Derwasaquestionabtawomanwtast rongfamil
yhxofDM andbpof145/somti
n..
her
fast
ingwaselev
ated.
..Watt
odo.
..Repeatin4weeks,
commencemetformine,commence
amlodipi
ne.
Cancerpat
ientonmetformi
neandlongact
ingi
nsul
i
ncameinwtsev
ere
hypogl
ycemia.
.pl
an.
..
reducei
nsul
i
ndoseorchanget oOHA
DI
ZZINESS..
hypogl
ycemi
agotbet
terwtbi
scui
tsandt
eaandonmet
for
mineand
gl
i
clazi
de.
..Wattodo.
.It
hink.
.
Boywtpai
nfulhi
pjoi
ntandmi
l
dpy
rexi
aopt
ions.
.Sl
i
ppedepi
phy
sis,
sept
icar
thr
it
is,
per
chesdx.
the
Chi
l
dwtv
omi
ti
ngndmassabdomi
nal
..Opt
ionsUSabdomen.
.
Anot
herpersonwtepi
gast
ri
cpainmi l
danddiar
rhea.
.
Nodyspepsiai
nopti
onsbutgast
roenter
it
is
Awomanwtabr
upt
iopl
acent
a.
Awomanwtecl
ampsial
readyonhy
dral
l
azi
nandmgso4dr
ipwhohadanot
hersei
zur
e.
whatt
odonext
..
.Mgso4bolus
Awomanwtbr eastlump1x1cm..smoot
h,wel
ldemar
cat
ed,
grandmot
herhadbr
east
cancer
..
.Opt
ionscancer
,fi
broadenoma.
..
Afamil
ytr
eef rduchennedy
str
ophy
.Wat
sdpossi
bil
i
tyofdsecondsonhav
ingi
t.
..a.0%b.
25%c.50:d.100%
Aquest
ionabtagi
rlwtshor
tst
atur
eanamenor
rhea.Tur
nersy
ndr
ome
DepotPr
over
awomanwtbl
eedi
ngsi
xwksaf
terwatt
odo.
.Reassur
e.
65yr
soldwtbr
owndi
schar
geand8mm endomet
ri
um.
..Watt
odo.
.Hy
syer
oscopyand
bi
opsy
Anot
herpat
ientangr
ywtdoct
orsf
rsur
ger
yandl
atert
hankf
ul.
..
a.Adj
ust
mentdi
sor
derb.
Redi
tchyper
iar
eol
arr
ash.
..Opt
ionspaget
sdi
seaseoft
hebr
east
,cont
actder
mat
it
is.
Jaundi
ce,
darkuri
ne,mil
danemia.wi
thhxoft
aki
ngant
imal
ari
alpr
ophy
laxi
swhowas
ret
urni
ngfr
om Thai
land.
.Opt
ionshad
Adiagnosi
sofmeningococcalmeni
ngi
ti
swhent
oal
ertaut
hor
it
ies.
.
a.
Onsuspicion,
b.onconfi
rmati
on
Ahomel
essguywi
thposi
ti
veAFB.
,A.t
oisolat
eandar r
angefrcont
acttr
aci
ng,B.getal
ter
nat
iveaccommodat
ionv
iasoci
al
ser
vice.
C.StartDi
rect
lyobser
vedTherapy
Afoundati
ondoctorsuspect
edofcannabi
sabusehav
ingpoorwor
kandhal
l
uci
nat
ions.
.
Waytodo? .
a.Reportt
oeducati
onalsupervi
sor
b.Reportt
oGMC
C.advi
cetotake1weekl eave
D.Advicet
ostartt
reatment
Aladywhost artedhavi
ngcrampsanddiarr
hea5day saft
erreat
ingi
nanewr
est
aur
ant
.
Shewor ksinanothereat
ery.Whenshdshegobackt owork?
A.Whendi arr
heasettl
esandshef eel
sbet
ter,
B.48hrsafter
C.24hoursafter
D.Aft
ernegat i
vestoolmicr
obiol
ogysampleresul
tisobt
ained
Awomanwtf r
othypoo..
.Watt est
?
.Ant
i-t
issueTransgl
utaminaseanti
body
..Forcoel
i
acdx.
..
Apat
ientwhowasfoundout
sidedQueenshousesay
ingpr
inceChar
lessentf
rhi
m.What
ki
ndofdelusi
on
a.Gr
andiosedel
usi
on.
..
Anurseorl
adywtahxofrepeat
edhamdwashingmul
ti
pleti
mesaday
.Herhands
becameredandi
taf
fect
edberperf
ormanceatwor
kOCD. .
Tr
eat
mentf
orgar
dner
rel
a..Met
roni
dazol
e,doxy
cycl
i
nasopt
ion.
Pl
eural
effusionwatt
odot
or el
i
evesy mptomsaswomanhadaf
ewweekst
oLi
v.
..a.
Aspi
rat
ion,b.commencef
rusemide.
.c.i
nsertchestt
ube
Amanwtonesi
depai
nwor
sei
neat
ing.
.Watt
odo.
.t
empor
alar
ter
ybi
opsy
Someonewtdecr
easi
ngacui
tyandhxofmy
opi
a..
.Gl
aucoma,
cat
aract
..
Hoar
senessaf
tersur
ger
yfr
om r
ecur
rentl
ary
ngeal
ner
vet
rauma.
.
Laryngotr
acheobr
onchi
ti
sinchi
l
dwt
outt
reat
mentwati
sdout
comea.compl
ete
resolut
ionb.
r
iskf
rrepeatst
roke.
.ABCDE.
.
SOMEONEWTLUNGCANCERANDSOI
UM 119.
.CAUSE.
.OPTI
ONHADADRENALI
SUFFI
CIENCY,
HYPONATRAEMI
A
TRANSURETHRALPROSTATECTOMYWHATDOUSEE.
.aHYPONATRAEMI
A..
b.
hypokal
emi
a(al
lopt
ionswer
ehy
po)
, Quest
ionwithsuddenhxofbreat
hlessness,
clearchest
,Muf
fl
edhear
tsound,
engor
ged
neckvei
n.a.car
diactamponade.
QUESTIONonpneumot
hor
axwatt
odoi
mmedi
atel
y.
.Phy
siot
her
apy
,ther
apeut
ic
t
boracocent
esi
s..
Onechestpai nnotknownwtbporanymedsbutnor
mal
troponi
nandnor
mal
x-r
ayand
ecg..FatherhadBPandMI
a.costochondri
ti
sb.MI,c.PEd.Pani
cat
tack
Pat
ientwhobuy snonprescri
pti
onmeds( adrugofabuse)wtdi
l
atedpupi
l
s,r
hinor
rhoea,
l
acerat
ion.
.a.cocai
ne,b.cannabi
s,her
oine.c.amphet
amine
Achil
dcamei nunconsci
ousbutamongstot
herf
indi
ngsconst
ri
ctedpupi
l
s..Watt
odo.
.
Methadone.
.
Someoneunconsci
ouswtamt
ri
pty
li
npackempt
yinpocket
..
Someonet
ost
opal
cohol
,watdr
ugst
ogi
vsl
owl
yfr
st.
.a.chl
ordi
azepoxi
debdi
sul
fi
ram
Parest
hesi
a,hy
per
ref
lexi
ainapat
ientt
aki
ngl
evot
hyr
oxi
ne.
.Watv
itami
ncausedi
t.
.
a.B12c
Tr
aumat
ocommonper
oneal
ner
vewtf
ootdr
opanddr
est
.
1.Al adywhohadhipsur
ger
y2day
sago,
present
sacut
elywi
thshor
tnessofbr
eat
h.
Diagnosis.
a.Car di
acTamponade
b.M. I
c.Pleuralef
fusi
on
d.Pul monar
yemboli
sm
2.Malepr esentswi t
hyel
l
owi
shpl
aqueoney
eli
dsov
er2y
ear
svar
yingi
nsi
zef
rom 0.
3cm-
0.5cm.Diagnosis
a.Apicalcarci
noma
b.Basalcellcarcinoma
c.Meiboiancy sts
d.Xanthelmast a
3.Boywhowasr i
dingabi ke,f
ell
off&hi
thi
slegl
ater
all
ybel
owt
heknee.Dor
sif
lexi
on
present
, whichnerveisinvolv
ed?
a.Femor alnerv
e
b.Commonper oneal nerv
e
c.Suralnerve
d.Obturatornerve
yhxofDM andbpof145/somti
n..
her
fast
ingwaselev
ated.
..Watt
odo.
..Repeatin4weeks,
commencemetformine,commence
amlodipi
ne.
Cancerpat
ientonmetformi
neandlongact
ingi
nsul
i
ncameinwtsev
ere
hypogl
ycemia.
.pl
an.
..
reducei
nsul
i
ndoseorchanget oOHA
DI
ZZINESS..
hypogl
ycemi
agotbet
terwtbi
scui
tsandt
eaandonmet
for
mineand
gl
i
clazi
de.
..Wattodo.
.It
hink.
.
Boywtpai
nfulhi
pjoi
ntandmi
l
dpy
rexi
aopt
ions.
.Sl
i
ppedepi
phy
sis,
sept
icar
thr
it
is,
per
chesdx.
the
Chi
l
dwtv
omi
ti
ngndmassabdomi
nal
..Opt
ionsUSabdomen.
.
Anot
herpersonwtepi
gast
ri
cpainmi l
danddiar
rhea.
.
Nodyspepsiai
nopti
onsbutgast
roenter
it
is
Awomanwtabr
upt
iopl
acent
a.
Awomanwtecl
ampsial
readyonhy
dral
l
azi
nandmgso4dr
ipwhohadanot
hersei
zur
e.
whatt
odonext
..
.Mgso4bolus
Awomanwtbr eastlump1x1cm..smoot
h,wel
ldemar
cat
ed,
grandmot
herhadbr
east
cancer
..
.Opt
ionscancer
,fi
broadenoma.
..
Afamil
ytr
eef rduchennedy
str
ophy
.Wat
sdpossi
bil
i
tyofdsecondsonhav
ingi
t.
..a.0%b.
25%c.50:d.100%
Aquest
ionabtagi
rlwtshor
tst
atur
eanamenor
rhea.Tur
nersy
ndr
ome
DepotPr
over
awomanwtbl
eedi
ngsi
xwksaf
terwatt
odo.
.Reassur
e.
65yr
soldwtbr
owndi
schar
geand8mm endomet
ri
um.
..Watt
odo.
.Hy
syer
oscopyand
bi
opsy
Anot
herpat
ientangr
ywtdoct
orsf
rsur
ger
yandl
atert
hankf
ul.
..
a.Adj
ust
mentdi
sor
derb.
Redi
tchyper
iar
eol
arr
ash.
..Opt
ionspaget
sdi
seaseoft
hebr
east
,cont
actder
mat
it
is.
Jaundi
ce,
darkuri
ne,mil
danemia.wi
thhxoft
aki
ngant
imal
ari
alpr
ophy
laxi
swhowas
ret
urni
ngfr
om Thai
land.
.Opt
ionshad
Adiagnosi
sofmeningococcalmeni
ngi
ti
swhent
oal
ertaut
hor
it
ies.
.
a.
Onsuspicion,
b.onconfi
rmati
on
Ahomel
essguywi
thposi
ti
veAFB.
,A.t
oisolat
eandar r
angefrcont
acttr
aci
ng,B.getal
ter
nat
iveaccommodat
ionv
iasoci
al
ser
vice.
C.StartDi
rect
lyobser
vedTherapy
Afoundati
ondoctorsuspect
edofcannabi
sabusehav
ingpoorwor
kandhal
l
uci
nat
ions.
.
Waytodo? .
a.Reportt
oeducati
onalsupervi
sor
b.Reportt
oGMC
C.advi
cetotake1weekl eave
D.Advicet
ostartt
reatment
Aladywhost artedhavi
ngcrampsanddiarr
hea5day saft
erreat
ingi
nanewr
est
aur
ant
.
Shewor ksinanothereat
ery.Whenshdshegobackt owork?
A.Whendi arr
heasettl
esandshef eel
sbet
ter,
B.48hrsafter
C.24hoursafter
D.Aft
ernegat i
vestoolmicr
obiol
ogysampleresul
tisobt
ained
Awomanwtf r
othypoo..
.Watt est
?
.Ant
i-t
issueTransgl
utaminaseanti
body
..Forcoel
i
acdx.
..
Apat
ientwhowasfoundout
sidedQueenshousesay
ingpr
inceChar
lessentf
rhi
m.What
ki
ndofdelusi
on
a.Gr
andiosedel
usi
on.
..
Anurseorl
adywtahxofrepeat
edhamdwashingmul
ti
pleti
mesaday
.Herhands
becameredandi
taf
fect
edberperf
ormanceatwor
kOCD. .
Tr
eat
mentf
orgar
dner
rel
a..Met
roni
dazol
e,doxy
cycl
i
nasopt
ion.
Pl
eural
effusionwatt
odot
or el
i
evesy mptomsaswomanhadaf
ewweekst
oLi
v.
..a.
Aspi
rat
ion,b.commencef
rusemide.
.c.i
nsertchestt
ube
Amanwtonesi
depai
nwor
sei
neat
ing.
.Watt
odo.
.t
empor
alar
ter
ybi
opsy
Someonewtdecr
easi
ngacui
tyandhxofmy
opi
a..
.Gl
aucoma,
cat
aract
..
Hoar
senessaf
tersur
ger
yfr
om r
ecur
rentl
ary
ngeal
ner
vet
rauma.
.
Laryngotr
acheobr
onchi
ti
sinchi
l
dwt
outt
reat
mentwati
sdout
comea.compl
ete
resolut
ionb.
r
iskf
rrepeatst
roke.
.ABCDE.
.
SOMEONEWTLUNGCANCERANDSOI
UM 119.
.CAUSE.
.OPTI
ONHADADRENALI
SUFFI
CIENCY,
HYPONATRAEMI
A
TRANSURETHRALPROSTATECTOMYWHATDOUSEE.
.aHYPONATRAEMI
A..
b.
hypokal
emi
a(al
lopt
ionswer
ehy
po)
, Quest
ionwithsuddenhxofbreat
hlessness,
clearchest
,Muf
fl
edhear
tsound,
engor
ged
neckvei
n.a.car
diactamponade.
QUESTIONonpneumot
hor
axwatt
odoi
mmedi
atel
y.
.Phy
siot
her
apy
,ther
apeut
ic
t
boracocent
esi
s..
Onechestpai nnotknownwtbporanymedsbutnor
mal
troponi
nandnor
mal
x-r
ayand
ecg..FatherhadBPandMI
a.costochondri
ti
sb.MI,c.PEd.Pani
cat
tack
Pat
ientwhobuy snonprescri
pti
onmeds( adrugofabuse)wtdi
l
atedpupi
l
s,r
hinor
rhoea,
l
acerat
ion.
.a.cocai
ne,b.cannabi
s,her
oine.c.amphet
amine
Achil
dcamei nunconsci
ousbutamongstot
herf
indi
ngsconst
ri
ctedpupi
l
s..Watt
odo.
.
Methadone.
.
Someoneunconsci
ouswtamt
ri
pty
li
npackempt
yinpocket
..
Someonet
ost
opal
cohol
,watdr
ugst
ogi
vsl
owl
yfr
st.
.a.chl
ordi
azepoxi
debdi
sul
fi
ram
Parest
hesi
a,hy
per
ref
lexi
ainapat
ientt
aki
ngl
evot
hyr
oxi
ne.
.Watv
itami
ncausedi
t.
.
a.B12c
Tr
aumat
ocommonper
oneal
ner
vewtf
ootdr
opanddr
est
.
1.Al adywhohadhipsur
ger
y2day
sago,
present
sacut
elywi
thshor
tnessofbr
eat
h.
Diagnosis.
a.Car di
acTamponade
b.M. I
c.Pleuralef
fusi
on
d.Pul monar
yemboli
sm
2.Malepr esentswi t
hyel
l
owi
shpl
aqueoney
eli
dsov
er2y
ear
svar
yingi
nsi
zef
rom 0.
3cm-
0.5cm.Diagnosis
a.Apicalcarci
noma
b.Basalcellcarcinoma
c.Meiboiancy sts
d.Xanthelmast a
3.Boywhowasr i
dingabi ke,f
ell
off&hi
thi
slegl
ater
all
ybel
owt
heknee.Dor
sif
lexi
on
present
, whichnerveisinvolv
ed?
a.Femor alnerv
e
b.Commonper oneal nerv
e
c.Suralnerve
d.Obturatornerve
