Pneumonia (1418/1700)

A 49yo man comes with hx of cough and SOB. His CD4 count is measured as 350. CXR shows lobar consolidation. What is the single most appropriate option?

a. Mycobacterium avium intercellular
b. CMV
c. Streptococcus
d. Toxoplasmosis
e. Pneumocystis jerovici

Hepatitis B vertical transmission (1336/1700)

A mother got infected with Hep B during pregnancy. Her child is born and she is worried about
the risk of infection to the baby with Hep B. What would you give to the baby?
a. Hep B Ig only
b. Hep B full vaccine and Ig
c. Hep B vaccine only once
d. Nothing until immune status is checked
e. Hep B vaccine once and Ig

Pneumonia (1438/1700)

A 50yo DM pt came to the OPD with complaint of of fever, muscle ache, dry cough and anorexia. Inv: CXR=upper lobe cavitation. What is the single most likely causative organism?
a. Legionella
b. Mycoplasma
c. Staphylococcus
d. Klebsiella
e. Streptococcus

Tonsillitis (930/1700)

 A 4yo boy presents with fever, sore throat and lymphadenopathy. The dx of tonsillitis has been
made. He had 3 episodes last yr. What is the most appropriate management for this pt?
a. Tonsillectomy
b. Paracetamol/ibuprofen
c. Oral penicillin V
d. IV penicillin
e. None

Pneumonia (924/1700)

924. A 33yo man has a temp=38.5C, cough and chest pain on the right side on inspiration. He also has purulent sputum. What is the most likely organism to cause pneumonia in this pt?
a. Gram +ve diplococcic
b. Coagulase +ve cocci
c. PCP cold agglutinins
d. AFB
e. Gram –ve diplococci

Many vesicles on his back (914/1700)

A 5yo boy was brought to GP with high temp and many vesicles on his back. What is the most
appropriate management?
a. Topic acyclovir
b. Oral acyclovir
c. Oral antibiotics
d. Topical steroids
e. None

Foul smelling vaginal discharge (562/1700)

A 34yo female presents with a foul smelling discharge. What set of organisms are we looking for
to be treated here?
a. Chlamydia, gonorrhea
b. Chlamydia, gardenella
c. Chlamydia, gonorrhea, gardenella
d. Gonorrhea, gardenella
e. Gardenella only

Pneumonia (691/1700)

691. A 16yo girl has been unwell for 5days with malaise, headache and dry cough. She has a few crackles in her chest. Her CXR shows patchy consolidation in the lower lobes. What is the single most likely causative organism?
a. Cold agglutinins
b. Gram –ve diplococci in sputum
c. Gram +ve diplococcic in sputum
d. Serology for legionella
e. Sputum staining for mycobacterium TB

Dysphagia, Soreness in the corners of the mouth (512/1700)

A pt presents with dysphagia and pain on swallowing. He has sore mouth and soreness in the
corners of the mouth. What is the single most likely dx

a. Kaposi’s sarcoma
b. Molluscum contagiosum
c. CMV infection
d. Candida infection
e. Toxoplasma abscess

Treatment of chlamydia (509/1700)

What is the most appropriate antibiotic to treat uncomplicated chlamydial infection in a 21yo
female who isn’t pregnant?
a. Erythromycin
b. Ciprofloxacin
c. Metronidazole
d. Cefixime
e. Doxycycline

Purple papular lesions (499/1700)

A pt presents with purple papular lesions on his face and upper trunk measuring 1-2 cm across.
They aren’t painful or itchy. What is the single most likely dx?
a. Kaposi’s sarcoma
b. Hairy leukoplakia
c. Cryptosporidium
d. CMV infection
e. Cryptococcal infection

Ear ache and pre-auricular swelling (497/1700)

A 17yo man has acute pain and earache on the right side of his face. Temp=38.4C and has
extensive pre-auricular swelling on the right, tender on palpation bilaterally. What is the single
most likely dx?

a. Acute mastoiditis
b. Acute otitis externa
c. Acute OM
d. Mumps
e. OM with effusion

Lesions on palate and external auditory meatus (495/1700)

A 68yo woman has a sudden onset of pain and loss of hearing in her left ear and unsteadiness
when walking. There are small lesions visible on her palate and left external auditory meatus.
What is the single most likely dx?

a. Acute mastoiditis
b. Cholesteatoma
c. Herpes zoster infection
d. Oropharyngeal malignancy
e. OM with infusion

Treatment of toxoplasmosis (494/1700)

A 20yo lady is suffering from fever and loss of appetite. She has been dx with toxoplasmosis
What is the tx?
a. Pyrimethamine
b. Pyrimethamine + sulfadiazine
c. Clindamycin
d. Spiramycin
e. Trimethoprim + sulfamethoxazole

Herpes Zoster in Pregnancy (491/1700)

A primiparous woman with no prv infection with herpes zoster is 18wk pregnant. She had recent
contact with a young 21yo pt having widespread chicken pox. What is the most suitable
management for the pregnant lady?

a. Acyclovir PO
b. Acyclovir IV +IVIG
c. Acyclovir IV
d. Reassure
e. IVIG

Investigations following recovery from Meningitis (490/1700)

A child has just recovered from meningitis. What inv will you do before discharge?
a. CT scan
b. EEG
c. Blood culture
d. Repeat LP
e. Hearing test

Grey membrane on tonsil (479/1700)

A 30yo man presents to the ED with difficulty breathing. He has returned from India. Exam:
throat reveals grey membranes on the tonsils and uvula. He has mild pyrexia. What is the single
most relevant dx?
a. Diphtheria
b. IM
c. Acute follicular tonsillitis
d. Scarlet fever
e. Agranulocytosis

Pneumonia (471/1700)

A 45yo IV drug abuser is brought into the ED with complaint of fever, shivering, malaise, SOB
and productive cough. Exam: temp=39C, pulse=110bpm, BP=100/70mmHg. Inv: CXR=bilateral
cavitating bronchopneumonia. What is the single most likely causative organism?

a. Mycoplasma
b. Staphylococcus
c. Chlamydia pneumonia
d. Pseudomonas
e. PCP (pneumocystitis pneumonia)

Renal failure following bloody diarrhea (469/1700)

A 10yo girl presents with pallor and features of renal failure. She has hematuria as well as
proteinuria. The serum urea and creat are elevated. These symptoms started after an episode of
bloody diarrhea 4days ago. What is the most probable dx?

a. TTP
b. HUS
c. ITP
d. HSP
e. ARF

Causative Organism (464/1700)

464. A 30yo female attends OPD with a fever and dry cough. She says that she had headache, myalgia and joint pain like one week ago. Exam: pulse=100bpm, temp=37.5C. CXR: bilateral patchy
consolidation. What is the single most likely causative organism?

a. Pneumococcal pneumonia
b. Legionella
c. Mycoplasma
d. Klebsiella
e. Chlamydia pneumonia