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QUESTION 138
A 58-year-old man comes to the office a few days after an episode of chest pain. This was his first episode of pain, and he has no risk factors. In the emergency department, he had a normal EKG and normal CK-MB and was released the next day.
Which of the following is most appropriate in his further management?

QUESTION 139
A 27-year-old, generally healthy woman comes to the office with burning on urination. There are 50 white cells on the urinalysis.
What is the next best step in management?

QUESTION 140
Patient came with pitting edema grade 1, where fluid is will accumulate.

QUESTION 141
A 65-year-old woman comes to the emergency department with acute, severe shortness of breath; rales on lung exam; S3 gallop; and orthopnea.
Which of the following is the most important step?

QUESTION 142
A 65-year-old man presents with significant weight loss and complains of cough, SOB and chest pain. Exam constricted, drooping of left eyelid.
What is the most likely diagnosis?

QUESTION 143
24-year-old man presented with 4-month history of diarrhea with streaks of blood & mucous. Ulcerative colitis was confirmed by colonoscopy.
The initial therapy for this patient is _______________________.

QUESTION 144
65 years old male with hypertension, congestive heart failure and peptic ulcer disease came to your office for his regular blood pressure check. Although his blood pressure is now under control, he complains of an inability to maintain an erection. He currently is taking propranolol, verapamil, hydrochlorothiazide, and r pressure is 125/76 mmHg. His pulse is 56 and regular. The rest of the cardiovascular examination and the rest of the physical examination are normal.
Which of the following generally considered the MOST common cause of sexual dysfunction?

QUESTION 145
A 37-year-old lady strongly believes that a famous politician has been sending her flowers every day and is in love with her.
However, this is not the case.
What is the most likely diagnosis?

QUESTION 146
Victim of RTA came with multiple injuries to abdomen, chest and limbs. BP is 80/ 50. upper limb has upper third near amputation that bleeds profusely, what is your first thing to do:

QUESTION 147
A 26-year-old political refugee has sought asylum in the UK and complains of poor concentration. He keeps his family whom he saw killed in a political coup. He is unable to sleep and feels hopeless about his survival. But he is afraid to go out.
What is the most likely diagnosis?

QUESTION 148
The child bought by a mother having bouts of severe abdominal pain that cause child to bring his legs to fold to abdomen, settles after sometime, now again he had this attack with vomiting. On examination child is distressed with pain and there is a mass in epigastrium.
What Investigation you will do?

QUESTION 149
To prevent tetanus in neonate:

QUESTION 150
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?

QUESTION 151
Which of the following is most sensitive for detecting diabetic nephropathy?

QUESTION 152
An asymptomatic 56years man who has never consumed alcohol came for a routine checkup. Exam: increase spider angioma, Cardiomegaly, S3 gallop, liver firm with 8cm span, no ascites.
He is in the risk of which condition?

QUESTION 153
19-year-old sexually active lady came for her annual check-up, she is otherwise healthy using no contraceptive, her pap smear and all investigations are normal.
What will you suggest regarding her next check-up?

QUESTION 154
Drug of choice of generalized anxiety disorder is ______________.

QUESTION 155
A new screening test has been devised to detect early stages of prostate cancer.
However, the test tends t of people with no cancer, although they do have cancer as diagnosed by other standard tests.
What is this flaw?

QUESTION 156
An 18years female has periorbital blisters. Some of them are crusted, others secreting pinkish fluid.
What likely diagnosis?

QUESTION 157
A 62-year-old male comes to the GP complaining of double vision while climbing downstairs.
Which of the following nerve is most likely involved?

QUESTION 158
A 42-year-old salesman was admitted with a diagnosis of pneumonia. He is allergic to erythromycin. X-ray shows a hazy opacity in the right lower and mid-zone. Blood investigations show hyponatremia and slight rise in the level of liver aminotransferase. After starting the medication on the fifth day he became acutely jaundiced and his liver aminotransferase level became very high. He also complained of discoloration of his urine, which did not show hematuria on dipstick testing.
Which of the following drugs probably caused the jaundice?

QUESTION 159
A patient who has recently undergone hip fracture repair develops the sudden onset of shortness of breath. His pulse is 110 per minute. The chest is clear to auscultation. Chest x-ray is normal, and the EKG shows sinus tachycardia. ABG shows pH 7.48, pCO2 28, pO2 75.
What is the next best step in management?

QUESTION 160
A 45-year-old woman was texting while driving when she lost control of her car and ran into a tree. She is complaining of chest pain; physical examination reveals pallor, and cool extremities, a heart rate of 120 bpm, and JVD. Blood pressure is 80/40. Chest x-ray reveals 3 broken ribs over the left side of the chest.
Which of the following is the most likely type of shock?

QUESTION 161
A 65-year-old lady who is on thiazide suffers from falls in the morning.
What is the cause for her symptoms?

QUESTION 162
Patient had seasonal runny nose, itching and nasal obstruction, treated many times with broad-spectrum antibiotics.
The most effective therapy is: