1) 40 smth year old woman g3p3 post coital bleeding has
myoma + has cervix lesion severe dysplasia on colposcopy,
treatment?
A) hysterectomy
B) ablate the lesion
C) smth stupid (hormones or smth)
2) ectopic pregnancy biggest risk factor? (From the ones listed)
PID
3) pregnant woman (unknown weeks ) in trauma, 89% sat,
unstable, abdomen soft non rigid wtv, had pneumothorax, needle
thoracostomy done, "patient somewhat improved" -> vitals post
thoracostomy NOT given. What do you do?
A) CXR and pelvis XR
B) CT trauma
C) insert chest tube
D) FAST
4) patient in trauma, GCS 8, trachea deviated no breath sounds
on one side etc etc (pneumothorax), next step?
A) needle thoracostomy
B) intubate
C) cervical collar
5) Young man had pain while lifting log, tenderness over spine,
bilateral straight leg raise positive, no urine or fecal
incontinence, refused PR exam, MRI given (i have no idea what
the MRI was nothing was showing), what do you do?
A) neurosurgery OPD in 7 days
B) neurosurgery OPD tomorrow
C) elective decompression
D) emergency surgery
E) discharge with nothing
6) patient with TIA, best drug to prevent more episodes?
A) aspirin
B) warfarin
C) clopidogrel
7) patient with elevated LDH, low hb, and NORMAL mean
corpuscular hemoglobin concentration. What would the findings
be if he had b12 deficiency?
My answer was high volume and high mean corpuscular
hemoglobin
8) The q about the woman who takes methyldopa and gets
microangiopathic hemolytic anemia
- it is NOT drug induced, there are schistocytes in the smear and
i dont even think it was an option
9) extremely confusing question
22 year old college student, headaches for 9 months, grades
dropping, has weakness in left arm and left quadrantonopia smth
like that, nonspecific symptoms other than that. Headache has
been getting worse. CT done- shows temporal hemorrhage. CT
angio- normal. MRI- temporal hemorrhage, multiple subcortical
infarcts, "areas of decreased contrast uptake" bilaterally. LP
done opening pressure 21, cells 3, lymphocytes 90% (normal).
What do you do next?
A) MR cerebral sinuses
B) Anticardiolipin and autoantibodies stuff
C) Carotid doppler and echo
10) Patient from Kenya came with description of erythema
nodosum (lesions on shins) as well as SOB, cough, etc. was
diagnosed as sarcoidosis started on corticosteroid. Patient
deteriorated and died. What's the diagnosis?
Cant recall options but my ans is histoplasmosis
11) Farmer presenting with fever, hepatosplenomegaly, mild
abdominal rash?
Brucella
12) how to prevent brucella?
A) Avoid contact with infected animals
B) pasteurize milk
13) SVT description no ECG given (P waves hidden in QRS
complex), patient did not respond to mechanical measures?
Adenosine
14) Pregnant primi no risk factors of anything how to prevent
miscarriage?
A) smoking cessation
B) cerclage
C) oral progesterone
15) Patient had white frothy discharge, hyperemic cervix, Ph 5.8
Vaginosis
16) 23 year old filipino woman unprotected sex with partner not
sure if hes monogamous frothy discharge and strawberry cervix,
picture of trichononas attached, what to do?
Give metronidazole to her and partner and check them for other
STDs
17) pic of penile ulcer (syphilis) diagnosed from FTA ABS to be
syphilis, what do you do?
A) 2.4 million units of benzathine penicillin, tell health
department, tell patient to contact partners
B) 4.8 million units of benzathine penicillin, do VDRL and HIV,
do close contact smth
C) 2.4 prozathine penicillin with probenecid, 1 g doxy, VDRL
and oropharyngeal swabs and culture of discharge
Other combos of the above
18) 19 year old boy fell while playing football, now has pain in
tibia 3 cm below tibial tuberosity, examination shows painful
non mobile firm mass, what do you expect on XR of the mass?
- pedunculated mass growing towards knee
- pedunculated mass growing away from knee
- lytic lesion with sclerotic margins
- lytic lesion with diffuse calcifications (smth like this)
19) intercept q
20) learn the definitions of:
Quality assurance
Quality improvement
Efficiency
Effectiveness
21) Patient says he stopped taking diabetes drugs bc they make
him feel bad, what should you as the doctor say?
"What do you mean by that?"
22) 59 year old Woman glucose 48 mg/dL conscious but has
symptoms of hunger, weakness, etc. She is in a clinic. What do
you do?
- glucose tablets
- dextrose IV
- glucagon IM
23) 23 year old girl seizure first time has tongue laceration
lasted roughly 25-35 seconds, previously well. Now she is
having altered mental status but overall still fine. What to order?
- lactate
- prolactin
- glucose
24) 25 year old woman had hyperension 150/smth, started on
lisinopril. She has RA as well as history of repeated UTIs as a
child. She now has worsening fatigue, etc (renal failure). CXR
shows pulm edema. No blood in urine, 1+ protein. Abdominal
US showed one kidney is smaller than the other. Her BP now is
160/x. She has borderline elevated K and borderline low Na
(hyperaldosteronism). Creatinine high. What do you do to
confirm dx?
- US abdomen and pelvis (already done in the q)
- MRA
- VCUG
- Renal biopsy
25) 19 year old man frank hematuria, no pain, blood 3+ protein
1+, creatinine 1, electrolytes normal, had pharyngitis treated
with antibiotics 2 weeks ago, BP and vitals normal, no mention
of whether any episode like this had happened before. What do
you do?
- IV diuretics
- Conservative
- Dialysis
26) anaphylaxis
27) Migraine in 17 year old girl, what do you give to abort?
- nsaid
- sumatriptan
- ergotamine
28) woman had insect bite and got wheezes, vitals all normal, no
stridor or anything, what do you give?
- IV epinephrine
- IV salbutamol
- dopamine
29) child with continuous 2/6 soft murmur infraclavicular
disappears on lying down what is the diagnosis?
A) venous hum
B) still murmur
C) ASD
D) pulmonic stenosis
30 and 31) 2 questions about how you measure success of fluid
resus- IVF
32) calculate OR it was 2
32) otitis media 2 most common causes - strep pneumoniae and
h influenzae
33) Patient with peritonsillar abscess, picture given. What is the
LEAST appropriate management for this patient?
- i&d
- needle aspiration with 18 gauge needle
- paracetamol mouthwash
- penicillin and clindamycin
- CT
34) Lost in desert, creatinine went up
Random shit about kidneys, i chose hypoperfusion
35) Patient went to sub saharan Africa, what is the diagnosis? (I
AM NOT FREAKING JOKING THAT IS LITERALLY THE
ENTIRE QUESTION)
- ebola
- malaria
- cholera
- dengue
36) villagers drinking from water well randomly started having
hyperkeratosis, hyperpigmentation, and anemia. What is the
CORE MANAGEMENT for this situation/ condition?
(? Copper toxicity)
A) chelation
B) change water source
37) young girl (4 years old) with picture of very very thin hair.
Description says hairs of diff length, no evidence of scarring,
mom says never was able to brush or pull up her hair and her
hair falls a lottt
- alopecia areata
- lichen pillifollicular smth idk bas i think it's wrong
- loose anagen smth syndrome
38) young patient has throat pain and fever, pic given and
description says right sided tonsillar enlargement and uvula
deviated to left
- peritonsillar abscess cant remember the other answers
39) first sign of appendicitis
- fever
- generalized abdominal pain
- RLQ pain
40) Yellow skin but normal sclera in woman with BMI 16,
cause?
Carotenemia (probably anorexic)
41) Patient post cholecystectomy has no pain, mild wound
tenderness, but jaundice.
- clipping of CBD
42) patient has gallstones on US , elevated amylase, normal
CBD 7 mm, next step
ERCP
PTC
MRCP
CTC
43) LR (abducens palsy)
44) child unresponsive, SVT, what to do
Synchronized cardioversion
45) Thyroid mass interferes with breathing moves with
deglutition what to do
- FNA
- Partial thyroidectomy
- some other shit, TSH was not in options
46) Australian fair skinned farmer, has lesion on cheek that
ulcerated, scales, been going on for years, every time he touches
it it bleeds more, non healing. Pic was given it was not BCC in
my opinion
- SCC
- BCC
- acanthoma
- melanoma
47) Study about bedouins and sun exposure and skin cancer or
smth where they surveyed all + their risk factors or smth
48) A test was found that discovered cervical cancer "earlier"
than Pap smears however the mortality of patients discovered by
pap smears and this new thing is the same, what bias?
⁃ sample
⁃ Lead time
⁃ Length time (cant remember if it was in the options)
⁃ Other stuff
49) Ulcer on medial malleolus and varicosities, what to do?
Compression bandage
Can't remember options but they had nothing to do with varicose
veins or ulcers
50) Patient taking anti-HTN has repeated syncope, his ECg is
normal, no palpitations no SOB no chest pain no AMS no
symptoms other thsn the syncope. Cause?
- orthostasis
- anemia
- arrhythmia
51) 70 year Woman who fell she is independant lives alone no
problems no symptoms. What to do?
- medication review
- other options included some random shit like leaving lights on,
move in with family, absar esh
52) open eye spontaneously, confused and disoriented,
withdraws from pain, gcs?
53) old woman 80 yo after operation developed SOB chest pain
blah blah blah what do u do
- CT angio
54) many CT scans, choose the one thats subdural hematoma
55) many CXRs, choose the one thats heart failure
56) hepatitis B serology, which indicates acute hepatitis B
- positive hbsag and positive hbeag (this one)
- positive hbab and positive hbcab
- random shit
57) gout patient what do you do (he's taking hydrochlorothiazide
and getting recurrent attacks)
- stop thiazide
59) patient has htn, previous dvt, previous miscarriage, fhx of
dvts, now presenting with calf pain etc etc, whats the risk factor
that is NOT related to dvt in this patient
HTN
60) infant 18m with low hb, RDW high, MCV low everything
else normal whats ur dx
- sickle trait
- sickle anemia
- IDA
- beta thalasemia trait
61) infant 6 months coming with cough (not paroxysms), well
hydrated, supraclavicular recessions, paradoxical breathing,
wheezes all over chest, what to do?
- oxygen
- icu
- intubate
(Btw o2 sat not given)
62) 18 year old for the past 2 years has been more isolated, not
socializing, no positive schizophrenia symptoms, but decreased
affect, poor hygiene; not taking care of himself, no friends, etc
- schizophrenia
- schizoid
63) old man 70+ brought because of some forgetfullness works
as college professor fam says he forgets where he is for eg in the
parking lot, he is very depressed for 2 weeks and hasnt been
enjoying spending time with family, he's been suspicious of the
neighbors poisoning him, very irritable. Cause?
- dementia
- schizophrenia
64) clozapine. Whats false?
- STRONGLY blocks d2
- supersensitivity in substantia nigra
- weight gain
- agranulocytosis
65) patient with displaced fracture of radius after MVA what is
the basics or smth like that of managing this patient?
- orif
- closed reduction and splint or smth like that
- cant remember but smth related to antibiotics and analgesia
66) patient died MVA from cardiac arrest underlying cause of
death- rta
67) baby dehydrated hasnt passed urine in a while what do u
want to order
- urea and electrolytes
- urinalysis
- cbc
68) patient with surgery admitted to ICU takes multiple
antibiotics now presenting with severe diarrhea >3 times per day
what do you want
- stool cd toxin
- stool analysis and culture
- random shit
69) XR of sigmoid volvulus (old man presenting with abdominal
distension, vomiting, constipation and XR attached and you just
had to write the diagnosis)
70) Random question about meningococcemia extremely clear,
young patient, shock, rash, etc etc, also description of gram
negative kidney shaped diplococci
71) rate limiting enzyme for dopamine synthesis
- dopa hydroxylase
- dopa decarboxylase
- MAO smth
72) girl broke up with her bf, stopped talking, parents say shes
always been dramatic. Dx?
- hysterical aphonia
- acute transient stress related episode
73) patient with severe chest pain for 12 hours in ED, ECG
normal, what do you need before discharge
Troponin
74) wrong blood given to patient, he gets shock and dies. Whats
this?
- sentinel
- adverse
- near miss
75) what is do no harm
- nonmaleficence
76) patient had gastrectomy and lost a lot of weight. Now is
having ataxia, MRI showing affected mamillary bodies
- wernicke
77) breast mass now she got ataxia, scanning speech, tremor
with other cerebellar symptoms, whats the cause
- paraneoplastic cerebellar degeneration
78) when can a doctor ignore confidentiality
- if patient gives permission (this one)
- if asked by insurance
- if believes in best interest of patient to reveal
- if not revealing harms someone else was NOT AN OPTION
79) the pelvic abscess post- appendectomy question in the
previouses
(Rupture of appendicular stump abscess was an option)
80) 45 yo man had one reading bp of 145/x. What do you offer
him?
- nothing
- ambulatory
- anti htn drugs
81) patient with intermittent claudication and pic of angio
attached. The question is literally "what is this pic" (not
diagnosis.. literally what)
Venogram
Angiogram
Lymph smth
82) child with meningitis + purpuric rash, vitals are stable.
Next?
- antibiotics
- iv fluids
83) some child with pharyngitis, take culture and give him
antibiotics (calculate centor but im sure he needed)
84) the q about the child with seizures and eye deviation +
FNDs. Frontoparietal lesion
85) cancer patient with cachexia, no appetite
- megesterol acetate
86) obese 12 year old presented with pain in hip for 1 week,
limp, leg externally rotated (i think)
- scfe
- avascular necrosis of femoral head
- random shit
87) ACL MRI (identify it)
88) Kehr sign in splenic rupture (description and asks u for
name of the sign)
89) patient had laparotomy 8 years ago now presenting with
clear IO (vomiting, increased bowel signs, constipation). Cause?
- incisional hernia
- adhesions
90) IUCD and cervical lesion
- remove + punch bx
91) burn patient with green/ blue discharge and infxn
- pseudomonas
92) q about patient with matted neck LNs from recalls
- tb adenitis
93) q about patient smoker + alcoholic with jugulodigastric node
hard and enlarged
- oropharyngeal cancer
94) the q about divide half in formalin half in nothing
95) the patient with bleeding, EGD done shows forrest 2
nonbleeding ulcer with vessel dilated over it, what to do for
him?
- clip vessel
- other options angioembolization
- epi injection i think
96) patient with massive UGIB, blood filling mouth, cant talk,
GCS good, first step?
- ett
- ngt
- octreotide
97) patient with CHF diagnosed one month ago: now
exacerbated. No symptoms over the past month; labs all normal:
why exacerbated?
- diet/ medication non compliance
98) did an intubation on a patient using A MIXTURE OF
COCAINE AND XYLOCAINE (???) and now he has anterior
MI. What to do
- PCI
- alpha blocker
- beta blocker
- nitrate
99) Q about second degree prolapse cervix
100) the q with the prostate thats firm and before PSA was 7.8
now 7.9 or smth
101) give acei what to monitor
-k
- na
- cl
102) child with coryza conjunctivitis rash on body koplik spots
what to give
- vitamin A
103) some man who lost a lot of weight bc of a stomach ulcer,
bmi went from 25 to 20, he is already on ranitidine, smth snth
and will be started on omeprazole. "What is your concern?"
- MI
- osteoporosis
- hypomagnesemia (or hyper i forgot)
104) swelling medial and above the inguinal ligament direct
hernia
105) that same q about familial hypercholestrolemia vs
combined hyperlipidemia
106) the q about automation and ventilation occupational hazard
107) AML patient induction chemotherapy given now temp is
38
- antibiotics
108) best way to measure temp- rectal
109) boy came back from summer camp with tonsillitis, HSM,
fatigue, what will you find on blood smear
- atypical lymphocytes
110) pseudocyanosis how do you know its not cyanosis
- blanches on pressure
111) 4 day old neonate passed meconium yesterday AXR shows
dilation of both small bowel and large bowel
- hirschsprung
112) post menopausal woman with breast cancer having hot
flashes. What to give
- diazepam
- clonidine
- progesterone
- propanolol
(No actual rx for hot flashhes in the options)
113) patient took first dose of haloperidol now having
"movement problems" what is it
- acute dystonia
- NMS
- tardive dyskinesia
114) q in IDUs about asbestosis and malignant mesothelioma
115) ecg changes in pregnancy
- lad
Left strain
116) septic abortion, what to do
- suction
117) man working in garage now confused headache wtv ABG
shown with high COHb what do you do
- high flow oxygen
