51-patient on oral anti diabetics has to undergo sugery
Stop meds on the day of surgery
52-long scenario….poatssium raised to 5.7
Iv calcium gluconate
53- another scenario for hyperkalemia
Answer:Iv insluin plus dextrose because ca gluconate was not in option
54-patient with swollen feet knee joint x ray showing punched out lesions
Diagnosis gout
55.scenario of septic arthritis
Joint asprate for culture
56-patient admitted for surgery has glucose in urine
Cause stress induced
57-patient came for routine check up blood sugar random was abnormal
Follow up investigation?
Repeat fasting sugar
58-asthamtic patient with silent chest
Finding indicating severity
I chose high paCO2 levels
59-case of copd came to hospital not improving with o2 bronchodilator and steroid
Next step
NIPPV
60-male with multiple painful penile ulcers
Cause
Herpes
61-moderate dyscariosis on cervical smear
Next step
Colposcopy
62-Sexually active female with new partner comes with post coital bleeding and increased discharge
Cause
Clamydia cervicitis
63-postmenupausal woman with hot flushes …..20cigarretes per day and hypertensive taking amlodipine for hypertensin and blood pressure well controlled
Treatment
-Esterogen and progesterone or clonidine
I chose HRT as she was already taking amlodipine so shdn’t add clonidine.
64.case of subdural hematoma
Investigation CT
65-VT and haemodynamically unstable
Dc cordioversion
66-PT in CCU with arrhythmia unstable
Cardoiversion
67-patient with pulse of 34per minute
Atropine?It says in samson notes that atropine should be given
68-patient with frequent episodes of palpitations and chest pain Ecg normal
Patient stable
Best investigation
24 hour ecg
69-Bulima nervosa and bmi 17
Refer to eating disorder unit
70-patient took amitryptyline and is stable
Ecg monitoring
71-delirium tremens
Chlordiazepoxide
72-overdose of drugs and coarse tremor
Lithium
73-patient on indapamine falls in morning frequently
Postural hyptotension
74-patient with sudden painless vision loss
Fundoscopy shows flame shaped hemorrhages
Answer CRVO
75-hypertensive patient on amlodipine
Fundoscopy shows dot blot and hard exudates
Answer Hypertensive retinopathy
76-patient with problem in giving presentations ….
Social phobia
77-child with periorbital pain fever swelling
Answer preorbital cellulitis
78-patient with pain on corner of
Lower eye lid side of nose and lip
Answer infraorbital nerver?
79.patient involved in fight and got a punch
Pain and swelling in eye and diplopia
Bone damaged
Sphenoid bone? According to samson or swammy mock key
80-scenario of chronic fatigue syndrome
81-scenario of bppv
Hallpike menuever
82-tremor on streching hands and relived by alcohol
Answer benign essential tremor
83-non sedating anti histamine
Cetrizine
84-Allergy and breathlessnes
Im epinephrine
85-woman with bee stungs multiple times
What advise would you give for future
Answer-apply anti histamine cream
86-psychotic depression
87-psuedo dementia
88-chicken pox exposure pregnant lady no antibodies
Answer give immunoglobulin
89-hep b positive mother gives birth to a baby
Answer give hep b immunoglobulins
90-scalded skin sydrome
91-hiccoughs in cancer patient
Answer chorpromazine(haloperidol was not in oprion)
92-cervial cytogy for suspected cerival cancer
93-adult with pencil rubber in ear
Remove with a hook
94-ear discharge hearing loss
Chloesteatoma
95-cancer patient with cough not responsing to codine
Answer antimuscuranic injection
96-pain controlled with oral
Morphine 60mg BD now cannot take orally
Answer subcutaneous 60mg OD
97-woman with 2 previous abortions
Advice for future
Answer aspirin as soon as pregnant
98-women shifted in a new house
No history of trauma presents with pain in upper arm
Supraspinatous tendnitis or bicep tear?
I chose supraspinatous as in 1700 files by dr khalid
99-asthmatic patient pain in joint
Answer paracetamol
100-pregnant woman with osteoarthritis
Answer paracetamol
