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Cardiology

1. 28 yr old young patient with palpitation, for 4 hours, bp stable, no heart disease , no
previous problems, still having Afib on ecg , which medicine will u give .. Flecanide

2. Patient with wide qrs having ventricular tachycardia.. whatecg featuresdiffertiates it from
SVT with aberration - AV dissociation

3. Patient with infective endocarditis, on treatment already having long PR , which of the
signs will reflect an immediate need for surgery. Prolongation of PR interval

4. Patient with severe Aortic Stenosis , what sign is going to depict the severity of the AS
.Dec intensity of 2nd Heart Sound

5. Patient with A Fib , is to go for Radiofrequency ablation procedure, which part of the heart
will give best result - Pulmonary veins catheter ablation with 85%success rates.

6. Patient with Antero-Lateral MI , with ST elevation went through Cardiac Catheterization
and Primary PCI done , now back to floor, the ecg shows wide complex tachycardia 108,
patient with normal BP ,-IV what will you give the patient, do nothing- no treatment
required as it is idioventricular rhythm

7. Patient with chest pain having Bradycardia and low bp, pulse 60 BP 90/60 high JVP with st
elevations admitted- which coronary artery is affected,Proximal Right Coronary artey.

8. YoungPatient with breathlessness and systolic murmur at the left sternal border, which
increases with inspiration , what is the possibility..Pulmonary Stenosis

9. Ascites+ early diastolic murmur + x and y descent ? : constrictive pericarditis ..i guess it
was Superior Vena Cava Syndrome as the face was flushed and on chest auscultation right
heart was clear no addes sounds were there jvp was raised . I went for SVC syndrome
instead

10. Patient with complete heart block , what will you find variable 1st heart sound Other

11. cadiovascular risk assment-which are related to the increased cardiovascular risk answer
is HDL and TG as Dec HDL and inc TGS are independent risk factors for CardioVascular
Diseases

12. Old man with A-fib, started on warfarin therapy , is having dm with following
medications-ramipril, furosimide,etc what are you going to add ? ------- Bisoprolol

13. patient with K 7.9 : IV cagluconate or temporary pace maker ?? one of the cardiologist I
discussesd with , says we have to give iv first then go for pacemaker later

14. levels do not increase in heart failure nor drenaline,endothelin ? Natriuretic Peptide ..

15. post PCI with incrasedEosinophils, Creatinine, ,change in color of the foot . It was :
Cholestrol embolism

16. patient for long haul flight had a lot of alcohol before flight then had nausea vomitting
Blackout in Plane gained consiousness immediately was being handled by air crew reason -
VASOVAGAL SYNCOPE

Clinical haematology and oncology

17. Young patient with recurrent infections and blood picture showing Howel Jolly
bodies,history of Road Traffic Accident-what is the reason for his blood picture - Asplenism

18. A Patient taking medication for Ischemic Heart Disease including Clopidogrel, ACEI, Bet
Blocker is presented with HUS/ TTP; Which test would be abnormal--- Raised aPTT

19. Irradiated PRBC : ? Patient given irradiated blood .. what is the benefit ... - TO PREVENT
VIRAL INFECTION CMV

20. HIV pt with Red cell Aplasia : CMV or EBV ?? ERYTHRO VIRUS B-19 =pure red cell aplasia in
hiv

21. patient with Renal impairment and neuroSgin : TTP

22. Pokilo cell : mylofibrosis

23. Patient after Gastric Bypass : which is most common deficiency observed in these
patient..Vitamin B12 Deficiency (most common) followed by Iron etc.

24. Patient with Erythema Nodosum, for investigations?sarcoidosis inves do CXR .. IN THIS
QUESTION PATIENT HAD NO RESP SYMPTOMS , BLOOD TEST COULD HAVE ALSO BEEN OFFERED
as next step in Diagnosis.

25. Patient with Backache, High Creatinine and High Calcium .what is the most appropriate
investigation for this patient..serum electrophoresis for myeloma

26. HUS IN adults- female visited a farm and after that had diarrhea with inc creating so
ecoli-0157

27. Young female with menorrhagia (family history present) - Von willibrand disease

28. Patient with Hemochromatosis is being treated with venesection , how will you monitor
this .serum ferritin level

29. Polycythemia rubravera - JAK2 mutation

30. splenomegally and bleeds- with gum hypertrophy, .AML


31. epistaxis stopped,ITP- predinsolone

32. Female with fatigue and splenomegaly - Myelofibrosis I guess this is the question in
which there myeloid series cells on peripheral film n myeloblasts..aswellhmm I went for
CML ..

Clinical Pharmacology, Therapeutics and Toxicology


33. morphine Toxcicity : Dcrease lean body Mass ..i guess.. Decreased Renal Clearance

34. Time of Elemnation of a drug to 1/8 , half life 2 h , Elimination rate 0.4/h : 6 .. right 6
hours

35. Patient started on Bupropion to stop smoking .. what is the contraindication to the use of
this medication..h/o seizure disorder ( h/o Epilepsy)

36. patient with nasal blockage , SOB :: Asprin

37. Patient on warfarin for afib, started on antituberculosis treatment lately, having the inr
decreasing from 2.5 to 1.3 which drug might be the reason .. Rifampicin

38. patient on warfarin and started on metronidazole treatment , now adjusted dose of
warfarin is needed to maintain inr- Reason? ..cyp2c9 gene

39. Mechanism of Action of Allupurinol .. inhibition of Xanthine oxidase enzyme

40. Whats the mode of action of Calcineurin,Imitanib=Tyrosine Kinase Activity inhibition

41. What is the Mechanism of Action of ..Ciclosporin-IL2 inhibition

42. Patient already taking Ciclosporin post Renal Transplant and stable is diagnosed with
fungal infection and started on Fluconazole .. after 10 days or so the patients creatinine
jumps what is the reason .Ciclosporin toxicity sec to Fluconazole

43. Patient with Facial Hair growth and Acne, side effects of which drug Prednisolone..
other options were cyclosporine etc.

44. What is the site of action of the Thiazide Diuretics .Prox.DistalConvulatedTubles

45. paracetamol overdose with hepatic necrosis ,which is the best test for following the
prognosis of the patient .. s/ creatinine

46. Patient with cholestatic LFT : amoxaclin I guess Augmentin is the one causes cholestasis
with Hepatits while Flucloxacillin causes cholestatsis with bile duct injury

47. metronidazole and lithim given together leads to .. increased lithium toxicity due to ..
dec renal excretion of lithium .

48. Patient is started on Aspirin and dipyridamole post stenting what is the mechanism of
action of Dypyridamole . Phosphodieterase Inhibitor
Clinical sciences

49. Homocystinuria decreased cystathionine B synthase

50. Analysis : IgE or mast cell Trypase .. its Tryptase from 1hr to 5 hr after reaction

51. Patient with backache, with normal urine control having difficulty dorsifexing the the big
toe and sensory loss on the foot ..where is the lesion.. : L5

52. Patient with weakness of ant.thighmuscles,and weak flexion at the hip with absent knee
reflex and having area of sensory loss in lower leg lateral aspect where is the lesion
.Femoral N

53. amaurosisfugax :: MCA or Carotid .. ..Internal Carotid Artery

54. Patient with pain at the medial epicondyle having difficulty dorsifelxing wrist against
resistance, ..what is the diagnosis Medial Epiconylitis

55. Patient with congenital Long QT syndrome, scenario, then question asked which of the
ions is reasonable for REPOLARIZATION,of cardiac action potential.K+ CHANNELS

56. Patient with weak flexion of the triceps muscle of right arm as compared to left with
sensory loss at the base of the right thumb difficulty extending the wrist .where is the
lesion.RADIAL Nerve

57. Down syndrome 47 XY +21 aneuploidy

58. Patient with Post.dudenal cap ulcer the artery affected? gastrododenual Artery supplies
till mid of 2nd part and its part of anterior gut .. after that duodenum is supplied by
mesenteric Artery Answer is .Gastrodudenal artery.

59. Nurse with Latex allergy 10 years back and now got the same problem wearing rubber
(latex) gloves- What is the mode of this reaction - TYPE IV HYPERSENSITIVITY

60. Nurse with recurrent hand symptoms of allergy eczema&angio-edema =LATEX Allergy

61. Turner syndrome associated - gonadal malignancy

62. Embryonic stem cell for DM management : protect itself from destruction ?? well I guess I
read somewhere that embryonic cells implanted in Type 1 dm (islet cell ) are put in a
membrane to avoid carcinogenic changes in these cells and not to avoid destruction or
apoptosisor senescence.so I went for other option .. to avoid carcinogenic change.. I dont
remember the exact wording now .

63. Alkaptanuria...... is it an amino acid metabolic disease or glycogen storage disease or
enzyme defect ...

64. Which of the following stimulate the brain chemoreceptor for respirationH+ions

65. Patient with difficulty opposing the palms of her hand with inability to close hand and the
ring and little fingers flexed ? ..Dupuytrens contracture..


66. Patient with Hemochromatosis, high ferritin level . What is the mode of inheritance of
Hemochromatosis..Autosomal Recessive

67. How To know NPPC :Compare Gene map? Amsterdamcriteria to screen then do GENETIC
testing

68. Patient with dec food intake, now put on NG feeding , how to proceed with diet , the first
day .50% of the dietery requirements

69. The genetic of DM and sensorineural hearing loss, mother had mild symptoms, sister had
mild
symptoms, but the brother had severe symptoms - Mitochondrial disorder Or X-linked
Dominant answer .MITOCHONDRIAL

70. Patient with cardiac arrest and you are resuscitating him , family including parents and
girl friend are present .. who Is going to decide to stop the Resuscitation ? .. Team leader of
Resuscitation team

Dermatology

71. Patient with a few pearly umblicatedpapular lesion on lower abdomen suprapubic area
..what is the diagnosisMOllascumContagiosum

72. IntraepidermalIgG- phemphigus as its IgG deposition , if it was igA then we should think
Herpitiformis

73. Patient with long history of a pigmented lesion on face(cheeks), having irregular edges
and uneven pigmentation . elder man with flat lesion >>>LentigoMaligna .. its the
carcinoma in situ for Melanoma ..

74. patient with web space lesion itchy rash weeks back was given local steroids and the
lesion expanded further to reach the dorsal aspect of the foot spreading ever since. He was
treated with a high-potency topical steroid cream, .....................answer was TINEA
INCOGNITO ........

75. A young girl with history of paracetamol overdose who had rashes at the flexor surface, in
linear fashion previously had self-medicated - Dermatitis Artifacta

76. Acanthoysis nigrcans in obese ass e >> DM? or GI Malignancy ?ans ..Diabetes M.

77. Woman with Papules in vulva and a Macular rash in the Palms( and soles?)with Genital
Warts ......what is the most appropriate next step for Investigating the Conditions the options
were :HPV pcr/syphilis Serology VDRL = Syphilis Serology (Secondary Syphilis

78. Male from Ghana/Gambia .. comes back with multiple areas of skid depigmentation with
sensory loss , what is the condition. Tuberculoid Leprosy.

Endocrinology


79. BitemporalHeminopia : Cabergoline or Surgery as it is non secretory , and causing
pressure sx surgery is the best option

80. A patient asks you about the best indication for the Hormone Replacement Treatment,
..for Postmenopausal symptoms control

81. pt e HTN DM colon CA and increased sweating ..Dx. .Acromegaly

82. Patient with cough, drowsy, having right upper lobe lesion on cxr , with labs showing
Hyponatremia 115 and urinary Na 65 .. what is going to be the most appropriate
management ..Fluid Restrictionthe first step in SIADH

83. Patient with Recurrent Headaches, high Urinary Cathecholamines =pheochromocytoma:
with family history of Thyroid disease /Nodule which thyroid Condition can be associated
with it . Mecullary CA thinking MEN 2 syndrome

84. Marfan scenario ,eye feature with pesescavatum . Ectopia lentis

85. 19y Female with facial hair,acne obese( had all features of pcos) but lab results for
premature ovarian failure but clinically not ???premature mature ovarian failure or PCOS ?

86. Patient on long term Hemodialysis having vit D and Calcium with the labs showing high
serum calcium, high phosphates, high PTH .. what is the reason for this ..Tertiary
Hyperparathyroidism

87. Hormone which leads to increased hunger . Ghrelin

88. Patient with lid lag, thyroid nodule .. treatment with which modality will worsen the
thyroid eye disease - RADIOIODINE

89. Patient with type T1DM received blood transfusion.. the optimal time for measure of
HA1c? 6 months

90. Male with Gynaecomastia, Low testosterone and raised FSH and LH Klinefelter

91. 16 Y OLD BOY with less height than his class fellows, with lack of secondary sex
characteristics and small testes ..( volume around 4 ml or less), while others in the class had
pubic hair , facial hair , labs were fine and no other abnormality observed.. what is the cause
of his delayed puberty......simple constitutional delayed puberty, kallman, keinfleiter etc...
and the answer was Simple Constitutional Delayed puberty..

Geriatric medicine

92. Elder female e UTI ,, allergic to pen : TMP/SMX .. I think the empirical treatment is either
TMP/SMX or nitrofurantoin

93. Elderly man, had microscopic hematuria, kidneys were normal- flexible cystoscopy Or CT
abdomen ?? well the NEXT step would have been to do an Xray KUB to rule out stone first then
to refer to a urologist this is what I think .. though it comes under a category of urgent
referral to a urologist

94. Old aged woman in garden-goes and gets heat exhaustion what age related change has
made her more prone to this conditiondec.Sweating

95. A study done shows that the Pulse pressure tends to increase with increasing age.. what
do u think is the reason for that ...reduce aortic compliance

Gastroenterology


96. Lipaemic serum pancreatitis - Chylomicrons

97. Patient with diarrhea blood stained , having itching labs showing increased bilirubin and
alkaline phosphatase while ALT is within normal range and USG abdomen is normal as well ..
what is the most probable cause-Primary Sclerosing cholangitis.

98. lady for 3 weeks hx of abdo pain and loos stools plain xray normal, with Ulcerative colitis,
patient doesnt improve in 3 days what should u do next......X-Ray abdomen ( to rule out
Toxic Megacolon)

99. Dumping syndrome 8 yr post Gastric surgery , having symptoms just after eating with
nausea, vomiting, flushing etc .. what to do ??. It is Dietary Advise ..

100. Patient present e only high bilirubin , other LFTs fine Gilberts Syndrome

101. Patient with history of pyloric ulcer had an operation done 8 years back with suction
splash positive having vomiting and nausea .. what metabolic abnormality will he
developHypokalamic Alkalosis

102. Patient on long term Peritoneal Dialysis comes with abdominal pain, ascites .. the
Ascitic tap done what will help u with diagnosis of peritonitis: High Neutrophils in Fluid

103. Patient presents with dysphaia of food and drinks both ,Dx..: Achalasia

104. Patient presents with jaundice.. serology given shows IgM for hepatitis A, IgGHep B, and
anti-HBC..whats the Dx Hepatitis A

105. Female with itching and right abdominal pain , with sister having the same disease and
mother also affected, no history of hepatitis, drug use her s/anti mitochondrial antibody is
positive .. what is the diagnosis Primary Biliary Cirrhosis

106. Patient with malignancy not responding to morphine ,liver capsule pain in metastatic
malignancy- steroid dexamethasone

107. Nutrition for Patient with acute abdominal pain (severe pancreatitis due to gall stone)
NPO

108. Patient with suspected longstanding Chrons Disease having stricture in the small
intestine with capsule endoscopy and later diagnose as Malignant Stricture.. what is the most
common pathology . LYMPHOMA

109. Diagnosis of Giardia if not seen in stool -wet stool sample or Microscpe with Duodenal
Aspirate ??if stool culture not positive multiple times=RadioImmuoassay(CDC)

110. A girl with negative anti-TTG but presented with coeliac symptoms- Gastroscope with
duodenal Biopsy ?

111. gall stones in hereditary sickle cell disease=pigment stones

112. carcinod syndrome intial symptom: facial flushing

113. Female Patient with Chrons disease smoker, with stable disease.. which association is
going to be most predictive of disease.Cigarette Smoking= 60%

Infectious diseases and GUM

114. A School Teacher is diagnoses with Pneumococcal Meningitis , there is no one else
affected in the school what should we do for the contacts at school.isolate & observe till
one week

115. Patient with history of travel to spain had sex with two , come to you with dry cough ,
having on blood dechemoglobin,normalwbc, peripheral blood pic of agglutination,
Mycoplasma

116. Patient diagnosed with NisseriaMeningitidis Meningitis , what prophylaxis should be given
to the household contacts.Ciprofloxacin

117. Child bit by a cat-it gets swollen and wond on hand get worse-what is the most probalble
organism = BartonellaHenslae

118. African tick bite- ricketsia coronii

119. Strongyloidsstercoralis- wearing foot wear and avoid bare foot as it enters the skin

120. Epilepsy and malaria prophylaxis- mefloquine , Malarone

121. gonorrhea ttt UTI : ceftriaxone .. as treatment for chalymydia was already given n
culture showed gm negative diplococci

122. Tonsils weren't coated but had exudates ??? :: diphtheria

123. Patient with Lyme Disease with multiple eschar/ erythema sites 2nd day of treatment
with anaphylaxsis and body reaction - EXPOSURE and INTERACTION WITH DEAD PATHOGENS ?
(JerishHerxheimer reaction)

124. Patient with tuberculosis for diagnosis , what is the most sensitive Pleural test for
Tuberculosis Pleural Fluid LDH, Pleural Biopsy and culture, Sputum Culture, Pleural
aspirate culture, Bronchial lavage culture ..??? I dont know the answer ??

125. Patient who is neutropenic on the floor .. with decwbc and dec neutrophil count .
Antibiotics against which organism would be your first priority MRSA, Pseudomonas
Aurogenosa,PCPetc ??

126. The hospital experiences multiple cases of MRSA , you are in hospital policy making
committee... what is the best way to decrease the MRSA hospital infection... ...........answer
was HAND WASHING

Neurology

127. A typical hx of tuberous sclerosisa 22yr old girl, 4 yrhx of HTN , on Amlodipine,came for
r/v gives a family hx of Nephrectomy to her father following a cystic disease of kidney.O/e-
nodules round nose , macular patches on trunk Diagnosis?.(TUBEROUSSCLEROSIS) Adult
Polycystic kidney/Von HippelLindau dis

128. Poor Sign of Alzheimer : Poor Identification of Time ? POOR ORIENTATION OF TIME

129. Highest risk for Alzheimer : Family HX ?? Increasing age is the greatest known risk factor
for Alzheimer's

130. Poor Prognosis after stroke : visual spatial neglect ?? Dysphagia I guess , as neglect
responds very nicely to the Neurorehablitation..

131. Occipital Headache : Bailar Migraine(symptoms of vertebrobasilar insufficiency, which
may precede the headache=Basilar Migrane.)

132. Patient with vision defects lately having accidents .. is having right inferior quadrantopia
and unable to calculate.where is the lesion.. Left Parital Lobe

133. Patient diagnosed with GB syndrome, how will you monitor his respiratory function
.FVC (Forced Vital Capacity)

134. Patient with Occipital Headache, neck stiffness , 2 weeks with Bilateral 6th nerve Palsy
andpapilledemaand CT scan is normal.. what is the diagnosis.. BIH

135. Pain on walking relieved on sitting - Spinal stenosis

136. Korsakoff syndrome - Short term memory loss

137. Patient with ataxia and nystagmus - Posterior inferior cerebellar artery

138. Tonic clonicseziure , Alcholic and blood sugar 3.1 >>> idiopathic epilpsy or alcohol
releated seizure ? it was a young adult but all labs were within normal limit and also ecg ..
so I went for idiopathic Epilepsy .. diagnosis of exclusion

139. Prophylaxis for trigeminal neuralgia : Carbamezepin

140. A patient with ant spinal cord syndrome with all limbs paresis, loss of temp/, while fine
touch AND Vibrations are preserved what is the diagnosisAnterior Spinal cord lesion/
Syndrome

141. A female with parkinson's disease having upgaze palsy recurrent fall --------
p.supranuclear palsy

142. Patient with dementia, wide based gait, urinary incontinence diagnosesd with NPH
...what is the Treatment of Normal Pressure Hydrocephalus - CSF DRAINAGE

143. Patient with NON Hodgkins Lymphoma treated with Vinca Alkaloids 2 years back ,
presents with Pins and Needles and impaired vibration and position sense in Big Toe .. Labs
showed Lower Levels of B12 in Serum and also folate in lower Range... No MCV given in
details... what is the cause of his symptoms...... well i guess B12 Deficiency was the answer
..

144. pt.parkinson on ropirinole for 3 years and dterurating ,,O/E mild tremor and sever
dyskinesa and regdity what is best RX? benzexol or carpidoa or....ANSWER.ADD CARBIDOPA

Nephrology

145. Simvastatin used by a patient having mascular pain and high creatinine, what will u find
on urine examination myoglobin

146. Patient with Medullary Sponge Kidney Disease, regarding the complication what is going
to be the final outcome of this patient NephroCalcinosis

147. A patient with SLE having increased creatinine, with IGa,IGg,IgM deposited in the
glomerular membrane what will u expect .. Low C3 in Serum

148. Histology from renal biospy, neutrophils, eosinophils with normal renal capsule- AIN

149. Medication in diabetic renal pt-losartan

150. Beer and polyuria - decreased aquaporin channels yeah

151. Young with proteinuria and lower limb oedema with biopsy showing Minimal change
disease -what intervention will decrease the Proteinuria in this patient = Prednisolone

152. A pt with multiple sclerosis , on Baclofen, developed urinary incontinence. Post voided
volume 20ml. Rx.1. Intra vesicalBotulinum toxin. 2.suprapubic catheter.3.tolterodine

Bio Statistics and Epidemiology

153. why we randomise people on study : ??

154. what is the chance that the Test will be post ice :: Positive predictive value it was some
thinglke 380/405 I guess..

155. Chiquard study

156. A study has alot of confounding factors....??? analysis of confouctor ---as much as I could
get from internet search it comes to .. Spearman Rank correlation

157. question for Drug trial in which two groups were studies one placebo , and the value was
nominal .. and we had to choose the test to compare before and after the treatment I
rembere answer was UNPAIRED T test ..

Ophthalmology


158. Patient with Transit loss of Vision , Carotied 50% what to do?? : Aspirin (endarterectomy
from70-99%)

159. Patient with decreased vision in one eye with swollen disc on retinoscopy central
scotoma where is the lesion.OPTIC nerve

160. Ehler Danlos e angioid present e sudden visual loss the cause---well the Choroidal
Neovascularization may lead to retinal haemmorhage in macula and loss of vision ..i dont
remember the option

161. cotton wool spots and haemorrhage and vision loss .the most common cause would
be retinal vein thrombosis . .( please confirm that)

Psychiatry

162. Patient Detached from self : Depersonalization disorder

163. Hypochondrosis

164. post natal low mode with tearingPATIENT HAD DEPRESSIVE SYMPTOMS ,with tendency
to cry and low mood so I guess post natal depression was a better choice .. ??

165. A young male since child hood had grunting, abnormal movement and occationally falls-
Tourrete syndrome

166. Post op patient known parkinson disease old pt wit psychosos: Patient of parkinsonism
presented with Delirium .. what to give .. well haloperidol cant be given as it increases the
extrapyramidal symptoms so have to select from one of the benzodiazepines.. Lorazepam .. i
selected this as it is long acting ..other benzodiazepine was short acting

167. Patient talking on its own and replying " no ididnt do that" , while u never asked such a
question ... what is she experiencing ...................auditory hallucinations

168. Patient with chronic alcohol use presents to the ER with tachycardia agitation , abnormal
behavior and Dilated PupilsWhat overdose has he taken . Ecstacy

169. Female patient wth history of multiple suicidal attempts and harsh physical relationship,
low mood and hearing voices off n on ,history of self harm DiagnosisBorderline
personality disorder(other options were , bipolar disorder, .paranoid schizophrenia, )

Respiratory medicine

170. PCP finding :: Normal CXR or Crakles all over the chest ? normal auscultation

171. After internal Jugluar line : Heaomothorax I guess it was Pneumothorax as the lung was
collapsed and its a know complication of central lines

172. Patient with difficulty breathing, having dec FEV1, FVC and dec TLCO ,dec DLCO what is
the most probable diagnosis.. Pulmonary Fibrosis

173. Female pregnant already taking salbutamol, inhaled steroid 400mcg/day, and recently
added long acting Beta stimulants,still wakes up at night twice a week and has sob-what will
u do next= Increase the dose of Inhaled Steroid 800(beclomethasone)

174. Male Welder who gets sick at work having fever, body aches, running nose, difficulty
breathing immediately but stays well off it .Monday morning SOB FEV!/FVC 71% = Metal Fume
Fever

175. COPD patient with reduced Sats 86% on Room air having tachypnea needs to be given
oxygen what is the best mode to deliver the oxygen ..Venturi Mask - Venturi mask ?

176. RA on methotrexate- Bronchiolitis obliterans Or MethotraxateToxicitiy Or Pulmonary
vasculitits ?

177. Obese man with BMI of 41, feeling sleepy all day long having high score on epworth
sleepless ness scale 18 and having apnic episodes 4/hr ( normal less than 5) what is the most
important intervention .. Weight reduction

178. Pneumothorax risk : smoking there are two things which a patient shouldnt do.. after
pneumothorax correction as per bts guidelines Smoking .. then to avoid scuba diving and
other is Contact sportsfor 6 weeks.

179. Abbreviated mental test score (AMTS) 7/10- Patient with confusion, having hr of 28, bp
of 110/70?, tachypnea, which is the most important prognostic sign =Confusion

180. -Patient with respiratory distress, having high PCO2 and hypoxia ,drowsy , copd
exacerbation , what is the best way to give oxygen .. Non Invasive PPV

181. Patient with Cystic Fibrosis ,comes to you for vitamin suppliments what will is the most
important vitamin you will prescribe .. Vitamin A

182. Patient with history of childhood pneumonia,recurrent infections , having daily
productive cough with auscultatorycrepts at baseBronchiectasis

183. Patient with recurrent DVT , with resp distress and leg swollen ..PE e DVT what is the
best investigation : CTPA CT pul Angiography


Rheumatology

184. Patient with new onset prox muscle weakness , with a rash on the backside of hand and
proxinterphalangeal joints.. Dermatomyositis.

185. Female with marginally raised cpk, incesr, with macroglobulin in serum, tired, unable to
stand from chair, no muscle weakness, .. Polymyalgia Rheumatica-PMR

186. Young adult 29y , having back pain and gets better after he walks in morning , improves
with his exercise.Ankylosing Spondylitis

187. Primary biliary cirhosis>>>antimitochondirial

188. Patient with right hand small joint involment and left hand middle finger dactylitis,and
having metatarsophlangeal joint involvement Psoriatic Arthritis

189. Old woman with Left wrist swelling- Pseudogout OR Ostomylitits ? people voted for
OsteoNecrosis mostly

190. Patient withHerbendenNodes and bouchards node + dip pain with normal labs .
Osteoarthritis

191. 45 years old with large joint involvement- RA ?

192. Male with no history of STD but having arthralgias and gastroenteritis 2-3 weeks-which
organism can be involved-Reactive Arthritis= CompylobacterJejuni

193. Patient with SLE is having ANA positive but forgot to order the Immunoglobin class .
which class does ANA belong to. IgG

194. RA eye manifestation-episcleritis

195. Pt. e HTN ,raynad , SOB and cough >>> systemic sclrosi s

196. A young pt with recurrent DVT with family history of thromboembolism , with
antiphospholipd antibodies positive .. which is the common cause for thrombophelia in this
patient ..protein C Def/antithrombin Def./factor V Leiden mutation /polycythemia/protein S
def-----answer=Factor V leiden Mutation