Q.2. 20 year old male known case of sickle cell anaemia presented with vaso occlusive crisis and is febrile, blood gram, stain showed gram-negative bacilli. Which of the following is the most likely organism?

Q.3. A child came with severe dehydration and started on IV fluids. After 8 hours started to have seizures. Serum sodium was found to be 162. What is the most likely cause for his seizures?

Q.4. Parents brought their child to the clinic. The child looks dirty and is dressed inappropriately. The parents looked careless and the child is not vaccinated. Their last visit to the clinic was four years ago. What is the form of abuse?

Q.5. A two year old boy who took BCG vaccine came with his mother because his grandfather had open TB and they live in the same house. The boy is asymptomatic but the mother is worried. What should you do?

Q.6. A 55-year-old female, presented with abnormal uterine bleeding, she had history of myomectomy and two DNC's. Upon examination, abdomen bulky with no tenderness, no adnexal masses. Ultrasound showed endometrial thickness of 20mm. What is the most likely diagnosis?

Q.7. After vaginal delivery, patient developed postpartum haemorrhage, had failed manual compression and oxytocin. The patient is haemodynamically unstable (hypotensive). What should you do next?

Q.8. Three-year-old patient came with 10 cm, hard, immobile mass on the lateral aspect of the neck. Aspiration revealed lymphatic fluid. What is the next step in the management?

Q.9. 4 year old boy has chronic constipation despite eating, high-fibre diet and taking stool softeners. Examination shows empty rectum but after DRE there was gush of stools. What is the next step in the management?

Q.10. A 70-year-old male patient came with productive cough, oriented to person but not to time and place. His BP - 95/46, RR- 23, BUN - 28. What should be the next step?

Q.11. Traveller who recently came back is currently complaining of headache and fatigue. He is a febrile, and platelet count is within normal range. Gram stain showed gram-negative coccobacilli. What is the most likely organism?

Q.12. What is the best antibody diagnostic test for primary biliary cholangitis?

Q.13. A 25-year-old male presented to medical check up found to have ejection systolic murmur that becomes louder with Valsalva and standing, decreases with squatting and hand grip. What is the diagnosis?

Q.14. Patient presented with chest pain, ECG showed ST elevation in leads II, III, aVF. On examination his JVP was noticed to be high. Which of the following medications is absolutely contra indicated?

Q.15. A known case of Type 2 DM, CKD and IHD on Metformin and Glimepiride, he reports history of recurrent light headedness that improves with sugar drinks, he is refusing Insulin, his HbA1C is 9, BMI is 34. Which of the following is the best management?

Q.16. Which sign will differentiate Cushing syndrome from simple obesity?

Q.17. 20-year-old male came with fever, anorexia, weight loss, arthritis, nausea and vomiting, unequal pulses, barely audible subclavian artery, pulse is present in lower limbs and absent in upper limbs. What is the most likely diagnosis?

Q.18. Patient with TB on medications, notes that he has change in urine discolouration (red orange). What is the medication that causes this condition?

Q.19. 32-year-old patient on four antihypertensive medications, but still his BP is high. Renal imaging showed asymmetrical kidneys. What is the most likely diagnosis?

Q.20. 88 year old male known case of hypertension presented with unsteady gait and he later develops forgetfulness and urine incontinence. What is the most likely diagnosis?

Q.21. Case of meningitis, CSF analysis showed picture of tuberculous meningitis with high protein and low glucose. What will be the predominant type of cell?

Q.22. Old patient with unilateral headache on temple area associated with jaw claudication. Lab results showed ESR : 112. What is the most likely diagnosis?

Q.23. What is the effect of valproic acid on fetus if taken during pregnancy?

Q.24. 46-year-old man came with 1st MTP joint pain for 12 hours, sinovial fluid showed needle like crystals, negative birefringent. Which medication you should not give in this acute attack?

Q.25. 20-year-old female with transient vision loss during sports, no other symptoms. MRI brain : multiple demyelinating hyper intense lesions in periventricular and white matter area. What is the most likely diagnosis?

Q.26. Pregnant lady at 27 weeks of gestation with history of PPROM. The CTG is reassuring, normal CBC, she is medically free, she denies any uterine contractions. What's the management?