Theme 1: Mg. Of Ophthalmologic conditions.
A. Intraoccular steroids.
B. I/V steroids.
C. Oral steroids.
D. Eye surgery.
F. Laser treatment.
G. Syst. Anti-biotics.
H. No treatment.
1. A pt. With sudden loss of Vn. And h/o temporal arteritis.
2. A pt. With decreased Vn. On watching TV, gives h/o tunnel Vn. On examination cupping of disc is seen.
3. Pt. With h/o of SLE develops lens opacities.
4. A diabetic pt. Develops proliferative diabetic retinopathy.
5. A 80 yr. Old man with marked loss of Vn. On fundoscopy bilat. Macular degeneration and pigmentation.
Theme 2: Side Effects of Drugs.
A. Liver Failure.
D. Ryes syndrome.
E. Dry Mouth.
G. Gastric erosion.
H. Dilated pupil.
6. A child who takes a large amount of paracetamol.
7. A pt. on chronic use of Aspirin.
8. A pt. Taking cabamazepine for some painful problem.
9. A pt. With some psychiatric problem on TCA.
10. A pt. on chronic use of Ibuprofen.
Theme 3: Involvement Of Cranial Nerve.
A. Nerve I
11. A. Pt. Involved in RTA. Has MRI done which shows longitudinal # of temporal petrosal bone of skull and now is unable to perceive smell.
12. A 19 yr. Old pt. Sustained # of base of skull, presents with ptosis, loss of pupillary reflex associated with lat nystagmus.
13. Pt had trauma to back of skull and since cannot shrug his shoulders.
14. A pt cannot move his lower facial muscles but there is sparing of the forehead muscles.
15. A pt. Had a stroke and has lost the ability to feel taste in the Ant. 2/3 of the tongue.
Theme 4: Diagnosis Of Anemia.
A. Pernicious anemia.
B. Aplastic anemia.
C. Iron deficiency anaemia.
D. Coeliac disease.
E. Anaemia due to Iron malabsorption.
F. Anaemia due to folate malabsorption.
G. Folate deficiency anaemia.
16. A man on treatment with cyclophosphamide for lung alveolitis develops anaemia.
17. A man with h/o of gastric erosion develops anaemia.
18. A strict vegetarian develops malnuturion and anaemia.
19. A pt. With coeliac disease develops anaemia.
Theme 5: Vaginal Conditions In Female child.
A. E. Vermicularis.
B. Examine under GA.
C. Local hygine.
D. Take high Vag. Swab.
E. Culture and investigate for Chlamydia.
F. Local Nystatin.
20. A child with itching in vulva mostly at night.
21. A child with excoriation and ulceration in vulval region.
22. Rash is noted in vulva in a diabetic child.
23. A child with some kind of vaginal discharge.
24. Rash in a normal child when nappy removed.
Theme 6: Diagnosis Of Confusion.
B. Subdural Haem.
C. Extradural Haem.
D. Subarachnoid haem.
E. Wernicks Encephalo.
F. Drug overdose.
25. Pt admitted in hospital with some ailment then becomes confused and irritated.
26. A pt is operated, on gaining consciousness becomes confused and disoriented.
27. An alcoholic with h/o of recurrent falls is confused.
28. A rugby player hit by a ball on head loses consciousness and then become normal now is brought in hospital with detoriating consciousness.
Theme 7: Prevention Of Heart Disease.
B. Reduce Wt.
C. Stop Alcohol & Cigar.
29. A pt. With hyperlipidaemia develops cardiac problems.
30. A smoker & alcoholic develops cardiac problem.
31. An obese develops cardiac problems.
Theme 8: Investigations In Breast Lumps.
E. Stereotactic Biopsy.
F. Stereotactic Fine needle biopsy.
G. Excisional biopsy.
32. A pt. With fibrocystic disease with symptoms related with menses.
33. A pt. With breast lump but has morbid fear of needles.
34. A pt with no obvious palpable lump but with axillary lymph nodes.
35. A pt with retraction of nipple.
Theme 9: Investigations In Convulsions.
B. CT Scan.
E. No Investigation.
F. I/v valproate.
36. Mother brings child who had some febrile condition, the child was wrapped in multiple blankets, he had convulsions, when the blanket was removed he was alright and playing happily.
37. A boy with h/o of convulsions starting with tingling in Thumb of one hand.(Jacksonian)
38. A pt. With convulsions and an EEG was done, which showed firing impulses in temporal area.
39. A pt had generalized tonic clonic convulsions.
Theme 10: Diagnosis In Dementia.
D. Senile dementia
E. Muti infarct dementia.
F. Lewy body dementia.
G. Frontal lobe dementia
H. Huntington’s dementia.
40. A pt had some psychiatric problems with thought insertion.
41. Commonest dementia in UK
42. Dementia which has neurofibrillary tangles.
43. Pt. With cognitive impairment.
44. A hypertensive with dementia.
45. Dementia treated with anti depressants.
Theme 11: Diagnosis Of Hearing Loss.
A. Menier’s Disease.
B. Wax Impaction
C. Acoustic Neuroma
D. Act. Otitis Media.
G. Viral Involvement of nerve.
H. Otitis Externa.
46. A pt. With intermittent tinitus, giddiness, and vertigo.
47. A 50 yr. Old man with bilat. Deafness, his father also had hearing loss.
48. A brown mass obliterates the tympanic membrane.
49. A woman with unilat. Conductive hearing loss.
50. A pt. With tinitus, vertigo and tingling on one side of face, and numbness.
Theme 12: Diagnosis In Rheumatology.
A. Chondromalecia patella.
B. Rheumatoid arthritis.
D. Psoriatic arthritis.
E. Enteropathic arthritis.
F. Ankylosing spondylitis.
G. Septic arthritis.
H. Reactive arthritis.
I. Pseudo gout.
J. Gonococcal arthritis.
51. A 65 yr.old man has a swollen left knee jt. For ten yrs. With associated swelling but no skin changes, he had no other problems.
52. 35 yr. Old woman with left knee pain and associated problems, and with nail pitting and discoloration.
53. A 45 yr. Old man on anti hypertensive treatment, presents with lt knee pain which is swollen and hot to touch.
54. Pt. Returned from Thailand develops painful swelling and warm rt. Knee.
55. A female with symmetrical and crippling arthropathy.
Theme 13: Diagnosis Of Ulcerative Colitis.
A. Ulcerative Colitis.
B. Pseudo membranous colitis.
D. Anal fissure.
E. Crhon’s disease.
56. A pt taking iv antibiotic treatment for some disease develops diarrhea and bowel changes.
57. A pt has bleeding mixed with stool and also bleeding after passing stool.
58. This was a question on ulcerative colitis.
59. pt passes stool with blood streaked on it.
Theme 14: Investigation In Lung conditions.
C. Sputum cytology.
D. Sputum culture.
E. Lung biopsy.
60. Elderly man has lower lobe consolidation and fever, he was treated with antibiotic, which resolved the fever but the consolidation persisted after 4 wks.
61. A pt with lung affected due to asbestos exposure.
Theme 15: Investigation In Haematology.
A. Bleeding time
B. Clotting time
C. Platelet count
D. Von willebrand
62. A pt. is taking warfarin develops bleeding problems.
63. A female pt with rash and other symptoms of purpura develops hemorrhage.
65. A 16 yr. Old girl is pale. Weak presents with menorrhagia and epistaxis, mother also had similar problems.
66. I think another question on Von Willebrand.
Theme 16: Diagnosis of Meningitis.
A. Streptococcal Meningitis.
E. Leukaemic Infiltration.
67. A 3 yr. Old boy developed URTI and also had recent h/o ear discharge, now presents with neck stiffness.
68. A child is diagnosed with meningitis his CSF examination shows 10 blood cells with 1-2 lymphocytes, and the glucose level is not too reduced.
69. A child with meningitis, his CSF examination shows presence of gram –ve encapsulated diplococci.
70. A child with signs of menigism and presence of abnormal blood cells in the CSF.
Theme 17: Management of Thyroid Problems.
H. Auto anti body.
I. Thyroid ultrasound.
71. A female pt. Presents with wt. Loss, palpitations and diarrhea.
72. A female pt. Having previous h/o of asthma is now complaining of wt. Loss and diarrhea.
73. A female pt with diffuse enlargement of thyroid, but otherwise well and asymptomatic.
74. A pt. With a solitary thyroid nodule of about 3 cm in size.
75. A woman presents with features of hypothyroidism and a tender thyroid.
Theme 18: Mgmt. Of Trauma In Children.
A. iv morphine.
B. Endotracheal intubation.
C. Intraosseous line.
D. CV line
E. Oropharyngeal airway.
F. Nasopharyngeal airaway.
76. A 4 yr. Old child with 10 % scalds on chest.
77. 6 yr. Old, intubated after RTA, BP low, pulse high.
78. 2 yr. Old with hypovolemic shock, unable to get iv access.
79. 5 yr. Old with soot in nostril.
80. 13 yr. Old in shock, unable to get iv access.
Theme 19: Mgmt. Of Varicella.
A. Oral Acyclovir
B. Iv acyclovir.
C. No treatment required at present.
D. Varicella Ig.
E. Barrier nursing.
G. Check immune status.
81. A pregnant woman who is in her last trimester of pregnancy, and her husband is infected with varicella.
82. A boy who is taking steroids for asthma gets chicken pox.
83. A child having lymphoma/leukemia, his father has shingles.
84. A boy whose sister has just had renal transplant and is returning from the hospital.
85. 80 yr. Old man develops ophthalmic shingles.
86. A boy has developed vesicles all over the body and also has high fever.
87. A woman with vesicles on small part of the chest.
Theme 20: Diagnosis Of Acid-Base Disturbances.
A. Metabolic Acidosis.
B. Metabolic Alkalosis.
C. Respiratory Acidosis.
D. Respiratory Alkalosis.
F. Renal Failure.
H. Fluid overload.
88. A man having projectile vomiting due to pyloric stenosis with hypokalaemia & base excess.
89. A man with villous adenoma of rectum with diarrhea.
90. A man with pulmonary embolism, with tachycardia, hypotension and breathlessness.
91. A man with pallor, dry skin, and anuria.
92. A pt. With post operative breathlessness, and peripheral oedema.
Theme 21: Psychiatry Next Step.
E. Continue the same drug orally.
F. Stop the treatment.
93. A pt. After treatment with antipsychotic, he develops hyper salivation.
94. A pt. After treatment with haloperidol, a man develops stiffness of limbs.
95. A pt. stabbed his father in acute psychosis, and then was treated with anti psychotic, now believes himself to have recovered from the illness.
96. A pt who has recurrent hiccups, due to anti psychotic treatment.
Theme 22: Investigation In Renal stones.
A. Serum Ca Level.
B. Plasma Urate level.
C. Serum Alk. Phosphatase, Calcium, and phosphate level.
D. Dietary conditions.
E. Urea & Electrolytes.
F. Urinary Calcium.
97. A 25 yr. Old man presented with recurrent loin pain and stone in the ureter.
98. A 35 yr. Old man presented withy loin pain all serum biochemical investigations were done and are non conclusive.
99. A man with gouty skin changes of the ear pinna.
100. A man with stone in the kidney which is radio luscent.
Theme 23: Mgmt. Of Trauma In Children
A. CT Scan
B. Barium Swallow.
D. X- Ray abdomen.
E. Peritonial Analysis.
101. A child with stab wound of abdomen, and signs of peritonism and shock.
102. A child involved in RTA was seated in backseat, with seat belt on, presents with pain in Lt. Hypochondrium, pallor, low BP, tachycardia.
Theme 24: Investigations In Diabetes.
A. Random Blood Sugar.
B. Fasting Blood Sugar.
C. Oral Glucose Tolerance Test.
D. Insulin Level.
E. Urine Sugar.
F. Blood Sugar.
G. Post parandial blood Sugar.
103. A 25 yr. Old male who is conscious and wants to know weather he is diabetic.
104. A 65 yr. Old male with h/o of polyurea wants to know abt. His diabetes.
105. A 20 yr. Old girl presented to you with history of attacks of hypoglycemia when ever she misses her meal.
106. Mother brings in a child she is worried if he is diabetic.
Theme 25: Mgt. Of Ectopic Pregnancy
B. Diagnostic Laproscopy.
D. 24 Hr. B HCG.
107. A 25 yr. Old girl with 8 wks. Ammenorrhea presents with BP 70/50 and pulse 140/mt.
108. A 35 yr. Old woman with bleeding per vagina and USG shows empty uterus.
109. An 28 yr. Old woman presents with 5 wks. Ammmenorrhoea and has h/o vaginal bleeding her B HCG is 5000.
Theme 26: Control Of Hypertension.
A. B blockers.
B. Ace inhibitor.
C. Diet Control.
D. Stop Smoking.
F. I/V Anti Hypertensive.
G. Fish Oil.
110. 30 yr. Old lady with a BP of 160/100 rec. on 3 times consecutively BMI is 27 and drinks 7 units of alcohol and smokes 1 pac. Cigarrets.
111. 35 yr. Old lady with BMI is 33 and drinks 3 units of alcohol/wk. And BP rec. 160/100 3 times in a row.
113. A 50 yr. Old with h/o Htn. Not relieved by diuretics.
114. A pt . with family history of cardiovascular disorders.
Theme 27: Next Step In treatment Of Psychiatric Pateints.
A. Oral anti psychiat drug.
B. IV anti psych.
C. Stop Rx.
D. Continue same treatment.
E. Review after 3 mths.
F. Regular visits to Doctor.
115. 30 yr. Old with psychiatric problem on oral anti psychotics.
116. Pt who is doing well on anti psych. on his regular visit to GP after 3 months.
Theme 28: Cervical Pathology
B. Cervical Ectropion.
C. Endometrial Carcinoma.
D. Cervical Cancer.
E. Vaginal Cancer.
F. Vaginal Trauma.
G. Chlamydial Infection.
H. Cervical Smear.
117. A female presents with a cervical lesion which bleeds to touch, she gives h/o multiple
sexual partners recently.
118. A female with bleeding on oral contraceptive pills.
119. A woman with post menopausal bleeding and with Endometrial thickening.
120. A woman who has got unpleasant vaginal discharge.
121. An post menoupausal old lady presents with post coital bleeding after having sex for the
“first time in her life!!” .
Theme 29: Respiratory Pathology.
A. Chloride Channel Defect.
B. Surfactant Deficiency.
C. Alpha 1 antitrypsin deficiency.
122. A baby who has recurrent pneumonitis.
123. A baby with RDS.
124. A woman who has h/o of recurrent jaundice as a child and now develops emphysema.
125. A child who develops cough and difficulty in breathing during winter.
Theme 30: Investigations In Acid Peptic Disease.
A. H. Pylori Serology.
B. Oesophageal Manometry.
D. Faecal Occult Blood.
E. 24 Hr. ambulatory Ph monitoring.
F. Barium meal.
G. Do nothing.
126. A 50 yr. Old obese woman with h/o pain in epigastrium which is present specially at night and after meals, also has water brash.
127. A woman with h/o pain in stomach after a fundoplication operation.
128. Woman with long h/o peptic ulcer disease with positive H. Pylori serology comes for re-examination after 4 yrs.
129. A 36 yr. Old man has been treating himself for dyspeptic symptoms for many years.
Theme 31: Treatment For Upper GI conditions.
A. Give antacid.
B. Give H2 blockers.
C. Esophageal dilatation.
D. Esophageal Excision.
E. Celestin Tube.
H. Endoscopic Biopsy.
130. A pregnant woman with dyspeptic symptoms since past 4 days.
131. A pt. With chronic dyspepsia has developed Barrets esophagus.
132. A pt with esophageal stricture.
133. A pt with a localized esophageal tumor with no signs of metastasis.
134. Patient with CA of oesophgus and mets.
Theme 32: Management Of Injury to Upper Limb.
D. Apply plaster cast.
E. Admit for further Investigations.
F. No treatment required.
135. A child with pulled elbow first presents to A & E.
136. A child with h/o fall presents with tenderness & pain below the thumb, X-ray is normal.
137. A child presents with torticollis she has no h/o trauma.
138. A child presents to A&E with limping and pain on rotation after playing football.
Theme 33: Management In Case Of Ischaemic Limb.
A. Incise the Fascia.
D. Atrerio Venous Grafting.
139. A pt with h/o atrial fibrillation presents with a pale, cold, pulse less, leg which he can barely move, and has very little perception of touch.
140. A pt with bilateral diabetic lesions on the feet, presents with a foot with multiple malodorous gangrenous lesions on one foot.
141. A pt. With trauma to leg presents with # of both the bones, sever pain and a lot of swelling.
142. A diabetic pt with a unilateral ulcer on foot, which has absent pulse arteriography shows lack of blood supply.
Theme 34: Management Of Osteoporosis.
C. Reduce Wt.
D. Wt. Bearing Exercise.
E. Calcium Supplement.
143. A woman with high BMI.
144. A 40 yr. Old lady with family history of osteoporosis, comes for advice.
145. A pt who needed dietry calcium.
Theme 35: Head Injury.
A. Mild Injury
B. Moderate Injury.
C. Sever Injury.
D. Fracture Skull.
E. Fracture Base of Skull.
146. 45 y old alcoholic with h/o recurrent falls was brought to A&E by his wife in a
Confused state, his GCS is 12.
147. 7 y old boy with h/o fall from cycle.Lost consciousness initially but alert, oriented
now.Xamination reveals no abnormality.
148. A man with head injury who also has haemotympanum.
149. 23 y old footballer brought to the A&E.Was talking to the paramedics well after
injury but subsequently lost consciousness.
150. 42 y old man fell down .o/e GCS-13.
Theme 36: Management Of drug abuse:
A. opiate abuse.
B. Opiate withdrawal.
C. Alcohol withdrawal.
151. A female pt comes to A&E demanding pain relief.
152. A pt with h/o of alcohol abuse with signs of alcohol withdrawal.
Theme 37: Analgesia In terminaly Sick.
A. Pt Controlled Analgesia.
E. Palliative X-Ray.
G. i/v opioid
153. A pt with bladder carcinoma, now presents with metastasis to the spine presents with severe pain in the back.
154. A pt with carcinoma colon has sigmoidectomy done.
155. A woman who has had breast surgery done.
156. A pt. With carcinoma rectum.
Theme 38: Management Of cardiac Conditions.
D. B blocker.
E. DC Cardioversion.
G. Thiazide diuretic
157. A pregnant female with tachycardia of 160/min. she shows no response to Adenosine.
158. A pt with refractory pulmonary edema and cardiac failure, was prescribed furesemide, but the pt. Still continues to detoriate in spite of furesemide therapy.
159. A diabetic pt who develops hypertension.
160. A pt with family history of sudden death, and signs of HOCM.
Theme 39: Respiratory Disorders.
D. Coarctation Of Aorta.
F. Sleep Apnoea.
161. An obese male who is tired lethargic, gives h/o repeated awakening during sleep with sweating, palpitations, and tachypnoea.
162. A pt with COPD develops sudden breathlessness and absent respiratory sounds on one side of chest, X-ray shows absent lung shadow.
163. A tall male develops sudden central chest pain, becomes pale, and tachycardic with difference in pulse.
164. A teenager with fever and cough and pain in lt lower side of chest on breathing.
165. A pt with pain in central chest, which is relieved by bending forward, also raised JVP and pericardial rub.
166. A child with bronchiolitis.
Theme 40: Diagnosis Of Urinary Retention.
A. Clot Retention.
D. Systemic Sclerosis.
E. Compression Of Spinal Cord.
F. Incontinence Pants.
167. A child is brought by mother who says he is sometimes faecaly and urinary incontinent.
168. An old pt. Who has been incontinent for a long long time now develops signs of dysuria.
169. A pt. With carcinoma of prostate, and urinary symptoms, has haematuria and then sudden retention of urine.
170. A pt with history of urinary hesitancy, has a large amount of alcohol, and then presents with sudden retention of urine.
171. A pt. With huge enlargement of prostate, it is eaven palpable suprapubicaly, presents with weakness of feet and retention of urine.
172. A pt with history of recurrent numbness of feet and recurrent focal neurological signs, and retention of urine.
Theme 41: Pre Operative Investigations.
A. Excecise ECG.
173. A pt with respiratory problem due for operation.
174. A female on chronic use of OC pills.
175. A pt with h/o angina on exertion.
Some Miscellaneous Questions:
176. An old pt with his dentures missing.