Start QuizPage 1 of 10 A 65yo man presents with painless hematuria, IVU is normal, prostate is mildly enlarged with mild frequency. What is the most appropriate next step? a. US Abdomen b. Flexible cystoscopy c. MRI d. Nuclear imaging e. PSA Page 2 of 10 2. A 74yo smoker presented to his GP with cough and SOB. Exam revealed pigmentation of the oral mucosa and also over the palms and soles. Tests show that he is diabetic and hypokalemic. What is the most probable dx? a. Pseudocushing syndrome b. Conns disease c. Ectopic ACTH d. Cushings disease e. Hypothyroidism Page 3 of 10 A 44yo woman has lost weight over 12 months. She has also noticed episodes where her heart beats rapidly and strongly. She has a regular pulse rate of 90bpm. Her ECG shows sinus rhythm. What is the most appropriate inv to be done? a. Thyroid antibodies b. TFT c. ECG d. Echocardiogram e. Plasma glucose Page 4 of 10 A 79yo anorexic male complains of thirst and fatigue. He has symptoms of frequency, urgency and terminal dribbling. His urea and creatinine levels are high. His serum calcium is 1.9 and he is anemic. His BP is 165/95 mmHg. What is the most probable dx? a. BPH b. Prostate carcinoma c. Chronic pyelonephritis d. Benign nephrosclerosis Page 5 of 10 A 64yo man has recently suffered from an MI and is on aspirin, atorvastatin and ramipril. He has been having trouble sleeping and has been losing weight for the past 4 months. He doesn’t feel like doing anything he used to enjoy and has stopped socializing. He says he gets tired easily and can’t concentrate on anything. What is the most appropriate tx? a. Lofepramine b. Dosulepin c. Citalopram d. Fluoxetine e. Phenelzine Page 6 of 10 A 67yo man after a stroke, presents with left-sided ptosis and constricted pupil. He also has loss of pain and temp on the right side of his body and the left side of his face. Which part of the brain is most likely affected? a. Frontal cortex b. Cerebellum c. Pons d. Medulla e. Parietal cortex Page 7 of 10 A 60yo man presents with dysphagia and pain on swallowing both solids and liquids. A barium meal shows gross dilatation of the esophagus with a smooth narrowing at the lower end of the esophagus. What is the SINGLE most likely cause of dysphagia? a. Achalasia b. Myasthenia gravis c. Esophageal carcinoma d. Esophageal web e. Systemic sclerosis Page 8 of 10 A man undergoes a pneumonectomy. After surgery, invs show hyponatremia. What could be the cause of the biochemical change? a. Removal of hormonally active tumor b. Excess dextrose c. Excess colloid d. Excessive K+ e. Hemodilution Page 9 of 10 A pregnant lady came with pain in her calf muscle with local rise in temp to the antenatal clinic. What tx should be started? a. Aspirin b. LMWH c. Paracetamol d. Cocodamol e. Aspirin and heparin Page 10 of 10 A 53yo female presents with an acute painful hot knee joint. She is a known case of RA. On examination, the knee is red, tender and swollen. The hamstring muscles are in spasm. Her temp is 38.5C and BP is 120/80mmHg. What is the SINGLE best next inv? a. Joint aspiration for cytology and culture and sensitivity b. Joint aspiration for positive birefrengent crystals c. Joint aspiration for negative birefrengent crystals d. Blood culture e. Serum uric acid
