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1) A 34 yr old gravida 4, para 3 + I presents at 20 weeks with a grossly distended abdomen. She is dyspnoeic and complains of general abdominal discomfort. Abdominal USG shows the deepest pool of amniotic fluid to be IOcm and a normal fetus. What is the single most likely management plan?

One answer only.

   Induce labour & deliver immediatelyhypotensive

   No treatment, observation only

   Abdominal amniocentesis

   Give diazepam PR

   4-5 g IV MgS04 +hypotensive

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2) A 24 yr old primi gravida presents at 36 weeks with abdominal discomfort and on examination her abdomen is found to be larger for dates. She is dyspnoeic and complains of indigestion and claims the abdomen has swollen to this size within a week. USG shows the fetus to be normal. What is the single most likely management plan?

One answer only.

   Give 500 mg stat Acetazolamide

   Do emergency cardiotocography

   Propanolol immediately

   Induce labour & deliver immediatelyhypotensive

   No treatment, observation only

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3) A 40 yr old lady 38 weeks pregnant is brought to A&E fitting. Prior to this she had complained of epigastric pain. Her BP is found to be 200/110 mmHg. What is the single most likely management plan?

One answer only.

   Induce labour & deliver immediatelyhypotensive

   No treatment, observation only

   Abdominal amniocentesis

   Give diazepam PR

   4-5 g IV MgS04 +hypotensive

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4) A 59 yr old woman whose periods stopped 5 yrs ago has become increasingly depressed. She now feels life is no longer worth living and threatens suicide. What is the single most likely management plan?

One answer only.

   Psychological support

   Referral to psychiatrist

   Regular exercise

   Vaginal lubricant

   Vaginal estrogens

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5) A 72 yr old woman has experienced of micturition intermittently for the last few months. Midstream urine cultures have been persistently nega- tive. She is well otherwise, but would like her symptoms to be resolved. What is the single most likely management plan?

One answer only.

   Clonidine

   Combined HRT

   Hypnotic preparations

   Mineral supplements

   Oestrogen only HRT

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6) A 70 yr old woman presents with confusion and productive cough. CXR shows right lower lobe consolidation. What is the SINGLE most likely causative organism?

One answer only.

   Actinomycosis

   Pneumocystis carinii

   Streptococcus pneumoniae

   Mycoplasma pneumoniae

   Staphylococcus aureus

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7) A pet shop owner presents with high swinging fever, cough and malaise. He has scanty rose spots over his abdomen. CXR reveals diffuse pneumonia, What is the SINGLE most likely causative organism?

One answer only.

   Chlamydia psittaci

   Streptococcus pneumoniae

   Mycoplasma pneumoniae

   Haemophilus influenzae

   Staphylococcus aureus

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8) A 70 yr old alcoholic man presents with sudden onset of purulent productive cough. CXR shows consolidations left upper lobe. What is the SINGLE most likely causative organism?

One answer only.

   Pneumocystis carinii

   Aspergillus fumigatus

   CMV

   Actinomyces israelli

   Kiebsiella pneumonia

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9) A 10 yr old boy with cystic fibrosis presents with pneumonia. What is the SINGLE most likely causative organism?

One answer only.

   Pseudomonas aeruginosa

   Pneumocystis carinii

   Aspergillus fumigatus

   CMV

   Actinomyces israelli

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10) A 30 yr old man with AIDS presents with fever, dry cough and dyspnoea, CXR shows diffuse bilateral alveolar and interstitial shadowing beginning in the perihilar regions and spreading outward, What is the SINGLE most likely causative organism?

One answer only.

   Pseudomonas aeruginosa

   Pneumocystis carinii

   Aspergillus fumigatus

   CMV

   Actinomyces israelli