1.

sympotamic low sodium, euvolemic --> give hypertonic saline

2. LEAD poisoning, basophilic stipling on blood smear --> lead poisoning

3. trauma had epidural hematoma, low sodium what is the cause --> inapporiate ADH release

4. hypoglycemic attacks, high insulin high C peptide what is the cause --> pancreatic parenchymal
mass

5. patient with recurrent sinusitis and liver staph aureus abscess, his brother the same exactly, the
patient now has pneumonia, he is on prophylaxis
TMP and interferon gamma, what do you give him for pneumonia --> i put vanco, meropenem
and Itraconazole

6. case painful thyroid mass after viral infection --> subacute thyroiditis

7. *patient had throat symptoms weeks ago, he had knee pain 2 days ago, now cured but has
ankle pain, the joint is warm and edematous what to test for
 anti streptolysin O

8. myocarditis symptoms --> coxsackie

9. case appendicitis very very clear--> laproscopy

10. *case crohns RLQ pain

11. patient came with coughing up coffee ground stuff, now stable --> endoscopy

12. pregnant had LEEP for CIN 3, now at 20 weeks her cervix is 8 cm dilated and approximately 70-
80% effaced --> discuss paliative care, steroids?
13. patient with aura migraine cames for contraception --> i put levongestrel IUD

14. patient had posterior cerebral artery stroke a long time ago, has 4-5 car accidents, what do you
expect to see on the eye things

15. patient came aftre trauma has crepitus on left upper chest wall, gave you X ray, the picture was
slightly tilted, I saw very mild tracheal deviation so --> i put it as tension

16. surgeon noticed his anasthesiologist sleeping and tells him wake up, he replies that he was
resting his eyes, this is last surgery of day anasthesiologist is malodorus and has stains on his
scrubs --> talk to him about incident, report to medical director.

17. pregnant had diarrhea, child is born and has sepsis, what is the organism --> listeria, GBS

18. patient was hurt by gardening tool, now has cellulitis what is organism --> GAS, perfinges,
aureus, *pseudomonas*

19. check what is heterogenity in biostatistics, it ws I or L squared and was one of the options, the
question was what is the problem with the study, i put confounding

20. patient anorexic with suicidal ideation --> admit regardless if she wants to or not

21. antisocial drug asking, smiles inapporiately, piercing eye gaze, hes stable now --> CBT,
respiridone, clonazepam ,one person gives him the drug

22. patient with generalised anxiety but has social anxiety (it was very very emphasized in question)
what is best long term treatment
 SSRI

23. young boy with testicular torsion --> surgery

24. patient clear slipped capital, what is most likely prognosis --> osteo arthritis, osteonecrosis, SCFE
in other leg

25. patient with stridor, wheezes, harsh cough, he has asthma but albuterol didnt help, on the way
to the hospital, resolution of symptoms except for cough, what do you give
 steroids, epinephrine, azithro, amoxicilin

26. patient had heroin misuse, now shes stable and havent used opioid for so long, but she has a
stressful life and has cravings, and finds herself driving to a clinic that is known for giving out
opioids easily, and she is crying because she doesnt want to use again what do you do -->
buprenorphine, naltrexone, CBT

27. patient is pregnant, frank breech 36 weeks, what to do --> expectant, CS, *external cephalic*

28. Vitamin A def.

29. kid with stridor, no information in the question --> i put laryngomalacia, but im not sure

30. patient has 18mm on PPD --> isoniazid

31. patient 7 year old bed wetting --> urinanalysis, reassurance, desmopressin

32. RRR was asking about primary end point, there were other values so be careful --> (0.25-
0.21)/0.25 = 16%

33. trauma to face, edema lip and face --> c1 esterase

34. diarrhea rash fever --> graft vs host

35. case sudden onset abdominal pain, had mild pain before, very weird CHEST xray, LUQ looks very
very weird look it up --> i put PUD but im not sure, volvulus
36. patient with ASCUS what to do she was 27 --> HPV co testing

37. Classic case of MS and wants the diagnosis

38. patient was in some kind of trauma and now cant walk, everything is normal, neuro examination
muscle strength 5/5, diagnosis --> conversion

39. patient with crohns what do you need to give --> Vit B12

40. patient with PAD sudden --> give heparin??

41. patient with rem behaviour sleep disorder hes at risk for what --> lewy body, there was no
parkinson

42. case the answer for it was juvenile dermatomyosistis

43. case of recurrent infection and heart sounds are more prominent on the left than the right hes
at risk for --> infertility (there was no picture)

44. case of fanconi anemia, all labs were very low, where in the kidney does it work --> PCT

45. patient with bipolar on lithium, he has symptoms, lithium levels were subtherapeutic, when
asked, he said "i guess im not supposed to take my medicine", when asked the parents say they
havent given him his meds for the past 7 days, what do you do? child protective services, inquire
about cultural something (not sure)

46. patient always measures her blood pressure at church and always normal, now her blood
pressure is 160/100 but with NO END ORGAN DAMAGE, what do you do? ambulatory BP
monitoring, give lisinopril, give amlodipine, check renal arteries

47. patient is sedated and has to go to surgery --> wait till sedation wares off to get consent
48. picture of vagina with A LOT of condyloma accuminata, what to do --> test HIV

49. picture of hydradinitis suppuritiva, smokes half a pack a day, BMI was super high minimum 40
what is the risk factor --> obesity, smoking

50. case of a child after trauma has thigh pain, pain at night not responding to nsaids, done X-ray
and showed medullary reaction, done MRI and shows 4 cm mass intramedullary with periosteal
reaction and there was a histology of bone --> osteosarcoma, there was every bone tumor you
can think of in the option

51. patient with G6PD def. and wants to travel to malaria area what drug you CANT give -->
primaquin

52. WPW ECG --> ablation of tract

53. ECG of PE, i answered from stem

54. patient with scleroderma, what do you expect to see in the esophagus muscles strength, arrows
--> upper, middle, lower ---> LOW LOW LOW

55. case was admitted for pneumonia 2 weeks ago, his WBC were 60k,its C. diff, CLL, toxic
megacolon, --> I answered C diff PCR (very unsure of it)

56. patient on antipsychotic came with parkinsonism, what to do --> benztropine

57. 2 Apnea tests

58. patient with migraine prophylaxis --> propranolol

59. Septic shock person BP low, given fluids still low --> NE
60. Arrows for HF, renal stenosis and something else --> ALL UP, check for ANP all of them had ANP

61. patient was completely fine, deployed to latin america, when he returned he had recurrent
infection, on examination he had no tonsils, what is the diagnosis --> CVID (not sure)

62. patient with fat in calves --> biopsy of muscle

63. patient DVT --> heparin

64. patient with mass behind knee and no pulse below it, it was confusing options --> I put popliteal
aneurysm

65. DRESS syndrome taking TMP --> stop drug (the picture was looking very benign so be careful)

66. patient with HbSF what do you do --> penicillin

67. patient is very ill, nothing specific in the case except for low BP, labs had very very hight lactic
acid --> high anion gap metabolic acidosis

68. pregnant with kenonuria --> do ultrasound to check for multiple pregnancy or molar pregnancy

69. patient with ectopic pregnancy rupture unstable and in severe pain with peritonitis signs, on
examination she had right or left max point adnexal tenderness --> laprotomy

70. patient with osteoarthitis, the physician is hesitant to give him drugs that might increase the
chance of the PUD, the patient has no abdominal symptoms what do you give?
 celecoxib + bethanecol, Piroxicam + smth, Ibuprofen + smth, all were COX 1 inhibitors
except for celcoxib, (one had surcalfate in it)

71. all screening were easy

72. patient with history of shingles, she is above 65, she took pneumococcal vaccine, she wants to
take care of her grandchild, what vaccine do you give?
 VZV, nothing, meningococcal

73. patient 16, has nothing, he is most at risk of? --> car accident, substance abuse

74. patient with low Hb, he is coombs positive, IgG and C3 were mentioned i think they were
positive what do you give? --> steroids, IVIG, packed RBC

75. what do you in an old patient that is at high risk for falls? --> physical therapy, Exercise, optimize
the environment around the patient (??) i put physio

76. Mobitz type 2 on ECG --> diagnosis

77. case with wheezing, difficulty breathing for a long time, on CT he had a mediastinal mass,
showed you a histology --> i put non hodgkin because it is mediastinal

78. young kid has 8 colon polyps, what does he have? --> juvenile polyposis, FAP, other options, im
not sure

79. eosinophilic esophagitis --> PPI

80. patient with vocal cord papillomatosis --> surgery

81. case of MVA shown pelvis X-ray, pubic symphysis is so wide and he has bleeding from meatus,
they tell you after we stabilize the patient, what do you do --> retrograde urethrography

82. patient with unilateral cryptorchidism <6 months, and you dont feel anything on examination,
what do you do? --> nothing, laprotomy, CT to find it, Karyotyping

83. umbilical hernia 2 cm he was 7 month, what to do? --> nothing

84. Hemophilia 2 questions, one was what do you give --> factor 8, the other what is prolonged -->
PTT

85. patient with HIV CD count like 10 has bleeding per rectum, he has violacious skin --> kaposi

86. patient taking antiretroviral with nephrotoxicity, asking which drug is the cause --> tenofovir

87. ROC curve, most equitable --> the line in the middle (C)

88. sponge count --> tell patient

89. sponge count is not right as the surgeon is closing wound --> stop everything and recount, xray if
the count is not right

90. diptheria grey membrane --> penicillin

91. ear out and and erythamatous --> IV antibiotics

92. ASCVD 10.7% --> Statin

93. sequential, patient has epilepsy on carbamazepine, plans to get pregnant what to do --> high
dose folic acid, 2nd question, the patient is on high dose folic acid and stable dose of
carbamezepine, quadruple test shows high AFP 3 times upper limit what to do --> ultrasound

94. case of old patient with history of sexually transmitted disease that was not treated, he now has
symptoms of aortic regurg and crackles what do you do? --> VDRL (case was very hidden)

95. SIADH --> fluid restriction

96. patient trauma has JVD, hypotension and muffled heart sound and abdominal pain, what is your
next step --> pericardiocentesis, FAST (not sure)
97. patient car accident and shes fine what do you do --> seatbelt teach her

98. patient works in steel --> lung cancer

99. fetus has abdominal content out of the umbilical cord what is he at risk for --> omphalocele

100. X ray of kid showes wide bone to bone connection ( i thought rickets) calcium level is on
the lower end but normal, PTH was very very high, what is your diagnosis --> vit D def.

101. patient takes clopidogrel and aspirin, needs to go to surgery, what do you give to
reverse the effects of drugs? --> platelet transfusion (chat GPT) RBC, full blood, cryoprecipitate
fresh frozen plasma

102. gave you lipid profile, completely normal, what to do? --> nothing

103. CD30 positive what to do --> PET scan, CT, radio, therapy

104. case of wiskott aldrich

105. Serum sickness after penicillin --> do nothing

106. patient sudden wheezing and urticaria, given albuterol no improvement --> epi

107. patient with jaundice, fever, RUQ pain, shock, confusion (all the pentad) --> cholangitis

108. patient with cleft lip, cardiac anomalies, chest X ray no thymus what do you expect -->
hypocalcemia

109. rhizopus micropicture what do you give --> amphoterecin B

110. hereditary spherocytosis blood smear --> splenectomy

111. malaria smear what do you give --> check them, the answers were all malaria drugs

112. patient with white cervical discharge and she has an IUD in, the string is showing what
to do --> remove IUD

113. patient schizophrenia or parkinsons, shes on drugs, suddenly she mortgaged her house
twice to get money to gamble, what is the diagnosis --> impulse disorder

114. LFTs high AST ALP, mildly increased bilirubin and ALP --> hep A

115. 3 months of symptoms with visual hallucination of cats and parkinsinosim --> lewy body

116. Rate of recurrence

117. confirmatory bias

118. TYpe I error

119. patient is adopted, his biological mother called his other mother and says she has
huntigton, the other mother brought him for genetic testing, the physician refused what did he
do
 non malifecence

120. patient came agitated and it took 4 people to hold him down --> all options were
depressants except methamphetamine

121. wernicke encephalopathy --> thiamine

122. ECG Afib --> dabigatran

123. patient bleeding per rectum painless coating of the stool fresh blood --> colonoscopy,
anoscopy, sigmoidoscopy

124. Candida diaper pic  azole

125. Patient has asthma exacerbation, you gave him everything possible still not treated
what do you do  MgSO4 (no intubation)

126. Case of has refractory hypocalcemia, what do you expect is the cause 
hypomagnesemia

127. Hypertensive patient with very high BMI, best advice  lose weight (I think it was 9kg)

128. Quality control want to lower CLABSI rates what to do  wash hands ?

129. Patient A and patient B have the same name and birthday come to clinic, patient A
comes for chemo, patient B for antibiotics or something, there is a new trainee nurse assigned
for patient A, she takes antibiotics and as she is about to give him, the senior nurse tells her this
is not right. How do you prevent this error?????--> I put do not schedule patients with same
name and date on the same day (very not sure)

130. Patient history of cerebellar tumor, now shes fine, her father had RCC at 40, someone in
her family has pheochromocytoma, what to do  retinal exam

131. Patient is 11 years old, has painful breast after trauma, on exam she has a tender mass
below areola  reassurance (I thought puberty)

132. Patient with severe kyphosis, shows u Xray AP and lateral, what do you expect to see on
PFT  I forgot what they asked for exactly but I put restrictive pattern

133. Classic Kawasaki case  high dose aspirin

134. Parkinson patient is very terminally ill with no appetite and will die because of eventual
anorexia, he has full capacity and tells you he’s not worried about pain because he knows
palliative care will make sure he doesn’t die in pain, but he asks you to describe how his
experience will be, what do you do  you will become weaker then your systems will shut
down and youll go into coma then die, this is a very good question I think you should ask your
neurologist, cases are different and difficult to predict (????)