unwell. He has constant noisy breathing and he is drooling saliva. His temp=39C.

What is the
most imp dx?
a. Acute asthma
b. Bronchiolitis
c. Croup
d. Epiglottitis
e. Tonsillitis
864. A pt with terminal cancer is being treated with chemo develops tingling and numbness of the
fingertips of both arms. What is the single most likely cause of the symptoms?
a. Bone mets to cervical vertebrae
b. Post-chemo neuropathy
c. Hyponatremia
d. Hypocalcemia
865. An 80yo man has a permanent catheter. Catheter specimen urine found lots of e-coli. What is
the single most appropriate management as he wants to attend his daughter’s wedding next
week?
a. Change the catheter
b. Prolonged antibiotics
c. Bladder wash
d. Repeat MSU after wedding
e. Reassure
866. A 35yo male typist who suffered a scaphoid fx was treated with a scaphoid cast. After 2wks
when the cast was removed for a review XR, it was found that he had problems in moving the
thumb, index and middle fingers. What would you suggest as the management for the recent
prb?
a. Release of flexor retinaculum
b. Release of common flexor sheath
c. Release of palmar sheath
d. Ulnar nerve release
e. Fasciotomy
867. A pt on insulin is booked in for a hernia operation. What is the most appropriate management of
insulin?
a. Give insulin and saline pre-op
b. Stop insulin for the duration of the op
c. Give IV insulin + dextrose + saline pre-op
d. Give insulin as usual pre-op
e. None
868. A 35yo male who recently had an appendicectomy has got severe pain in his right big toe. Joint
is red and swollen. He consumes 30 units of alcohol/week. What is the most probable dx?
a. Rhabdomyosarcoma
b. Osteoarthritis
c. Gout
d. Pseudogout
e. Arthritis
869. A 25yo male who recently noticed change in his shoe size, he is also constipated, has a
preference to hot weather, his skin is dry, has severe pain in wrist joint. Joint is red and swollen.
What is the most probable dx?
a. Chondro-sarcoma
 b. Lipo-sarcoma
c. Gout
d. Pseudogout
e. Ankylosing spondylitis
870. A 45yo woman had her visual acuity checked at her local optician. 12h later she presents to the
ED with severe pain and redness in her eye. What is the single most appropriate option?
a. Iris
b. Ciliary body
c. Ant chamber
d. Post chamber
e. Cornea
871. A 75yo man who has DM and HTN experiences acute monocular blindness which resolves after
1h. What is the most likely dx?
a. GCA
b. Optic neuritis
c. Lacunar infarct
d. Pontine hemorrhage
e. Amaurosis fugax
872. A 26yo presents with prolonged constipation, blood on side of stool and very painful defecation.
PR exam: very painful. What is the single most likely dx?
a. Ca Colon
b. UC
c. CD
d. Anal fissure
e. Constipation
873. A 35yo man with painless left testicular enlargement for the past 6m which is increasing in size
and 3x larger than the right side. There is no tenderness or redness. What is the most likely dx?
a. Testicular tumor
b. Hydrocele
c. Epididymal cyst
d. Epididymo-orchitis
e. Reassure
874. A middle aged man who has had a hx of chronic sinusitis, nasal obstruction and blood stained
nasal discharge. He now presents with cheek swelling, epiphora, ptosis, diplopia, maxillary pain.
What is the single most likely dx?
a. Nasopharyngeal ca
b. Pharyngeal ca
c. Sinus squamous cell ca
d. Squamous cell laryngeal ca
e. Hypopharyngeal tumor
875. A 60yo man with a long hx of smoking and alcohol presents with nasal obstruction, epistaxis,
diplopia, otalgia and conductive deafness. What is the single most likely dx?
a. Nasopharyngeal ca
b. Pharyngeal ca
c. Sinus squamous cell ca
d. Squamous cell laryngeal ca
e. Hypopharyngeal tumor
876. A 60yo is on tx for IHD, HTN and hyperlipidemia. During the night he complains of wheeze and
SOB. Which of the following meds is responsible for that?
a. Amlodipine
b. Atenolol
c. Ramipril
d. Simvastatin
e. Bendroflumethiazide
877. A 15yo boy who complains of pain in his leg which has settled with aspirin. What is the most
probable dx?
a. Leomyosarcoma
b. Liposarcoma
c. Painful hip
d. Exostosis
e. Osteod osteoma
878. A 20yo fit man suddenly developed severe lower back pain as getting up from bed. What is the
single most probable dx?
a. Paget’s disease
b. Multiple myeloma
c. PID
d. AS
e. Spondylosis
879. A 60yo man brought to the ED with fx hip, he is deaf and has bilateral pedal edema. What is the
single most probable dx?
a. Paget’s disease
b. Osteoporotic fx vertebra
c. Secondary
d. Multiple myeloma
e. Spondylosis
880. An 80yo lady presents wih pain on left 6th rib for a week. It is non-tender on examination. What
is your most likely dx?
a. Herpes zoster
b. Costochondritis
c. Bone degeneration
d. Thoracic vertebra compression
881. A 68yo DM, HTN with a 45pack/year smoking hx, has left sided chest pain increased with
breathing. Exam: myosis on left side and wasting of small muscles of left hand. What is the
single most appropriate dx?
a. Costochondritis
b. Lung cancer
c. Good pasture’s syndrome
d. MND
e. Progressive massive fibrosis
882. A 34yo man had a cold 2d back. He now presents with right sided facial pain. What is the single
most likely dx?
a. Maxillary sinus
b. Ethmoid sinus
c. Septal hematoma
d. Septal abscess