August plab 1 question & answer

The answers are highlighted in YELLOW

1. Someone that hears voices when about sleeping

A . Hypnagogic

B. Hypnopompic

2. A woman with itchy dry eyes, Shimmer’s test 7mm

A. Hypromellose drops

B. Saline

C. Prednisolone

D. IVIG

3. A man with weakness of the right arm and slurred speech that
lasted for 5mins

MRI Normal. ECG of atrial fibrillation

How do you prevent further stroke?

A. Aspirin

B. Clopidogrel

C. Statin

D. Rivaroxaban

4. Child, 7 days post tonsillectomy with bleeding and clots seen

A. Iv antibiotics

B. Call surgeon for exploration.

D - Packing

E - Urgent exploration of the tonsillectomy bed

5. 4-year-old boy, 4 weeks post tonsillitis with bilateral cervical

LN enlargement. Developed lump m neck. All Signs and
investigations are normal. What's the most likely diagnosis?
A. AML

B. Hodgkin L

C. Non-HL

D. reactive lymphadenopathy

E. TB

6. In laparoscopic surgery for gall stone, the trocar placed

midway between the midline and the mid axillary line pierces
what structure?

A. Rectus muscle

B. Linea alba

C. conjoint tendon of ext. And int. Oblique

D. ext. oblique aponeurosis and int. Oblique muscle

E. transverse abdominal muscle

7. 80-year-old woman who had hip fracture following mechanical

fall, being prepared for surgery. She is alert but disoriented in
time and place, has inattention, and does not retain info. No
relatives to contact. No history of previous mental conditions.
What should be done?

A. Make her sign consent and move on with surgery

B. Do surgery in her best interest

C. Refer to psychiatry for assessment

D. Manage fracture conservatively

E. Postpone surgery till her condition improves

8. A 56-year-old man with sudden onset of double vision on

looking to the right. He is otherwise healthy and CT scan is
normal. What is the paralysed nerve?

A. Left trochlear nerve

B. Left oculomotor nerve

C. Left Abducens nerve

D. Right Abducens nerve

E. Right Trochlear nerve

9. A 56-year-old man, a known diabetic that needs a prescription

after a discharge from the ward. (A picture was given)

A. Insulin glarine 86 units SC in the evening

B. Tego-glefor (can’t remember the name) 300units/ml 86 u SC in the

evening

C. The same name 300 units/ml 86 iu SC in the evening

D. insulin glargine 100 units/ml 86 units SC in the evening

10. A 58-year-old man given clarithromycin for lower respiratory

tract infection. He is hypertensive and diabetic, he is on
furosemide 40mg daily, Metformin 500mg twice daily,
simvastatin 40mg daily, ramipril

40 mg daily.

What changes will be needed to the medication?

A. Increase the dose of furosemide

B. Reduce the dose of metformin

C. Increase the dose of ramipril

D. No changes needed.

E. Withhold simvastatin

11. A young man has multiple warts like lesions around his anus.
Which organism is responsible?

A. HSV
B. HPV

C. H. Ducreyi

D. Syphilis

E. LGV

12. A 46yr old DM, hypertension, and HF. He's on metformin

hydrochloride, atorvastatin, amlodipine, Furosemide and
Ramipril.

Lab: K= low

What medication is responsible

A. Metformin

B. Atorvastatin

C. Furosemide

D. Ramipril

E. Amlodipine

13. Patients has Nystagmus, ataxia, vertigo. Location of the lesion

A. Brain stem

B. Cerebellum

C. Auditory canal

D. Cranial nerve 8

14. A 80-year-old patient presents with reduce vision, conjunctiva

is clear, doesn't see faces in the dark. Other investigations
are normal

A. Age related macular degeneration

B. Retinitis pigmentosa

C. Chronic Uveitis

15. A 42 man with unilateral scrotum swelling, painless.

Transillumination +. Tested couldn’t be palpated. What’s the
DG?
A. Epididymal cyst

B. Varicocele

C. Hydrocele

16. 10-year-old girl with bloody diarrhoea and electrolyte

derangement. What’s the Dg?

A. HUS

17. Case of Multiple myeloma, predominant cells that will be seen

on a bone marrow biopsy?

a. Plasma cell

18. Case of 5th disease, with rash in a child. Question was about
when it's safe for the child to return to school?

A. reassurance/ child can return to school

19. A man with incision on the wrist, now having loss of sensation
on the medial aspect of the forearm and little finger plus
inability to abduct and adduct the fingers. Which nerve is
affected?

A. Radial

B. Median

C. Ulnar

20. A man with right sided headache, pain on chewing, temporal

tenderness, bp 165/95. What's is the most appropriate
investigation?

A. MRI head

B. CT

C. Temporal artery biopsy

21. A 48-year-old man, he drinks and smokes, has painful swelling

in the right foot. X ray showed: joint erosions and punched out
erosion on the MTP joint. What is the diagnosis?

A. Rheumatoid arthritis
B. Gout arthritis

C. Osteoarthritis

D. Osteoporosis

22. A 5-year-old with a 6-day history of fever, red and fissured lips,
non-purulent conjunctivitis, cervical lymphadenopathy, and
polymorphic rash. What is the most appropriate treatment?

A. IV Co-amoxiclav

B. IVIG

C. Oral Ibuprofen

D. Oral acyclovir

E. Oral prednisolone

23. A 40-year-old female with breathlessness, no cough. T: 37.7,

SPO2: 89, other vitals were stable. Most investigation results
were normal except slightly elevated D-dimer & CRP. COVID-
19 test: Negative. A Chest X-ray was displayed. What is the
diagnosis?

A. Atypical pneumonia

B. COVID pneumonitis

C. Spontaneous pneumothorax

D. pulmonary embolism

24. A 37-year-old male is tired of life. He is the manager of a big

supermarket, separated from his wife, suffers from asthma.
What is the biggest risk factor for suicide?

A. COPD

B. Male sex

C. Marital status

D. Employment status

E. Age
 25. 18 Months old child referred by the Health Visitor for
assessment of Developmental milestones, has the following,
which would disturb you on assessment?

(a)Has social smiles

(b)Passes objects from one hand to another without showing

cerebral dominance

(c)Walks but does not run nor kick a ball

(d)Does not make eye contact

(e) Scribbles lines and babbles 2 words.

26. A 4-Yr old child suffers from Cystic Fibrosis, both parents do
not sufferer from it, has a 14Yr-old sister. What's the sister's
risk of carrying the gene?

(a) 1/1

(b) ½

(c) ¼

(d) ⅔

(e) None.

27. Q.36) A 60-Year-old man suffers a massive left lateral parietal

cerebral infarct and has been on Iv. Fluids for weeks. Doctors
think he needs proper nutrition. His wife says she wants
nothing artificial for his nutrition. Best option?

(a)Continue Iv. Fluids and reassess in 48Hrs.

(b)Give thick oral gel.

(c)Nasogastric tube feeding.

(d) Percutaneous Endoscopic Gastrotomy

28. 77-year-old male with severe dementia. Wakes up early at 5am

but his wife who is his caregiver locks him in. Next
appropriate step.

A. Arrange for safeguarding

B. Inform the police

C. Prescribe hypnotic

D. Admit

E. No action

29. 6-week-old patient with a two-week history of projectile

vomiting, lost 300g has a right sided abdominal mass. What
will be seen on investigation?

A. Hyperchloremia

B. Metabolic alkalosis

C Hyperkalaemia

30. A woman went for routine cervical smear which revealed

moderate dyskaryosis. Most appropriate management?

A. No further investigation

B. Refer for colposcopy

C. Endocervical swab

D. Repeat smear in 6months

E. Repeat smear in 3 years

31. A 50+ woman with Breast Cancer with metastasis to the liver
and peritoneum. She has vomiting and nausea. All lab values
were normal except high urea 10.4, high creatine and high
calcium (corrected) . What is the initial management?

A. 0.9% NaCl

B. 0.45% sodium chloride

C. 5% dextrose saline

32. 56-year-old woman with tiredness and constipation over 4

months. Anti TPO – positive, T3 normal, T4 – low, TSH elevated

A. Levothyroxine

B. Propranolol

C. Propylthiouracil
D. Tamoxifen

33. A drug trial involving 1000-woman half where given drug A and
the other half where given drug B and followed up for 5years?
Type of study?

A. Retrospective study

B. Cohort study

C. Randomized control trial

D. Prospective study

34. 72 years old man stroke patient with intermittent dysphagia

for 6 months. He is now unable to swallow both solid and
liquid. What is the most appropriate mode of treatment?

A. Nasogastric tube

B. percutaneous endoscopic gastrostomy

35. A woman with lethargy and weight gain for 4 months. She had
postpartum haemorrhage 6month ago and was unable to
Breastfeed her child. Which part of the brain is affected?

A) Hypothalamus

B) Pituitary

C) ovary

D)Uterus

36. A 48hours post MI, presents with breathlessness, has

pansystolic murmur and raised JVP. What’s the Dg?

A. Acute AR

b. Acute MR

C. Tricuspid regurgitation

37. A depressed man previously managed with CBT. Has no self-

harm. Which Medication to start which?

A. Sertraline

B. Mirtazapine
C. Amitriptyline

D. Quetiapine

38. A 52yr old with sudden severe headache and watering of the
right eye. This has occurred 6 months ago and resolved 2
weeks later. His BP was 144/88mmhg. What’s the most
appropriate treatment?

a. Aspirin

b. Naproxen

c. Propranolol

d. Codeine and Paracetamol

e. Sumatriptan

39. A 66yr old man was brought to the Emergency Department

with breathlessness, BP 70/50mmhg, RR 40, PR 130b/m.
Oxygen saturation is 98% on high flow O2. Auscultation shows
reduced air entry on the left while right chest is inaudible,
trachea is deviated to the left. Most initial appropriate
management?

A. Insert a Selinger chest drain in d right axilla

B. Insert a Selinger chest drain in d left axilla.

C. Insert a Selinger chest drain in d right pleural cavity

D. Insert a wide bore needle in d 2nd left intercoastal space.

E. Insert a wide bore needle in d 2nd right intercoastal space

40. A 64yr old male has epigastric pain every night for the past 4
months with occasional nausea but no vomiting. Other
parameters are normal. Most appropriate diagnostic test.

a. Barium swallow

b. Plain X-ray Abdomen

c. Helicobacter pylori serology

d. CT Abdomen
e. Upper Gastrointestinal Endoscopy.

41. Man with renal sarcoma with posterior abdominal wall

metastasis. Increasing pain, was on slow-release morphine
210ml twice daily, increased to 200ml twice daily. He also
takes daily subcutaneous dose of morphine 120ml. What to do
to alleviate pain?

A. Replace with fentanyl patch

B. Replace with oxycodone

C. Increase the dose of subcutaneous morphine

D. Replace with diamorphine

42. A young man who took ecstasy, found unconscious. Reduced

respiratory rate, high pulse, pupils dilated. The man also had
rigidity in limbs and raised lactate. What’s Drug to be given?

A. Baclofen

B. Cefotaxime

C. Dantrolene

43. A 51-year-old woman with hot flushes for 9 months. She had a
hysterectomy 5yrs ago. What is the management for her?

A. Raloxifene

B. Oestrogen only HRT

C. Combined HRT

D. Propranolol

44. A 60-year-old man booked for coronary angiogram, has a hx of

Ischemic heart disease, HTN, and DM. What can be done to
reduce the risk of contrast induced AKI?

a) 0.45% N/S

b) 0.9% NaCl

c) 5% dextrose

d) Mannitol
 45. A question about a woman with atrial fibrillation, diabetes,
schizophrenia, depression who presented on account of
recurrent falls. Investigations listed showing electrolyte
abnormalities (hyponatremia). Which medication is likely to be
the cause?

A. Apixaban

B. Atorvastatin

C. Clozapine

D. Duloxetine

E. Metformin

46. A 24-year-old woman who presented on account of fatigue and

irregular menstrual cycles. TSH – Normal, Prolactin – Normal
and FSH – 80. What’s the diagnosis?

A. Hyperthyroidism

B. Prolactinoma

C. PCOS.

D. Hypopituitarism

E. Premature Ovarian Failure

47. A 30-year-old man has been having pain on passing urine for 3
days. He is otherwise fit. He has 4 painful ulcers on the glans
and preputial skin, non-indurated. What is the diagnosis?

A. Bechet’s disease

B. Chlamydia infection

C. Gonorrhoea infection

D. Herpes Infection

E. Primary Syphilitic Infection

48. 25-year-old woman who is 12 weeks pregnant with second

pregnancy with the same partner. Previous child was
diagnosed with Congenital adrenal hyperplasia, 21hydroxylase
 deficiency. What’s the chance that the unborn child is
affected?

A. 0

B. 1:1

C. 1:2

D. 1:4

E. 2:3

49. A 7-year-old who has 3 recurrent throat infections in the last

one year, was brought to the GP surgery by parents because
they are worried about the frequency of his infection. What is
the best management?

A. Do Full Blood Count

B. Give Immunoglobulin

C. No action needed

D. Give antibiotics in anticipation of next infection

E. Refer for ENT review

50. Middle aged man recovering from Gillian Barre Syndrome. He

is a chemist and wants to know the reason for his condition.
What is the pathology behind the disease?

A. progressive demyelination of the peripheral nerves.

B degeneration of the spinothalamic tract.

51. An 18-year-old woman with features of hyperthyroidism -

palpitations, tremors for 2 months. Symptom of thyroid eye
disease. What is the most likely feature of the thyroid function
test?

A. High TSH, High T4

B. Low TSH, High T4

C. Low TSH, Low T4

D. High TSH, Low T4

 52. A 21-year-old woman presents with history of loose stool
containing mucus for 1-month, associated 3kg weight loss, her
appetite is normal, her menses is normal. Investigation done -
Hgb - 95g/dl, MCV - 68. Most likely diagnosis

A. Coeliac disease

B. Inflammatory Bowel disease

C. Irritable Bowel syndrome

D. Laxative abuse

53. A 50-year-old Southeast Asian male presents to the GP surgery

with no complaints, his Ambulatory Blood Pressure Monitoring
with home average BP 165/98mmhg. Nil medical history of
note. Investigations done Urine ACR -1.95 *normal, HbA1C –
38, E/U/Cr - within normal ranges, ECG - sinus rhythm. Best
initial management

A. Amlodipine

B. Bisoprolol

C. Indapamide

E. Ramipril

54. A woman who is 14weeks pregnant and is a sickle cell carrier,

also discovered her partner is also a sickle cell carrier. what
are the chances of her unborn child being affected with sickle
cell disease?

A. 25%

B.30%

C. 50%

D 100%

55. A picture of the retina in a known hypertensive woman on

amlodipine with progressive decline in vision. BMI 34kg/m2.
What’s diagnosis?
A. Diabetic maculopathy

B. Hypertensive retinopathy

C. Retinitis pigmentosa

D. Macular degeneration

E. Retinal vein occlusion

56. A man with colon cancer who had resection. On the 10th day
he had abdominal pain, temp-38, PR110bpm. Dg?

A. pelvic hematoma

B. Pelvic abscess

C. Vein thrombosis

57. A 65yr old woman with metastatic breast cancer and right hip
pain on oral morphine. Most appropriate medication for the
pain

A) Bisphosphonates

B) Chemotherapy

C) Radiotherapy

D) Naproxen

58. 25yr old with acne and irregular periods Testosterone-

elevated. Most appropriate treatment?

A COCP

B Metformin

C Tranexamic acid
 59. 80-year-old man with haematuria. Prostrate mildly elevated.
Investigation: PSA- 15. Most likely diagnosis?

A) Bladder CA

B) Prostate CA

C) BPH

60. A 51year old woman with amenorrhoea for 6months, she has
flushes, sweats etc. Next investigation?

A. FSH

B. Thyroid function

C. Oestrogen

D.

61. A question on woman with unilateral leg weakness. Extension

against resistance causes her to extend her hip. She has
asthma and epilepsy. Examination of normal limb elicited
movement in the abnormal limb. MRI and other investigation
were normal. What’s the Dg?

A. Multiple Sclerosis

B. Chronic fatigue syndrome

C. Functional weakness

D.

E. Todd paresis

62. Bleeding discharge from nipple. On examination, blood can be

expressed from the nipple. What’s the Dg?
A. intraductal papilloma
B. Duct ectasia
C. Duct fistula

63. A 33-year-old man with loss of libido, erectile dysfunction.

A. Cabergoline
B. Octreotide

C. Sildenafil

D. Testosterone

64. Elderly man with features of pneumonia on methadone for

alcohol dependence. Fever 38.2. Other vitals normal. He is
allergic to penicillin. Most appropriate management?
Has normal testes and other sexual characteristics.
Investigation: only prolactin is elevated excessively, others
are normal. MRI shows: prolactinoma. Most appropriate
management?

A. Clarithromycin

B. Co amoxiclav

C. Levofloxacin

D. Benzylpenicillin

E. Doxycline

65. Patient with history of untreated mild ulcerative colitis.

Presented with loose stool with mucus for 1 month. No weight
loss. Hb - 95g/dl. Most appropriate management

A. Mesalazine

B. Something hydrochloride

C. Antibiotic

66. A 38yr old with maculopapular rashes. Had painless penile

ulcer a week ago which had resolved. Developed mouth ulcers.
Vital sign normal. What's the investigation to aid in diagnosis?

A. Blood culture

B. Swab from the rash

C. Serology for rash

D. Swab from mouth ulcers

E. Serology for PCR of the mouth ulcer

 67. A woman with discharging pus between the nipple and areola.
What condition is it?

A. Papilloma CA

B. Duct Fistula

C. Duct Ectasia

68. A 35-year-old man presents with a painless firm mass. Mass

located at the upper part of testis. Most appropriate initial
investigation?

A. Aspiration of swelling

B. CT of Abdomen and Pelvis

C. Organize an exploration of testis.

D. Serum Tumour Marker

E. Ultrasound scan of scrotum

69. A 21-year-old woman is concerned about her weight. She takes

laxative and diuretics. BMI - 17kg/m2. BP- 95/60mmHg. Most
appropriate action/management?

A. Organize Psychodynamic therapy

B. P...

C. Refer to Dietician

D. Refer to eating disorder unit

E. Admit

70. A 30-year-old man ingested 45 500mg of paracetamol 10 hours

ago. He presents to the Emergency. GCS - 15/15. PR - 90bpm.
SPO2- 99%. Next appropriate management?

A. Check for Serum levels of PCM.

B. Gastric lavage

C. Start 50g of activated Charcoal

D. No action required. Discharge home.

E. Start N- Acetylcysteine.
 71. Young man, presented to the ER with complaints of tingling,
perioral paraesthesia, and other symptoms usually over 5-
10mins which have worsened over last 3 months. PR-100bpm,
ECG normal. What's most appropriate immediate treatment?

A. IV sedation

B. Rebreathe into a bag

C. Refer to take panic disorder course

D. Refer for urgent cardiology opinion

72. Patient treated for acne who developed dry eyes amd dry nose

A. Topical Isoretinol

B. Topical Benzoyl peroxide

C. Topical Retinoid

73. A lady working in a residential home for elderly with itching

and marks (attached picture).

A. Fusidic acid

B. Permethrin 5%

74. A 2-day old baby whose mum is deaf and on hearing aid. What
to do next?

A. Distraction test

B. AABR

75. A man who went to the peri operative clinic, scheduled for
rotator cuff surgery, patient is on Amlodipine,
 Beclomethasone, Lisinopril, BP was 131/78. Which drug to omit
before the surgery?

A. Beclomethasone

B. Amlodipine

C. Lisinopril

D. Atorvastatin

76. A 50-year-old man presents with flight of ideas which are

rambling and disinhibited. He is distractable, confused and
overactive. What is the most likely dx?

a. Dementia

b. Mania

c. Schizophrenia

d. Psychosis

e. Acute confusional state

77. A man underwent TURP, developed confusion and then had

seizure, electrolyte responsible

A. Hypocalcaemia

B. Hyponatremia

C. Hypercalcemia

78. 72-year-old man, memory loss, inappropriate sexual

comments. Diagnosis?

A. Lewy body

B. Alzheimer’s

C. Huntington

D. Frontotemporal dementia

79. 34 weeks pregnant woman, had flu like symptoms for 2 days
presented with increase temp 37.4, pulse rate increased, other
parameters are normal. She noticed decreased foetal
movement. Which investigation to perform?
A. Urgent CTG

B. Foetal Doppler scan

C. Urgent biophysical profile

80. A young woman who was involved in an RTA. Vitals were fine
except for SPO2 of 94% and RR of 36. She has right chest pain
and breathlessness. Trachea wasn’t deviated to the left,
reduced and bronchial sounds on the right. Has fracture of 5th
to 7th ribs on the right side. Dullness on percussion. What’s
the diagnosis?

A. Haemothorax

B. Pneumothorax

C. Flail chest

81. Young female with sudden occipital headache. Has history of

migraine without aura. There is no neck stiffness. He vitals are
within normal. What investigation

A. Head CT

B. Carotid artery Doppler???

82. 50year old man on amlodipine for his hypertension he had

stopped Ramipril because of dry cough but his BP is still
158/96mmhg, what medication to add?

A. Furosemide

B. Verapamil

C. Valsartan

83. 4 weeks old girl failing to thrive with pale stool, jaundiced,
what's the diagnosis?

A. Biliary atresia

B. Hypothyroidism

C. G6PD def

D. Breast milk jaundice

 84. Elderly man admitted for pneumonia and has now been
discharge on antibiotics what's is the most important follow
up investigation, initial cxr showed bibasal crepitations

A. Bronchoscopy

B. CXR

C. Blood culture

D. CTPA

85. A man comes in crying, and he’s intoxicated and wants to stop
alcohol intake. He doesn’t want to be admitted. What do you
do.?

A) Compulsory admission for detoxification

B) Refer to one alcohol place for support

C) give a dose of disulfiram

86. A man is anuric and has fever. U/S shows dilated kidneys. A
stone was seen but size w was not given. Had left
nephrectomy in the past. What next?

A) Percutaneous nephrostomy

B) Lithotripsy

87. Pregnant woman for 20week anomaly scan, no gastric bubble

A. Duodenal atresia

B. Jejunal atresia

C. Oesophageal atresia

88. Patient taking multiple drugs and has frequent falls. Which
drug is responsible?

A. Beclomethasone

B. Salbutamol

C. Statin

D. Denosumab

E. Duloxetine
F. Furosemide

89. Patient with reactivation of varicella zoster. Who should

receive prophylaxis?

a. All pregnant women who came in contact with him irrespective of

their ab level

b. All pregnant women who came in contact with him with negative
antibiotic level

c. All the ward staff

D. All the patients in the ward.

E. None

90. A 72-year-old woman who had cholecystectomy. Post

operatively respiration rate 8.

A. MRI brain

B. CT scan.

C. Naloxone.

D.

91. A 42-year-old lady presented with dilated pupil, paralysis of

elevator palpebral superioris, ptosis and diplopia on downward
gaze. What next is affected.

A. Abducens

B. Oculomotor

C. trigeminal

D. Trochlear

92. A 57-year-old lady presented with worsening flashes and

floaters.

A. Anterior glaucoma

B. Iritis

C. Retinal detachment

D. Age related macular degenerate.

 93. A 21-year-old male who fell from a height of 2.5 metres. And
presented with pain and swelling of the heel. Which bone is
most likely fractured?

A. Calcaneus

B. Navicular

C. Talus

D. Cuboid

94. A 70-year-old woman who had a fall and sustained a fracture of

the radius with minor displacement of distal radius. Hand was
swollen and X-ray showed minimal displacement of Distal
radius. What is your management?

A. Below elbow POP with backslap

B. Below elbow with full POP.

C.WRIST SPLINT.

D. Close reduction

E. Open reduction

95. A 3-year-old girl brought to the hospital by paramedics, with

c/o falling out of bed. X-ray shows spiral fracture with callous
formation with another healed fracture of the radius. What is
the mechanism of the current fracture?

A. NAI

B. Accidental

C. Osteogenesis imperfecta

96. Middle aged woman (50 year) with abnormal per vaginal
bleeding. What is the initial management?

A. Hysteroscopy with biopsy

B. Transvaginal uss

97. Patient with right apical lung cancer. Has bad mouth odour.
What would you do?
A. Antiseptic mouth wash

98. An elderly woman on anticoagulant found on the ground

confused with periorbital ecchymoses. Other exams are
normal. What is the next investigation to find out the cause of
her symptoms?

A. Facial X-ray

B. Coagulation screen

C. Ct scan head

99. A man with severe depression who lacks capacity. The man
needs treatment. But after family meeting with his daughter.
She still doesn't want him to be treated.

A. Go ahead and treat him treatment

B. Wait till daughter give consent

C. Inform the medical defence union.

100. The girl who slit her wrist because her boyfriend broke
up with her

A. Depression

B. Bipolar disorder

C. Acute stress reaction

D. Acute psychosis

101. Patient had two or three black outs a week ago. ECG
showed 3rd degree heart block in lead II. What is the
management?

A. Permanent pacemaker

102. Elderly with 10 days fresh per rectal bleeding. Had

constipation and left lower pain for last 4 months. No weight
loss. What is the diagnosis ?
A. Sigmoid CA

B. Sigmoid polyp

C. Diverticular disease

103. An 80-year woman who had fracture. What drug to give to

prevent further fracture?

A. Bisphosphonate

B Calcitonin

C Calcium

D Vitamin D

104. An infant with cough, fever and the question was the
organism likely responsible?

A. Strep pneumoniae

B. H. Influenza

C. Mycoplasma

D. Rsv

105. Patient with dizziness, feeling of pressure in one ear and

tinnitus. Diagnosis

A. BPPV

B. Labrinthitis

C. Meniere’s disease

D. Vestibular neuronitis

E. Acoustic neuroma.

D.

E.

106. A woman who became depressed after her husband's

death of cancer. She was using Amitriptyline. Her appetite has
improved. She used the antidepressant for 3months and
wanted to stop. She now feels she has cancer. Most
appropriate action
A. Stop Amitriptyline

B. Encourage to Continue Amitriptyline

C. Change to SSRI

D. ECT

E. Bereavement counselling.

107. There was also a question concerning a lady whose

menstrual cycle was 32 and was planning to conceive. What
was her ovulation day?

a)7

b)15

c)24

d) 25 midluteal progesterone

e)

212. A child whose mother was worried about his hearing. The child
has been having recurrent ear problems. Child was born premature
and stayed in ICU. Tympanic membrane was bulging and conductive
hearing loss. Diagnosis

a)

b)

c) Otitis media with effusion