HAAD QUESTION

1. Patient with HIV, CD4 COUNT 700. Pt doesnt have vaccine from
last 12 years. What should be the next step? I mark DT Vaccine
but still I am confused in this.
a.
b.
c.
d.
e.

INH
SEPTRAN
DT Vaccine
MMR
Rifabutin
2. Pt is taking gingko Biloba. He is at increased risk of : I marked
H. Stroke
3. Pt with symptoms of multiple sclerosis and MRI showing areas in
periventricular white matter. Asking about which drug increase
survival.
I mark IFNb.
4. Patient with fracture of 8to 10th rib, having decrease Bp and
diffuse tenderness on the left side of abdomen. Asking about
most likely Dx: I marked Ruptured Spleen.
5. Pt with headache, Hct 65%, Hb 20% Ask about physical exam
finding you find. I mark Splenomegaly because patient is
having Polycythemia Vera.
6. Patient with same scenario 05 question and asking about the
next step: I mark Pulse Oximetry.(I mark because to
differentiate b/w polycythemia vera and reactive
polycythemia.) Dont remember exactly whole scenario and
options.
7. Again same question asking about the management . I mark your
condition is an emergency and you need immediate care. Other
options seems to be very closure.
8. Pt with symptoms of Lumber spinal stenosis. Asking about Dx
Test; I marked MRI.

9. Patient with Dx case of RA taking NSAID, MTX AND STERIOD.

Asking about the next step. I mark add CALCIUM AND
VITAMIN D In the diet (Because pt is taking Steroid thats why)
10.
Patient with Knee pain and pain in the hand also hand
show Nodule (Heberden ) Asking about the disease mechanism. I
mark Degenerative Joint Disease.
11.
Patient with Lung mass, flushing and Diarrhea. Asking Dx I
mark Carcinoid Tumour.
12.
Patient with sx of hypothyroidism asking about physical
finding. I mark Delayed Relaxation of deep tendon
reflexes.
13.
Patient with Thryoiditis asking about next Step 01. Beta
Blocker 02. Antithyriod Drugs I mark Beta Blocker because AT
DRUGS are not effective in Thyrioditis as hormone are already
been released into the circulation we have to control the
Symptoms.
14.
Patient with Chancre and Nontender lymphadenopathy.
Asking about Next Step I mark DARK FIELD MICROSCOPY
very important
15.
Patient with Uveitis, Arthritis and B/L adenopathy. Asking
about disease mechanism Granulomatous disease. This patient
has Sarciodosis.
16.
Patient with B/L adenopathy ask about finding in Blood. I
marked Ca+ level
17.
Patient with wheezing, sob, no smoking, no alchohol, 02 sat
normal. F/H bro died at young age due to liver disease. Asking
about the next Step: I mark Alpha one antitrypsin Deficiency.
18.
Patient with Decrease phosphate and Increase Calcium. Dx
Primary Hyperparathyroidism.
19.
Patient is taking antifreeze (Oh form) asking about lab
finding I mark Increase Anion Gap with Metabolic Acidosis.

20.
Patient with muscular pain and elevated CK level. What is
the mechanism. I mark drug induced. I dont remember exactly
what were the other option and complete scenario.
21.
Patient with DKA. Asking apart from insulin/Iv FLUIDS what
else you give. I makr Potassium because level is 4.5 meq/l.
22.
Patient with DKA. Asking about pathophysio. I mark
Absolute deficiency of Insulin. Other options were 01. Steriod
iduced 02.Insulin Resistance. dka
23.
Patient with sx of Diabetes asking about next step in DX. I
mark FBS.

24.
Patient with abdominal pain. Taking OH and TG level
840mg/dl. Asking about finding in the liver.
a. Hepatic steatosis (I marked)
b. Cirrhosis
c. Fibrotic changes without cirrhosis
25.
Patient went on party drink Oh lot and develop vomited
blood what is the most likely Dx. I mark Mallory weiss tear.
26.
Patient complains of decrease libido. He is taking multiple
drugs as well. Asking about why is that. I mark cimetidine.
cimitidine

27.
Patient with jaundice(Inc conjugated) asking about the
mechanism I mark Obstruction of the bile flow. Patient A.PO4 was
also raised. He is asked about mechanisms of liver disorders.
28.
Patient with jaundice (Inc conjugated) asking about the
mechanism.I mark impaired excretion through liver because pt
also have increase level of aminotransferase as well.
29.
Patient with meningitis, Inc FFP and decrease fibrin.
ASKING DX. I MARK DIC.

30.
Patient with pancreatitis, CXR show B/L infiltrate what is
this. I mark ARDS.
31.
Patient with tender abdominal mass asking about the next
step
a. Operative repair (I marked).
b. Ultrasound abdomen how would u proceed with tender abdominal
mass.?

32.
Patient with increase ESR and stiffness next step. I mark
prednisone.
33.
Patient having dysphagia, stiffness as well. Asking about
most likely DX. I mark mixed connective tissue disease. Because
there was no option of Scleroderma. Other were
a.
b.
c.
d.
e.

SLE
POLYMYOSITIS
DERMATOMYOSITIS markers
RA
OSTEOARTHRITIS.
34.
Patient with facial rash and increase with stress asking
about the Dx. I mark Acne Rosacea.
35.
Patient with transfusion develop flank pain. They ask apart
from stopping transfusion what else you will do. I mark Give Iv
fluids.
36.
Patient with clinical picture of marfan syndrome. Asking
about further recommendation what will you do, I mark
Echocardiography (as Marfan patient has Aortic Dissection).
Dont remember other option.

37.
Patient having tubular adenoma. They have removed they
were asking what else you have to do:
a. COLONOSCOPY NOW (I MARK THIS TO VISULIZE WHOLE)
c. SIGMOIDOSCOPY NOW

d. DO NOTHING
38.
Patient with diabetes having bloating asking DX. I MARK
GASTROPARESIS.
39.
Patient with ulcer on medial side of the foot. Ask
mechanism why they happened I mark due to venous
insufficiency.
40.
Patient is smoker and having F/H of AAA. Asking how I have
to prevent my self from developing. I mark Stop Smoking.
41.
Patient with joint pain, recently dx with diabetes develop
discolouration on the back asking what you will do. I mark Ferritin
Concentration (B/c of HEMOCHROMATOSIS).
42.
Patient with join pain. SF show crystal positively
biriferengent. Dx Pesudogout.
43.
Scenario showing rash with sandpaper. Asking about
pathogen. I MARK GABHS that is Group A beta Hemolytic
Streptococci. Try to do organisms see bacteria list in FA
44.
Patient with fever, headache and Ct show ring enhancing
lesion. Asking about the Diagnosis
a. ENCEPHALITIS
b. ABSCESS (I MARK)
c. STROKE
45.
Patient with back pain which is relieved my rest. It seems
picture like Lumbar spinal Stenosis. Asking next step I mark MRI
SPINE.
46.
Patient with syringomelia. Asking about association. I mark
Arnold chairi Malformation Type 01.
47.
Patient with G.lambia infection. Asking apart from
hydration and metronidazole what else you advice. I mark advice
patient to stop drinking OH while taking MZ (to prevent from
disulfiram like reaction)

48.
Patient with Multiple Myeloma. Increase level of calcium.
What is the mechanism. I mark its because of IL1 AND TNF (IL06
IS OA factor).
Do mm. mul scle,cll,cml,iron anemia
49.
Patient with distended bladder, pass urine after Foley. O/E
patient has enlarged prostate. Asking about the cause of
retention. I marK BPH.
50.
62 year female patient with backpain anemia and increase
CA. dx Multiple Myeloma.
51.
Patient with Aortic Stenosis develop syncope. Asking about
the next step I mark Echocardiography.
52.
80 year Patient develop hypotension after standing. He is
taking lot of medication. Asking next Step I mark adjust
medication.

53.
40 year old patient has impaired FBS, SMOKE AND HTN AS
WELL. Asking further risk after 10 year.
a. CAD (I MARK)
b. STROKE
c. LUNG DISEASE
54.
Patient health care worker PPD 12MM ASKING NEXT
STEP..I MARK CXR
55.
Patient with pneumonia and pleural effusion show Glucose
100mg/dl, neutrophil increase and Ph show 6.9. Asking next step
I mark Chest Tube drainage (I was thinking this patient develop
empyema).
56.
Patient with PE have mesothelial cell asking next step. I
mark pleural Biopsy because I was suspecting Asbestosis
induced Mesothelioma

57.
65 year female Patient came for health maintenance.
Asking what else you do.
a. Pap smear
b. Dexa scan (I MARK)
There was no any option of Mamography and I didnt mark pap smear
because pt already had Hysterectomy because of Menometrorrahgia.
58.
Patient came for health maintenance 55 year old. Asking
next step. I mark colonoscopy and other option I dont
remember.
59. Patient with syphilis have sex with 03 person. In ONE AND 3 HE USED
CONDOM WHILE NOT IN 2ND. Question is to whom you will give prophylaxis.
Very difficult
a. ALL THREE
B. ONLY TWO (I mark)
C. NONE
60. Patient with back pain which increase on coughing. Asking about dx I
mark Disc Herniation.
61. Patient with ataxia, nystagmus. Asking what else will be there. I mark
Confabulation
62. Patient wants smoke cessation but concerned about weight gain. I mark
bupropion.
63. Patient with alcohol withdrawal what ill you give? I mark Diazepam
64. Patient with opoids withdrawal. What will you do?
a. Clonidine

b. Meperidine I mark B option. Nb imprt

65. Pic scenario child having rashes on hands. Ask what will you do before
discharging the patient?
1. EKG 2. ECHO 3. CHEST XRAY 4. BLOOD CP
66. Patient with femoral neck fracture what ill you do? I mark pinning the
femoral head. I dont know about other option

67. Patient taking Aspirin, bleeding increased ask why is this. Asking about
mechanism. I marked inhibition of COX.
.