1.

Someone that hears voices when about sleeping

A . Hypnagogic

B. Hynopompic

2. A woman with itchy dry eyes, Schimmer’s test 7mm

A. Hypromellose drops

B. Saline

C. Prednisolone

D. IVIG

3. man with weakness of the right arm and slurred speech that lasted for 5mins

MRI Normal. ECG of atrial fibrillation

How do you prevent further stroke

A. Aspirin

B. Clopidogrel

C. Statin

D. Rivaroxaban

4. An elderly man with 3+of blood in urine (microscopy). EUCR normal. Most appropriate next
investigations

A. Renal biopsy

B. PSA

C. CT KUB

D. Abd X-ray
E. Urodynamics

5. A woman with worsening frequency, urgency and nocturia more than 1year. It is affecting her quality
of life. How to manage

A. HRT

B. Antibiotics

C. Anticholinergics

D. Bladder neck ligation

6. Child, 7 days post tonsillectomy with bleeding and clots seen

A. Iv antibiotics

B. Call surgeon for exploration.

D - Packing or sth like that in Accident and Emergency

E - Urgent exploration of the tonsillectomy bed

7. 4 year old boy, 4 weeks post tonsillitis with bilateral cervical LN enlargement. Developed lump m
neck. All Signs and investigations are normal. What's the most likely diagnosis?

A AML

B Hodgkin L

C Non HL

D reactive lymphadenopathy

E TB

8 In laparoscopic surgery for gall stone, the trocar placed midway between the midline and the mid
axillary line pierces what structure?

A. Rectus muscle

B linea alba
C conjoint tendon of ext. And int. Oblique

D ext oblique aponeurosis and int. Oblique muscle

E tranvsersus abdominal muscle

9. 80 year old woman who had hip fracture following mechanical fall, being prepped for surgery. now
she is alert but is not oriented in time and place, has inattention and does not retain info. No relatives to
contact. No history of previous mental conditions.What should be done?

A. Make her sign consent and move on with surgery

B. Do surgery in her best interest

C. Refer to psychiatry for assessment

D. Manage fracture conservatively

E. Postpone surgery till her condition improves

10. A 56 year old man with sudden onset of double vision on looking to the right. He is otherwise
healthy and CT scan is normal.

What is the paralysed nerve?

A. Left trochlear nerve

B.Left oculomotor nerve

C.Left Abducens nerve

D.Right Abducens nerve

E. Right Trochlear nerve

11. A 56 year old man, a known diabetic that needs a prescription after a discharge from the ward. (A
picture was given)
A.Insulin glarine 86 units SC in the evening

B.Tego-glefor (can’t remember the name) 300units/ml 86 u SC in the evening

C. The same name 300 units/ml 86 iu SC in the evening

D.insulin glarine 100 units/ml 86 units SC in the evening

12. A 58 year old man given clarithromycin for lower respiratory tract infection. He is hypertensive and
diabetic, he is on furosemide 40mg daily, Metformin 500mg twice daily, simvastatin 40mg daily, ramipril
40 mg daily.

What changes will be needed to the medication?

A. Increase the dose of furosemide

B. Reduce the dose of metformin

C. Increase the dose of ramipril

D. No changes needed.

E.Withhold simvastatin

13. A young man has multiple wart like lesions around his anus. Which organism is responsible

A. HSV

B. HPV

C. H. Ducreyi

D. Syphilis

E. LGV
14. A smoker on multiple medications(cimetidine, atrovastatin, amlodipine, metformin, procyclidine)
decides to quit smoking. Which medication will need a dose adjustment if he finally succeeds with
quitting

A. Atrovastatin

B. Amlodipine

C. Cimetidine

D. Metformin

E. Procyclidine

15. A 46yr old DM/ hypertension and HF. He's on metformin hydrochloride, atrovastatin, amlodipine,
Frusemide, Ramipril.

Lab: K= low

What medication is responsible

A. Metformin

B. Atrovastatin

C. Frusemide

D. Ramipril

E. Amlodipine

16.Patients has Nystamus ,ataxia , vertigo

Location

A. Brain stem

B. Cerebellum
C. Auditory canal

D. Cranial nerve 8

E.

17. A 28 yr old lady presents to the clinic for implant remove 6 months ago , has regular menses, jog 10-
14 mils per week, Weight 20kg/m2.

Wants to conceive, best advise

A.Fertility return late after implant

B.Encourage to reduce exercise

C.Encourage to gain weight

D. Inter course during post ovulation

E. Encourage her to gain weight

18. 80yr with reduce vision, conjunctiva is clear, doesn't see faces in the dark, every other thing is
normal

A. Age related macular degeneration

B. Retinitis pigmentosa

C. Chronic Uveitis

D.

E.
19. A 42 man with unilateral scrotum swelling, painless. Transillumination +. Tested couldn’t be palpated

A. Epididymal cyst

B. Varicocele

C. Hydrocele

20. 82 year old woman who had breathlessness, COPD, 20year smoking history, bilateral wheeze,
inspiratory crackles. Altered abi na tingling sensation along the left 6th and 7th rib with tenderness

A. Carcinoma of lung

B. Herpes Zoster

C. Pathological fracture of rib

D. Osteoporotic fracture of thoracic vertebrae

21. 10 year old girl with bloody diarrhea

Some electrolyte derangement. Can’t remember the rest

A. HUS

22. Was an Ecg, can't really remember

23. Case of Multiple myeloma, predominant cells that will be seen on a bone marrow biopsy

24. Case of 5th disease, with rash in a child. Question was about when it's safe for child to return to
school

25. woman taking pills (POP).. LMP was 14 days ago, sex 5 days ago, 14 hours late on POP

options

A Take next dose and continue as usual

B Take next dose and continue but add barrier protection till end of present cycle

C Offer emergency contraception and continue POP

D Offer emergency and restart POP at next cycle.

(26)A man with incision on the wrist, now having loss of sensation on the medial aspect of the forarm
and little finger plus inability to abduct and adduct the fingers. Which nerve is affected

A. Radial

B. Median

C. Ulnar

(27)A man with right sided headache, pain on chewing, temporal tenderness or so, bp 165/95.

What's is the most appropriate investigation?

A. MRI head

B. CT

C. Temporal artery biopsy

28. A 48 year old man, he drinks and also smokes, has painful swelling in the right foot.

X ray showed ... joint erosions and punched out erosion on the MTP joint. What is the diagnosis

A. Rheumatoid arthritis

B. Gouty arthritis

C. Osteoarthritis

D. Osteoporosis

29. a 64yr old man with hematuria detected on urinalysis blood ++

Next most appropriate investigation

A. CT abdomen

B. PSA

C.

D.
30. A 60 yr old man has been feeling low, cannot maintain eye contact during the consultation

He has history of postural hypotension and BPH.

Appropriate medication

A. SSRI

B. SNRI

C. TCA

31. A 5-year-old with a 6-day history of fever, red and fissured lips, non-purulent conjunctivitis, cervical
lymphadenopathy, polymorphic rash. What is the most appropriate treatment?

A. IV Co-anoxiclav

B. IVIG

C. Oral Ibuprofen

D. Oral acyclovir

E. Oral prednisolone

32. A 40-year old female with breathlessness, no cough.

T: 37.7, SPO2: 89, other vitals were stable.

Most investigation results were normal except slightly elevated D-dimer & CRP. COVID-19 test: Negative.
A Chest X-ray was displayed.

What is the diagnosis?

A. Atypical pneumonia

B. COVID pneumonitis

C. Spontaneous pneumothorax

D pulmonary embolisn
33. A 37-year old male is tired of life. He is the manager of a big supermarket, separated from his wife,
suffers from asthma.

What is the biggest risk factor for suicide?

A. COPD

B. Male sex

C. Marital status

D. Employment status

E. Age

Q.34) 18Month old child referred by the Health Visitor for assessment of Developmental milestones, has
the following, which would disturb you on assessment?

(a)Has social smiles.

(b)Passes objects from one hand to another without showing cerebral dominance.

(c)Walks but does not run nor kick a ball.

(d)Does not make eye contact.

(e) Scribbles lines and babbles 2 words.

Q.35) A 4-Yr old child suffers from Cystic Fibrosis, both parents do not sufferer from it, has a 14Yr-old
sister. What's the sister's risk of carrying the gene?

(a) 1/1

(b) ½

(c) ¼

(d)⅔

(e) None.
Q.36) A 60+ Yr old man suffers a massive left lateral parietal cerebral infarct and has been on Iv. Fluids
for weeks. Doctors think he needs proper nutrition. His wife says she wants nothing artificial for his
nutrition. Best option?

(a)Continue Iv. Fluids and reassess in 48Hrs.

(b)Give thick oral gel.

(c)Nasogastric tube feeding.

(d) Percutaneous Endoscopic Gastrotomy

46. 77 year old male with severe dementia. Wakes up early at 5am but his wife who is his caregiver locks
him in. Next appropriate step.

A. Arrange for safeguarding

B. Inform the police

C. Prescribe hypnotic

D. Admit

E. No action

47. 6 week old patient with a two weeks history of projectile vomiting, lost 300g has a right sided
abdominal mass. What will be seen on investigations

A. Hyperchloremia

B. Metabolic alkalosis

C Hyperkalemia

48. 54 year old male admitted with an acute onset of dizziness and light headedness. with a history of
anterior stemi. Observations normal except bp 90/60 mmhg. On auscultation chest clear, soft heart
sounds.

Cxr: enlarged globular heart clear lung fields

What is the diagnosis

A. Cardiac tamponade

B. Papillary muscle rupture

C. Left ventricular aneurysm

D. Pericarditis

49) A woman that went for routine cervical smear , revealed moderate dyskaryosis. Most appropriate
mgt

A. No further investigation

B. Refer for colposcopy

C. Endocervical swab

D. Repeat smear in 6months

E. Repeat smear in 3 years

50) A 60+ year old man with breathlessness at rest. Increase breathlessness on walking and has a 40
pack year smoking history. Chest X-ray shown . What’s the most likely diagnosis

A. Bronchopneumonia

B. COPD

C. Asthma

D. Pulmonary fibrosis

E. Pulmonary Embolism
51) A 50+ abi 60+ woman with Breast Cancer with metastasis to the liver and peritoneum. She has
vomiting and nausea. All lab values were normal except high urea 10.4 , high creatine and high calcium
(corrected) . What is the initial management

A. 0.9% Nacl

B. 0.45% sodium chloride

C. 5% dextrose saline

52. 56 yr old woman with tiredness and constipation over 4 months.

Anti TPO - positive

T3 normal

T4 - low

TSH - Elevated

A. Levothyroxine

B. Propranolol

C. Propylthiouracil

D. Tamoxifen

53. 36 ur old patient planned for herniorraphy but he is not able to sign consent due to learning
disability and surgical team called for a meeting regarding his case. What to do regarding his consent

A. Advocate

B. His employer

C. Antidepressant

D. Safeguard lead

54. About a drug trial involving 1000 woman half where given drug A and the other half where given
drug B and followed up for 5years or so

A. Retrospective study
B. Cohort study

C. Randomize control trial

D. Prospective study

55. 72 years old man stroke patient with intermittent dysphagia for 6 month.He is now unable to
swallow both solid and liquid. What is the most appropriate mode of treatment

A Nasograstric tube

B percutaneous endoscopic gastrostomy

56. A 32 years old man with recurrent cough since childhood. Each episode present with difficulty with
breathing and wheezing.

What is his diagnosis

A. cystic fibrosis

57. A woman with lethargy and weight gain for 4 month. She had postpartum haemorrhage 6month ago
and was unable to Breastfeed her child.

What part of the brain is affected

A)Hypothalamus

B) Pituitary

C) ovary

D)Uterus

58. A 48hours post MI, presents with breathlessness, has PSM, raised JVP

A. Acute AR

b. Acute MR

C. Tricuspid regurgitation

D.
59. A depressed man previously managed with CBT. Has no self harm

Medication to start.

A. Sertraline

B. Mirtazapine

C. Amitriptyline

D. Quetiapine

60. Reason for adrenaline plus lidocaine

A. Augments its effect

B. Shortens duration

C. Prolongs duration

D. Reduces effect

61.A 52yr old with sudden severe headache and watering of the right eye.This has occurred 6mnths ago
and resolved 2wks later BP 144/88mmhg,Most appropriate treatment

a.Asprin

b.Naproxen

c.Propanolol

d.Codein and Paracetamol

e. Sumatriptan

62. A 66yr old man was brought to the Emergency Department with breathlessness, BP 70/50mmhg RR
40 c/m ,PR 130b/m .Oxygen saturation is 98% on high flow O2.Auscultation shows reduced air entry on
d left while right chest is inaudible,trachea is deviated to d left.Most initial appropriate mgt

A. Insert a Sedlinger chest drain in d right axilla

B. Insert a Sedlinger chest drain in d left axilla.

C. Insert a Sedlinger chest drain in d right pleural cavity

D.Insert a widebore needle in d 2nd left intercoastal space.

E. Insert a widebore needle in d 2nd right intercoastal space

63. A 64yr old male has epigastric pain every night for d past 4months with occasional nausea but no
vomiting.Other parameters are stable.Most appropriate diagnostic test.

a. Barium swallow

b. Plain X-ray Abdomen

c. Helicobacter pylori serology

d. CT Abdomen

e. Upper Gastrointestinal Endoscopy.

64. A lady passed large black tarry stool. Has rheumatoid arthritis and chronic anaemia. Low BP,high
pulse rate. Has received 4 units of blood but vitals have not improved. Whta to do?

A. I.V omeprazole

B. I.V vit k

C. Urgent laparotomy

D. Urgent GIT endoscopy

E.

65. Man with renal sarcoma with posterior abdominal wall mestasis. Increasing pain,was on slow release
morphine 210 mls 2ce daily,increased to 200 mls 2ce dly,also takes subcut dly dose of morphine 120
mls. What to do to alleviate pain.

A. Replace with fentanyl patch

B. Replace with oxycodone

C. Increase the dose of subcutaneous morphine

D. Replace with diamorphine

E.

66. A young man who took ecstasy,found unconscious. Reduced respiratory rate,high pulse,low
BP,pupils dilated, the man also had rigidity in limbs and raised lactate. Drug to give?

A. Baclofen

B. Cefotaxime

C. Dantrolene

67..... A 51yr old woman with hot flushes for 9/12 duration. She had a hysterectomy 5yrs ago. What is
the mgt for her

A. Raloxifen

B. Estrogen only HRT

C. Combined HRT

D. Propanolol

68. 60yr old man post abd surgery, 30mls of urine noted in urine bag 2hrs post op. What is the next
appropriate step

A. Abd scan

B. Flush catheter

C.IVF challenge

69. A 75yr old man who had PEG inserted after a stroke one week ago. Enteral feed was noted from the
site of insertion of the tube, pt has stable vitals and no abd distension. What is the most appropriate
mgt
A. CT abd

B. X-ray abd

C. Continue enteral feeds

D. Push the tube 2cm in

E - Irrigate with normal saline

72) A 60 year old man booked for coronary angiogram, has a hx of Ischemic hrt dx, HTN, and DM. What
can be done to reduce the risk of contrast induced AKI.

a) 0.45% N/S

b) 0.9% N/ S

c) 5% dextrose

d) Mannitol

73. A question about a woman who has completed her family size and is seeking contraception. She has
migraine as well as heavy menstrual flow. Which contraceptive would be beneficial for her?

A. COCP

B. IUCD

C. Laparoscopic sterilisation

D. Condoms

E. Progesterone implant

74. A question about a woman with atrial fibrillation, diabetes, schizophrenia, depression who
presented on account of recurrent falls.

Investigations listed showing electrolyte abnormalities (hyponatremia, I think).

Which medication is likely to be the cause?

A. Apixaban
B. Atorvastatin

C. Clozapine

D. Duloxetine

E. Metformin

75. A 24 year old woman who presented on account of fatigue and irregular menstrual cycles.

TSH - Normal

Prolactin - Normal

FSH - 80

What’s the diagnosis?

A. Hyperthyroidism

B. Prolactinoma

C. PCOS.

D. Hypopitituarism

E. Premature Ovarian Failure

76. A 30 year old man has been having pain on passing urine for 3 days. He is otherwise fit. He has 4
painful ulcers on the glans and preputial skin, non indurated. What is the diagnosis?

A. Behçet’s disease

B. Chlamydia infection

C. Gonorrhea infection

D. Herpes Infection

E. Primary Syphilitic Infection

77. A 25 year old woman 12 weeks pregnant with second pregnancy with the same partner. Previous
child was diagnosed with Congenital adrenal hyperplasia, 21 hydroxylase deficiency. What’s the chance
that the unborn child is affected?

A. 0
B. 1:1

C. 1:2

D. 1:4

E. 2:3

78. A 7 year old who has 3 recurrent throat infections in the last one year. Was brought to the GP
surgery by parents because they are worried about the frequency of infection. What is the best
management.

A. Do Full blood Count

B. Give Immunoglobulin

C. No action need

D. Give antibiotics in anticipation of next infection

E. Refer for ENT review

79. Old lady with weakness and ....... Na, urea and creatinine increased, k+ normal.

What is d reason for her condition

A. Dehydration

B. DI

C. Chronic kidney diseas.

80. Middle aged man recovering from gullian barry disease. He is a chemist and wants to know the
reason for his condition.

What is the pathology behind the disease.

A, progressive demylination of peripheral nerves.

B degeneration of the spinothalamic tract.

C.

81. Oh God, I can't remember what was asked here

88. An 18 year Woman with features of hyperthyroidism - palpitations, tremors for 2 months. Symptom
of thyroid eye disease. What is the most likely feature of the thyroid function test?

A. High TSH, High T4

B. Low TSH, High T4

C. Low TSH, Low T4

D. High TSH, Low T4

E. ??

89. A 21 year old woman presents with history of loose stool containing mucus for 1 month, associated
3kg weight loss, her appetite is normal, her menses is normal.

Investigation done - Hgb - 95g/dl, MCV - 68. Most likely diagnosis

A. Coeliac disease

B. Inflammatory Bowel disease

C. Irritable Bowel syndrome

D. Laxative abuse

E. ??

90. A 50 year old South East Asian male presents to the GP surgery with no complaints,  his Ambulatory
Blood Pressure Monitoting with home average BP 165/98mmhg. Nil medical history of note.

Investigations done

Urine ACR -1.95 *normal

HbA1C - 38

E/U/Cr - within normal ranges

ECG - sinus rhythm

Best initial mgt

A. Amlodipine
B. Bisoprolol

C. Indapamide

D. ?

E. Ramipril

100. A woman who is 14weeks pregnant and is a sickle cell carrier, also discovered her partner is also a
sickle cell carrier, what are the chances of her unborn child being affected with sickle cell disease

A. 25%

B.30%

C. 50%

D 100%

101. A picture of the retina in a known hypertensive woman on amlodipine with progressive decline in
vision BMi-34kg/m2

Diagnosis

A. Diabetic maculopathy

B. Hypertensive retinopathy

C. Retinitis pigmentosa

D. Macular degeneration

E. Retinal vein occlusion

102. A man with colon cancer who had resection, on the 10th day he had abdominal pain, temp-38, PR-
110bpm

A.pelvic hematoma

B. Pelvic abscess

C. Vein thrombosis

103) A 65yr old woman with metastatic breast cancer and right hip pain

On oral morphine

Most appropriate medication for the pain

A) Biphosphonates

B) Chemotherapy

C) Radiotherapy

D) Naproxen

104) 25yr old with acne and irregular periods Testosterone- elevated

Most appropriate treatment

A COCP

B Metformin

C Tranexamic acid

105) 80yr old man with hematuria. Prostrate mildly elevated (PSA- 15)

Most likely diagnosis

A) Bladder CA

B) Prostate CA

C) BPH
106. A 70year old woman presented with low mood, feeling of tiredness...

She is on bisoprolol, ramipril, something and something 🙈

What is the appropriate management?

A. Quetapine

B. Olanzapine

C.

D. Settling

E.

107. A 51year old woman with amenorrhoea for 6months, she has flushes, sweats etc.

Next investigation?

A. FSH

B. Thyroid function

C. Oestrogen

D.

108. A 21year old woman presents to the GP for fitness note. She has had repeated episodes of panic
and her fears that her job is at risk.

What is the best action?

A. Refer to occupational therapist.

B. Anti-emetics

C. Tell her to get a better job.

D. Tell her she doesn't need a fit note

E. Refer for psychiatric assessment

109. A question on woman with unilateral leg weakness. Extension against resistance causes her to
extend her hip. She has asthma and epilepsy. Examination of normal limb elicited movement in the
abnormal limb. MRI normal every othrr thing normal

A. MS

B. Chronic fatigue syndrome

C. Functional weakness

D.

E. Todd paresis

110. An iv drug user found in kitchen pupils dilated. Immediate treatment?

A. Fluids

B. Antibiotics

C. Naloxone

D.

E.

111. Bleeding nipple discharge.

On examination, blood can be expressed from the nipple.

A case of intraductal papilloma

112. A 33 yr man with loss of libido, erectile dysfunction. Has normal testes and other sexual
characteristics. Inv: only prolactin is elevated excessively others are normal

MRI : prolactinoma

Most appropriate management

A. Cabergoline

B. Ostreotide
C. Sildenafil

D. Testosterone

113. Elderly man with features of pneumonia on methadone for alcohol dependence. Fever 38.2

Other vitals normal. He is allergic to penicillin

Most appropriate mgt

A. Clarithromycin

B. Co amoxiclav

C. Levofloxacilin

D. Benzylpenicillin

114. Px with history of untreated mild ulcerative colitis. Presented with loose stool with mucuc for
1month. No wt loss.

Hb - 95g/dl

Most appropriate management

A. Mesalazine

B. Something hydrochloride

C. Antibiotic

No hydrocortisone in the other options shaaa.

118) A 38yr old with maculopapular rashes. Had painless penile ulcer a week ago which had resolved.
Developed mouth ulcers. Vitals normal

What's the investigation to aid in diagnosis?

A. Blood culture
B. Swab from the rash

C. Serology for rash

D. Swab from mouth ulcers

E. Serology for PCR

120. A man with chest pain and breathlessness.. which investigation to do?

A. CTPA

B. Chest X-ray

C. Echo

121. A woman with discharging pus between the nipple and areola. What condition is it?

A. Papilloma CA

B. Duct Fistula

C. Duct Ectasia

133. A 35 yr old man presents with a painless firm mass. Mass located at the upper part of testis. Most
appropriate initial investigation?

A. Aspiration of swelling

B. CT of Abdomen and Pelvis

C. Organize an exploration of testis.

D. Serum Tumour Marker

E. Ultrasound scan of scrotum.

134. A 21 yr old woman is concerned about her weight. She takes laxative and diuretics. BMI - 17kg/m2.
BP- 95/60mmHg. Most appropriate action/mgt?

A. Organize Psychodynamic therapy

B. P...

C. Refer to Dietician

D. Refer to Eating disorder unit

E. Admit

135. A 30 yr old man ingested 45 500mg of paracetamol 10 hours ago. He presents to the Emergency.
GCS - 15/15. PR - 90bpm. SPO2- 99%.

Next appropriate mgt.

A. Check for Serum levels of PCM.

B. Gastric lavage

C. Start 50g of activated Charcoal

D. No action required. Discharge home.

E. Start N- Acetylcysteine.

138. Young man, presented to the ER with complaints of tingling, perioral paresthesia and other
symptoms usually over 5-10mins which have worsened over last 3 months. PR-100bpm, ECG normal.
What's most appropriate immediate treatment?

A. IV sedation

B. Rebreath into a bag

C. Refer to take panic disorder course

D. Refer for urgent cardiology opinion

139. 56yo, breast ca, metastasis to brain, has headache and vomiting... Best management
A. Tamoxifen

B. Metoclopramide

C. Cetirizine

D. Dexamethasone

E. Ondansetron

140. 76yo, takes warfarin and statin. Has hematuria. ApTT high, PT high, fibrinogen normal, urinalysis
non significant. Most appropriate investigation

A. ct KUB

B. Abdominal USS

C. Uroflow studies

D. PSA

E. Xray KUB

142.. Question on someone treated for acne who developed dry eyes,dry nose...

A. Topical Isoretinol

B. Topical Benzoyl peroxide

C. Topical Retinoid

143. A lady working in a residential home for elderly with itching and marks(attached picture)

A. Fusidic acid

B. Permethrine 5%.

144. A 2wks abi 2days old baby whose mum is deaf and on hearing aid..what to do next

A. Distraction test

B. ABR
146) A man who went to the peri operative clinic, scheduled for rotator cuff surgery, patient is on
Amlodipine, Beclomethasone, Lisinopril, (cant remember the rest), BP was around 131/78. Which drug
to omit before the surgery?

A. Beclomethasone

B. Amlodipine

C. Lisinopril

D. Atovarstatin

147) A patient who presented with chest pain associated with dyspnea and swelling.

ECG was given, there was LAD on ECG.

Diagnosis?

A. Myocardial infarction

B. Pericarditis

C. Pulmonary embolism

148. A 50yo man presents with flight of ideas which are rambling and disinhibited. He is distractable,

confused and overactive. What is the most likely dx?

a. Dementia

b. Mania

c. Schizophrenia

d. Psychosis

e. Acute confusional state

150.A man underwent TURP, developed confusion and then had seizure, electrolyte responsible-
A. Hypocalcemia

B. Hyponatremia

C. Hypercalcemia

151. 72 yr old man, memory loss, inappropriate sexual comments. Diagnosis

A. Lewy body

B. Alzheimer’s

C.Huntington

D.Frontotemporal dementia

153. 34wks pregnant woman, 2 days his of flu, with increase temp 37.4, pulse rate increased, other
parameters are normal. She noticed decreased fetal movement. Investigation to perform

A. Urgent CtG

B. Fetal Doppler scan

C. Urgent biophysical profile

157

A young woman who was involved in an RTA. Vitals were fine except for SPO2 of 94% and RR of 36cpm.
She has right chest pain and breathlessness. Trachea deviated to the left, reduced and bronchial sounds
on the right … fracture of 5th to 7th ribs on the right side. Dullness on percussion. What’s the diagnosis?

A. Hemithorax

B. Pneumothorax

C. Flail chest

158.
Middle aged female wh had a c/s 4 days ago. Swollen left leg, mottled ..the entire left leg. Which vessel
was affected

A. Aorta-ilia

B. Femoral

159.

Young female with sudden occipital headache. Has history of migraine without aura. There is no neck
stiffness. He vitals are within normal

What investigation

A. Head ct

B. Carotid artery Doppler???

160. 50year old man on amlodipine for his hypertension he had stopped Ramipril because of dry cough
but his BP is still 158/96mmhg, what medication to add?

A. Frusemide

B. Verapamil

C. Valsartan

161. 4weeks old girl failing to thrive with pale stool, jaundiced, what's the diagnosis?

A. Biliary atresia

B.Hypothyroidism

C.G6PD def

D. Breast milk jaundice

162. Elderly man admitted for pneumonia and has now been discharge on antibiotics what's is the most
important follow up investigation, initial cxr showed bibasal crepitations

A. Bronscopy

B. CXR

C. Blood culture

D. CTPA

163) A man comes in crying and he’s intoxicated and wants to stop alcohol intake. He doesn’t want to be
admitted. What do you do.?

A) Compulsory admission for detoxification

B) Refer to one alcohol place for support

C) give a dose of disulfiram

164) A man is anuric and has fever. U/S shows dilated kidneys. A stone was seen but size was not given.
Had left nephrectomy in the past. What next?

A) Percutaneous nephrostomy

B) Lithotripsy

165) A 20wk pregnant woman does scan and no bubbles was seen

A) Esophageal atresia

(If anyone remembers the other options in these questions plz add it. Time was flying)

166. Pregnant woman for 20week anomaly scan, nip gastric bubble

A. Duodenal atresia

B. Jejunal atresia
C. Oesophageal atresia

167. Pxt taking multiple drugs and has frequent falls. Which drug is responsible

A. Beclomethasone

B. Salbutamol

C. Statin

D. Denosumab

E. Duloxetin

F. Frusemide

168. Patient with reactivation of vzv. Who should receive vzv oh

a. All pregnant women who came in contact with him irrespective of their ab level

b. All pregnant women who came in contact with him with negative ab level

c. All the ward staff

D. All the patients in the ward.

E. None

172... A 72 yr old woman who had cholecystecomy. Post operatively resp rate 8cpm.... Can't remember
other things.

A. MRI brain

B.. CT scan.

c. Naloxone.

D..

173. A 42 yr old lady presented with dilated pupil, paralysis of elevator palpebral superioris, ptosis and
diploplia on downward gaze. What next is affected.
A. Abducens

B. Occulomotor

C . trigeminal

D. Trochlear

174. A 57 yr old lady presented with worsening flashes and floaters.

A. Anterior glaucoma

B. Iritis

C. Retina detachment

D. Age related macular degenerate.

178. A 21 year old male who fell from a height of 2.5 metres. And presented with pain and swelling of
the heel. Which bone is most likely fractured?

A. Calcaneus

B. Navicular

C. Talus

D. Cuboid

179. A 70 year old woman who had a fall and sustained a fracture of the radius with minor
displacement of distal radius.Hand was swollen and X-ray showed minimal displacement of Distal radius.
what is your management?

A. Below elbow POP with backslab

B.Below elbow with full POP.

C.WRIST SPLINT.

D. Close reduction

E. Open reduction
180. A 70 year old woman with non visible haematuria. Other investigations were normal. What is the
next appropriate investigation?

A. CT KUB

B. Cystoscopy

C. Urodynamic studies

D.

E.

181. A 3 year old girl brought to the hospital by paramedics, with c/o falling out of bed. X-ray shows
spiral fracture with callous formation with another healed fracture of the radius. What is the mechanism
of the current fracture

A. NAI

B. Accidental

C. Osteogenesis imperfecta

182. A 3yr old child or so wt unilateral greenish offensive nasal discharge, for abt 5days or so. Coughs at
night. There is a positive family history of asthma. What is the diagnosis?

A. Asthma

B. Foreign body

C. Nasal polyp

D. Sinusitis

E. Adenotonsilitis

183. There is one middle aged woman I think 50 yrs or so with abnormal bleeding pv

What is the initial mgt

A Hysteroscopy with biopsy

B transvaginal uss

184. Patient with right apical lung ca. Has bad mouth odour. What would you do?

A. Antiseptic mouth wash

D antibiotics

185. This question was a healthcare worker woman working in nursing home presenting with itching
over hand, under her breast region with this pic attached. What is the Rx?

A. Fusidic acid

B. Hydrocortisone 1%

C. 5% permethrin

186. An 18 months old child who choked on the sweet he was treated and was scheduled for
discharged. Parents asking what to do next time.

A. Back slaps

B. Back slaps and chest compressions

C. Place in recovery position

D. Abdominal thrust

E. Back slap on standing

187. A child with history of asthma and eczema with unilateral foul smelling greenish nasal discharge.

A. Foreign body
B. sinusitis

C. Adenotonsilitis

D. Nasal polyp

E. Sinusitis

188. A question on a man with fresh painless rectal bleed with ? And pain. and exam was normal.. No
masses. No weight loss.Cause

A. Sigmoid polyp

B. Sigmoid can

C. Crohns

D. UC

189. An elderly woman on anticoagulant found on the ground confused with periorbital
ecchymoses.Other exams normal.What is the next investigation to find out the cause of her symptoms

A. Facial X-ray

B. Coagulation screen

C. Ct scan head

190. A question with symptoms(muscle rigidity, elevated temperature) in keeping with ecstasy toxicity.
What is the antidote

A. Baclofen

B. Dantrolene

C. Naloxone

D.

E. Suxamethonium
191. Question about halitosis. everything was normal but had halitosis

A. Oral antiseptic wash

B. Iv antibiotics

C. Oral antibiotics

D. Swab Mcs or so

192. One question on a man with severe depression who lacks capacity. The man needs treatment. But
after familty meeting with his daughter. She still doesn't want him to be treated.

A. Go ahead and nak him treatment

B. Wait till daughter give consent

C. Inform the medical defence union.

193. The girl who slit her wrist because her boyfriend broke up with her

A. Depression

B. Bipolar disorder

C. Acute stress reaction

D. Acute psychosis

194. A woman with breast discharge who had previous history of recurrent abcess .What is the
diagnosis?

A. Mammillary duct fistula.

B. Periductal mastitis

C. Breast abscess
195. A 24 year old with mobile breast lump, non tender and firm. Has a family history of breast cancer in
the mum and grandma. What is the diagnosis

A. Fibroadenoma

B. Fibrocystic disease of the breast

C. Breast cancer

196. Question on gastronomy tube discharging food from around the insertion point

A. Flush with normal saline

B.push 2cm further

C. Abdominal xray

197. 72 year old man with oral pain,ulcer was noted on the mouth.diagnosis

A.crohns disease

B.Hodgkin

C SCC

D TB

E Sarcoidosis

198. A man had diplopia on downward and outward gaze.

A. Right Abducent nerve

B. Right trochlear nerve

C. Oculomotor nerve

D. Left Abducent nerve.

E. Trigeminal nerve.

199. Patient had two or three black outs a week ago. ECG showed 3rd degree heart block in lead II. What
is the management.

A. Permanent pacemaker

200. 72yr old woman with urinary frequency,nocturia and urgency.mgt

A. Anticholingerics

B.HRT

C.pelvic floor excersie

201. Elderly with 10 days fresh per rectal bleeding. Had constipation and left lower pain for last 4
months . No weight loss. What is the diagnosis ?

A. Sigmoid CA

B. Sigmoid polyp

C. Diverticular disease

202. There was one question on a man with penicillin allergy with pneumonia. Treatment

A. Doxycycline

B. Amoxyclav

C. Amoxyl

D. Clarithromycin

203. A question abut an 80yr woman who had fracture. What drug to give to prevent further fracture

A. Biphosphonate

B Calcitonin
C Calcium

D Vitamin D

204. An elderly with metastatic cancer of liver to intestine now presenting with abdominal pain ,
bloating . He takes oral morphone solution , bowel sound is present . There was an X ray with it. What is
the Rx?

A. Haloperidol

B. Metoclopramide

C. Levomepromazine

D.

E.

205. There is a scenario of an infant with cough, fever and the question was the organism likely
responsible

A. Strep pneumoniae

B. H. Influenza

C. Mycoplasma

D. Rsv

206. There is one middle aged woman I think 51 yr old woman with 6month hx of abnormal bleeding,
heavy bleeding, hot flashes n co

What is the initial Investigation

A Hysteroscopy with biopsy

B transvaginal uss

C. Serum estradiol

D.serum fsh
207. There was another question concerning dizziness, feeling of pressure in d ear and tinnitus.Diagnosis

A. BPPV

B. Labrinthitis

C. Meinner's

D. Vestibular neuronitis

E. Acoustic neuroma.

208. There was a question about acne. Young man had acne, he was prescribed a drug for it. Now he has
dry lips. What's the name of the drug?

A. Isotretinoin

B. benzoyl peroxide

C. Retinoid

D.

E.

209. A 23YO male gets severe anxiety when he boards a train or goes to the shopping center. He would
develop palpitations and nausea and feelings to escape as soon as he enters a train or mall. This has
been worsening over 3yrs. Like diagnosis

A. Claustrophobia

B. Agoraphobia

C. Panic disorder

D. GAD

E. Social phobia
210. A woman who became depressed after her husband's death of cancer. She was using Amtriptylin.
Her appetite has improved. She used the antidepressant for 3/52 and wanted to stop. She now feels she
has cancer. Most appropriate action

A. Stop Amtriptylin

B. Encourage to CT Amtriptylin

C. Change to SSRI

D. ECT

E. Bereavement counselling.

211. There was also a question concerning a lady whose menstrual cycle was 32 and was planning to
conceive What was her oulation day

a)7

b)15

c)24

d)

e)

212. Another question was asked concerning a child whose mother was worried about his hearing
capabilities,chil has been having recurrent ear problems.the child was born premature or so and stayed
in d ICU .Tympanic membrane was bulging or so and child cldn't diagnosis

a)

b)

c) Otittis media

d)

I'm not sure I structured d question well,pls let anyone who recalled it help us to recall it well abeg.The
way GMC restructured most familiar questions,Na for Baba God hand we dey.
lol