1) A 30 y old IV drug user presents with fever, night sweats, chest pain, and
arthralgia. O/E painless erythematous lesions noted on the palms of the
hands; with round erythematous lesions and central clearing noted in the
retina and splinter haemorrhage under the fingernails.
Which of the following is the most likely diagnosis?
A) Syphilis
B) HIV infection
C) Infectious hepatitis
D)Bacterial endocarditis
2) A 70-year-old patient has a sudden onset of pain in the left lower limb. The
pain is severe and associated with numbness ,The patient had an acute
myocardial infarction 2 weeks before and was discharged 24 hours before this
presentation. The left leg is cold and pale, the right leg is normal.
Which of the following is the most likely diagnosis?
A) Acute arterial thrombosis
B) Acute arterial embolus
C) Deep vein thrombosis
D)Dissecting aneurysm
,3) A 75-year-old man who has been followed up routinely for hypertension
and type 2 diabetes mellitus was found to have an irregular pulse which was
not found 6 months earlier. In addition to hypertension and diabetes, his past
history confirms a previous transient ischemic attack. He is currently
asymptomatic and is compliant with his medications
ECG:
Atrial fibrillation at rate of 70 beats per minute
Which of the following is the most appropriate management plan?
A)Add digoxin to his current treatment regimen
B)Pharmacological cardio-version to sinus rhythm
C) Start anticoagulation therapy to prevent stroke
D) No further step is needed as he is asymptomatic
4) A 55-year-old woman presents with sudden left eve visual loss for 20
minutes. The vision returned to normal after this episode. History reveals, she
has diabetes mellitus. The physical examination is normal.
Vitals within normal..
Which of the following is the most likely diagnosis?
A) Multiple sclerosis
B) Retinal detachment
C)Conversion disorder
D)Transient ischemia attack
5) A 60-year-old diabetic patient presents for follow-up. He is on metformin,
HA1c 5.8%. Physical examination is normal,
Blood pressure 149/90 mHg (three readings)
Other vitals within normal
Which of the following is the most appropriate management?
A) No change in therapy
B) Add ACE inhibitor
C) Add beta-blocker
D) Add sulfonylurea
, 6) Long case bla bla bla , the Q was What should be the target HA1C
percentage?
A. <5.0
B. <5.5
C. <6.0
D. <7.0
7) 53-year-old woman presents to the clinic She has been unwell for 6 months
with arthralgia, fever, weight loss and pleuritic chest pains. She also has
synovitis of the small joints of the hands. There were no rashes
Vitals within normal
Low Hb , normal MCV , low wbc, low plt , high neutrophils
High CRP , high ESR , high ferritin
Which of the following the most likely diagnosis?
A)Infective endocarditis
B) Adult-onset still's disease
C) Systemic lupus erythematosus
D)Rheumatoid arthritis with vasculitis
8) A 68-year-old man was admitted to ER with a 24-hour history of sudden
severe lower abdominal pain, associated with progressive abdominal
distension and constipation. On examination, the abdomen was hugely
distended, Digital rectal examination confirmed empty rectum
High wbc
Abdominal plain X-ray:
Y-shaped shadow surrounded by a hugely distended colon arising from the
pelvis
Which of the following is the most appropriate intervention?
A)Fleet enema
B)Colonoscopy
C) CT with double contrast
D) Sigmoid colectomy with end colostomy
arthralgia. O/E painless erythematous lesions noted on the palms of the
hands; with round erythematous lesions and central clearing noted in the
retina and splinter haemorrhage under the fingernails.
Which of the following is the most likely diagnosis?
A) Syphilis
B) HIV infection
C) Infectious hepatitis
D)Bacterial endocarditis
2) A 70-year-old patient has a sudden onset of pain in the left lower limb. The
pain is severe and associated with numbness ,The patient had an acute
myocardial infarction 2 weeks before and was discharged 24 hours before this
presentation. The left leg is cold and pale, the right leg is normal.
Which of the following is the most likely diagnosis?
A) Acute arterial thrombosis
B) Acute arterial embolus
C) Deep vein thrombosis
D)Dissecting aneurysm
,3) A 75-year-old man who has been followed up routinely for hypertension
and type 2 diabetes mellitus was found to have an irregular pulse which was
not found 6 months earlier. In addition to hypertension and diabetes, his past
history confirms a previous transient ischemic attack. He is currently
asymptomatic and is compliant with his medications
ECG:
Atrial fibrillation at rate of 70 beats per minute
Which of the following is the most appropriate management plan?
A)Add digoxin to his current treatment regimen
B)Pharmacological cardio-version to sinus rhythm
C) Start anticoagulation therapy to prevent stroke
D) No further step is needed as he is asymptomatic
4) A 55-year-old woman presents with sudden left eve visual loss for 20
minutes. The vision returned to normal after this episode. History reveals, she
has diabetes mellitus. The physical examination is normal.
Vitals within normal..
Which of the following is the most likely diagnosis?
A) Multiple sclerosis
B) Retinal detachment
C)Conversion disorder
D)Transient ischemia attack
5) A 60-year-old diabetic patient presents for follow-up. He is on metformin,
HA1c 5.8%. Physical examination is normal,
Blood pressure 149/90 mHg (three readings)
Other vitals within normal
Which of the following is the most appropriate management?
A) No change in therapy
B) Add ACE inhibitor
C) Add beta-blocker
D) Add sulfonylurea
, 6) Long case bla bla bla , the Q was What should be the target HA1C
percentage?
A. <5.0
B. <5.5
C. <6.0
D. <7.0
7) 53-year-old woman presents to the clinic She has been unwell for 6 months
with arthralgia, fever, weight loss and pleuritic chest pains. She also has
synovitis of the small joints of the hands. There were no rashes
Vitals within normal
Low Hb , normal MCV , low wbc, low plt , high neutrophils
High CRP , high ESR , high ferritin
Which of the following the most likely diagnosis?
A)Infective endocarditis
B) Adult-onset still's disease
C) Systemic lupus erythematosus
D)Rheumatoid arthritis with vasculitis
8) A 68-year-old man was admitted to ER with a 24-hour history of sudden
severe lower abdominal pain, associated with progressive abdominal
distension and constipation. On examination, the abdomen was hugely
distended, Digital rectal examination confirmed empty rectum
High wbc
Abdominal plain X-ray:
Y-shaped shadow surrounded by a hugely distended colon arising from the
pelvis
Which of the following is the most appropriate intervention?
A)Fleet enema
B)Colonoscopy
C) CT with double contrast
D) Sigmoid colectomy with end colostomy
