amrit march 2013 solved modified by aarav

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  • 8/13/2019 Amrit March 2013 SOLVED Modified by Aarav

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    Amrit

    March 16, 2013

    1 - Back stiffness cause? Osteoporosis/disc prolapsed/cervical spondylosis (ANS C)

    Osteoarthritis of lumber that is lumber spondylosis is better

    answer.

    2- Osteoporotic fracture

    3- L5/s1? Absent ankle jerk/weakness dorsiflexor ( (ANS S1 ABSENT AJ & WEAK PLANTAR FLEXION))

    S1

    4- Estrogen/progesterone?

    Decreases breast cancer after 2 years use/ decreases cardiovascular disease/decreases

    thromboembolism

    Bbbbbbbbbbbbbbbbb?????????????/

    Decreases hot flushes

    5- Pt. Taking hrt, what is the most likely problem in 2 years of time? Very tricky (( HRT DEC CVS RISK

    AFTR 5 YR USE, OSTEO RISK BY 10 YR, INC STROKE /THROMBOEMBOLISM,PROTECT AGAINST COLONCA & ALZHEIMER,IN 2 YR ONLY VASOMOTOR CAN DECREASE))

    6- Case related with pulmonary atelectasis

    7- Post of case sudden dysnea, most effective? Ctpa/dimer/vq [[ANS; A, CTPA ]]

    8- Wegeners granuloma? (( a febrile illness and respiratory symptoms, but early

    diagnosis is essential. It usually gets confused with

    benign nasal conditions.

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    Clinical features

    Adolescence to elderly, mean age 40-45 years

    Constitutional symptoms (as for PN)

    Lower respiratory tract (LRT) symptoms (e.g. cough ,

    dyspnoea)

    Oral ulcers

    Upper respiratory symptoms: rh inorrhoea, epistaxis,

    sinus pain

    Eye involvement-orbital mass

    Pol yarthritis

    Kidney involvement- usually not clinically apparent

    (about 75% get glomerulonephritis)

    Chest X-ray points to diagnosis-multiple nodes,

    cavitations

    Anti neutroph il anti bodies (c-ANCA) are a useful

    diagnostic marker (not specific)

    Diagnosis confirmed by biopsy, usually an open lung

    biopsy

    Better progn osis with early diagnosis and treatment

    with cyclophosphamide

    DxT: malaise+ URTs (e.g. rhinitis, sinusitis)

    + LRTs (e .g. wheeze, cough) =Wegener

    granulomatosis

    DxT: asthma + rhinitis + vasculitis+

    hypereosinophilia = Churg-Strauss vasculitis))

    9- Lactose intolerance baby case? [[ PERI ANAL EXCOIRATION]] [[ COW MILK ALLERGY HAS VARIOUSPRESENTATION ; Symptoms ; The principal symptoms are gastrointestinal, dermatological and

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    respiratory. These can translate to: skin rash, hives, vomiting, and gastric distress such as diarrhea,

    constipation, rhinitis, stomach pain or flatulence. The clinical spectrum extends to diverse disorders:

    anaphylactic reactions, atopic dermatitis, wheeze, infantile colic, gastroesophageal reflux (GER),

    oesophagitis, allergic colitis, headache/migraine, oral irritation, and constipation.]]

    10- Ethics 3-4 questions

    11- Very tricky question on Chlamydia infection

    12- Read stds very carefully, i got about 3-4 qestion on those topics

    13- Case of generalized lymphadenopathy, fever, painless maculopapular rash over penis 21 years

    old kid, most common cause? Primary hiv/ secondary syphilis [[ ANS; B SECONDARY SYPHILIS]]

    14- Lump over neck for 6 months, lady. Two weeks on and off? What is the diagnosis?

    Lymphoma/cll/aml/all/glandular {{ ANS; LYMPHOMA}}

    Follicular lymphoma..wax and wayne LAN

    15- 8 yrs old child with mobile lump over her right breast brought by her mother? What inv would u

    do?

    Usg/reasurence/surgery/wait till it grows (( ans ;b REASSURE))

    16- Myocardial infarction case- 3-4 questions,

    17- Case of copd? Domestic o2 therapy case

    18- Child with eye flutter some seconds? Gradually increasing. Eeg 3 spikes. What treatment is

    needed?

    Carbamazepine/ct head/reassure (( ANS : ETHIOSUXIMDE FOR CHILDREN.))

    Absence seizure.here reaasure

    19- Case on alzhiemer

    20- Tibia/fibula fracture with diagram what would you do next? Reduction/tt/analgesics/surgery

    ((ANS ; SURGERY))

    21- Transilluminable swelling on posterior compartment neck? Diagnosis: cystic hygroma/branchial

    cyst {{{ ANS : A}}

    22- Venous ulcer with pic? Feb question- hemosiderin depositon/hemmorghage {{ANS ; A}}

    23- Westnile fever encephalitis case, what would you do? Vaccination/avoid tse tse flies/mosquitorepellants {{{ ANS :c}} [[[4/16/2013 3:37:59 PM] dorin hussain: Prevention

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    Low-cost, ceiling hung mosquito netting for a bed.

    Personal protective measures can be taken to greatly reduce the risk of being bitten by an infected

    mosquito:

    Using insect repellent on exposed skin to repel mosquitoes. EPA-registered repellents include

    products containing DEET (N,N-diethylmetatoluamide) and picaridin (KBR 3023). DEET

    concentrations of 30% to 50% are effective for several hours. Picaridin, available at 7% and 15%

    concentrations, needs more frequent application. DEET formulations as high as 50% are

    recommended for both adults and children over 2 months of age. Protect infants less than 2 months

    of age by using a carrier draped with mosquito netting with an elastic edge for a tight fit.

    When using sunscreen, apply sunscreen first and then repellent. Repellent should be washed off at

    the end of the day before going to bed.

    Wear long-sleeved shirts which should be tucked in, long pants, and hats to cover exposed skin.

    The application of permethrin-containing (e.g., Permanone) or other insect repellents to clothing,

    shoes, tents, mosquito nets, and other gear for greater protection. Permethrin is not labeled for use

    directly on skin. Most repellent is generally removed from clothing and gear by a single washing, but

    permethrin-treated clothing is effective for up to 5 washings.

    Be aware that most mosquitoes that transmit disease are most active during twilight periods (dawn

    and dusk or in the evening). A notable exception is the Asian Tiger mosquito which is a daytime

    feeder and is more apt to be found in, or on the periphery of, shaded areas with heavy vegetation.

    They are now widespread in the United States and in states such as Florida they have been found in

    all 67 counties.[51]

    Staying in air-conditioned or well-screened housing, and/or sleeping under an insecticide treated

    bed net. Bed nets should be tucked under mattresses and can be sprayed with a repellent if not

    already treated with an insecticide.]]

    24- Case on preeclampsia

    25- Diabetic foot

    26- Case with pinpoint pupil? Caused by what? Benzo overdose/cocaione overdose/heroin ((ANS :

    HEROINE ;) LOL }}

    27- Melanoma pic given? Many irrelevant options except punch biopsy

    28- Question on pill endoscopy (thought it as a capsule endo)

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    29-Terminal painless hematuria 2 cases given? Investigation and management were

    asked((BLADDER CA ))

    30-Svt ecg given. Adenosine/carotid massage

    31- Heart block ecg given diagnosis

    32- Hypertrophic cardiomegaly ecg asked

    33- 16 wks pregnant lady comes with 37cms pelvic enlargement? Cause? Hydatidiform

    mole/diabetic/multiple pregnancy (ANS : A))

    34- Question on prevalence

    35- Very tricky question on schizophrenia

    36- Question on bone age

    37- Xray and stem with empty rectum? Diagnosis

    38- Small bowel obstruction xray, hx of appendicectomy previously.

    39- Pt admires u and wanna go for a dinner, u get attracted too.. what would you do? Carry on dr/pt

    relation/refer to other doctor and explain why you cant continue the dr pt relationship(( LET HER GO

    ))

    40- Xray on aortic dissection

    41- Case of aortic aneurysm

    42- Question related with barium enema 2 questions were asked

    43- Case of papua guinea repeated question

    44- All the hepatic enzymes values were raised? What might be the causes.. i opted for viral serology

    45- Overian mass? What would you do? Laparatomy/laparoscopic ((ANS :B}}

    46- Question on mammography of microcalcification? What would you do?[[ MICRO CA , MACRO

    BENIGN]]

    47 Options were like sentinel node biopsy/core biopsy/chemoradio/excision ((ANS C }}

    48- Gm positive cocci.. drugs? Ceftrixone/flucloxacillin/penicillin {{ANS :B}}

    49- Case of intermittent claudication.. most appropriate? Venography/Doppler (( ANS :DOPPLER))

    50- Mode of inheritance percentage basis- b thallesemia and cystic fibrosis

    51- A child immediately after birth presented with grunting and subcostal recession, pregnancy

    normal, no other complication noted? Meconium stained/pneumonia((MECONIUM))

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    52- Rt arm and leg weakness, lesion present? Frontal lobe/parietal/occipital/temporal/internal

    capsule {{ANS ;E}}

    53- Question related with levodopa

    54- Turp complication? Epididymitis/bladder neck stenosis {{ ANS ;B }}

    55- Question related with rheumatic fever? Very tricky..

    56- Surgical case and various fluids were given? Haartman solution/2 lit saline/5% dextrose, very

    irrelevant and mindboggling one..

    57- Swelling infront of ear during eating? Submandibular/parotid/abscess {{PAROTID}}

    58- Kid 3 mnths loose motion esr raised?

    59- Past stem where undescented testes is commonly asso with?( hernia ))

    60- Post partum psychosis? Appropriate treatment? Ect/cognitive/antipsychotics ((ANS A))

    61- Diagnosis of pregnancy of uncertain period question? How would you tell the date? Pelvic

    examination when its supra bulge or 24 weeks or 6 weeks or when bulge below umbilicus {{18

    WEEKS BULGE BELOW UMBLICUS }} ans 6 weeks

    62- One stem on stroke and paralysis? Very tricky one

    I dint get any milestone questions.. no fundoscopic pics.. no cts.. not a single stem from bluebook...

    ...Well guys, i find my stems were really very tough.. hardly got any recalls but that doesnt mean

    they dont get recalled... many others got them recalled ..so in terms of getting them back is entirely

    the lady luck.. as for me, all i had was my logic and clicking the very fresh vignettes infront..

    Anyway, i have tried my best to recall my questions and this is all i could do.. i havent included the

    options, basically i couldnt recall thembut to be honest.. itsbetter to study this topic carefully

    and the answers are all in there.. so all the very best and keep working hard...