NO.107 A patient presented to you who is known case of hypothyroidism and on thyroxin, he also has increase PT normal Vitamin D, Creatinine is very high.
On examination tapping of the angle of jaw produce facial spasms, what diagnosis?

NO.108 50 year’s old male complained of right iliac fossa dull aching pain. Exam showed that he had right iliac fossa mass with positive cough impulse. The examining doctor found a bluish tinge on the mass surface & the percussion tab was positive.
The most likely diagnosis is:

NO.109 A 76-year-old woman is brought in for respiratory distress and altered mental status. Her medical history records right-sided hemiplegia from a stroke several years ago. She has blood pressure 86/52; heart rate 123 BPM, breathing rate 33 Br PM, temperature 102.3°F, and O2 sat 84%. Exam reveals rhonchi bilaterally with “E to Ah” changes and warm extremities with faint pulses. Chest x-ray shows bilateral infiltrates.
What is the likely etiology of this patient’s hypotension?

NO.110 A 45-year-old woman has a 2-cm breast cancer tumor removed by lumpectomy, and the breast is irradiated. The cancer is negative for estrogen receptors and positive for progesterone receptors. Three of 14 nodes removed from the axilla are positive for cancer.
What is the next best step in management?

NO.111 The patient passed a 4 mm stone in his urine. Does he have a 3mm stone in the renal pelvis found on an ultrasound?

NO.112 A lady developed breast abscess after delivery.
What is the most likely organism?

NO.113 A 20 year’s man presents with painful swallowing. Exam: trismus and unilateral enlargement of his tonsils Peritonsillar region is red, inflamed and swollen.
What is the most appropriate treatment?

NO.114 Female with recently inserted IUCD coming with watery brownish vaginal discharge & abdominal pain what is the most likely diagnosis?

NO.115 A young man comes up with a headache, which he describes that this headache is the most severe headache in his life.
Which of the following will be less useful?

NO.116 A 28-year-old female presents with 1-week history of jaundice and 2days history of altered sleep pattern and moods. She was diagnosed with hypothyroidism for which she is receiving thyroxine. Thyroid function showed increased TSH. PT=70s.
What is the most probable diagnosis?

NO.117 Hypothyroid patient on thyroxin had anorexia, dry cough and dyspnea& left ventricular dysfunction. She had normal TSH & T4 levels, Hyperphosphatemia & hypocalcemia.
The diagnosis is:

NO.118 Best method to maintain air way in conscious multiple injury is _______________________.

NO.119 At what CD4 count should anti-retroviral treatment commence in asymptomatic HIV patients?

NO.120 A 65-year-old man with longstanding diabetes comes to the office with a “pins and needles” sensation in both his feet. He is also chronically bloated and constipated. On review of systems, you find he cannot maintain erection sufficiently to complete intercourse. Urinalysis shows microalbuminuria. His LDL is 147.
What is the best management for this patient?

NO.121 A 65-year-old lady who is on thiazide suffers from falls in the morning.
What is the cause for her symptoms?

NO.122 A 24-year-old male with a history of gang violence presents to the emergency room with 3 stab wounds to the abdomen. He was intubated in the field for airway protection and is barely conscious. Blood pressure is 70/30 mm Hg and pulse is 140/min. On exam, 3 penetrating wounds covered by abdominal pressure pads are noted.
Which of the following is the best next step in management of this patient?

NO.123 A 6 months old boy with cough and wheezy chest. The diagnosis is:

NO.124 A 78 year’s retired teacher was admitted for a hernioplasty procedure. After the operation he became agitate and confused.
What is the most appropriate management?

NO.125 A man comes to the clinic having had a painless, firm genital lesion for the last several days. The inguinal adenopathy is painless.
What is the most accurate diagnostic test?