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call from mom who concerned about her 18 years daughter depression, mx

1. Tell her come with her daughter


2. Cant ask about any other pt
3. Yu will discuss daughter depression with her

2.Pt took naloxone for pin point pupil, took many medication, pcm, indomethacin
abg o2 6L

PO2 120

PCO2 65

HCO3 NOT SURE

NEXT

1ANTHER NALOXONE DOSE

2. repeat abg

3.reduce o2

4. pcm assay

3.70 years old , blood stained dischargr. Ectocervix normal in examination. Markedly
atrophied cervical mucosa, normal cervical cytology mx

1.HRT

2.VAGINAL ESTROGEN

4.22 MAN WITH MARKED ANXIETY, VAGUE SUSPIOUS. Isolated, poor hygiene, leave
school, nevere work.what will help u to reach dx

1.eccentric attair

2. perplexity

3. depressed affect
3.auditory hallucination

4 delayed responce

5.34 yrs man get from work last warning due to excessive recheck,took sich leave.
Come to you, after relaxation teqnique, what is the mst appreopriate

1,exposure sensitization

2.citalopram

3,olanzapine

6.nurse mother, his boy fall pump helmet , 3 days ago, c/o of intermittent
headache,tenderness , no swelling,normal nurological exam, no loss of concious she
force u to do something as she is afraid from skull feacture,what u will do

1.ct head

2.x ray

3 admit

4. Nothing

6.38 wks preg. BP 150/95 MILD FEVER, HEADACHE OVER 24 HS, RUQ pain, no
palpable liver

Rup tenderness T 37.8. fundal height 34 wks dx no vaginal bleeding in the


cenario

1.cholycyctitis

2. hellp

3.concealed abruption placenta

7.RUQ pain , fever, palpabale mass, US shows thick walled gall bladder full of
stone, bile duct 8 mm with no filling defect, dx

1.billiary colic

2.acute cholecystitis

3.choledocholycystitis

4.cholangitis
8.70 years old man with hemoptysis forone yr cxr

1. Recurrent pulmonary embolism


2. Broncjiactsis
3. Bro, carcinoma
4. Bronchitis

9. pt anorexia nervosa, interscapular pain, tenderness on percussion, dx

1, vertebral compression fracture

2, pul. Embolism

3.pneumonia

10. col mining engnier , heavy smoker, nocturnal cough. Normal cxr, next

1. ct

2.upper endoscopy

11.4 yrs child easly brusing , petechae, 5cervical ruberryLN, no splenomegaly.plt


5x109

Other blood valu within normal level, mx

1. Cytotoxic drug
2. Prednisolone
3. Ivig
4. Plt

12.aboriginal child wellow ear dis charge nasal dis charge 2 months,

1amoxcillin

2, ear toilet

13.pt arrive from travel. Chest pain sibce 4 hrs which is worsening now, sweating ,
BP 90/60
1. Lbbb
2. Inf mi
3. Pul. Embolism
4. pericarditis

14. old man diagnosed with lower disc prolapse after lifting heavy object.he is
on analgesic since that and advised to mobilize, now present with urine
retension since 8 hours.dx

1. spinal lumber disc prolapse


2. 2. Bladder outflow bstruction
3.

15. 4 yrs old gir, presened with c/o of easily brusing,petechae, 5 cervical
LN, rubbery
All lab seem within the normal range except plt,5x 1o9

Mx

1.cytotoxix drug
2.plt
3.predinsolone
4.ivig

16. 3 LN in the posterior neck triangle, smooth, firm, fnac normal cxr appear
normal to me, next
1.ct chest
2. ct neck
3, exision

17.cenario f acute limb ischemia mx


1. LMWH
2. IV HEPARIN
OTHER OPTION I DONTR REMIND

18.DAY CARE CHILD 2 years old. 2wks harsh cough, mx

1. Naso pharyngeal asprate


2. Serology

18. study conducted to measure the incidence of influ. Infection among university
students who wear mask, there is 2 groups, masked and unmasked, what is
measure its validity

1. double blinded

2.randomsation

19.41 yrs old female, co of hot flush, arthralgia, fatigue , fever 37. After 4 houre
fever 38.5, mx

1. ana

2.blood culture

3.crp

4. anti doucribocyli dont remind it exactly

19. pt on multiple medication who stop all of it 3 wks ago, known to have CHF ,
PAROXYSMAL ATTACKS OF af ,now odeama up to ankle , crckles, but no necg given

1. frusemide

2. digoxic

3all medication

20. old pt previously healthy , now co from palpitation with irregular irregular
pulse,BP 120/80. What u will find in examination

1. normal cardiac exam

2.pda

3.ms
21.pt after surgery for perforated sogmoid,after 2 days, become agitated, tell I know
u will kill me.inv.

1.pu;lse oximetry

2. electrolyte

3.urine culture

22.pt intoxicated, threatned to through himself infront of car if not admitted, h/o of
several admission for toxic alcohol withdrawal , said 2 days he drinks sheep alcohol
and eat street fod. Next

1.iv diazepam

2.glucose

3. thiamine

23. 64 old male, lost 8 kg in 6 wks , lethargic. Ll odema left side chest crackles.
Fatigue . smoke 40 packs per yearfor long time , but stopped 5 years ago after he
gets MI, DX

1.COPD CORPULMONALE

2. CHF

3. INTERSTITIAL LUNG DISEASE WITH BRONCHISAL CARCINOMA

4.

24.OLD LADY WITH RECURRENT CO Of valvular itching ver last 6 month , tt wiyh
clotrimazole, recovered , but recurremt again

1.Vulvular cu;lture

2. rectal swab

3.hiv serology

4. urine culture

25.8 yrs girl with recurrent URTI and pallor, cbc result given all normal except, low
HB. LOW MCV, NEXT

1. ELECTROPHORESIS

2. CULTURE
25. 52 YEArs old with sudden loss of vision in the rt eye, c/o of recurrent throbbing rt
sided hesadache, history f myalgia, fatigue weakness, ESR 32. EYE EXAMINATION
NORMal

Mx

1. ASprin
2. PREDINSOLONE
3. WARFARIN

26. VANCOMYCIN SENARIO , I marked idiocyncrsy reaction but not sure

27. vancomycin and amlodipine , nect

1. give same dose at slow rate

2. not give

3. give with steroid or antihistamin . I dont remind exactly

28. 24yrs old girl regular normal cycle, started ocp 2 month ago, now c/o of
intermenstrual bleeding and painful menses

1. cervisitis

2. endometrium respons to ocp

3. cancer cervix

29.tight cast, first clinical feature

1. pain

2. color change

3.swelling

30.pt with hlo of food anaphylaxis , when go to restaurant what advice u give

1. steroid

2, antohistamin

4. Pre filled adrenalin pen


31. pt on colanzapine , start cannabis , tobacco, now c/o of akasethia and want to
stop clonzapin, mx

1. tell him if he stop there is a recurrence in one year

2.bezotropine will stop akasthesia quickly

3. stop the medicine

4.advice him to stop cnnabis and tobacoo if he want better outcome for his health.

32. old man c/o of drinks 2 peers per day, vam with mild abdominal distension ,
mild pain, lower limb odema,urine +++rbc , +++proien. Wbcs cast

1. alcoholic cirrhosis

2, interstitial nephritis

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