1. A 4 month old child weighs 4.1kg.

She presents with multiple bruises on her left and right lower
leg. Her left ankle is swollen and she appears irritable. She also has a runny nose. What is the
most likely diagnosis?
Hemophilia
thrombocytopenia
Non accidental injury
2. A 60 year old man experienced sudden painless loss of vision. On examination, multiple flame
shaped hemorrhages were seen. What is the most likely diagnosis?
Central retinal artery occlusion
Central retinal vein occlusion
3. Patient with bilateral cerebellar-pontine tumors, bilateral sensorineural hearing loss and cafe au
lait spots is pregnant. What are the chances of her child having the condition?
1:2
1:4
2:3
1:8
4. A young girl has cystic fibrosis. Her 14 year old sister does not have the disease and wants to
know the chances of her having the gene for the disease. None of her parents are affected.
What are the chances of the 14 year old girl being a carrier?
A. 1:2
B. 1:4
C. Nil
D. 100%
E. 2:3
5. A 26 year old man travelled from New York to the U.K on business. He had night sweats, fever
and lymphadenopathy for 3 weeks. What is the most likely diagnosis?
Tuberculosis
Lymphoma
6. 44 year old woman presents with unilateral headache and photophobia after tingling and
numbess of her hand. What is the most likely diagnosis?
TIA
Migraine
Meningitis
Stroke
7. Patient had a deep cut on her palm. She has inability to extend the distal phalanx of her ring
finger. What is affected?
digitorum profundus

8. A woman of child bearing age has extensive fibroids which have distorted her uterine cavity. She
says she has difficulty in remembering to take pills. What is the best contraception for her?
Implanon
Depot provera
IUS (Mirena)
COCP
POP
9. A patient presents with right sided hemiplegia and aphasia. Symptoms resolved in 6 hours. What
is the best scoring method to assess his risk for future stroke?
ABCD2
10. 60 year old patient had a cystoscopy and he was found to have transitional cell carcinoma. He
has smoked for 15 years and works in a coal factory. What is the greatest risk factor for TCC?
Smoking
Coal dust exposure
11. You are a junior doctor suspecting one of your colleagues to be under the influence of
recreational drugs. What will you do?
A. Inform police
B. Confront your colleague directly first
C. Inform senior consultant
D. Seek more evidence first
12. A primigravida in 28 weeks gestation having BP 150/100 mmHg. What will you give for blood
pressure?
A. Labetalol
B. Hydralazine
C. Indapamide
D. Losartan
13. Child presents after taking OD of medicines belonging to his grandmother, who is a patient of
epilepsy, atrial fibrillation and hypertension. She cannot tell which medicines are missing. The
child is hypotensive, dilated pupils and with extra systoles on ECG. Which drug has he taken?
A. Amitriptyline
B. Carbamazepine
C. Digoxin
D. Metoprolol
14. Male with increase thirst and increase micturation. Has an intracranial tumour. Where would it
be found?
Diencelhalon
Midbrain
Medulla
Pons
15. A patient had a fly enter his ear. What to do next:
Removal with forceps
Removal under general anesthesia
Administer mineral oil
16. Pregnant lady 28 wks gestation , Hb 11 ... MCHC normal range , MHC normal
What to do
- check serum iron
-check serum Ferritin
-explain normal physiological phenomenon

17. Women with prescribed antibiotics. She is on COCP. What advice would u give ?
No extra precaution needed
18. bilateral shin lesions scenario of sarcoidosis. How to Diagnosis?
Serum ACE levels
CT scan
19. unilateral loss of vision, pain on eye movement, fundoscopy normal. Diagnosis?
Retrobulbar neuritis
20. Woman went to Bangkok didnt have malaria prophylaxis
- Malaria
 - Dengue

21. Kid vomiting, passes 2-3 stools in days ( pyloric stenosis) . how to diagnose?
US abdomen
22. Lady with petechial rash and menorrhagia, Hb wcc normal, Plt 14. Diagnosis?
ITP
23. One scenario was pt after antibiotics develops lesions /rash with necrotic base after antibiotic
therapy .. mucosa n genital not involved ?
- erythemia multiforme
-erythema nodosum
-erythemia migrans

24. a child unable to climb stairs and diminished deep tendon reflexes
Duchene muscular dystrophy
GBS
25. Child with painful crusted lesions on face and neck. Face is hot.
Impetigo
Measels
Chicken pox
26. Depression post MI
Sertraline
27. Patient with cervical spondylitis, develop eye pain, irregular pupils
- iridocyclitis

28. 35 yr old man with allergy, he has wheeze, stridor and dyspnea. What to give him:
A. Intramuscular adrenaline 1:1000
B. Intravenous adrenaline 1:1000

29. Woman feeling weak malaise. Amenorrhoea 10 months. BMI 30-32. Low potassium 2.5
- cushing disease
-Pcos
- Primary hyperaldosteronism

30. Female with malodorous clear vaginal discharge. pH>? Diagnosis??

Candida
Gardnella
Trichomonas vaginalis
31. Young male after RTA, Breathless, right side chest pain, fracture in 5 n 6 rib. Wht to do next?
analgesia
Intubate
32. Pt with back pain , after recent shifting to new house ..what to do ?
- mobilise and analgesia
-bed rest
- manipulation
-acupuncture

33. Young man, testicular swelling few months, can get above it.
-Hydrocele
34. Pt with fracture of distal radius ... dorsal angulation >10 degrees . No neurovascular compromise
mentioned .treatment ?
- arm slab
- close reduction
-ORIF

35. Swelling on anterior neck triangle . Increase in size recently , transilluminating

branchial cyst
cystic hygroma
36. Post RTA, patient with femoral shaft fracture. Which artery involved
-Femoral a.

37. Wrist drop and loss of sensation on the space between thumb and index finger
Radial
38. Fluctuating swelling lower border of knee. Which bursa
Prepatellar..
39. Man, chronic smoker. Then there's postural drop in BP. Sitting 140/80, lying 110/70. I think.
They ask for electrolyte Imbalance
-Hyponatremia
-Hyperkalemia
40. Man alcoholic, GCS fluctuating, muttering etc
-Capillary blood glucose
41. Young lady with bilateral iliac fossa pain and vaginal discharge. What antibiotics to give:
A. Ciprofloxacin + metronidazole
B Doxicycline + Ceftriaxone + metronidazole
C. Doxicycline + metronidazole + ciprofloxacin
42. Women with breast ca had mastectomy with clearance develop swollen upper limb
-Lymphedema
43. Ataxia, nystagmus and vertigo. Where is the lesion.
Cerebellum,
brainstem
44. Post MI scenario. BP low with broad complex tacyarryhtmia. Unconscious with shallow
breathing (respi rate 4/min)
-DC shock
-Intubation and ventilation
45. Diabetic lady had weakness with slurred speech.
- Stroke
46. Painless vaginal bleeding in 32 weeks. pregnant the single most diagnostic test...
Trans vaginal US
Trans Abd. US
47. Hyperemesis gravidarum patient-fluid of choice
normal saline.
48. A case about submandibular calculus- pain after having large meal.
49. 40 year old lady with occasional dizziness tinnitus and hearing loss. Diagnosis?
Menieres disease
Acoustic neuroma
50. Adult patient with ear pain, loss of hearing. Otoscopy showed vesicals in ear
 Ramsay hunt syndrome
51. Moderate dyskaryosis. Management?
Colposcopy in 4 weeks
52. Patient after party, can see colors. Which drug?
Heroin
Cocaine
LSD
Cannabis
53. RIF mass with round tenderness and guarding for the past 2 weeks. Diagnosis?
Appendicular mass
54. Classic picture with transmular involvement. Diagnosis?
Cohrn disease
Ulcerative colitis
55. Very high ferritin, at risk of which cancer?
Liver
Pancreas
56. Female on treatment of PID now is ill, abd pain etc. best investigation ?
Ultrasound
57. child with febrile convulsion. What advice will u give to parents ?
can reoccur with fever until age of 6
can reoccur until age of 10
58. Child, doesnt play with his siblings, vocal delay etc etc etc. diagnosis ?
Autism spectrum disorder
59. Patient bitten by human.
Hep B
Hep A
60. Sparse hair, cold extremities etc etc features of hypothyroidism. Investigation?
Thyroid function test
61. A girl who eats a lot and vomits, took her mirror off and stopped going out because she thinks
everybody looks at her. Diagnosis?
Bulimia nervosa
Body dismorphic disorder
62. Primary male infertility with azoopermia. Test to confirm diagnosis?
FSH
Testosterone
63. Classic scenario of Hypochondriac patient
64. Boy with offensive unilateral discharge from nose from last few months. Cause?
Foreign body
Rhinitis
Polyp
65. ACEI for microalbuminuria
66. Female, afraid to go outside house. Only goes with her husband. Diagnosis?
Agoraphobia
67. Old man with previous suicidal attempt. What will increase suicide risk?
Family history
Lack of social contact
Previous suicidal attempts
68. Another suicidal risk question .
 Alcohol dependence
69. Post op 2 days . patient become agitated confused etc etc etc. diagnosis?
Delirum tremens
70. Dehydrated child. Maintenance fluid of choice ?
Normal saline + dextrose
71. Neck stiffness, non blanching rash, photophobia. What is the causative organism?
N. meningitis

72. Patient get hallucinations when going to sleep.

Hypnogogic hallucinations
73. Elder female with severe progressive nausea and back pain. Where is the primary cancer?
Stomach
Breast
Pancreas
74. Old female, on steroids, progressive loss of vision in one eye. Diagnosis?
Cataract
75. Classic scenario of bipolar disorder
76. Patient on depo porvera for 6 weeks but has intermittent bleeding since then.
Reassure
Cervical smear
77. Ipsilateral vision loss and CL hemiplegia (something like this.)
Internal carotid
External carotid
Ant. cerebral
78. Female with metastasis, has weakness of her legs, minimal knee and absent ankle tendon
reflexes, a palpable bladder, a power of 2/5 at the hip, 3/5 at the knee and ankle, and
tenderness over the 2nd lumbar vertebra. Diagnosis ?
Paraneoplastic
Spinal cord compression
79. Patient after surgery, aggressive etc. but after 2-3 days, came back and thanked the doctor.
Diagnosis ?
Adjustment disorder
PTSD
80. After watching an accident, lost his eye sights . diagnosis ?
Conversion disorder
81. Old patient with anemia , increased Ca, disturbed kidney function, hematuria, nocturia, dysuria.
Diagnosis?
Multiple myeloma
Prostate ca
Bladder ca
82. Child with vomiting and constipation. K+ - low, Na = low. Other normal. Diagnosis?
Hyponatermic dehydration
Pyloric stenosis
83. Young female, had abdominal bloating and pain for 9 months. Stool contains mucous but no
blood. No diarrhea. Relieved by defecation. Clinical exam remarkable. Diagnosis?
Corhn disease
Irritable bowel syndrome
Ulcerative colitis
84. Nose bleed pinch the soft part
85. Old man, low mood, feeling guilty towards family. Diagnosis ?
Depression
86. A woman 3-5 days after the obstructed labor presents with pain and swelling upto inguinal
crease in one leg, blue mottling etc etc. diagnosis?
DVT
Post phlebitis syndrome
Embolus
87. Patient with sudden onsent of headache, photophobia, neck stiffness etc. diagnosis?
Subarachnoid
Meningitis
88. Old lady with confusion ( probably SDH) etc etc. Best investigation?
CT brain
89. Old lady, xray shows opacities, she has pleural fluid . what to do ?
Pleural aspiration
90. Young female with irregular heavy painful mensturation. Best contraception?
Cocp
91. Post RTA, tender breast lump. Diagnosis?
Fat necrosis
92. Healthy child. Normal weight gain. Feeding properly but have jaundice from few days of life till 4
weeks. Diagnosis ?
Breastfeeding jaundice
93. 54 year old man, dyspepsia, weight loss and anemia . investigation ?
h.pylori test
endoscopy
breath test
94. Old man with progressive memory loss. Cant remember name or address( something like that),
diagnosis?
Delirium
Alzheimer
95. Patient with facial neurogenic pain (trigeminal neuralgia features), what should be given for
pain?
Antiepileptic
Antidepressant
96. Patient on antidepressant ( have bipolar disorder). What should be given to improve his
symptoms etc?
Mood stabilizers
97. Young man with sore throat followed in few days by hematuria, HTN, renal symptoms etc.
diagnosis?
a. Post-streptococcal GM
b. IgA nephropathy
98. Pregnant female presented at 16 weeks of gestation. What should be done ?
a. Amniocentesis
b. Villous sampling
99. A pregnant female, what should she be tested for ?
Rubella and syphilis
100. Mechanism of breast cancer spread or something like that asked- infiltration of
underlying cells of skin
101. Few days after Post thyroidectomy. Vomiting with altered blood. Temperature 38.5.
management?
a. Admit of parenteral antibiotics
b. Oral antibiotics and discharge
c. Pack the operated site
102. Patient presented after RTA, had glycosuria. Later resolved. Diagnosis?
A. DM1
B. DM2
C. Normal stress response
103. Mother of 5 children. Incontinence only when coughing and sneezing . dx?
Stress incontinence
104. Pregnant female at 29 weeks has BP of 160/110 and proteinuria 1.5 (not sure). BP at 10
weeks of gestation was 120/80. Diagnosis?
a. Pre-eclampsia
b. Gestational hypertension
105. Boy dont want to go to school. Complains of headache and giving some reasons.
Mother has depression and recently started medication. Management ?
a. Get collateral info from parents and school
106. Typical case of child with odema and proteinuria. Dx ?
a. Minimal change disease
107. Another scenario of minimal change disease. Most appropriate investigation?
a. Albumin
108. Patient with heart rate over 170, bp- 90.70. on ecg shows atrial fibrillation. Immediate
next step ?
a. DC cardio
b. Iv amiodarone
c. Digoxin
109. Patient suffering from motor neuron disease. Cant swallow. Management ?
a. Ng tube
b. Percutaneous endoscopic gastrostomy
110. Girl, with history of diarrhea, renal impairment. Diagnosis? HUS
111. Young male, has dysphagia. Initial investigation? barium swallow
112. An old patient with increasing chest pain, systolic murmur. Diagnosis?
a. Aortic stenosis
b. Mitral regurgitation
113. Typical scenario of child with fever and cough. Diagnosis? Bronchiolitis
114. Young patient with palpitations. Investigation? 24 hours ECG
115. Indirect hernia. What best describes it ?
a. Passes through deep inguinal ring
116. Glucose test value given. Interpretation asked impaired glucose test
117. Young man, smoker, pneumonia symptoms. Cavitating lesion on xray. Causative
organism ?
a. Staphylococcal au.
b. H. influenza
118. Typical question of patient from nursing home. Itching. Dx ? Scabies
119. 18 months old child. Choking. What to do if same happened at home?
a. Back slaps and chest thrusts on Lap
120. Turn to right diplopia and resolves when one eye closed. Cause?
 a. Right abductens
121. Ischaemic stroke. On aspirin 75mg. presented about 6 hours later. What would the best
next treatment?
a. Clopidogrel
b. Aspirin 300mg
c. TPA
122. Mode of spread of chicken pox Air
123. Classic presentation of chicken pox and causative agent asked Varicella zoster
124. Diabetic patient with painful lesion on anal area, fever. Peri-anal abcess
125. Patient with progressive ear ache, hearing loss on same side. Moderate tonsillar
erythema, several cervical lymphnode. Ear drum is dull inflamed. what is the cause of his ear
problem.
a. Acute OM
b. Glue ear
c. Tonsillitis
d. Acute OE
126. Post ERCP pancreatitis small beads visible on pancreas.
a. Fat necrosis
b. Abscesses
127. A 76yo man suddenly collapsed and died. At post mortem exam, a retroperitoneal
hematoma
due to ruptured aortic aneurysm was noted.
a. Atheroma
b. Cystic medial necrosis
c. Dissecting aneurysm

128. Woman after mastectomy has loss of sensation on the inner side of arm. reason?
a. Axillary
b. Costo-brachio
c. Brachial plexus
129. Post RTA, BP low, abdominal distension and rigidity. Most appropriate investigation?
a. Ct abdomen/pelvic
b. US abdomen/pelvic
c. Erect Xray
d. Diagnostic peritoneal tap
130. Most common cause of kidney transplant in Uk Diabetes
131. Amitriptyline toxicity, what should be done ECG
132. Scenario of PCOS
133. Chronic GI bleeding
134. Typical scenario of Hep A IgG positive and Hep B IgG negative. What to do next to
confirm diagnosis?
a. Hep A IgM
135. Old man, intermittent heamaturia, low back pain, PSA value high.
a. BPH
b. Bladder stone
c. Prostate ca
d. Bladder ca
e. Uti
136. Life threatening asthma Altered sensorium
137. Old woman with urinary catheter for incontinence becoming confused etc etc
a. Delirium
b. Picks disease
138. Admitted with pancreatitis twice. No alcohol history given. Paresthesia.
a. Thiamine
b. Cobalamin
c. pyridoxine
139. patient with 40% partial thickness burn. BP 90/60, RR 20. Fluid management?
a. Blood transfusion
b. Fluid bolus for shock
c. Fluid from time of burn
140. Patient with retrosternal pain on inspiration. Vitals are fine. Little pyrexical.
a. Pericarditis
b. Esophagitis
141. Patient had tibia closed fracture. On cast. After 4 days complains pain. Limb warm and
good pulse. What to do next?
a. Increase analgesia
b. Reassure and review in a week
c. Remove cast
142. 30 year old woman, gradual loss of vision in last 1-2 years, now upto hand movement/
finger counting. Diagnosis ?
a. Iritis
b. Glaucoma
c. Cataract
d. Macular degeneration
143. Post gastrostomy, neurological signs etc .
a. B12 deficiency
b. Folate deficiency
144. Fibroadenoma in a young girl
145. Post op patient. After 5 days develops shortness of breath. PE suspected. Already on
LMWH. What to do ?
a. Keep on same LMWH and do CTPA
b. INCREASE LMWH AND DO CTPA
146. Post op patient on oxygen mask and breathless, abg given. (seemed like a case of
atelectasis)
a. Chest physiotherapy
b. Reduce oxygen
147. Typical scenario of DKA. What should be done ABG
148. Patient with low Hb, PR mucous, weight loss cecal carcinoma
149. Alzheimer patient came with her granddaughter. Wants to change her will.
a. Proceed with the changes she wants to make
b. Tell her she cant make any changes
c. Refer the lady to psychiatrist for full capacity assessment
150. 80 year old lady, severe tenderness in 5th n 6th intercoastal space, altered sensation in 5th
th
and 6 space etc etc something like this .
a. Pathological fracture
b. Herpes zoster
 c. Vertebral compression osteoporotic fracture (cant remember properly)
151. Lady suffering from depression. Doesnt eat or drink. Dont want to go out. Mental and
physical deteoration getting worst. What to do
a. ECT
b. CBT
c. Urgent NG tube feeding
d. TEN
152. Rash on shin Sarcoidosis
153. Some female with autoimmune hypothyroidism symptoms pernicious anemia
154. Upper lid ptosis and slight constricted pupil but still react to light and accommodation.
Which ganglion involved?
a. Otic
b. Celiac
c. Thoracocervical
d. Submandibular
155. Old woman with GI symptoms Digoxin toxicity
156. Unconscious man with empty beer cans around him, signs of chronic liver disease.
Electrolyte imbalance ?
a. Hypoglycemia
b. Hyperglycemia
c. Hypercalcaemia
157. Female on steroids for asthma I think candida laryngitis
158. Neonate after PROM and premature delivery. Nasal flaring, intercostal recessions, no
fever. What to do ?
a. CXR
b. Blood culture
159. Pregnant woman at 34 weeks gestation presents with tingling and numbness with
altered sensation of her right middle and index finger. Tinnel test is negative. What is the most
likely diagnosis?

Carpal Tunnel
Radial nerve entrapment
160. An 18 month old boy pulled over a cup of hot tea. He presents with 6% burn on his
chest. What is the treatment?
IV fluid calculated from the time of burn
No need for IV treatment
161. Took 100 tablets of TCA and now refusing the treatmet
a. Observe
b. Treat her against her will
c. Access her capacity to refuse the treatment
162. Question about syphilis antibodies
163. Purple bag syndrome, not sure if nitrates present or not in dipstick.
a. Do nothing
b. Culture and CS
164. Before giving lithium check tft
165. Female on cocp, 1 week after long flight PE
166. Congenital adrenal hyperplasia 1:4 ( autosomal recessive)
167. A 12 yo boy had got big ears. His mother wants to take him to private centre for
pinnoplasty. The kid thinks that his ears are just okay. what will u do?
options included :
a. refer the child to private for procedure
b. referreal isnt possible without the childs consent
c, take the child to be counselled
168. Pt with heart problem and other co morbids in itu , has red wollen painful joint .. what
investigation will confirm diagnosis?
A. Serum uric acid levels
B. Joint aspirate microscopy
169. Pt of rheumatoid arthritis, on methoetrexate , nsaids
Labs: hb low , mch low
A. Folate def
Bvit b 12
C hemolytic anemia
D aplastic anemia
E. cheonic gi bleeding
170. A situation of chronic liver disease. Spider naevi. Slow growing ascites. Transudate <25
- Cirrhosis
171. 22 yo with frequent fainting attacks since childhood. Normal pr interval and qrs but qt is
prolonged. Cause of faint?
Asystole
Complete heart block
Af
VT
Sick sinus syndrome
172. Pt with clavical fracture.. alredy on paracetamol and brufen .. pain not controlled .. what
to add next ?
-morphine
-codiene sulphate
-tramadol
173. Intermittent dysphagia at night with regurgitations. No weight loss.

Motor neuron disease

Achalasia
Esophageal carcinoma
scleroderma

174. A pt presents with numbness below the chin and just left to the incisor on the left side .
A history some dental procedures on the same side,which nerve is involved?
A. Lingual nerve
B. Inferior alveolar
 C. Inferior orbital
D.facial nerve
175. patient with GCS 6 and respond to painful stimulus?? minimal conscious state or
coma?
176. old woman! Who was unkempt and started wandering around the neighborhood. Her
husband was deceased 5 years previously. What was the diagnosis
Delirium
Lewy body dementia
Depression
Alzheimer's
schizophrenia
177. Patient with HIV and CD count 50. Symptoms of pneumonia but Pneumocyst excluded.
Options of treatment:
-amphotericin
-dexametazone
-rifampycin and isoniazid
178. Changes in melanoma to suspect malignancy
179. oes anyone remember the question about couching patient? Which hormone should we
check? Renin, erythropoietin
180. anemia of chronic disease
181. Old man with nose bleed. On warfarin for af
182. A butcher accidentally stabs his groin. Bleeding profusely. Towel soaked in blood. Option
like:
Raise leg
Apply pressure
Immediate surgical exploration
183. X ray picture given
184. 1-A 6 year (or 4 year old?) admitted with Chest infection weight __ kg (that was below
third centile). He gained weight 1 kg in hospital. Then was admitted again with impetigo, weght
again reverted to previous weight (loss of 1 kgl). This increase and decrease in 1kg occurred yet
again again after 1 month.

A) Cystic Fibrosis
B) Celiac
C ) Neglect
D) DM
185. Old lady with epilepsy. Found drowsy. But gcs 15/15. Tremors, nystagmus, vertigo.

Which drug level should be checked

a) Carbamazepine
B) Paracetamol
C) Statin
186. Complication of ERCP biliary infection
187. 26 yr old male presented with pain in scrotum, left side for 4 hours. He has h/o similar
pains over past 2 months but never took treatment. He is sexually active with multiple partners.
What will be the management for this patient?
A. Send home with antibiotic cover
B. Ultrasound of scrotum
C. Urgent surgical exploration

188. A lady with pain in her neck and parasthesia in inner part of her right upper arm, web
between her thumb and index finger and weakness at the wrist. Which nerve root is affected:
A. C5
B. C6
C. C7
D. T1

189. Scenario on old woman who has dementia her daughter locks her in house so that she
do not wander around and get lost . What is most apropriate action.
- inform safeguardings to raise concern
- admit patient to elder care /palliative care home
-dont do anything duaghter has good intentions for pt best interest .

190. Oral hypoglycemic before endoscopy