pneumonia anemia theme(megaloblatic anemia,intrinsic facor deficiency,) obsessive compulsive disorder anxiety toxocology(alcohol withdrawal,opiate addiction,acomprosate bacterial vaginosis diagnosis and treatmenta,clamyedia treat ments,swabculture where shoulsd it take from herpes symplex ectopic pregnency diagnosis(beta HCg)and laperoscopic diagnosis after uss of ectopic

Anatomy (in anaphylaxix where should trachiostomy done(cricothyroid,2 trachial ring?) laperoscopy where should it insert(lenia aliba)tention pneumothorax(where shouls needle go(intercostal musles) lumbar puncture where should it go(via intercostal musls? cystic fibrosis gluten aminosentesis vwf deficiency inr values chron disease eye symptoms in hypothyroidism conjuncivitis diagnosis and treatmenta chronic chest infection in hiv positiv pt(pneumosystic) cystic fibrosis pt with green sputum legionella treat ments post partum-8days pneumonia ecg peri carditis ask about sandle patters ectopic af sinus tachycardia diagnosis cardiac temponade(low heat sounds) endometritis after wide epis pre eclampsia(visual disturbances) treatmenta for prevent eclampsia dehydration(severe bolus infusion) oral rehydration iv antibiotic for diarrhoea with skin leason meningitis diagnosis encephalitis diagnosis(confusion) head injury(detoriation in 48 hrs(edh) seizure (ct investigation) scaphoid fracture humerus head injury ulnar fracture CRANIAL NERVE DAMAGE FACIAL FALSY OPTIC N ACSSERY NERVE ancylosing spondilitis -eye disesase investigation x ray lumba hyperprolactinemia ct pitutary asthma using short acting b2 agonist with low dose steroid,with night symptoms with mid exercise indused asth ma .what should add on that regime sle diagnosis in renal investigation,as well as chronic renal failure with invetigatin resuls and tubular acidosi with invetigation results hemolitic uremic xn with investigation and acue GN diabeti ketoasidosis (absolute insulin deficiency) DM with relative deficiency increased glucocorticoid increased thyroxin(hyperthroidism symptoms) paper was not bad overall simple and conceptual questions which we tend to forget easily same

old important topics were repeated 1.pneumonia types and management 2.depression,psychosis,schizophrenia,alcohol intoxication 3.cns disorders 4.MI, angina,imp investigations according to cause in CVS 5.Paediatrics s very imp diarrhea,vomiting,rehydration,antibiotics in uti,cystic fibrosis 6.gynaecological disorders,breast abscess,ectopic pregnancy,problems post and intrapartum 7.surgery hernia,imp anatomical landmarks for certain procedures 8.orthopaedics fractures colles,clavicle,n shoulder dislocations thasnx God not a single question from epidimeology organism in breast abscess,hematuria once after injury investigaton chest pain? theme ;; qwaves and st dep;ression in lead 2 ,3 1nd avf >inferior mi st depression in leeds v1- v4 i wrote posterior but actually it was anterior sba: an afro crebian women with typ;e 1 DM is going 4 febroid surgery wots themost imppt preop investigation-op;tion were a: capilary blood glucose b:coag screen sickling test and it was the answe, q 199: pt presented with blow on abdo/somewhere,there was perneal bruise and rectal exam was normal,option were ascending urogram,us abdo,catheterisation,surapubic catheter and q200: pt had blow on lower back,presented with one episode of haemuturia other wise normal wat was the answer

hi every 1 finally paper z over few past paper q fracture schapoid supracondylar fracture ulnar fracture humerus neck fracture BLOOD pernacious anemia anaplastic anemia vit 12 diet deficiency CVS pericarditis saddle shape cardiac temponade ventricular anuresyms RESP hiv...pnemocystic cystic fibrosis with green sputum and on floxacillin prophylixix.... pseudomonas got this one wrong child with ear problem and resp symptoms... streptococcus mycoplasm pneumonia for bilateral patchy lesion clithromicin in penicillin allergic pt boy on ahort acting b agonist and inhaled steroids drug 2 add.... long acting betaantagonist treatmen of misotheloma ..i wrote aspiration since he was brethless with large left sided effusion Dermatology Q ON Psoriasis with family history erythema nodosum premathamin for old man with scabies PYSCI Q

flight of ideas pressure of speach panic disorder paranoid dulision agoraphobia ocd social anxiety LIVER increasing jaundic ... ca pancreas GIT COELIC DISEASE endoQUES absulut deficiency...for kitosis relativ ansulin deficiency for type 2 dibetes glococoticoid excess catacholamin excess insulin excess Q FOR INVESTIGATION dibetic ketoacidosis check arterial gas analysis for lady with type1 diabetes preop investigation for myomectomy i went for hba1c level MISLINIOUS Q staphlococcus aurious for abscess 25 ovulation day in 32 day cycle amniocentasis at 16 week for amphatamin naltrioxon for withdral clorodizeperoxide for alcohol unplasent effect acomprosate for craving disulfaram tb for multiple nodules pancost tumor thyroid tumor for lidlag 3 nerve palcy investigatin..thyroid function test fabrile convulsions encephalitis extradural hematoma BURN UNIT FOR FULL thickness burn in arm escharotomy for child with crying morphin for person with pain and redness of skin paracatamol there were few questions on diagnosis of deafness post traumatic sn deafness prebycusis,functional deafness 1-for child with ear infection and resp prob the answer should b h influenza 2-boy on ahort acting b agonist and inhaled steroids drug 2 add.... long acting betaantagonist q was that he was taking low dose steroids and answer was increase steroid dose 3-staphlococcus aurious for abscess q was that she after giving birth so group b strpto what was the answer to uti with leucocytes and nitrates?

what about that smoker lady who had horseness and bilaterlal enlarged lymph nodes? what was the etest to check restricted eye movements and difficulty in looking upwr-----was it tensilon test? what about that q in ehich lady had abd pain and on us there was thick uterus but no free abd fluid?

I remmber also that theme : in cardiology a man after MI with regular ECG found ST elevation in V1234 and the answer was venticular anurysm

old lady from nursing home with scabies, they asked whats the initial tretment for her symptoms, chices were permethrin and chlorphenramine.. i wrote chlorphnrmine...... anybody? permethrine is specific tx,but for her intitial syptoms its h1 blocker i think...agreed? *a theme on ovarian cancer investigations... *a man has prostate cancer strong family hx,he is worried,DRE normal what u do next... i wrote PSA... agreed? *a theme on MI's ECG findings wre given, lead 2 3 avf elevation, there was no inferrior wall MI in options so i wrote posterior wall infarction.. gus was there inferior wall MI given in options coz i looked but couldnt find it in options...was it there? *can we give morphine to a 4 yr old child? heme on fractures of uper limb, *a man cant lift his hand from the table.....was it colles? there was 1 very tricky SBA,giving sceniorio of and alcoholic in hypglcemia,asking WHAT SHOULD BE THE 1ST IMMEDIATE IV THERAPY.... choices were: thiamine dextrose i wrote thiamine....

*inspiratory and expiratory stridor with mass in front of neck.. i wrote thyrod cancer among the options *an SBA on wernick encephelopathy *a small child with focal seizure for 5 min after which he is confused and doesnt recognize his mother,2 days back he had minor concusion of head... i wrote extradural hematoma...

agreed all, except inferior wall option was there, option 'd'. there were around 'n' options, so it was a tough search. man cannot lift hand from table, i filled in # neck humerus [affecting axillary nerve maybe].... there was a question: a post-morteum report. An old man who had amnesia, and died of intestinal obstruction, the pathologist report stated that there were multiple nodules (not sure here) scattered in the liver, urmm, with center depressions of 0.0016 mm? was it like that? options were: A-HCC B-Cirrhosis C-Secondary CA i went with secondary ca there was a q for a person with dvt.was operated 6 month ago and was on warfarin.again admitted in hosp for operation what next stop warfarin continue warfarin and add heparin i choose to stop warfarin and add heparin. a women with histerectomy bilateraloophorectomy presents with tense abd with distension There was a woman with purulent eye discharge on mornings and bilateral red eyes, what topical therapy to choose: -Anti-viral -Antibiotic urrmm was there a question like that or am i mixing up with questions i've been studying? it looked like a case of bacterial conjuctuvitis to me i went with antibiotics Pt with bilateral Redness and itching, with crusting in the morning > options were antibiotic, antiviral, mydriatic, steroid> this is the can be viral or allergic( if GMC says this is Bacterial, Might is right). No bacterial conjunctivitis will present with itching( 95% of times), it canot be viral option as no one gives Antiviral drugs for conjunctivitis. Answer is 100% antihistamines or Artificial eye drops. as there is no option , steroids should be correct. For Plab level Antibiotic may be correct this was seperate q u ar mixing it for this q answer was skin cwab for viral serology

A young lady with inferytility, wats the best time to check for ovulation. length of menstrual cycle is 32: A)16 B)21 C)25-correct answer D)14

Cranial nerve lesions: Options: A)accesory nerve B)optic nerve C)hypoglossal nerve D)glossopharyngeal nerve E)occulomotor nerve F)vestibulo-cochlear nerve G)trigeminal nerve H)facial nerve I)trocheal nerve 1) pt has problem in moving shoulder after getting stabbed in neck..(answer-A) 2)pt with some lesion of fore-head which has effected cornea as well..(answer-G) 3)pt with drooling of saliva+can't open his eyes..(answer-H) 4)pt's tongue devites to left side on protrusion..(answer-C) 5)pt has diplopia on looking upward +fixed dilation of pupils..(answer-E) day 21 serum progesterone should be the answer watever the length a cycle is. no we have to subtract 7 from the length of the cycle to find the day for checking progesterone level so the answer was 25th day what was the ans of ques on deafneess where pt had head injury.. the answer was - stop warfarin &start heparin i think it was bacterial conjuctivitis . becuz it was sticky purulent dischrge there was a question regarding causative organism of pt with COPD,who is on floucloacilin prophylaxis. wats was the answer- H.influenzae or pseudomoas? ENT questions otosclerosis sensoryneural deafness ? prsbycusis OPTHALMOLOGY prolferative retinopathy maccular degenaration? NEUROLOGY MS inv....MRI brain ? in opthalmology theme there was question abt pt on crticosteriods,red reflex absent... was it cataract? yes i aswered cataract too QA. oh yes the ENT theme, i believe there was a pregnant woman with deafness, i choose otosclerosis another man with a head trauma has developed hearing loss as well, i was confused whether to choose head trauma or someother choice which i totally forgot what it was. because it would be too easy it the hx said head trauma and the answer would be head trauma, wouldnt it?

There was a man with seizures and decreased level of serum glucose, i dont know if i shouldnt have but it made me go into an absent seizure myself! icon_smile.gif i chose the absolute increase in insulin, couldnt match a better choice. hope it's right~! *a 25 year old man on fundoscopy had microaneurysms and hemorrhages or something like that... i wrote diabetic retinopathy. Yeh I think that was diabetic retinopathy cos other options were quite out of the context... Dont remeber wat were the options where girl took illegal substance yes i think it was diabetic retinopathy becuz of micro aneurysms& haemorrhages. wat was the answer for yellow spots in the centre of retina.. macular degeneration? Also there was a man whose vision doesnt improve with glasses... was tht a tumor? diabetic retinopathy right macular degeneration right. the girl on drugs had a midline neck multinodular swelling, painless. obviously, the druggie thing might have been a distraction, they do that in PLAB1. the answer to that was - check thy. hormone levels.. pseudomonas correct. otosclerosis correct. head trauma [extremely stupid question] correct. cataract correct. There was a man with generalised seizures and decreased level of serum glucose - tough one. i got it wrong, think i marked something like a pit. tumor or summat. there was a question: a post-morteum report. An old man who had amnesia, and died of intestinal obstruction, the pathologist report stated that there were multiple nodules (not sure here) scattered in the liver, urmm, with center depressions of 0.0016 mm? was it like that? options were: A-HCC B-Cirrhosis C-Secondary CA secondary CA ...becoz in carcinod syndrome pt present with liver metastasis. patient with amphetamines misuse and is not ready to stop it, want to have a safer option Is it metadone? no its dexamphetamine.

a patient with alcohol problems is not ready for strong body reactions, wants to stop alcohol What is it? acamprosate.

disulphiram would cause those bad reactions. theme on burns superfecial burn with erythema on dorsum of the hand,no blisters what was the treatment dress it with antibacterial(something like that) or just paracetamol? other one partial and full thickness burn with signs of compartment syndrom is it escharotomy? SBA lady with Heavy vaginal bleeding with clots ,treatment? I think it was combined pils, am I right? concerning the ovulation day.. i think the right answer is 21 and this question is repeated.. in any lady for any test of ovulation.. 14 days "luteal phase time" are substracted from the next expected menstruation.. and the time of ovulation ranges till 48 hours.. so applying it here.. 3214= 18 and if u add 2 days it will be 20.. so 21 one is the nearest and usually made a day after to be sure of ovulation and calculation mistakes i guess combined pills too, superficial burn in a child with erythema.. i guess paracetamol is suiting because it mentioned the child was crying and irritable man worked in ship yard for many years came with pluritic pain and unilateral plural effusion ,what treatment will relief his symptoms Although i answered chemotherapy cos its case of mesothelioma but i think that was trick cos what will relief his his symptoms(plural effusion) would be plural fluid aspiration. what do you think? for the first one.. i wrote mid ulnar fracture the second one.. since there's no deformity.. i went for spiral fracture of the humerus... first, i thought about proximal humeral fracture but in this type of fracture.. it has 4 subtypes according to Neer's 4 segment classification, 1 fragment fracture, 2, 3 and 4 fragment fracture.. the only one which can be treated with collar and cuff since there's not displacement is 1 fragment fracture.. but other types need internal fixation as there's deformity to be corrected and it can't be done externally especially when greater tuberosity is affected..

aspiration. 'immediate relief of symptoms' was the question. man who raised hand above head - ulnar fracture. clots - cocp. child burn - paracetamol. compartment forearm - escharotomy.

soot in mouth - intubate. man with hand burn no blisters - dressing progesterone test for ovulation - 25 days. 32 minus 7 days. exactly 25. ref - OHCS. *the lady with heavy bleeding with clots: i think antifibrinolytics ( Tranexemic acid) *man with mesothelioma: I wrote Pleural flud aspiration Fracture theme: * man couldn't raise his wrist from the table, they said some injury around the shoulder, so I wrote Humeral Neck fracture *the guy who got hit by the bat: Ulnar fracture *the old lady who fell down and now had slight restriction of movements: Fracture of the clavicle *the 8 yr old girl or boy who fell down the tree: Supracondylar fracture * the first one with the boy who had some pain around the wrist: I thought it wud be Scaphoid fracture (not sure) or fracture I had this papers and the answers were as follow ,but dont take it guarantee cos no one is 100% sure the pld lady tripped while shopping is fracture neck of humerous unlar fracture as all answered it drop wrist cos of radial nerve lesion which is common with spiral fracture of humerous fracture scaphoid with little odeam fell on outstrech hand and abscent radial pulse is supracondylar fracture. he guy with DVT INR in preassessment should be? i checked it now.. u r right, the test is mid luteal as they say.. 7 days.. but the reference i read gyne from wasn't OHCS and it says it should be taken in serial samples starting from day after ovulation ending with midluteal sample for a thorough confirmation.. the case with DKA and asked for investigation i have practiced it before but answered wrong . correct answer was arterial blood gases Fracture theme: * man couldn't raise his wrist from the table, they said some injury around the shoulder, so I wrote Humeral Neck fracture too *the guy who got hit by the bat: Ulnar fracture *the old lady who fell down and now had slight restriction of movements: if this who have shoulder pain with no deformity, i wrote spiral radial but not sure.. clavicle can be right *the 8 yr old girl or boy who fell down the tree: Supracondylar fracture * the first one with the boy who had some pain around the wrist: I wrote is colle's but i guess scaphoid is the correct

the question about man with hypertention for long time and has microalbuminuria ,blood pressure was withen normal and some other values what treatment ACE-------------i chose this B blocker thiazide other them the patient with digoxin,frusemid ,..etc what to add somebody before exam was reading some past papers and that question was there so i learnt the answer and it was thiazide was it correct? young man with tight chest and feeling his heart racing but normal ecg and once it was 200 ,its not possible to be sinus tachycardia ..i chose pheochromocytoma------ what you think there was oartic dissection, muffled heart sound was cardiac temponate isn`t it? somebody tell me for sure the one with CF and on flucloxacillin with green phlem was H.influan. or psuedomonous? HIV with pnuemonia was pnuemosystic (not carrinni) was different name he theme about Dyspepsia: causative agent: (I've made mistakes in this one) * the boy who smoked a lot came with pain...: I wrote H.pylori as smoking wasn't there in the options *one was lady intolerant to Nsaids: I dont know what is right coz, I couldn't understand the qs( i think steroids should be its ans) *75 yr old man who had been experiencing dyspepsia since many years and also acid reflux, now present with increasing dysphagia for solids : I wrote Barette's esophagus *there was one with a man with long term treatment of chronic back pain, now presented with pain in the abdomen: I wrote Nsaids as the ans was there another one with multiple ulcers i chose gastrinoma. the question about man with hypertention for long time and has microalbuminuria ,blood pressure was withen normal and some other values what treatment ACE-------------i chose this_I TOO CHOSE THIS B blocker thiazide "somebody tell me for sure the one with CF and on flucloxacillin with green phlem was H.influan. or psuedomonous? " YES I THINK PSEUDOMONAS *MUFFLED HEART SOUND: CARDIAC TAMPONADE *There was one with Lady having 'missed beats' sometimes and then she's a gain well: IS IT VENTRICULAR ECTOPIC? *An elderly 1 month after MI came with palpitations and .....: I wrote VT ( since after MI), is it right? * Another woman who felt palpitations and maybe breathlessnesss, but feels ok after exercising or walking: is it SVT?

* An athelete qs with sometimes slow pulse , I think,: I wrote SINUS BRADYCARDIA *Another was a woman with palpitations, regular pulse, weight loss, constipation: (it was thyroid disorder but I was confused in this one) I wrote SINUS TACHYCARDIA? *Another with an old man after colectomy due to colon ca: presnted with irregular pulse, I think faintness too...and some other symptoms: I chose AF 1)man raised his arm to protect himself...so probably ulna is exposed,therefore answer was ulnar fracture 2)72 year old woman fell down,tht was fracture neck of humerus becuz tht is common in females in tht age group after sustaining a fall 3)pain distal to radius but no obvious deformity,answer was scaphoid fracture 4)pt who couldnt raise his wrist from table,answer was siral fracture of humerus becuz radial nerve gets damaged(radial groove in humerus) 5)i cant remember the other question..it was related to supraconylar fracture of humerus QA 5th was a boy fell on outstreched hand and i think it mentioned that radial pulse was abscent which is difinetly cos of supracondylar fracture UTI them i chose first was trimethoprim the one with protues i chose gentamycin i think one i chose vit. c cos there wasnt prophylactic antiboitic in the option with child which treated successfuly with uti. cenario indicated sarcoidosis and asked for the painful,raised skin leasion i chose erythema nodosum right? and lesion on nose for many years was is BCC? *a man who had been experiencing back pain since they had shifted ( Disc prolapse). what is the management? a)bed rest + analgesia b)early mobilization+analgesia c)wear a corset d)manipulation etc Another one: A man 20 yrs, chronic back pain. What wud be theinvestigation of choice? a)Ct lumbre spine b)Xray lumbre C)Mri Lumbre_I think this etc

yes it was erythema nodosum & second was basal cell . u r right renal theme what was the one with red cell cast and s.creatine and uria raised? I THINK IT WAS ACUTE GN? m not sure but the one who had chronic back pain but i think he had ankylosing spondylitis so we'll do x-ray lumbo sacral spine I chose mobilization and analgesia but not sure at all .yes it was disc prolaps In OHCS they have written mnagement of Disc prolapse: analgesia + early mobilization aand also Physiotherapy I chose manipulation, but I think 'mobilization + analgesia' wud be the best ans yeah nephro syndrome was in the options but it was for a different scenario,remember pt. with proteinuria,hyperlipidemia etc.. trauma theme 2cm stab in epigastrium cant remember . but one with rupture spleen(fracture ribs in left lower ribs) investigation i chose us of the abdomen. biobsy taken from colon after few days with pain ..etc sounded like gas under diaghram so i chose erect chest xray. in depression theme.. woman with post natal depression.. i wrote fluoxetine.. it's in OHCS Madiha wat was the answer for the question: SBA-Pt after MI had depression: amitryptilline fluoxetine etc *I wrote Fluoxetine, suitable for a heart patient. *For the lady with postnatal depression, I chose Interpersonal therapy, as I thought it wouldn't be appropriate to bring her directly on Fluoxetine( that I thought should be the next step) SBA: *A 30 yr old man took 100 paracetamol tabelets, nowhe's in A n E. You want to give him treatment but he hassimply refsed and doen't allowany treatment. Next step? a)treat without his consent b)assess his mental state_IS THIS THE ANS? c)leave him as he is d)assess his rights something.... can anyone tell me the answer for the elderly man in his seventies who required pneumonia

vaccine? pneumovax wasn't an option......was it influenza vaccine? 1-topical estrogen(female,74,dysuria) 2-16 weeks pregnancy->amniocentesis 3-mg sulphate to prevent further eclampsia 4-pre eclampsia(8 days postpartum,headache,visual distrurbances) 5-endometritis(fever,tender uterus,prolonged delivery and forceps extraction) 6-breast milk jaundice-->continue breast feeding 7-indirect inguinal hernia->pass through deep inguinal ring 8-sweat test in cystic fibrosis 9-investigation for CHPS(i made it ct abdomen but i think it is US ) 10-celiac disease(wasted buttocks) 11-child with UTI->trimethoprim 12-haemolytic uremic syndrome(anemia,thrombocytopenia,increased urea and creatinine) 13-CRF(raised urea,creatinine and K) 14-nephrotic syndrome(heavy proteinuria,hypervholesterolemia) 15-haematuria,increased blood pressure and urea ->renal biopsy 16-constipation and failure to thrive ->thyroid function test 17-meningococcal infection(fever,headache,rash) 18-reflex anoxic seizure 19-proctalgia fugax 20-anal fissure(pain with defecation,hard to perform PR coz of spasm) 21-acute perianal haematoma 22-carcinoma rectum 23-treatment of trichomonas vaginalis ->metronidazole 24-cervical ectropion 25-endocervical swab(bilateral pelvic tenderness and vaginal discharge) ON ECG st elevation in leeds 2 -3 and avf it was inferior mi and it was in option list ohcm 7th edition page 84 : the leeds affected reflect the site of infarct inferior: 2 -3 and avf anteroseptal:v1-v4 anterolateral:v4-v6 1 and avl posterior: tall Rwaveand st depression in v1-2 theme on anaemia 1 pt with macrocytosis and intrinsic factor antibody present..pernicious anemia 2 vegan with increased MCV ,...b12 deficiency dt diet 3 65 yr old man with splenomegaly,hepatomegaly....chronic leukemia

26-PID ,gonorrhea appeared negative-> chlamydia 27-candidiasis(vag. discharge and mycelia) 28-herpes simplex(superficial dysparonia and vesicle at introitus) 29-ovulation test(progesterone at day 25) 30-CA 125(female worried she might have ovarian carcinoma due to family history and pelvic US is negative) 31-bacterial vaginosis( clue cells) 32-MRI pituitary for features of hyperprolactinemia 33-MRI brain for M.S

34-X ray lumbosacral for ankylosing spondylitis 35-iritis in ankylosing 36-woman in depot provera and menstrual irregularity->reassure 37-pernicious anemia(intrinsic factor ab) 38-aplastic anemia in patient with cyclophosphamide and pancytopenia 39-chronic leukemia(lymphocytes were 500 000) 40-staph aureus(organism for breast abscess) 41-male with cancer prostate->PSA 42-male with cancer prostate and pain in back and hip-> bone scan 43-pneumonia allergic to penicillin->erythromycin or clarithromycin(actually not sure if that was really in the exam or was something i did before the exam) 44-cardiac tamponade(stab 2 cm in sternum) 45-RTA ,increasing pain and tenderness over the left lower ribs-> i went with splenectomy 46-CXR erect for perforated colon after colonoscope 47-antibiotics for conjunctivitis 48-psoriasis(female,scaly lesions appear and disappear with family history) 49-pulmonary embolus(female,post op,acute dyspnea,leg is normal) 50-female 48 hours after CS with 38.1 fever->i went for UTI the lady who was in nursing home s/s of scabies ohcm page 404 7th edition: only treatment 4 scabies is apply 5%permethrin wash off after 8-12 hours repeat after 7d pt who was alcoholic and with s/s of hypoglsemic wots the immidiate tx so my dear it was glucose not vitamin and pt who present with fracture not able to raise elbow was spiral humrus shaft fracture

51-patient with mesothelioma->i went with chemotherapy but i guess it is pleural aspiration 52-ECT for depression with suicidal attempt 53-nurse depressed,keeps washing hera hands and cleaning subjects->i did it interpersonal therapy but i dont think it is the right answer 54-OCD(boss who returns home many time during the day) 55-flight of ideas(jumping from one topic to another) 56-pressure to speech(speaking with no interruptions) 57-insight 58-Crohn"s disease 59-investigation for rupture urethra->ascending urethrogram 60-C T abdomen for kidney injury(haematuria once) 61-scaphoid fracture(pain in the wrist just distal to radius after a fall) 62-transverse fracture ulna 63-spiral fracture humerus(with no deformity) 64-supracondylar fracture humerus(pain ina arm and forearm) 65-fracture clavicle(alcoholic fell and cant left his wrist) 66-ACEIs for patient with microalbuminuria 67-cancer head of pancreas 68-ventricular ectopies 69-SVT 70-sinus tachycardia 71-AF (i actually chose it as an answer for 2 questions but i dont think i made it right in the arrhythmia questions at all) 72-SLE 73-NSAIDs(patient with chronic backaches and haematemsis)

74-Steroids(female with rheumatoid arthritis not tolerating NSAIDs) 75-Barett"s oes for mesothelioma pt who presented with plueral fluid i made the same mistake i chose chemo but according to ohcm 7th editin page 184 treatment of mesothelioma is symptomatic i-e aspiration of plueral fluid not chemo and i did it wrong nurse cleans her hand even when not needed ,nunecessary clening in hosp ward..but she sleeps well at night ,no weight loss.....ans is cognitive behavoural therapy. lady who is heroin addict ..but wants to stop taking drug..she is asking for treatment that ll reduce craving for heroin. alchoholic pt presented with ataxia, ophthalmoplegia, and confusion immediate treatment...thiamine Alcoholic undergone detoxificaton now wants something to stay away from alcohol without unpleasant reaction......acomprosate. 76-pancoast tumour 77-patient wit depression and had recent MI->fluoxetine 78-olanzepine(i dont remember the question) 79-increase dose of inhaled steroid(child on b2 agonist and low dose steroid with night cough and excercise induced wheezes) 80-cystoscopy 81-acamprosate 82-methadone for amphetamine 83-bronchoscopy for foreign body 84-oculomotor nerve 85-facial nerve 86-trigeminal nerve 87-accessory nerve 88-hypoglossal nerve 89-erythema nodosum 90-anterior infarction(elevated ST in v1->v4) 91-inferior infarction(elevated ST in ll,lll,avf) 92-pericarditis(saddle shaped ST) 93-escharotomy for full thickness burn 94-cover with sterile dressing(with man with hot drink and pain and erythema) 95-thiamine for alcoholic 96-TB(empyema,girl lost weight) 97-ORT(child with diarrhea ,vitals were stable) [snip]-slow iv infusion to replace deficit(dont remember that question either) 99-increase glucocorticoids(cushing,abdominal stria and central obesity) 100-increase catecholamines(pheochromocytoma) 101-DKA(absolute insuloin defeciency) 102-insulin increase(hypoglycemia) 103-investigation for DKA->ABGs 104-capillary blood glucose(pre op investigation for obese male ,diabetic with BMI 32) 105-keep INR between 2-3 106-coagulation screen(haematuria in patient with prosthetic valve) 107-lumbar puncture(pierce dura) 108-choking(pierce cricothyroid membrane) 109-pleural aspiration(pierce intercostal muscles)

110-midline laparoscopy(pierce linea alba) 111-B12 defeciency (diet),vegan with macrocytic anemia 112-iron defeciency(blood loss),i dont remember it and not sure about it 113-anaesthesia and intubate for old man who was on fire and coughing rusty sputum 114-Basal cell carcinoma 115-hepatic metastasis(multiple hepatic focal lesions with umbilication) 116-macular degeneration 117-diabetic retinopathy 118-CT scan for subarachnoid haemorrhge 119-treatment for scabies(i made it hydrocortisone ointment but i think it is perimethrin) 120-VWD 121-paranoid delusion 122-agoraphobia 123-stop warfarin and add heparin 124-foecal impaction management(i did it urinary catheterization aasuming that there is accompanying urinary retention ,but i think that was an extreme thinking) 125-woman with TAH& BSO with ditended dense abdomen->aspirate 126-skin swab for viral serology 127-a woman with menorrhagia and blod clots->i went for antifibrinolytics 128-aortic dissection 129-H pylori infection 130-Vit C 131-analgesia and mobilisation for backache after moving furniture 132-assess his capability to refuse treatment( man with paracetamol suicidal attempt),i dont know if it is right or not 90-anterior infarction(elevated ST in v1->v4) i thought that was ventricular aneurysm, after his MI. he had no signs or symptoms....... alcoholic who had hypoglycemia had sighns & symptoms of wernick encplpthy...search it in ohcs and ohcs,its somewhere in it... they state: "in alcoholisc/wernick with hypoglycemia...give IV bolus of thiamine 1st then dextrose coz dextrose will worsen wrnick's encplpthy... IV bolus thiamine followd by dextrose..." confirmed... *IN SCABIES,THEY HAD ASKED FOR INITIAL TREATMENT FOR HER SYMPTOMS I THINK IT SHOULD HAVE BEEN CHLORPHENRAMINE,PERMETHRIN IS THE CURE OF IT BUT ITCH MAY PERSIST FOR WHICH H1 BLOCK(CLRPHNRMNE)IS GIVEN.. *FOR INCONTINENT OLD MAN WHO HAD FECAL IMPACTION ON EXAMINATION,I WENT FOR PHOSPATE ENEMA *FOR THE MAN WHO HAD SOOTY COUHG ETC,I WENT FOR SAFEGUARDING REFERAL BUT I THINK IM WRONG AND IT WAS INTUBATION,BUT IMNOT SURE for amphatamin answer z naltraxon???? FOR CF PERSON ON FLOXACILLIN PROPHYLIXIX I WENT WITH staphlococcus aurius as he z on floxacillin.

few more twisted q 1....women with multiple lymphnodes on drugs i went wiht tb as tb z commen in drug absers 2...child with vomiting containing blood..i wrote endoscopy 3.......21 year old girl with heavy bleeding and clots i went with ANTIFIBRINOGEN was thinking of levonorgestril but there was no history of pain and ocps ar not given for clots 4 girl with defness after child birth .. i answered congenital sensinural defness coz according to weber test it was sensinural 5....child with hearing difficulty noticed by teachers in school answer chronic otitis media with effusio 6which drug to add in 80 year old man already on frusamid gtn i wrote nefadapin as ca blocker ar given in old people after diuretics 7women with abd pain after ovarian cancer surgeryans...ivp to see mets 8.. got wrong for person on warfarin i answered continue warfarin with hepar people do comment well for a person with type 1 diabetes with bmi of 32 i wrote hba1c level coz she was admitted for operation and to c her 3 month bloog sugar level we go for this.dont know i am right or wron for tht SBA, the correct answer was : evaluate pt's capacity to refuse treatment 5-endometritis(fever,tender uterus,prolonged delivery and forceps extraction) 9-investigation for CHPS(i made it ct abdomen but i think it is US ) It's USG only 10-celiac disease(wasted buttocks) 104-capillary blood glucose(pre op investigation for obese male ,diabetic with BMI 32) I think the ans for this is HbA1c since he is obese and we have to know whether he is on regular treatment and also,they have already mentioned that he is diabetic. that question was about 55 years old man,smokes 20 cigerrts /day,breatless,wt.loss,syncope,orthostatic hypotension..... The answer was Chest X-ray becuz it is the initial investigation for lung cancer. CHPS.. chronic hypertrophic pyloric stenosis.. i made it US.. i guess this was a child presenting with vomiting and haematemsis.. so it sounds more like CHPS yup madiha i too read that the glucose/dextrose would worsen the thiamine deficiency...but i read that in davidson's. something about thiamine being used in carbohydrate metabolism, as a cofactor or summat. thus the dextrose first wud decrease the b1 even more.... just checked: wiki thiamin, you'd see this: Thiamin pyrophosphate Thiamin pyrophosphate (TPP), also known as thiamin diphosphate (ThDP) or cocarboxylase, is a coenzyme for several enzymes that catalyze the dehydrogenation (decarboxylation and subsequent conjugation to Coenzyme A) of alpha-keto acids. Examples include:

* In mammals: o pyruvate dehydrogenase and -ketoglutarate dehydrogenase (metabolism of carbohydrates) o branched-chain alpha-keto acid dehydrogenase o 2-hydroxyphytanoyl-CoA lyase o transketolase (functions in the pentose phosphate pathway to synthesize NADPH and the pentose sugars deoxyribose and ribose ) think the question was going for an emergency procedure for air way obstruction and that would be cricothyroidotomy in the cricothyroid membrane... concerning tracheostomy it is not an emergency procedure and it is done at the level of 2nd and 3rd tracheal rings for the poerson with delerium tremens i wrote clorodizeperoxide it was not wernicks sorry i disagree delirium tremens will present with tachycardia, hypotension and tactile hallucinations.. hallucinations were absent.. and ataxia were present proving it's Wernick's.. reference OHCS it was wernicke"s encephalopathy,not delirium tremens..so the answer was thiamin another question of an old lady with influenza n after symptomatic trtmnt she again caught it i went for immunodeficiency can somebody help me in that i wrote reinfection due to low immunity there was a q with boy treated with antibiotics still presents with cough ct scan bronchoscopy were options yes that question was the presentation of foreign body and the answer was bronchoscopy african lady posted for myomectomy..which investigation to do in per op options coagulation screen sickle cell testing full blood count dont remem last one i wrote sickle cell testing on the question of the alcoholic who had been treated. recall the question states that the patient no longer had withdrawal symptoms. since thats the case then why chlordiazepoxide? i think it was Vit B cos question emphasized poor nutrition. the lady with the restricted eye movement was tensilon test. myasthenia gravis was the diagnosis urine with leucocytes and nitrites. i think its Proteus the lady with the restricted eye movement was thyroid tests. they clearly mentioned lid lag, NO DIPLOPIA,

exophthalmos what else do you need to think of graves? myasthenia has diplopia. HOARSENESS: *a lady 25 yr age,iv drug abuser present with recent onset cough hoarseness and cervical lymphadenopathy... i wrote hysteria for it... reference OHCM 7th edition pag 568. it states if a patient presents with hoarseness and can cough,it means his adductors of vocal card are functional and is not true paralysis of adductors..it states it happens in times of stress in young ladies.plz read that page.. yes thats boy age was 3 years but "unfortunately"(lolz)he had unilateral focal seizures not symetrical generalized tonic clonic seizures,thats why it couldnt be feb.convlzns if so can u remember the the forth choice coz i can't remember what i did it?? HbA1C serum glucose sickle cell test was it clotting factors?? but generally if sickle cell is mandatory, it's not a priority man.. and if she's diabetic, the priority is to control diabetes pre-ops then rule out other possibilities like sickle cell can any body recall two themes in Obs one with a 14yr. girl having p/v bleeding bt uterus bulky n no poc second was a lady with IVF n bleeding there were investigations required in the answer there was a q related 2 bone scan there was another q physci answer was adjustment disorde or social phobia for a person who has difficulty with his new job investigation for cholestasis ultrasound nurce with ocd ...behaviour therapy amphatamin ....naltraxon or methadon? yes u were wright in wernick encephalopathy rx of choice is urgent thiamine to prevent irreversible korsakoff syndrom and it on ohcm page 706 7th edition, the question abt bone scan was... pt with prostatic cancer presents with pain in back &hip about the pt who changes his job..the answer is social anxiety disorder ppl i dont know wether m right but for tht female diabetic pt. with high BMI,she was from Africa so i chose sickle test becuz there was no point of mentioning her country

of origin. Isn't it? Well guys about the african lady here's some clear point: * Page 553 OHCM 7th edition, pre-operative tests.. blood glucose if diabetic then comes Sickle tests is done in those from africa * so both answers are correct and it has to be one of them more correct than the other * if u are a surgeon or anaesthetic, what'll be important for you the most?? or what will be the priority?? * i guess a diabetic can never be operated without diabetes level and control.. but to a less extent a history of no chronic anemia, hemolysis or crisis can rule out sickle cell anemia to some extent.. but my point is sickle test can be clearly done but not as important as blood glucose in diabetic.. doesn't it make sense?? * i think the twist in mentioning the country of origin is to confuse u.. can somebody recall the question of heroin addiction naltrexone for heroin addiction A 30 yr old man took 100 paracetamol tabelets, nowhe's in A n E. You want to give him treatment but he hassimply refsed and doen't allowany treatment. Next step? a)treat without his consent b)assess his mental state c)leave him as he is d)assess his suuccide attempte ... sumthng i did the mrsa question the sam as u di...take swab from all the staff what about child with respiratory infection having ear problem i answered h influenza a child with pyloric stennosis which one should b the answer US or upper GI endoscopy? i went for endoscopy baby got jaundice after breast feed what should b answer for management can anyone explain pls. continue 2 breast feed, 4 months old child. A 30 yr old man took 100 paracetamol tabelets, nowhe's in A n E. You want to give

him treatment but he hassimply refsed and doen't allowany treatment. Next step? a)treat without his consent b)assess his mental state c)leave him as he is d)assess his suuccide attempte ... sumthng Ans: d its a repeat from october 07 some other answers 1-claithromycin again in a legionella suspected case . 2-mycoplasma pnuemoni (bcterial causes theme) 3-pnuemosystic in HIV patient 4-penecillin (case of boy with suspected GN due to streptococcal A infection. 5-endoscopy (for child with features of reflex oesophagitis not for pyloric stenosis which needs US) 6-in trauma theme (I think) features of rupture speen but mentioned his condition stable I chose US abdomen as mgt. 7- Psoriasis child with skin nd scalp rash and her aunt had similar condition 8-standing and lying blood pressure measurement(I cnt remember the theme) 9-24 hr Ambultory ECG (I cnt remember theme) 10-echocardio(in theme with valvl heart lesion) 11-Brain tumour(not sure thats in a child with seizure nd focal neurological sign). 12-urine cathetarisation(theme with acute urinary retention without mentioning blood on urithral meatus which is contraindication for cathetarisation)I think it was in theme on perinium bruises after trauma. 13-reassurance and review after 3 months(lady with amenorrhea after using depo provera) 14-IV ntiboitic for child with features of acute epiglottitis Sorry if answers are wrong or mixed up with other given answers, substitution for amphetamine is definitely dexamphetamine........i have observed this practically a kid with 4,5 dys history of diarrhea no signs of dehydration thriving well i went for continue the normal diet can anybdy recall About MRSA.. true patient should be isolated in a separate ward.. but i remember the theme was about a patient who's been diagnosed and treated right??? and the option was to transfer all the surgical ward beside in same page in OHCM.. it says surveillance swabs from patients and staff during outbreaks are to be made as a preventive measure.. so i went for this as the patient seemed to me he's treated and must have been isolated..

i remem one more qus..pt with hist of stroke 6 mths back treated for seizure ,now since 2 wks dizziness ,nystagmus,confusoin. i wrote ...drug level what abt others Pt can not lift the wrist > Its # involving the spiral grove and ulnar nerve> wrist drop Old lady fell on out streched hand > # neck of humerus

Well guys about the african lady here's some clear point: * Page 553 OHCM 7th edition, pre-operative tests.. blood glucose if diabetic then comes Sickle tests is done in those from africa * so both answers are correct and it has to be one of them more correct than the other * if u are a surgeon or anaesthetic, what'll be important for you the most?? or what will be the priority?? * i guess a diabetic can never be operated without diabetes level and control.. but to a less extent a history of no chronic anemia, hemolysis or crisis can rule out sickle cell anemia to some extent.. but my point is sickle test can be clearly done but not as important as blood glucose in diabetic.. doesn't it make sense?? * i think the twist in mentioning the country of origin is to confuse u.. hi doc aserief i chose blood glusoe for this question but i think i was wrong .ohcm 7th edition on page 326 clearlly written thatin <a href="http://www.rxpgonline.com/forum105.html">Anaesthesia </a> ,when vaso-occlusive events may occur,so all thoseof african descent need a sickl cell test preop. Hey doctor.. i guess the point is so clear.. a diabetic can't be operated without control, right??? this is the priority.. and sickle test can be done after.. and the thing is i work in africa and it's a trivial and never been done.. i'm asking everybody.. if u are an anesthetic.. which is more important to you?? a disease already there and need to be controlled.. or a disease might be there and needs to be screened?? for PYLORIC STENOSIS investigation is ULTRASOUND,not endoscopy.plz read page 172 OHCS(specialities).... it states ultrasound detects it,but is only needed if clinicl examination is negative.infere urself and read the topic in paeds.

dears most have written MACULAR DEGENRATION for yellow spots on center of retina of young man(age i dont remeber)in that loss of vision theme... i disagree with that,coz macular degenration happens in late age ONLY...thats why its called "AGE RELATED macular degenration... plz read pag 438 OHCS

Yes it was Senile Macular Deg, Macula also known as Macula Leutea meaning yellow spot. Only in this condition you get Crumpling of TV screen Picture. Black against redreflex > Cataract Due to steroids usage Otherone with Micraneurysm > Dabetic retinopathy Bacterial conj. ( I may be wrong) But all should look at the question> it is crusting not matting as it will be in Bacterial conj. Crusting occurs if the secretions are scanty and it is typical of Allergic or viral not as you are all saying Bact conj. If you look at the OHCS , in case of allergic conj Steroid can be used with specialist advice. All you may be wondering about my argument, Show me one bacterial condition with Itching, and itching was mentioned in the question. Only one clue I am missing is the number of days pt suferred, if it is more then Steroid is the correct answer. GMC is correct and ultimate.

the lady with the thick endometrial lining on pelvic uss but no free peritoneal fluid i.e under the theme of ectopic pregnancy, the thickness is in response to high b-hcg so check b-hcg. if raised, then high likelihood of ectopic preg. b-hcg 1st then Laparoscopy to confirm + treat does crohn affect rectum +bloody diarrhoa? 25% of patient with UC have skin tag i think granulomatous lesion was seen in endoscopy.. and this favours crohn' dis is regarding scabies treatment to alleviate itch-antihistamine and calamine lotion is given treatment is wid permerthin ointment as we all know i guess this qestion was asked in feb 09 progestrone level should be done 7 days before next period.25 day is ans for 32 day cycle. its so strange no one has mention Gynae questions in which a lady has tranverse baby in the womb waht complication she will have. does any one remember other question regarding cessarian section

hi there was a question about asthma in a child (cannt remember age) has a controlled asthama and is on loe dose syeroids and short acting bronchodilators comes with a complain of cough at night...A..add long acting bronchodilaters or increase dose of steroids... most people thought increase dose of steroids,,,,y...as y not add long acting bronchodilators?? he is already on short acting bronchodilator..still c/o night cough..he shd be given long acting bronchodilator..i wrote this in exam. I answered with increase dose of steroid and I passed my exam ,if you go back to OHCM u will see that next step after that is high dose steroid according to British Thorax guidence. Iam sure about the answer. The answer is long acting beta 2 agonist as per the British Thoracic Society guidelines of asthma management. well i think the first is usg abdomen and the second Detrusor muscle paralysis