HAADexam19052016

1. ECGsofAorticaneurysmalongwithclinicalscenarios
2. ECGofVentriculartachycardia.
3SymptomsofcushingandAddisontogether(Hyperpigmentation,HighACTH,
Abdominalstria,Faceacne,roundface)whatisthecause?
Adrenaladenoma
Adrenalcarcinoma
Pituitaryadenoma
MENsyndrome
4Pthascough,ptosis,anhydorsis&myosis(clinicalscenarioofHorner
syndrome),whatisinvestigationofchoice
CTscan
MRIbrain.
ChestXray.
5.Photographofchildwithrickets.
6.Comparisonofcow&breastmilk.
7Femalecomingwithlowerabdominalpain,tendernessanddyspareunia
,examinationshownoduleontheposteriorfornixofvagina.Whatisthenextstep?
Laparoscopy
Laparotomy
VaginalUS
8sideeffectofhaloperidol,hehasmotorrestlessnessunabletositdueto:
dystonia

dyskinesia
akanthasia
9.Cervicalintraepithelialneoplasia(CIN3),treatmentplan.
Cryotherapy.
Hysterectomy.
Conebiopsy.

10.Ptwithpretermlabour,afterdeliverybabyhadvomitingaftereveryfeed,
Xrayabdomenshowsdoublebubblesigndiagnosis?
Duodenalatresia.
Tracheoesophagealfistula
Pyloricstenosis.
1173yearoldladyhasvaginalbleeding,sheismenopausalsinceageof52
,examshowvaginalthickness3mm>withvaginalpeticiawhatisthediagnosis:
Atrophicvaginitis
Endometrialcancer
endometrialpolyps

12PatientadmittedfortttofinfectionwasgivenGentamycin,hisillness
improvedbutcheckingcreatininleveliselevated(wasnormalonadmission)what
isthecause:
proliferativeGN
Gentamycininduced
13..Cervicalulcer,investigagtionofchoice
PAPsmear

Calposcopy
Cervicalsmear.

13Pseudomembranouccolitisstartwaterydiarrheathenbecomebloodyafter
courseofamoxicillinfor5day+bleedingperrectumwhatisthediagnosis?
14AverylongcaseaboutSLE,hadbleeding,blueecchymoticpatchesonhis
handsandfeetandsomanyinvestigationsaskingwhichtesttoconfirmdiagnosis?
LowC3andC4
Antilupusantibodies
15EpidemiologyQ:thereisresearchaboutdecreasingtheinfectionindoctors
gettingneedleprick:whattodo:
a

makesuggestion/incidentsboxforcollectingdata

immunization

HandwashingandwearingGloves

Reporteveryneedelpric

16childhasvaricella,motherispregnantanddoesntrememberifshewas
vaccinatedornot.nextstep?
a. CheckVaricellaIgG
b. b.Igm
17DiagnosisofAbdominalAorticAneursmbyAbdominalUS
18CaseofDiagnosisofAcutepancreatitis(Diabeticwithepigastricpainradiate
totheback,nojaundice)

19.Teenagerwithseverescrotalpain.
Epidydmoorchitis
Testiculartorsion
Testiculartumor
2016yearoldgirlcomewithAmenorrhea,doesnthavebreastdevelopmentand
havepubichair,sheis46xxwhatisthediagnosis?
21.Clinicalscenariosofmedian&radialnerves.
22verylongcaseofRTAadmittedtohospitalfor4daysthendischarged.he
camewithhighCardiacoutput,whichtypeofshock?
septictherebecauseofhighCRP.
23Neobornbabyhadjaundiceintheseconddaythenonthirddaylevel31and
developedconvulsionsandpoorfeeding.DiagnosisKernictrus
23TypeofinsulinusedinDKA:
lent
ultralent
Crystalline
NPH
24child6weeksoldhaspansystolicmurmur,notpresentatbirth.Diagnosis
ASD
VSD
PDA
Coarctationoftheaorta
28Caseofpyelonephritiswhatantibiotictogive:

Septrimfor14days
Nitrofurantoinfor14days
Ceprofloxacinfor14days

29Breastfeedingwomanhasbilateralbreasttendernessandwarm,Mammogram
showdiffuseopacitybilateral
whatisthediagnosis?
BreastEngorgment
Mastitis

30.ClinicalscenarioofOrganophosphorouspoisoning

314weeksoldboyhasfever,rectaltemp38.9C,hedoesnthaveanyother
symptomsorfocalinfectionwhattodonext?
aOralfluid
bIVacyclovir

33Cardiologycaseandinthemiddleofthecasementionedsuddendeathhistory
inthefamilyaskthediagnosis=Hypertrophiccardiomyopathy.
34XrayandCTphotoaskingthediagnosisHyperparathyroidism
35CaseofAorticDissectiondescribingthechestpainintheintrascapularregion
andbroughtECGsameasbelowaskthediagnosis

36PhotoofBloodpicture

askingDiagnosisSickleCellAnemia
39JaundiceandPruritusandhistoryofulcerativecolitis=aPrimary
schelorosingcollengitisb.primarycirrhosis
40Pregnant6weeksLMPwas6weeksagoandtheuterinesizeis6weeks
pregnant.Shehasabdominalpainanddisturbedincarceratedcervix(somethinglike
thatIunderstoodthereistissueinCX)askdiagnosis:
Ectopic
Threatenedabortion
Incompleteabortion
Completeabortion
41Femalepatientcomplainofabdominalpain,hercyclesareregularandhas
mensesfor6daysbutlastmonthshehadherperiodforonedayonlythiswas3
weeksagoforoneday.asknextstep:
serumBHCG
Laparoscopy
US
42Femalepatienthadvaginaldeliveryof2900gramsathomeafter30minutes
.Shedevelopedvaginalbleedingofredcolourafter18hoursfromlabor.ask
diagnosis:
Atony
Vaginaltear
retainedplacenta
43femalepatientpregnant,herLMPwassince30weeks,shehasdoneUSnow
showingsheis32weeksbythebiparietaldiameter.ShehasdoneUS18weeksago
itwas16weeks.SOwhatisthegestational:
30
32
31
34(USinthetrimesteristhemostaccurate)

44FemalepatientG4P0.Shecamewithabortioninfirsttrimester.askthe
diagnosis?Idontrememberthechoicesbutifyoufacesuchquestiontheanswer
iseitherseptateuterusorantiphospholipidsyndrome.
45yearoldfemaleonOCPs,coofheadache,vomiting,examinationshow
papilledmasheisrelievedwhendoinglumbarpuncture.askdiagnosis?Idiopathic
orbenignincreaseofintracranialtension.
46CaseofKawasakiaskdiagnosis(fever,tonsillitis,strawberrytongue,enlarged
cervicalLN,edemaoffoot,eyeconjunctivitis)
47caseofirondeficiencyanemiaRDWHIGH
48caseofcowmilkproteinallergyinthecubitalfossaasknextstepgivesteroid
49QaskingthedefinitionofMinutelungvolume
50AverylongcaseofSLEcoofbleeding,blueecchymosisonhandsandfeet.Q
asktheinvestuigationtoconfirm
LowC3AndC4
Lupusanticoagulant
51stabwoundinthechest,muffled/distantheartsounds(cardiactemponade)ask
nextstep?
TransthoracicEcho
TransEsophagealEcho
52Caseofpostoperativehypotension+shiftingdullness.askingnextstep:
0.9%Naclbolusdose
Paracentesis
Laparotomy
5311yearoldChildwithasthmaonsalbutamoleinhaler200mghewantssome
betterdrug:
Ipratropium
Thyophylline
Cortisolinhalation
Salbutamoleanotherconc

54CaseofHornersyndrome(ptosis,myosis,anhydrosis)increasesweatinthert
sideofhisfaceasknextstepininvestigationChestXraytocheckforpancost
tumoracommonassociationwithHorner.
55Caseoforganophosorouspoisoningaskthediagnosis
(vomiting,miosis,diarrhea)
56Caseofhypertentionandproteinureawhatmedicationtogiveinnormotensive
patienttoprotecthiskidney?ACEI
57CaseofBPHhehasmildobstructivesymptomherefusedsurgeryaskwhatto
givetoreliefsymptomsGivealphablockers
58caseofwaterydiarrhea,pain,tendernessintherightloweroftheabdomen,
ulcerintheterminalileumaskthediagnosis:
Crohnsdisease
Appenicitis
Ulcerativecolitis
59Caseoforbitalcellulitis
60anewbabycomeoutofcsdevelopedtachycardiaincxrfluidinfissurewhatis
thediagnosis?Transienttachypneaofnewborn
61Pyelonephritis
62Anoldladyhashesitancy,urgency,nodysurialowerabdominalpainlast
periodbefore2year(Idiagnoseditasuterineprolapse)askttt:
IchoseAmoxicillin,antispasmodic,alkalitheurine,painkiller(imnotsure)
63EpidemiologycaseofJuvenileRheumatoidArthritisaskhowtocollectcases
fromConsultantdoctor
65pregnantladywithHashimotohypothyroidism.Sheisonthyroxindeveloped
Goitre2monthagowhenshebecomepregnant.HerinvestigationsshowNormal
TSHanddecreasedT4.Scanshoweuthyroidactivity.Whattodonext?
AReassurance;thisisnormalwithpregnancybIncreasedoseofThyroxin
66whatistheorganismintonsillitis:Groupastreptococci,Groupctreptococci
67Mass2cmfirmmobile,inmammogramshowcalcificationwith
spiking/speculation
Diagnosis?Firoadenoma

69Breastmass2cmwhenyoupressitthereisseroussecretionfromthenipple
whatisthediagnosisnoskinchanges:
CarcinomainSitu
ductalPapilloma
DuctalCarcinoma
pagets
70Anoldmanwithdelirium,10yearsagohehadstrokeandquadriplegia.When
hewakeuphedidntrecognizethenurseorhissonsanddaughtersnofever.what
isthediagnosis?UTI
71CaseofCaudaEquinalesionaskdiagnosis(Parethesiainperineum,LL
weakness,UrineIncontinence)
72Lowbackpainafterliftingheavyobjectwhatisnext?Diclofenac
73AnothercaseofhypotensionpfterD&Cwithhypotensionaskwhatisnext?
giveIV.09%NaClbolusdose
7430yearoldmentallyretarded,wasrecentlyemergedinthesocietynowsitting
inhisroomandclosehisdoor,hehasurineandstoolincontinence.Whatisthe
diagnosis?
Abuse
Majordepression
75Childof6monthagehasbilateralchestinfectionaskdiagnosis?Bronchiolitis
76CaseofCINgradeIIIaskmanagement?Hystrectomy
77CaseofAmenorrheaandweightloss,sheisdoingexercise.Whatisthecauseof
amenorrhea?
Hypothalamicamenorrhea
78Caseofasthma,smokingandnotcomplianttottt.Qaskingwhatisworsefor
him:
Heissmoke10cigaretteperday
Heisnottakingttt
Gettingchestinfection
79Caseoffibroidaskingbeforeremovalwhattodecreasesizeinorderto
decreasebleeding?

DailyProgesteron
DailyOCPs
Dailyestrogen
oxytocin
81PregnantladyhasanemiaHb7mg/dlaskmanagement:
giveherbloodtransfusion
giveherIronsupplenmtation
giveherparentralIronandmultivitamins(Imarkedthis)
Dietmodification
82AverylongcaseohHCVwithlivercirrhosisabdominaldistentionumbilicus
isevertedgeneralizedabdominaltendernesswithtemperature37.5whatisthenext
step
a.Dolapratomy
b.Needlparacentesis
83ptcysticfibrosisdevelopproductivecoughesputum,fevermainCauseof
pneumoniaincysticfibrosis
astaph
bstreptpneumonia
cpseudomonas
84femal(polyhydrominos,HITwithtraceproteinuria)postpartumbleedingwas
developedwhatisthebesttreatment
aoxytocin
bsyntenon
corgmetrine
85femalepregnant29thweeksuterinecontractionevery4mint,prexamination,
thecervixis1cm,nodrainageofbloodandmembraneintact,whatisthebestthing
forthefetus?
ainductionoflabour
bgivethepttocolytics

cgivecortisonetoprotecttherespiratorythelung
86pregnantwomenherfatushasdilated,bladderandhydrouretersandsheis
oligohydrominos,diagnosis:
arenalagenesis
bposteriorurethralvalve
87motherRhve,fatherRh+vethelastchildwasRh+veandhasjaundicesheis
pregnantnowat26thweektheindirectcomestest1:567nextstep?
agiveherantidnow
88femal29yearswithvaginalbleedingpostcoitalbleeding,speculum
examinationthereiscervicalulcernextstep:
a.smearforcytology
b.cervicalbiopsyhistopathology
c.colposcopy(Imarkedthis)

91.female10yearstallstatureenlargementofclitorisandlabiamajoraboneage14
yearsdiagnosis?
a.turnersyndrome
c.congenitaladrenalhyperplasia
c.testicularfeminization
94.babycomingwitheyelacerationpainproptosislimiteyemovementnormal
opticdisc DX?orbitalcellulitis
95.medilagemanhashistoryofchronicHTNcamewithhematuriahismotherhas
chronicrenalfailureDX?Polycystickidney
96.ateacherinschoolrecentlydiscoveredthatshehasbreastcancershestatethat
thereare3teacherinthesameschoolhadbreastcanceralsoshecametoyouand
insistthatthecauseofherisrelatedtoherschoolwhichbuiltsince4years?

1doaresearchtoknowtheoccupationalfactorcausethebreastcancerinher
school
2reassureherandtellherthattheschoolisonlyfrom4years
3tellhertocomeaftermastectomytodiscussherfamilyhistory,smoking.

99oldagecomewithmildsymptomofurinaryretentionhehasBHPherefusethe
surgerywhatyouwillgivehim?
a.alphablocker
balpha5reductase
cbetablocker

100caseofdysphagiatosolid,shepreferredfluidbecauseshegettiredwhenshe
eatsolidfoodDX?
a.sjogren
b.myastheniagravis

102.oldmancomewithchestinfectionduringexaminationfoundcentrallung
massabout2cmandthismassnow1cmfrom8yearsthemasscontainfattissue
whatisthenextstep?
a.ct
b.bronchoscopyandbiopsy
c.nothingtodo
.50yearsoldmancomeaskingforasprinforpreventionfromCADaccordingto
criteriathatwasgivenheis+1whatheshoulddotopreventriskofCADafter10
years?
a.asprine

b.atrovastine
c.walkingfor30minsperday
patient with painful contraction came and go but now no pain she had
multiple episode last week DX?
False labor pain
.infant of mother with gestional diabetes developed seizure after delivery
what is the cause ?
Hypoglycemia
pregnant lady at 26 wks her BL pr 160/100 with proteinuria +1 what the
drug of choice?
Methyldopa
Hydralazine
Beta blocker